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  • 1
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 10 ( 2021-05-18)
    Abstract: The 12‐lead ECG plays a key role in the diagnosis of Brugada syndrome (BrS). Since the spontaneous type 1 ECG pattern was first described, several other ECG signs have been linked to arrhythmic risk, but results are conflicting. Methods and Results We performed a systematic review to clarify the associations of these specific ECG signs with the risk of syncope, sudden death, or equivalents in patients with BrS. The literature search identified 29 eligible articles comprising overall 5731 patients. The ECG findings associated with an incremental risk of syncope, sudden death, or equivalents (hazard ratio ranging from 1.1–39) were the following: localization of type 1 Brugada pattern (in V2 and peripheral leads), first‐degree atrioventricular block, atrial fibrillation, fragmented QRS, QRS duration 〉 120 ms, R wave in lead aVR, S wave in L1 (≥40 ms, amplitude ≥0.1 mV, area ≥1 mm 2 ), early repolarization pattern in inferolateral leads, ST‐segment depression, T‐wave alternans, dispersion of repolarization, and Tzou criteria. Conclusions At least 12 features of standard ECG are associated with a higher risk of sudden death in BrS. A multiparametric risk assessment approach based on ECG parameters associated with clinical and genetic findings could help improve current risk stratification scores of patients with BrS and warrants further investigation. Registration URL: https://www.crd.york.ac.uk/prospero/ . Unique identifier: CRD42019123794.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2653953-6
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  • 2
    In: Biology, MDPI AG, Vol. 12, No. 4 ( 2023-04-17), p. 606-
    Abstract: The aim of this review is to identify possible structural abnormalities of BrS and their potential association with symptoms, risk stratification, and prognosis. (1) Background: BrS has always been considered a purely electrical disease and imaging techniques do not currently play a specific role in the diagnosis of this arrhythmic syndrome. Some authors have recently hypothesized the presence of structural and functional abnormalities. Therefore, several studies investigated the presence of pathological features in echocardiography and cardiac magnetic resonance imaging (MRI) in patients with BrS, but results were controversial. (2) Methods: We performed a systematic review of the literature on the spectrum of features detected by echocardiography and cardiac MRI. Articles were searched in Pubmed, Cochrane Library, and Biomed Central. Only papers published in English and in peer-reviewed journals up to November 2021 were selected. After an initial evaluation, 596 records were screened; the literature search identified 19 relevant articles. (3) Results: The imaging findings associated with BrS were as follows: right ventricular dilation, right ventricular wall motion abnormalities, delayed right ventricular contraction, speckle and feature tracking abnormalities, late gadolinium enhancement, and fat infiltration in the right ventricle. Furthermore, these features emerged more frequently in patients carrying the genetic mutation on the sodium voltage-gated channel α-subunit 5 (SCN5A) gene. (4) Conclusions: Specific imaging features detected by echocardiography and cardiac magnetic resonance are associated with BrS. However, this population appears to be heterogeneous and imaging anomalies emerged to be more frequent in patients carrying genetic mutations of SCN5A. Future studies with an evaluation of BrS patients are needed to identify the specific association linking the Brugada pattern, imaging abnormalities and their possible correlation with prognosis.
    Type of Medium: Online Resource
    ISSN: 2079-7737
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2661517-4
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  • 3
    In: Circulation: Genomic and Precision Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 14, No. 6 ( 2021-12)
    Type of Medium: Online Resource
    ISSN: 2574-8300
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2927603-2
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of Cardiovascular Medicine Vol. 22, No. 10 ( 2021-10), p. 738-743
    In: Journal of Cardiovascular Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 22, No. 10 ( 2021-10), p. 738-743
    Abstract: To assess whether frailty or reduced physical performance status may have an impact on clinical outcomes after pacemaker implantation in aging patients. Methods A prospective cohort of patients aged more than 70 years, admitted to the hospital for pacemaker implantation, was enrolled. Patients were evaluated with the Short Physical Performance Battery (SPPB) and Handgrip Strength Test at hospital discharge and at 1 year. Overall mortality was the primary study endpoint. Results Out of the 119 patients, the majority (71%) of patients had reduced physical performance (defined by an SPPB score 〈 10 points). After a median follow-up of 46 months, the mortality was 31% of the population. SPPB value at discharge predicted death even after adjusting for pertinent confounders (adjusted hazard ratio 0.91, 95% confidence interval (CI) 0.84–0.99, P  = 0.02). Patients with a poorer SPPB score at discharge (SPPB 0–3) had also an increased risk of death or rehospitalization at 1 year compared with patients with highest SPPB score (odds ratio OR 4.05, 95% CI 1–16.6). Conclusion Reduced physical performance is associated with increased mortality in aging patients with bradyarrhythmia requiring pacemaker implantation. The identification of patients with poor SPPB may tailor specific interventions to improve physical performance and outcomes after pacemaker implantation. The trial was registered in clinicaltrial.gov with the identifier NCT02386124
    Type of Medium: Online Resource
    ISSN: 1558-2027 , 1558-2035
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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