The association of gastroesophageal reflux disease with atrial fibrillation

Gastroesophageal reflux disease (GERD) is a very common condition, in which stomach content persistently and regularly flows up into the esophagus. It often causes unpleasant symptoms. It is apparently found in genetically predisposed individuals and it can be exacerbated by certain nutritional habits.

According to a recent study it is associated with an increased incidence of atrial fibrillation.

It is therefore important to effectively manage GERD, either with medication or modification of nutritional habits, not only to minimize the discomfort but also to reduce the incidence of arrhythmia.

Gastroesophageal reflux disease may causally associate with the increased atrial fibrillation risk:
evidence from two-sample Mendelian randomization analyses
Front. Cardiovasc. Med., 03 June 2024
Sec. Cardiac Rhythmology


The use of semaglutide (Ozempic) in patients with heart failure

In a recent study, presented at the European Society of Cardiology Heart Failure 2024 congress in Lisbon, it is nicely demonstrated that semaglutide (Ozempic) is beneficial in obesity related heart failure with preserved ejection fraction (HFpEF).

Semaglutide reduces the need for loop diuretics and has beneficial effects on symptoms, physical limitations, and body weight in this particular group of patients.

Additionally, it is found that semaglutide increases functionally capacity (6-minute walk test).

It is therefore demonstrated that this particular pharmaceutical agent has a significant role in the management of obese patients with HFpEF.



Self-monitoring of blood pressure

Arterial hypertension is considered one of the most important risk factors for cardiovascular disease. It is however, most of the times, manageable.

According to a recent study, blood pressure (BP) self-monitoring, along with self-titration of antihypertensive medications, is associated with a significant reduction in measurements.

Participants in the study were aged 40 years or older, with systolic BP over 145 mm Hg and/or diastolic BP over 90 mm Hg, and were randomly assigned to usual care versus an individualized, prearranged plan based on self-monitoring of BP plus self-titration of medications.

The results of the study suggest that simple, inexpensive, and convenient self-management interventions, such as self-monitoring of BP, have the potential to improve the long-term control of hypertension in daily clinical practice.

It is important to measure BP in a resting state, ideally early in the morning. Ideally a series of consecutive measurements and documentation, will enable for the general practitioner to decide which is the optimal management plan.

Long-Term Effect of Home Blood Pressure Self-Monitoring Plus Medication Self-Titration for Patients
With Hypertension
A Secondary Analysis of the ADAMPA Randomized Clinical Trial
JAMA Netw Open. 2024;7(5):e2410063. doi:10.1001/jamanetworkopen.2024.10063


Anger management: An important message to protect your heart

A recent publication adds nicely to the accumulating evidence base that mental well-being has a significant impact on cardiovascular health.

Intense acute emotional states, particularly anger, substantially increase the risk of cardiac events.

In this study, 280 apparently healthy adults were recruited. It is experimentally demonstrated that approximately 30 minutes after provocation of anger an abnormal endothelial response appears. Apparently a hormonal-mediated effect causes a hazardous injury to the vessels.

Consequently, individuals who frequent erupt with anger have possibly chronically damaged vessels and are susceptible to cardiovascular events.

Translational Research of the Acute Effects of Negative Emotions on Vascular Endothelial Health:
Findings From a Randomized Controlled Study
Published May 1, 2024. doi: 10.1161/JAHA.123.032698.


Association of night sleep quality with episodes of atrial fibrillation

It appears that night sleep has a heavy causative impact on arrhythmias.

Atrial fibrillation is a type of arrhythmia, which is quite common in the elderly. It may cause a stroke if remained undetected. Several studies confirm that optimization of arterial blood pressure, good nutrition and abstinence from alcohol abuse may reduce the incidence of atrial fibrillation.

In a recent study, it appears that a night of suboptimal sleep quality increases the likelihood of prolonged episodes of atrial fibrillation the subsequent day.

It is therefore very important to take all necessary measures to ensure good and unobstructed night sleep in order to reduce arrhythmias.

JACC: Clinical Electrophysiology
Preceding Night Sleep Quality and Atrial Fibrillation Episodes in the I-STOP-AFIB Randomized Trial
JACC Clin Electrophysiol 2024 Jan 01;10(1)56-64, CX Wong, MF Modrow, K Sigona, JJ Tang, E Vittinghoff, MT Hills, D
McCall, K Sciarappa, MJ Pletcher, JE Olgin, GM Marcus


Iron replacement therapy in patients with heart failure.

Most patients with heart failure and anemia demonstrate iron deficiency, which is often accompanied by anemia. Iron deficiency is generally defined as having a serum ferritin level <100 µg/L or, provided that ferritin level was >300 µg/L, a transferrin saturation (TSAT) <20%.

The IRONMAN randomized trial showed that, overall, for patients with heart failure who fulfilled the above definition of iron deficiency, IV iron increased hemoglobin levels, improved quality of life, and reduced the rates of hospitalization for heart failure but did not improve walking distance or reduce mortality.

According to a recent publication, the clinical response appears even greater in certain individuals with anemia with TSAT < 20% and ferritin > 100 µg/L.

This might identify a specific group of heart failure patients, who may obtain a significant benefit from intravenous iron.

European Heart Journal
Intravenous iron for heart failure, iron deficiency definitions, and clinical response: the IRONMAN trial
Eur Heart J 2024 Mar 06


Είναι αδύνατο να ξέρει την ιατρική, αυτός που δεν ξέρει ακριβώς τι είναι ο άνθρωπος. ΙΠΠΟΚΡΑΤΗΣ


It is impossible for one to know medicine if he doesn’t know what a human being is. HIPPOCRATES

Copyright by Dr Yiannis Panayiotides 2018. All rights reserved.

Copyright by Dr Yiannis Panayiotides 2018. All rights reserved.