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Park joon gyu wife sexual dysfunction

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Epicardial adipose tissue EAT is known to play an important role in atrial fibrillation substrate remodeling; however, the influence of sex Park joon gyu wife sexual dysfunction the association between EAT and left atrial LA transport function has not been elucidated.

Of the patients who underwent an index atrial fibrillation ablation procedure, postmenopausal women with no history of hormone replacement therapy and men who were matched for age, body mass index, type of atrial fibrillation, and CHADS 2 score were enrolled.

Blood samples were obtained from a coronary sinus for analysis of serum adiponectin level before the ablation procedure. There were no differences in baseline demographics and laboratory findings between sexes. The ratio of periatrial to total EAT volume correlated significantly with LA emptying fraction and LA voltage in both sexes, whereas total EAT volume and serum adiponectin level did not. On multivariate analysis, increased LA volume and higher periatrial: Compared with matched men, postmenopausal women with atrial fibrillation had higher periatrial adiposity, which was independently correlated with decreased LA voltage and LA transport function.

Women are known to be at higher risk than men for thromboembolism related to atrial fibrillation AF. Prior studies show that underlying atrial fibrosis and subsequent atrial dysfunction may contribute to cerebrovascular events in AF patients.

Left atrial LA bipolar voltage mapping was conducted before AF ablation. In an attempt to minimize the possible confounding effects of sex hormones, postmenopausal women receiving hormone replacement therapy and premenopausal women were excluded. The study protocol was approved by the institutional review board of Korea University Guro Hospital, and all patients provided written informed consent. Imaging was performed during a single inspiratory breath hold Park joon gyu wife sexual dysfunction the craniocaudal direction, in helical mode, with retrospective ECG gating.

Imaging was performed using the following parameters: Axial multiphase images were reconstructed slice thickness, 0.

Image analysis was performed on a workstation Extended Brilliance Workspace version 3. The endocardial border of the left atrium was traced semiautomatically on each axial image slice.

The LA appendage and pulmonary veins were carefully excluded at their junctions with the left atrium on all images. EAT was defined as the adipose tissue between the visceral layer of the pericardium and the surface of the heart.

EAT was separated from pericardial fat by manually tracing a single region of interest along the pericardium on each slice. We set the left main coronary artery as the top boundary and the apex as the lower boundary.

The voxels in each slice were summed to determine the total and periatrial EAT. Total and periatrial EAT volume measurements on multislice computed tomography. "Park joon gyu wife sexual dysfunction," Image analysis method for quantifying the total and periatrial EAT volumes.

B, Representative examples of the measured total and periatrial EAT Park joon gyu wife sexual dysfunction in both sexes. All computed tomography parameters were analyzed by 2 independent investigators blinded to the clinical information of the patients.

When higher discordance was observed, measurements were repeated. The LA voltage map was created during sinus rhythm before AF ablation. To access LA voltage with an equal distribution, the left atrium was divided into 6 anatomical segments; anterior, posterior, roof, inferior, lateral, and septal.

At least 10 points of voltage were acquired from each segment, and the voltage values of all points were exported for analysis.

The samples were assayed in batches and were processed by a technician blinded to all information about the participants.

Introduction

Continuous variables were initially tested for normal gaussian distribution by using the Kolmogoroff—Smirnov test. Categorical variables were presented as a number and percentage. In the present study, all analyses were stratified by sex.

Statistical differences of continuous variables between male and female groups were evaluated using the Student t test or Mann—Whitney U test, as appropriate for the data distribution. In each sex group, univariate and multivariate regression analyses were performed to identify independent parameters associated with LAEF.

All statistical analyses were performed using SPSS statistical software, version In total, men and women were enrolled in the present study. There were no significant differences in age, body mass index, type of AF, CHADS 2 score, medications, lipid profile, or any echocardiographic parameters between men and women.

Women had Park joon gyu wife sexual dysfunction total EAT than men The LA voltage mapping data were available for patients: A mean of The mean LA bipolar voltage amplitude was higher in men than in women 2. A, Comparison of the mean bipolar LA voltage amplitude between men and women.

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The main findings of the present study were Park joon gyu wife sexual dysfunction follows: To date, in serial research, the biological mechanisms that relate EAT to AF have been described as follows: First, EAT is anatomically contiguous with the myocardium without a distinct barrier, resulting in paracrine effects through the release of inflammatory cytokines, 12 which promote inflammation and lead to structural and electrical remodeling.

A recent study revealed that the amount of EAT was associated with the dynamic function of the left atrium and LA appendage in AF patients. These findings suggest that relatively abundant periatrial EAT, rather than the total amount of EAT, affects the functional and structural remodeling of the left atrium.

This difference could be explained from a hemodynamic perspective.

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The changes in hemodynamics and structure of the left ventricle are well known in postmenopausal women. Compared with premenopausal women, postmenopausal women not only have higher peripheral resistance and less nocturnal decrease in both systolic and diastolic blood pressures but also have greater left ventricle wall thickness.

Consequently, it might be reasonable to assume that another mechanism could be involved in the sex disparity of LA transport function in AF patients. Moreover, the regional distribution of EAT depending on sex and its influence on LA remodeling has not been elucidated.

Generally, regional fat distribution has been shown to be dissimilar between men and women: Visceral fat obesity is dominant in men, whereas subcutaneous fat obesity is dominant in women. Previous studies have shown that both the abundance and biological activity of EAT are diverse among individuals and during various clinical conditions.

With regard to the association of EAT with LA voltage in patients with AF, the presence of overlying EAT was reported to be associated with lower bipolar voltage and electrogram fractionation as electrophysiologic substrates for AF. We can thus postulate 1 that the bioactivity of periatrial EAT may be determined by the degree of periatrial adiposity; 2 that a metabolically active periatrial EAT produces proinflammatory cytokines, which may contribute to atrial remodeling and lead to further atrial contractile dysfunction in AF "Park joon gyu wife sexual dysfunction" and 3 that the difference in the regional distribution of EAT may contribute to the sex disparity in the functional and structural remodeling of the left atrium.

In a recent review of literature on this sex difference regarding stroke risk, several Park joon gyu wife sexual dysfunction mechanisms were suggested.

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This study has several limitations. First, we did not measure Park joon gyu wife sexual dysfunction components of body fat such as visceral fat of abdomen. These measurements might have added incremental information about the effects of local versus systemic adiposity. Second, the number of participants who underwent analysis of LA bipolar voltage mapping was relatively small; however, this did not negate the ability to assess the association between LA voltages and EAT profile by sex.

Third, we could not conclusively determine whether local fatty accumulation directly contributed to LA substrate remodeling because we did not perform a quantitative analysis of regional periatrial adipose tissue overlying the low—LA voltage areas, nor did we perform substrate mapping such as rotors or complex fractionated atrial electrograms during AF.

The causal relationships between periatrial adiposity and AF substrate remain to be clarified. In addition, ablation protocols among enrolled patients were heterogeneous, which may have influenced procedure outcome. Finally, our results may not be generalizable to other racial groups because the population in the present study was predominantly Korean.

Periatrial adiposity was significantly greater in women and thus may have an influence on their decreased LAEF and LA voltage. Our results suggest that the differences in regional distribution of EAT may play an important role in the sex disparity of LA functional and structural remodeling. J Am Heart Assoc. National Center for Biotechnology InformationU.

Published online Aug 4.

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Author information Article notes Copyright and License information Disclaimer. Hong Euy "Park joon gyu wife sexual dysfunction," Email: Received Mar 12; Accepted Jun Published on behalf of the American Heart Association, Inc. Abstract Background Epicardial adipose tissue EAT is known to play an important role in atrial fibrillation substrate remodeling; however, the influence of sex on the association between EAT and left atrial LA transport function has not been elucidated.

Methods and Results Of the patients who underwent an index atrial fibrillation ablation procedure, postmenopausal women with no history of hormone replacement therapy and men who were matched for age, body mass index, type of atrial fibrillation, and CHADS 2 score were enrolled.

Conclusions Compared with matched men, postmenopausal women with atrial fibrillation had higher periatrial adiposity, which was independently correlated with decreased LA voltage and LA transport function.

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