Background and Objectives: Circulating microRNAs (miRNAs) have been proposed as potential biomarkers in atrial fibrillation (AF) and heart failure (HF), but their role in patients with AF and heart failure with preserved ejection fraction (HFpEF) remains uncertain. Methods: We measured serum levels of 4 candidate miRNAs (miR-21, miR-146a, miR-146b, and miR-328) using quantitative polymerase chain reaction in 45 patients with persistent AF and HFpEF and five non-AF arrhythmia controls (Healthy). Expression levels were normalized to miR-16 and expressed as fold change (2−ΔCt ). Baseline (V1) and 3–6 months follow-up (V2) samples were analyzed, and comparisons were performed using non-parametric tests. Results: At baseline, none of the 4 miRNAs differed significantly between AF patients and Healthy controls; miR-21, 1.24 ± 0.55 vs. 1.15 ± 0.32 (P = 0.57); miR-146a, 0.66 ± 0.35 vs. 0.65 ± 0.06 (P = 0.71); miR-146b, 0.12 ± 0.07 vs. 0.11 ± 0.01 (P = 0.90); and miR-328, 0.08 ± 0.05 vs. 0.07 ± 0.03 (P = 0.95), all P > 0.5. Baseline comparisons were analyzed using relative expression values (2−ΔCt , normalized to miR-16), while longitudinal changes between V1 and V2 were assessed using fold change (2−ΔΔCt ). No significant longitudinal changes were observed across treatment groups. Conclusions In patients with persistent AF and HFpEF/HF with mildly reduced ejection fraction, circulating miR-21, miR-146a, miR-146b, and miR-328 showed no significant differences compared with the non-AF arrhythmia control group and did not change after 6 months of renin-angiotensin-aldosterone system-targeted therapy. These pilot data suggest that the short-term utility of biomarkers is limited and warrants validation in larger, randomized cohorts.

BACKGROUND: During head and neck surgery including orthognathic surgery, mild intraoperative hypothermia occurs frequently. Hypothermia is associated with postanesthetic shivering, which may increase the risk of other postoperative complications. To improve intraoperative thermoregulation, devices such as forced-air warming blankets can be applied. This study aimed to evaluate the effect of supplemental forced-air warming blankets in preventing postanesthetic shivering. METHODS: This retrospective study included 113 patients who underwent orthognathic surgery between March and September 2015. According to the active warming method utilized during surgery, patients were divided into two groups: Group W (n = 55), circulating-water mattress; and Group F (n = 58), circulating-water mattress and forced-air warming blanket. Surgical notes and anesthesia and recovery room records were evaluated. RESULTS: Initial axillary temperatures did not significantly differ between groups (Group W = 35.9 ± 0.7℃, Group F = 35.8 ± 0.6℃). However, at the end of surgery, the temperatures in Group W were significantly lower than those in Group F (35.2 ± 0.5℃ and 36.2 ± 0.5℃, respectively, P = 0.04). The average body temperatures in Groups W and F were, respectively, 35.9 ± 0.5℃ and 36.2 ± 0.5℃ (P = 0.0001). In Group W, 24 patients (43.6%) experienced postanesthetic shivering, while in Group F, only 12 (20.7%) patients required treatment for postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147-0.772). CONCLUSIONS: Additional use of forced-air warming blankets in orthognathic surgery was superior in maintaining normothermia and reduced the incidence of postanesthetic shivering.
Anesthesia ; Body Temperature ; Body Temperature Regulation ; Head ; Humans ; Hypothermia ; Incidence ; Methods ; Neck ; Odds Ratio ; Orthognathic Surgery* ; Postoperative Complications ; Recovery Room ; Retrospective Studies ; Shivering*