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Atrial cardiomyopathy in cardiac amyloidosis: clinical imaging and manifestations
Cardiac amyloidosis is a progressive infiltrative disease and an important cause of atrial arrhythmias, stroke and heart failure. Abnormal amyloid fibril deposition throughout the heart leads to a host of clinical manifestations and complications. Although atrial abnormalities are typically regarded as a consequence of ventricular diastolic dysfunction or atrial arrhythmias, there is emerging evidence that primary defects of atrial structure and function may be present. An atrial cardiomyopathy may be a sign of early cardiac disease, and an unrecognised independent marker of worse prognosis.
Atrial cardiomyopathy in endurance athletes
Atrial cardiomyopathy is characterized by electrical and structural remodeling of the atria, which can predispose to arrhythmias and thromboembolic stroke. Changes in atrial size and function are frequently observed in athletes engaged in endurance sports, a phenomenon known as “athlete’s heart.” Common left atrial observations in athletes may include larger left atrial volumes but lower left atrioventricular volume ratios, mildly reduced left atrial strain, possible mild left atrial fibrosis, longer P-wave duration, and greater atrial ectopic activity. However, it remains unclear whether these changes represent physiological adaptations to endurance exercise or disease-promoting pathology. While the athlete’s heart is considered a benign physiological phenomenon, endurance athletes have an established risk of atrial fibrillation. Therefore, atrial cardiomyopathy represents a significant consideration in disease prognostication and the development of management strategies for athletes. This review examines current literature with respect to the clinical features, causes, and consequences of atrial cardiomyopathy in athletes.
Role of pancreatic lipase inhibition in obesity treatment: mechanisms and challenges towards current insights and future directions
The worldwide health emergency of obesity is closely connected to how dietary fats are metabolized, whereas the process is significantly influenced by pancreatic lipase (PL), an enzyme critical for lipid hydrolysis into fatty acids. This narrative review employs a methodological approach utilizing literature searches of PubMed data up to March 2024. The search term criteria encompasses keywords related to the role, mechanism, challenges, and current and future treatments of pancreatic lipase in obesity with an overall references is 106. This paper offers a comprehensive explanation of the role of PL, underlining its significance in the digestive process and lipid imbalances that contribute to obesity and by extension, its impact on obesity development and progression. Additionally, it delves into the dual functionality of the pancreas, emphasizing its impact on metabolism and energy utilization which, when dysregulated, promotes obesity. A focal point of this review is the investigation into the efficacy, challenges, and adverse effects of current pancreatic lipase inhibitors, with orlistat being highlighted as a primary current drug delivery. By discussing advanced obesity treatments, including the exploration of novel anti-obesity medications that target specific biological pathways, this review underscores the complexity of obesity treatment and the necessity for a multifaceted approach. In conclusion, this paper emphasizing the importance of understanding the role of enzymes like pancreatic lipase mechanistic and adopting a multidisciplinary approach to treatment and side effects of current obesity drugs and explore new emerging therapeutic strategies for more effective obesity management.
Genetic and molecular underpinnings of atrial fibrillation
Atrial fibrillation (AF) increases stroke and heart failure risks. This review examines genetic and molecular mechanisms underlying AF. We review genes linked to AF and mechanisms by which they alter AF risk. We highlight gene expression differences between atrial and ventricular cardiomyocytes, regulatory mechanisms responsible for these differences, and their contribution to AF. Understanding AF mechanisms through the lens of atrial gene regulation is crucial for developing targeted AF therapies.
Pediatric obesity and the risk of multiple sclerosis: a nationwide prospective cohort study
Emerging evidence implies a link between high pediatric body mass index (BMI) and an increased risk of multiple sclerosis (MS). However, previous research suggests this association is only present for adolescent obesity and not childhood obesity. The present study aimed to assess the association between pediatric obesity and risk of developing MS, and to investigate if degree of obesity and age at obesity treatment initiation affects the risk. In a subgroup, response to obesity treatment on MS risk was assessed.
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