Emerging tobacco hazards in China: 2. Early mortality results from a prospective study

ObjectiveTo monitor the evolving epidemic of mortality from tobacco in China following the large increase in male cigarette use in recent decades.DesignProspective study of smoking and mortality starting with 224 500 interviewees who should eventually be followed for some decades.Setting45 nationally representative small urban or rural areas distributed across China.SubjectsMale population aged 40 or over in 1991, of whom about 80% were interviewed about smoking, drinking, and medical history.Results74% were smokers (73% current, only 1% former), but few of this generation would have smoked substantial numbers of cigarettes since early adult life. Overall mortality is increased among smokers (risk ratio 1.19; 95% confidence interval 1.13 to 1.25, P<0.0001). Almost all the increased mortality involved neoplastic, respiratory, or vascular disease. The overall risk ratios currently associated with smoking are less extreme in rural areas (1.26, 1.12, or 1.02 respectively for smokers who started before age 20, at 20-24, or at older ages) than in urban areas (1.73, 1.40, or 1.16 respectively).ConclusionThis prospective study and the accompanying retrospective study show that by 1990 smoking was already causing about 12% of Chinese male mortality in middle age. This proportion is predicted to rise to about 33% by 2030. Long term continuation of the prospective study (with periodic resurveys) can monitor the evolution of this epidemic.

Key messages

• In recent years most young men in China have become persistent cigarette smokers, starting at about age 20; this will cause high mortality in middle age and old age
• Currently, however, most middle aged and older smokers (particularly in rural areas) have not persistently used substantial daily numbers of cigarettes ever since they were young adults, so their current tobacco attributed mortality is more limited
• Nationally representative retrospective and prospective studies now show that in about 1990 “only” about 12% of adult male deaths in middle age were caused by smoking
• Continuation of the present prospective study will monitor the growth of the epidemic of tobacco related deaths in China over the next few decades

     

Plasma low-molecular-weight thiol/disulphide homeostasis as an early indicator of global and focal cerebral ischaemia

Objective: Recent studies have shown that cerebral ischaemia causes not only local, but also systemic oxidative stress. This leads to oxidation of thiol-containing compounds, including low-molecular-weight thiols (cysteine, glutathione, homocysteine and others). Therefore, the aim of this work was to verify the hypothesis that the thiol/disulphide homeostasis of low-molecular-weight thiols is disturbed in the early stages of cerebral ischaemia.

Methods: Two experimental rat models of ischaemia were used: a global model of vascular ischaemia (clamping the common carotid arteries?+?haemorrhage) and focal ischaemia (middle cerebral artery occlusion). The total levels of thiols and their reduced forms were measured before surgery and after 40 minutes of reperfusion (global) or 3?hours (focal) ischaemia.

Results: The global ischaemia model caused a marked (2.5–4 times, P?P?Discussion: These results suggest that plasma low-molecular-weight thiols are actively involved in oxidation reactions at early stages of cerebral ischaemia; therefore, their reduced forms or redox state may serve as a sensitive indicator of acute cerebrovascular insufficiency.     

Where is the origin of the Japanese gamecocks?

The tradition of cockfighting is widespread throughout the world. There is no doubt that the gamecock has evolved together with the human culture of cockfighting for a long time. In Japan, there is a group of gamecocks called "Shamo" that are used specifically for cockfighting. However, the process of the geographic distribution of cockfighting and the influx route of gamecocks into Japan are totally unclear. The molecular evolutionary study of gamecocks is obviously useful to gain profound insight into the understanding of not only the evolutionary origin of "Shamo" but also the distribution process of cockfighting as a culture. In this study, we collected blood samples of gamecocks from 11 different prefectures in Japan. Then, a phylogenetic tree was constructed using a total of 42 mtDNAs (D-loop, 1100 bp) sequenced. It showed that Japanese Shamo was clearly separated into two different groups: One group contains the samples from the island of Okinawa and the other group is composed of the samples mainly from Kyushu and Honshu of Japan. It suggests that Japanese Shamo must have been brought to Japan from two different origins. Our examination of historical records showed that the results of the phylogenetic analysis is consistent with the view that Japanese Shamo was originated from Southeast Asia and the mainland China independently, but was geographically a bit mixed afterwards.     

不同剂量白藜芦醇对糖尿病性白内障大鼠晶状体抗氧化酶活力的影响

目的:探究不同剂量白藜芦醇对糖尿病性白内障大鼠晶状体抗氧化酶活力的影响。方法:75只5周龄健康SPF级雄性SD大鼠按照随机数字表法分为正常对照组、模型组,白藜芦醇低剂量组,白藜芦醇中剂量组和白藜芦醇高剂量组,每组各15只。五组大鼠均给予常规适应性喂养,模型组和白藜芦醇低、中、高剂量组大鼠采用链脲佐菌素(STZ)以60 mg/kg的给药剂量制作糖尿病大鼠模型,成模后白藜芦醇低剂量组按20 mg/kg、白藜芦醇中剂量组按50 mg/kg、白藜芦醇高剂量组按100 mg/kg的给药剂量每日给予白藜芦醇灌胃。观察12周后5组大鼠晶状体的混浊程度,检测血糖、体重后处死大鼠,检测晶状体内超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)以及过氧化氢酶(CAT)的活性改变。结果:随着白藜芦醇剂量的升高,白藜芦醇低、中、高剂量组大鼠的血糖逐渐降低而体重逐渐升高,且组间比较均具有统计学差异(P0.05)。三组不同剂量白藜芦醇干预组大鼠晶状体的浑浊程度均低于模型组,且白藜芦醇高剂量组大鼠晶状体的浑浊程度最低,差异均具有统计学意义(P0.05)。白藜芦醇低、中、高剂量组大鼠SOD、GSH-PX和CAT酶活力与模型组大鼠相比均明显升高,而与正常对照组相比均明显降低(均P0.05)。随着白藜芦醇剂量的升高,白藜芦醇低、中、高剂量组大鼠SOD、GSH-PX和CAT酶活力逐渐升高,且组间比较均具有统计学差异(P0.05)。结论:高剂量白藜芦醇可更为明显地降低血糖浓度,提高晶状体SOD、GSH-Px及CAT酶活力,改善糖尿病性白内障晶状体的浑浊程度。     

Studies on Anticodon-anticodon Interactions: Hemi-protonation of Cytosines Induces Self-pairing Through the GCC Anticodon of E. Coli tRNA-Gly

Abstract

The temperature-jump method was used to compare the stability of anticodon-anticodon duplexes formed by the self-association of two tRNAs: yeast tRNA-Asp and Escherichia coli tRNA-Gly. Yeast tRNA-Asp duplexes contain a U/U mismatch while E. coli tRNA-Gly dimers have a C/C mismatch in the middle position of their quasi self-complementary anticodons GUC and GCC, respectively. At neutral pH, it is found that only tRNA-Asp duplexes exist whereas at pH 5.0 only tRNA-Gly duplexes are formed. This reflects the hemi- protonation of the N3 of the cytosines at pH 5.0 which induces a pairing between the two middle residues of the anticodon GCC in E. coli tRNA-Gly. This is the first evidence that a protonated C-C(+) base pair is compatible with the formation of a double helix with antiparallel strands in a natural RNA molecule.     

Anatomical location of the medial lemniscus and spinothalamic tract at the pons in the human brain: A diffusion tensor tractography study

Abstract

Using diffusion tensor tractography, we investigated the anatomical location of medial lemniscus (ML) and spinothalamic tract (STT) at pons. We recruited 47 healthy volunteers. Evaluation of the anatomical location of ML and STT was performed using the highest probabilistic location at the upper, middle, and lower pons. According to findings, MLs were located around the middle to medial one-third, between midline and lateral boundary of pons in the pontine tegmentum and STTs were located posterolaterally to ML.     

Foraging activity of the sand beach isopod Scyphax ornatus Dana

Abstract

The terrestrial isopod Scyphax ornatus lives on exposed sand beaches. Adult isopods spent the daytime in burrows near the high water mark and made nightly foraging excursions over the uncovered middle beach. Hourly records of their night time distribution showed that Scyphax congregated near the water’s edge during the last 4 h of flood tide, where they fed on carrion. Insects (mostly drowned honey bees) were the main food item, but coelenterates, amphipods, crabs, and goose barnacles were also eaten. During ebb and early flood tides Scyphax occurred at low densities over the uncovered middle beach. Analysis of the distribution of large and small food items on the beach showed that by feeding during the flood tide, Scyphax exploited a rich concentration of carrion that accumulated in the swash zone and that was moved slowly up the beach by the incoming tide.     

Theoretical study of AlH(2+)n (n=1-7) dications

The structures and stability of 1–7 dications were calculated at the ab initio MP2/aug-cc-pVTZ level of theory. The dications AlH²⁺ 1 and 2 were characterized to be unstable thermodynamically. However, these and the stable dications, 3–7 have considerable kinetic barriers for deprotonation. Each of the structures 3–7 contains one or more two-electron three-center (2e–3c) bonds. Aluminum atoms of these dications carry most of the positive charges, as indicated by NBO charge calculations.Dedicated to Professor Dr. Paul von Ragué Schleyer on the occasion of his 75th birthday     

桥接组合式内固定系统结合Nice结与锁定钢板治疗锁骨中段粉碎性骨折疗效比较研究

摘要 目的：对比桥接组合式内固定系统（OBS）结合Nice结与锁定钢板治疗锁骨中段粉碎性骨折的疗效。方法：回顾性选取2021年6月至2022年1月间在我院接受治疗的锁骨中段粉碎性骨折患者（n=66）的临床资料。根据手术方式的不同将患者分为A组（锁定钢板治疗,32例）和B组（桥接组合式内固定系统结合Nice结,34例）,对比两组临床症状恢复情况、并发症发生率、视觉疼痛模拟评分（VAS）、Constant-Murley评分和肩关节活动度。结果：两组骨折愈合时间对比无差异（P>0.05）。B组术中出血量少于A组,手术时间短于A组（P<0.05）。两组术后3个月Constant-Murley评分升高,VAS评分下降（P<0.05）,B组术后3个月VAS评分低于A组,Constant-Murley评分高于A组（P<0.05）。两组术后3个月前屈、后伸、内旋、外旋的肩关节活动度增大（P<0.05）,且B组术后3个月前屈、后伸、内旋、外旋的肩关节活动度均大于A组（P<0.05）。两组并发症发生率组间比较无统计学差异（P>0.05）。结论：OBS与锁定钢板治疗锁骨中段粉碎性骨折相比,OBS结合Nice结治疗可减少术中出血量,缩短手术时间,促进骨折愈合,扩大肩关节活动度,改善肩关节功能,疗效更好。     

水飞蓟宾诱导卵巢癌HO-8910细胞凋亡增殖及其机制探讨

目的:探讨水飞蓟宾对人卵巢癌HO-8910细胞增殖的抑制作用及其作用机制。方法:HO-8910细胞分为四组:(1)对照组;(2)水飞蓟宾低浓度组;(3)水飞蓟宾中浓度组;(4)水飞蓟宾高浓度组。通过MTT法测定细胞增值率,流式细胞技术检测细胞凋亡情况,Hoechst染色观查细胞核凋亡,Western-blot检测bax及bcl-2表达。结果:细胞增殖检测结果显示,水飞蓟宾低、中、高浓度组的抑制率(83.00±5.51%、65.33±3.48%、56.67±4.37%)与对照组(97.33±4.25%)比较差异具有统计学意义(P0.05)。流式细胞技术结果显示,水飞蓟宾低、中、高浓度组凋亡细胞比例分别为16.93±2.34%、26.20±2.21%和37.93±1.98%,与对照组(1.43±0.72%)相比差异均有统计学意义(P0.05)。Hoechst染色结果显示,水飞蓟宾低、中、高浓度组凋亡细胞比例分别为12.56±2.55%、25.73±2.05%和39.14±3.69%,与对照组(0.54±0.67%)相比差异均有统计学意义(P0.05)。此外,水飞蓟宾可以升高bax基因表达水平,降低bcl-2基因表达平。结论:水飞蓟宾能明显抑制HO-8910细胞增殖,促进细胞凋亡,通过改变凋亡因子表达诱导卵巢癌HO-8910细胞凋亡。     

Cone Beam Computed Tomography Assessment of the Maxillary Incisive Canal and Foramen: Considerations of Anatomical Variations When Placing Immediate Implants

IntroductionThe maxillary incisive canal connects the roof of the oral cavity with the floor of nasal cavity and has the incisive and nasal foramina respectively at its two opposite ends. Its close proximity with the anterior incisors affects one’s ability to place immediate implants in ideal position.ObjectiveTo avoid causing complication, variations in their dimensions were studied.ResultsThe mean labiopalatal and mesiodistal measurements of the incisive foramen were 2.80mm and 3.49 mm respectively, while the labiopalatal width of the nasal foramen was 6.06mm. The incisive canal was 16.33mm long and 3.85 mm wide. The anterior maxillary bone has an average thickness of 7.63 mm. The dimensions of the incisive foramen and incisive canal, and anterior maxillary bone thickness demonstrated gender differences with males showing greater values. The anterior maxillary bone thickness was affected by age but this difference was not observed in canal dimensions. The majority of subjects have a funnel shape-like incisive canal with the broader opening located at its superior. They seem to have a longer slanted-curve canal with one channel at its middle portion and a narrower incisive foramen opening than those reported elsewhere.ConclusionsThis study found that gender is an important factor that affected the characteristics of the IC and the amount of bone anterior to it. Male generally had bigger IC and thicker anterior bone. In addition, the anterior maxillary bone thickness was affected by aging, where it becomes thinner with increased age even though the subjects were fully dentate.     

Chitosan reduces inflammation and protects against oxidative stress in a hyperlipidemic rat model: relevance to nonalcoholic fatty liver disease

Background

An altered lipid profile may lead to the development of inflammation and NAFLD (Non-alcoholic fatty liver disease). Although statins have a positive effect on blood lipid levels their long-term use is known to cause adverse effects, in this backdrop there is an interest in natural compounds which may affect lipid metabolism and prevent NAFLD. We have examined the effect of Chitosan on rats subjected to a high-fat diet.

Methods and results

Male Wistar middle aged rats (12–16 months) were treated with high-fat diet orally for two months for creating a NAFLD model. Rats were also supplemented with Chitosan (2% chitosan daily) for 2 months. We assessed the activity of antioxidant enzymes, the histopathological profile of the liver. Inflammatory cytokines and adiponectin levels were also measured in serum. HFD induced significant changes in liver tissue and inflammatory markers (Il-6, TNF- alpha, NF-KB). Chitosan treatment protected rats from HFD induced alterations.

Conclusions

The findings suggest that Chitosan can effectively improve liver lipid metabolism by normalizing cholesterol, triglyceride, lowering NF-KB expression, and protecting the liver from oxidative stress by improving hepatic function. Chitosan also regulates genes related to lipidemic stress i,e leptin and adiponectin.

     

Body mass index and weight gain after middle adulthood are associated with risk of papillary thyroid cancer: A case–control study

BackgroundIt is unclear whether weight change after middle adulthood influences the risk of thyroid cancer. The aim of this study was to investigate associations between the risk of papillary thyroid cancer (PTC) and body mass index (BMI) and weight change after middle adulthood (age 35).MethodsA matched case–control study based on three hospitals included 516 pairs of cases newly diagnosed with PTC and controls. Current height and weight after defecation in the morning were measured by trained nurses. During measurement, all subjects were requested to wear lightweight clothing and no shoes. Weight at age 35 was self-reported. BMI and weight change were modeled as continuous and categorical variables. Conditional and unconditional logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95%CI) for the association between BMI and weight change after middle adulthood and PTC.ResultsAfter adjustment for covariates, measured BMI at the time of current diagnosis was positively associated with PTC (OR 1.16, 95%CI 1.10–1.21). According to WHO BMI guidelines for Asia-Pacific populations, the OR (95%CI) for PTC risk in obesity was 2.99 (1.92–4.67) compared to normal weight (p-trend <0.001). Moreover, PTC was positively associated with BMI at age 35; the OR (95%CI) for PTC risk per unit increase in BMI was 1.06 (1.02–1.11). Compared to stable weight (changed <0.5 kg/year), weight gain ≥1.0 kg/year after middle adulthood was positively associated with PTC (OR 2.57, 95%CI 1.39–4.76, p-trend <0.001). Compared to maintaining non-overweight status, the PTC risk was significantly increased in those individuals who gained weight and became overweight after middle adulthood (OR 3.82, 95%CI 2.50–5.85).ConclusionThis study showed that high BMI and obesity were positively associated with increased risk of PTC, and weight gain after middle adulthood also could elevate the PTC risk.     

New rodents (Mammalia) from the late Oligocene of Cabeza Blanca (Chubut) and the first rodent radiation in Patagonia

Caviomorph rodents, the New World Hystricognathi, are one of the most characteristic groups of South American mammals. Although they have been in the continent at least since the middle Eocene, those of the Deseadan Land mammal Age (early–late Oligocene) are the best source to understanding their early history due of their good record, large geographic distribution and good temporal calibration of many of the local faunas. Here, we describe the following new taxa from the classical locality of Cabeza Blanca: Octodontoidea Acaremyidae Galileomys baiosn. sp., Octodontoidea incertae sedis Ethelomys loomisin. gen.,n. comb., Acarechimys leucotheaen. sp., Protacaremys? adilosn. sp., Chinchilloidea incertae sedis Loncolicu tretosn. gen., n. sp., Incamys menniorumn. sp., Caviomorpha incertae sedis Llitun notucan. gen., n. sp., Leucokephalos zeffiaen. gen., n. sp. and Cephalomyidae Cephalomys ceciaen. sp. The DP4 of an ‘eocardiid’, Asteromys punctus? is described for the first time. These new taxa allow us to reinterpret the relationships of some of the previously known Deseadan species and genera. They show a great early diversification at least for extra Andean Patagonia, involving at least three of the main caviomorph lineages: octodontoids, chinchilloids and cavioids.     

经会阴三维超声评价不同分娩方式初产妇肛门括约肌复合体和盆膈裂孔的临床应用价值

摘要 目的：探讨经会阴三维超声在不同分娩方式初产妇肛门括约肌复合体（ASC）和盆膈裂孔（PH）影响的评估价值。方法：选择2017年1月～2019年12月我院进行分娩的初产妇150例,按照分娩方式分成阴道分娩组71例,剖宫产组79例,比较两组基线资料。对所有受试者均实施经会阴三维超声检查,比较两组缩肛动作下肛门内括约肌（IAS）远端、中端及远端平面厚度,肛门外括约肌（EAS）远端平面及耻骨直肠肌（PRM）中端平面厚度,分娩前、产后6周、产后3个月PH左右径、PH前后径以及PH面积。结果：两组孕妇年龄、孕周及体质指数比较无差异（P＞0.05）,阴道分娩组IAS近端6点钟方向、12点钟方向平面厚度以及IAS中端、12点钟方向平面厚度均小于剖宫产组（P＜0.05）。阴道分娩组EAS远端12点钟方向平面厚度小于剖宫产组（P＜0.05）。阴道分娩组产后6周的PH左右径大于剖宫产组（P＜0.05）。阴道分娩组产后6周的PH前后径大于剖宫产组（P＜0.05）。阴道分娩组产后6周的pH面积大于剖宫产组（P＜0.05）。结论：经会阴三维超声可有效评估初产妇ASC和PH的影响情况,分娩会对初产妇ASC和PH产生影响,阴道分娩的初产妇产后存在明显的ASC厚度减小和PH增大现象。     

Hospital surgical volume and colorectal cancer survival in Norway: A nationwide cohort study

BackgroundStudies of hospital surgical volume and colorectal cancer survival are inconclusive. We investigated whether surgical volume was associated with survival of patients operated for colorectal cancer in Norway.MethodsUsing Cancer Registry of Norway data, we compared excess mortality from colorectal cancer by hospital surgical volume among 26,989 colon and 9779 rectal cancer patients diagnosed 2009–2020 and followed-up to 31.12.2021. Hospitals were divided into terciles according to their three-year average annual surgical volume; colon: low (< 22), middle (22–73), high (> 73); rectal: low (< 17), middle (17–38), high (> 38). We estimated excess hazard ratios (EHR) with flexible parametric models adjusted for age, year, stage, surgical urgency and surgery location (within/outside patient’s residential health trust).ResultsLow-volume hospitals had the highest proportion of late-stage or acutely operated colon cancer patients. Colon cancer patients operated at low- versus high-volume hospitals had significantly increased crude excess mortality (EHR = 1.30; 95 % CI = 1.14–1.48) but no difference after adjustment for age, year, and stage (EHR = 0.97; 0.85–1.11). High-volume hospitals had the highest proportion of late-stage rectal cancer patients and patients operated outside their residential area. Rectal cancer patients operated at low- versus high-volume hospitals did not have significantly different excess mortality before (EHR = 0.84; 0.64–1.10) or after (EHR = 1.03; 0.79–1.35) adjustment for age, year, stage, surgical urgency and surgery location. After accounting for case-mix, hospital surgical volume was not associated with excess mortality from colon (P = 0.40) or rectal cancer (P = 0.22).ConclusionLow hospital surgical volume was not associated with poorer colorectal cancer survival.     

Effect of the Nature of the 3β-Substitution in Manoyl Oxides on the Thermotropic Behavior of DPPC Lipid Bilayer and on DPPC Liposomes

Functionalized manoyl oxide derivatives have been proved over the years to evoke several biological responses. Among them, 3β-hydroxy-manoyl oxide (1) and 3β-acetoxy-manoyl oxide (2) have been shown to exhibit in vitro antimicrobial and cytotoxic activity, while N-imidazole-3 β-thiocarbonyl ester of manoyl oxide (3) was found to exhibit potent cytotoxic effect. Their partitioning into phospholipid bilayers may lead to membrane structure modifications that are crucial in liposome development as they may influence their maintenance and integrity. DSC was used to study the modifications induced in DPPC bilayers by incorporating increasing concentrations of the three manoyl oxide derivatives. All derivatives were found to strongly affect the bilayer structural organization in terms of a decrease of the cooperativity, the fluidization and partially destabilization of the gel phase and the induction of a lateral phase separation in clustering domains. Derivatives 1 and 3 were incorporated into DPPC liposomes and their physicochemical stability was monitored at 4°C. The stability of liposomes was strongly influenced by the presence of 1 and 3 at any molar ratio studied. DPPC/1 liposomes were found to retain its stability for 48 h at low concentration of 10% mol, while at higher concentrations up to 30% mol they collapsed into aggregated material. In all cases DPPC/3 liposomes were found unstable and sticky aggregated structures precipitated from the bulk suspension.     

Diferencias en función de la edad y la autopercepción del envejecimiento en ansiedad,tristeza, soledad y sintomatología comórbida ansioso-depresiva durante el confinamiento por la COVID-19

ObjectivesTo analyze differences by age group in anxiety, depression, loneliness and comorbid anxiety and depression in young people, middle aged adults and older adults during the lock-down period at home due to the COVID-19 pandemic, and to explore the association between negative self-perceptions of aging and psychological symptoms controlling by age group.MethodParticipants are 1501 people (age range 18 to 88 years). Anxiety, sadness, loneliness and self-perceptions of aging were assessed. The sample was divided according to the age group and quartiles (lower, intermediate levels, and higher) of anxiety, sadness, loneliness and self-perceptions of aging.ResultsOlder adults reported lower levels of anxiety and sadness than middle aged adults, and middle aged adults reported lower levels than younger participants. Middle aged adults reported the lowest loneliness, followed by older adults and younger participants. For each age group, those with more negative self-perceptions of aging reported higher anxiety, sadness and loneliness. More comorbid anxiety and sadness was found in younger adults and less in older adults; more depressed participants in the middle aged group, and more older adults and less younger participants were found in the group with the lowest levels of anxiety and sadness. For all the age groups, participants with high levels of comorbid anxiety and sadness are those who report the highest scores in negative self-perceptions of aging.ConclusionsOlder adults reported lower psychological anxiety, sadness and loneliness than the other age groups. Having negative self-perceptions of aging damage psychological health irrespective of the chronological age.     

Phospholamban cardiomyopathy: a Canadian perspective on a unique population

Introduction

Phospholamban cardiomyopathy is an inherited cardiomyopathy, characterised by a defect in regulation of the sarcoplasmic reticulum Ca²⁺ pump, often presenting with malignant arrhythmias and progressive cardiac dysfunction occurring at a young age.

Methods

Phospholamban R14del mutation carriers and family members were identified from inherited arrhythmia clinics at 13 sites across Canada. Cardiac investigations, including electrocardiograms, Holter monitoring (premature ventricular complexes, PVCs), and imaging results were summarised.

Results

Fifty patients (10 families) were identified (median age 30 years, range 3–71, 46% female). Mutation carriers were more likely to be older, have low-voltage QRS, T‑wave inversion, frequent PVCs, and cardiac dysfunction, compared to unaffected relatives. Increasing age, low-voltage QRS, T‑wave inversion, late potentials, and frequent PVCs were predictors of cardiac dysfunction (p < 0.05 for all). Older carriers (age ≥45 years) were more likely to have disease manifestations than were their younger counterparts, with disease onset occurring at an older age in Canadian patients and their Dutch counterparts.

Discussion

Among Canadian patients with phospholamban cardiomyopathy, clinical manifestations resembled those of their Dutch counterparts, with increasing age a major predictor of disease manifestation. Older mutation carriers were more likely to have electrical and structural abnormalities, and may represent variable expressivity, age-dependent penetrance, or genetic heterogeneity among Canadian patients.