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Abstract Atrial fibrillation (AF) is strongly associated with strokes, heart failure, and increased mortality. This study aims to identify the monocyte–macrophage heterogeneity and interactions of these cells with non-immune cells, and to identify functional biomarkers in patients with AF. Therefore, we assess the single cell landscape of left atria (LA), using a combination of single cell and nucleus RNA-seq. Myeloid cells in LA tissue are categorized into five macrophage clusters, three monocyte clusters, and others. Cell-Chat analysis revealed that monocytes and IL1B+ macrophages send epidermal growth factor (EGF) signals to fibroblasts. Amphiregulin (AREG) is the most upregulated gene in monocytes and IL1B+ macrophages in the AF group, compared with healthy controls from other groups. Serum AREG levels are higher in patients with persistent AF. These data suggested that EGF signaling pathway could be a therapeutic target for AF and serum AREG levels provide an effective biomarker for predicting persistent AF.

Abstract Aims The aim of present study is to evaluate the clinical significance of the time‐dependent changes in xanthine oxidoreductase (XOR) activity during hospitalization for acute heart failure (AHF). Methods and results A total of 229 AHF patients who visited to emergency room were prospectively enrolled, and 187 patients were analysed. Blood samples were collected within 15 min of admission (Day 1), after 48–72 h (Day 3), and between Days 7 and 21 (Day 14). The AHF patients were divided into two groups according to the XOR activity on Day 1: the high‐XOR group (≥100 pmol/h/mL, n = 85) and the low‐XOR group (

Background: Plasma volume status (PVS) has been evaluated recently as a prognostic marker of acute heart failure (AHF). However, whether evaluating PVS alone is sufficient remains unclear. Methods: Of 675 patients with AHF screened, 601 were enrolled. The PVS, prognostic nutritional index (PNI) (lower = worse), and Controlling Nutritional Status (CONUT) score (higher = worse) were evaluated. Patients were divided into 2 groups according to PVS value (low- or high-PVS group) and were further subdivided into 4 groups (low- or high-PVS/CONUT group and low- or high-PVS/PNI group). Results: A Kaplan–Meier curve showed a significantly lower survival rate in the high-PVS group than in the low-PVS group, the high-PVS/high-CONUT group than in the high-PVS/low-CONUT group, and the high-PVS/low-PNI group than in the high-PVS/high-PNI group. A multivariate Cox regression model showed that high PVS (hazard ratio [HR], 1.642; 95% confidence interval [CI], 1.049-2.570) and high PVS/high CONUT (HR, 2.076; 95% CI, 1.147-3.757) and high PVS/low PNI (HR, 2.094; 95% CI, 1.166-3.761) were independent predictors of 365-day mortality. Conclusions: An adverse outcome was predicted by the evaluation of PVS; furthermore, a malnutrition status with a high PVS leads to an adverse outcome. The simultaneous evaluation of nutrition status and PVS is essential to predict an AHF outcome. Résumé: Contexte: La valeur pronostique du volume plasmatique (VP) dans l’insuffisance cardiaque aiguë (ICA) a récemment été évaluée. On ne sait toutefois pas si le volume plasmatique à lui seul peut suffire. Méthodologie: Sur les 675 patients présentant une ICA diagnostiquée, 601 ont été retenus. Le VP, l’indice nutritionnel pronostique (PNI; plus l’indice est faible, plus l’état nutritionnel est mauvais) et le score CONUT (Controlling Nutritional Status, contrôle de l’état nutritionnel; plus le score est élevé, plus l’état nutritionnel est mauvais) ont été évalués. Les patients ont été répartis en deux groupes en fonction du VP (VP faible et VP élevé), puis de nouveau en quatre sous-groupes (VP/CONUT faible ou élevé et VP/PNI faible ou élevé). Résultats: La courbe de Kaplan-Meier montre que le taux de survie est significativement inférieur dans le groupe VP élevé par rapport au groupe VP faible, dans le groupe VP élevé/score CONUT élevé par rapport au groupe VP élevé/score CONUT faible, et dans le groupe VP élevé/PNI faible par rapport au groupe VP élevé/PNI élevé. L’analyse au moyen d’un modèle de régression de Cox multivarié a révélé qu’un VP élevé (rapport des risques instantanés [RRI] de 1,642; intervalle de confiance [IC] à 95 % : de 1,049 à 2,570), un VP élevé assorti d’un score CONUT élevé (RRI de 2,076; IC à 95 % : de 1,147 à 3,757) et un VP élevé assorti d’un PNI faible (RRI de 2,094; IC à 95 % : de 1,166 à 3,761) étaient des facteurs prédictifs indépendants de la mortalité à 365 jours. Conclusions: L’évaluation du VP a permis de prédire une issue défavorable; en outre, les données montrent qu’un état de malnutrition conjugué à un VP élevé est un facteur de mauvais pronostic. Il est essentiel d’évaluer simultanément l’état nutritionnel et le VP pour prédire l’ICA.

Background: The relationship between the serum level of uric acid (UA) and the acute kidney injury on admission in patients with acute heart failure (AHF) remain unclear. Methods and results: A total of 1326 AHF patients were screened, and data for 1047 patients who were admitted to the intensive-care unit were analyzed. The patients were assigned to a low-UA group (UA ≤ 7.0 mg/dl, n = 569) or a high-UA group (UA > 7.0 mg/dl, n = 478) according to their UA level at admission. Acute kidney injury (AKI) at admission was defined based on the ratio of the serum creatinine value recorded on admission to the baseline creatinine value: no-AKI (n = 736) or AKI (n = 311). The patients were therefore assigned to four groups: low-UA/no-AKI (n = 428), high-UA/no-AKI (n = 308), low-UA/AKI (n = 141) and high-UA/AKI (n = 170). The high-UA patients were significantly more frequent in the AKI group than in the non-AKI group among all patients and the non-chronic kidney injury (CKD) cohort. A Kaplan-Meier curve showed a significantly lower 365-day survival rate in the high-UA/AKI group than in the other groups. The multivariate Cox regression model identified only high-UA/AKI as an independent predictor of 365-day mortality (hazard ratio [HR]: 2.511, 95% confidence interval [CI] 1.671–3.772 in all AHF patients, HR: 1.884, 95% CI 1.022–3.473 in non-CKD patients and HR: 3.546, 95% CI 2.136–5.884 in CKD patients). Conclusion: An elevated serum UA level complicated with AKI was an independent predictor of mortality in patients with severely decompensated AHF. Keywords: Acute heart failure syndrome, Uric acid, Renal function, Mortality