This study examined age-related differences in the perceptual organization and identification of Mandarin visemes, as well as the contribution of visual information to auditory consonant perception in younger and older adults. Analyses included hierarchical clustering of visual confusability patterns, viseme identification accuracy, visual enhancement for each viseme category and age group, and confusion matrices of articulation features. The results showed that older adults exhibited reduced differentiation among viseme categories, while the overall confusability structure was largely preserved. Older adults exhibited lower identification accuracy for all visemes except for Palatals, whereas audiovisual enhancement was comparable across age groups for most categories, except for retroflexes. Across both groups, Viseme Bilabials and Labiodental were identified more accurately and showed greater audiovisual enhancement than other categories. Moreover, audiovisual input reduced not only confusions across places of articulation but also across manners of articulation. These findings suggest that visual speech cues remain effective in supporting consonant perception in older adults.

Background:This study aimed to investigate the association between electrocardiogram (ECG) P-wave dispersion (Pd) in sinus rhythm and the risk of new-onset atrial fibrillation (NAF) within one year, to identify high-risk individuals earlier and improve clinical outcomes. Methods:(1) This retrospective nested case-control study included patients diagnosed with NAF at Changzhou First People's Hospital between July 2022 and June 2023. Cases were defined as individuals without a previous atrial fibrillation (AF) diagnosis who developed NAF regardless of symptom status. Controls were matched 1:3 by age and sex from individuals with sinus rhythm during the same period. (2) Using the date of the NAF diagnosis as the index date, then ECGs, echocardiographic data, laboratory tests, and basic clinical characteristics in the sinus rhythm were collected via the electronic medical record system for all subjects within one year post-index date. (3) Differences in ECG parameters, echocardiographic parameters, blood biological indicators, and basic clinical characteristics in the sinus rhythm were compared between the two groups. (4) Conditional logistic regression models were used to evaluate the association between relevant ECG indicators and NAF, with curve fitting performed using generalized additive models (GAMs). Results:(1) A total of 824 participants were enrolled, including 206 NAF cases and 618 matched controls. (2) A comparison between groups identified significantly higher diastolic blood pressure, glycated hemoglobin A1c, serum creatinine, P-wave duration, Pd, and left atrial diameter in the NAF group than the control group; meanwhile, uric acid, total cholesterol, high-density lipoprotein, and low-density lipoprotein were significantly lower (all p < 0.05). (3) In fully adjusted conditional logistic regression models, increased Pd was independently associated with a higher risk of NAF within one year (odds ratio (OR): 1.149; 95% confidence interval (CI): 1.099-1.202; p < 0.001). Curve fitting demonstrated a positive correlation between Pd and the risk of NAF. Conclusions:ECG Pd in the sinus rhythm was independently and positively associated with the risk of NAF within one year.

Neuroblastoma (NB) is a pediatric malignant solid tumor arising from peripheral neural crest cells, characterized by significant heterogeneity. Previous studies have stratified NB patients into risk groups based on pivotal genetic changes, but the suboptimal clinical outcomes of NB underscore the need for a more precise individualized grading system to guide the selection of novel therapeutic strategies. In this study, we developed a dense neural network molecular classifier utilizing bulk transcriptomics data from the UCSC Treehouse database and applied it to a single-center cohort. The neural network molecular classifier on bulk transcriptomics refined the classification in both high-risk and low-risk groups by the traditional classification method. The classifier identified four molecular subtypes: High-risk MYCN-high NB (HR1), High-risk MYCN-low NB (HR2), Low/Intermediate-risk NB (LR1), and Low/Intermediate-risk GNB (LR2). By applying the new classifier, we identified factors such as PIK3R1, GATA2, and EYA1 that may be associated with a low-risk, differentiated ADRN-subtype NB, in addition to the classical adrenergic fate-determining factors PHOX2B, ASCL1, ALK, and GATA3. Additionally, we observed elevated GD2 and CTLA-4 expression in the High-risk MYCN-low NB group, which may serve as a potential clue for the development of personalized immunotherapeutic strategies. Our model details the current NB risk stratification at the transcriptomic level with a molecular classifier and offers potentially more personalized immunotherapeutic strategies for High-risk MYCN-low NBs.

Congenital amusia is a disorder characterized by abnormal pitch processing, including pitch encoding and pitch memory. Individuals with amusia were impaired in speech perception, but they showed comparable speech production as those without (mainly investigated in tonal languages). Nonetheless, most previous studies collected amusics' recordings based on real words, and little is known about how amusics produce nonwords that incorporate phonological components of syllables and lexical tones. In this study, two participant groups of amusics and typical, musically intact controls (18 participants per group) attended a nonword repetition task. All nonwords were syllable-tone combinations created following the Chinese word structure. The length of the nonwords gradually increased from one to seven syllables. Repetition accuracy and error patterns were analyzed using linear mixed-effects models. Results showed that amusics had fewer correct responses to syllables and tones within a nonword, especially for longer nonwords. Besides, amusics' error rates for the double-type error, meaning the simultaneous mistakes on both syllables and tones, were also larger than controls in the longer lengths. It was revealed that amusics repeated the nonwords less accurately than controls, and they were struggling with concurrent processing of different phonological components within a nonword. This study provides novel evidence that amusics exhibit degraded nonword repetition involving both syllables and tones, which supports the perception-production link and sheds light on designing intervention programs to soften the disorder of amusia.

Hepatoblastoma (HB) is a rare but predominant liver cancer in children, with few treatment choices in advanced stages. YWHAE is closely related to several human diseases and acts as a molecular scaffold for malignant transformation. However, whether YWHAE promotes HB development remains unknown. Conducting RNA and m6A sequencing on HB tissues, we found that YWHAE was upregulated and modified by N6-methyadenosine. Functionally, YWHAE promoted proliferation and inhibited cell death in HB by in vitro and in vivo studies. Mechanistically, METTL3-dependent m6A modification activated YWHAE mRNA expression, and the m6A reader IGF2BP2 recognized and bound to the m6A site on YWHAE mRNA, thereby enhancing the mRNA stability of YWHAE. Interestingly, RNA sequencing revealed that YWHAE knockdown was involved in regulating ferroptosis of HB cells by mediating SLC7A11 expression. Moreover, knockdown of YWHAE significantly increased the levels of lipid ROS and peroxides in HB cells, promoting the susceptibility of HB cells to ferroptosis. In summary, these findings illuminated the role of YWHAE in HB progression and uncovered its relevance to ferroptosis as a new therapeutic target for HB.

Hepatoblastoma (HB) is the predominant hepatic malignancy among children. Despite therapeutic options for HB were gradually refined in recent years, patients with metastasis suffer from an unsatisfactory prognosis. Pyroptosis is a type of programmed and inflammatory necrosis. Neutrophils are crucial in innate immunity, which were shown to be associated with tumor progression. Our study strived to unravel the relationship between neutrophil-induced pyroptosis (NIP) and HB. The clinical and bulk RNA sequencing data of 38 patients with HB were obtained from Shanghai Children’s Medical Center. We established NIP score based on the LASSO regression. The single-cell RNA sequencing data (GSE186975) were used for for key genes identification, cellular communication, and differentiation trajectories of neutrophils. KEGG, GO, GSVA, and ssGSEA enrichment were used to analyze biological functions, including neutrophil extracellular traps (NETs), NOD-like receptors pathway, neutrophil activation, neutrophil-mediated cytotoxicity, and others. We constructed a NIP score based on the expression of three genes related to neutrophil and pyroptosis, namely ELANE, CASP1, and NOD2, which was positively correlated with a favorable prognosis of HB. Moreover, we clarified the function of ELANE in HB microenvironmwnt. Immunohistochemistry and transcriptome analysis unraveled a significant correlation between NETs and pyroptosis in HB, suggesting the key role of NETs-related neutrophils in inducing pyroptosis and prolonging survival. We also found upregulated tumor-promoting and immunosuppression-related pathways in the HB microenvironment. In addition, we clarified the growth trajectories and phenotypic changes of neutrophils in the immune microenvironment of HB, which can serve as potential targets for immunotherapy. The novel NIP score for patients with HB shows high predictive value for survival. Moreover, we identified biological function, cellular communication, and growth trajectories of neutrophils in HB. Our findings broaden insights into the treatment of HB.

Challenges in the ability of older adults to comprehend vocal emotion have been documented. However, limited research has investigated the combined effects of aging and age-related hearing loss. The present study aimed to bridge this research gap by comparing the performance of three participant groups (younger adults with normal hearing, older adults with hearing loss, and older adults without hearing loss) in identification of "happy" and "sad" emotions via prosodic and semantic channels. We conducted regression models to investigate the relationship between age, hearing threshold, cognitive abilities and overall emotion perception performance. Results of emotion identification accuracy demonstrated that older adults with hearing loss performed worse than other two normal hearing groups in both channels. Additionally, only older adults with hearing loss showed lower accuracy in the emotional prosody than semantics, indicating only this group is influenced by channel. As for response time, both older listener groups responded more slowly than younger listeners in both channels. They also exhibited faster responses to "happy" compared to "sad", supporting the positivity effect on emotion perception in older participants. Moreover, the regression models indicated that age, hearing threshold and working memory (measured by Digit Span test) were predictive of participants' overall identification accuracy, and selective attention (measured by Stroop test) was predictive of participants' overall reaction time. These findings suggest that the degraded emotion perception among older adults is attributed to complex underlying mechanisms, which can be reasonably explained by not only aging but also the decline in hearing sensitivity and cognitive functions.

OBJECTIVE:To assess left atrial (LA) structure and function in marathon runners using two-dimensional speckle tracking echocardiography (2D-STE) and real-time three-dimensional echocardiography (RT-3DE). METHODS:This study enrolled 50 healthy volunteers (control group) and 132 marathon runners, and collected their general information. 2D-STE and RT-3DE were performed to obtain LA structural and functional parameters and left ventricular mass index (LVMI). According to the LVMI criteria for diagnosing left ventricular hypertrophy (LVH), all marathon runners were divided into an LVMI normal group and an LVH group. A comparative analysis was performed among the three groups. Multivariate logistic regression was used to analyze the association, and curve fitting was used to show the change trends. RESULTS:Compared with the control group, LA total ejection fraction (LATEF) and LA passive ejection fraction (LAPEF) were higher in the LVMI normal group (p < 0.05). Compared with the control group and the LVMI normal group, LA maximal volume index (LAVImax), LA presystolic volume index (LAVIpre), and LA stiffness index (LASI) were higher in the LVH group, whereas LA reservoir strain (LASr), LA conduit strain (LAScd), and LA contraction strain (LASct) were lower (p < 0.05). Multivariate logistic regression analysis showed that LAVImax, LAScd, and LASct were significantly associated with LVH in marathon runners. Curve fitting showed that LAVImax increased with the increase of LVMI, whereas LAScd and LASct decreased. CONCLUSION:2D-STE and RT-3DE can effectively assess LA structure and function in marathon runners. Marathon runners with normal LVMI exhibit normal LA structure and function, and even some functional enhancement, while those with LVH exhibit increased LA volume and decreased LA strain function.

Background: This study aimed to use four-dimensional automatic left atrial quantification (4D Auto LAQ) to quantitatively evaluate the morphological and functional changes in the left atrium (LA) in asymptomatic type 2 diabetes mellitus (T2DM) patients with early chronic kidney disease (CKD), and explore its correlation with major adverse cardiovascular event (MACE) occurrence. Methods: This study enrolled patients with asymptomatic T2DM complicated with early CKD. Then, 4D-Auto LAQ was used to evaluate LA volume index (minimum, maximum, pre-ejection) and LA longitudinal and circumferential strains during each of the three LA phases: reservoir, conduit, and contraction. The primary endpoint for follow-up was defined as the first occurrence of nonfatal acute myocardial infarction, stroke, congestive heart failure, or cardiac death. Univariate and multivariate Cox proportional hazard analyses were used to evaluate the correlation between LA parameters and the MACEs in T2DM patients with early CKD. Results: A total of 361 patients were analyzed (mean age, 59.51 ± 11.17 years). During a median follow-up period of 47 months (interquartile range, 17–59 months), MACEs occurred in 70 patients. After adjusting for various clinical and echocardiographic predictors, increased LA volume and impaired reservoir function (ResF) were each independently associated with the primary endpoint: Left atrium minimum volume index (LAVImin) had an adjusted hazard ratio (HR) of 1.21 (95% confidence interval (CI), 1.08–1.35; p = 0.010), whereas left atrium longitudinal strain during the reservoir phase (LASr) had an adjusted HR of 0.81 (95% CI, 0.74–0.89; p < 0.001). Univariate and multivariate Cox regression analyses indicated that the cumulative incidence of MACEs was significantly greater in patients with LAVImin >16.9 mL/m2 than in those with LAVImin ≤16.9 mL/m2 (HR, 2.25; 95% CI, 1.03–6.39; p = 0.005). Furthermore, patients with a LASr <18.5% faced a markedly elevated risk of MACEs—nearly fourfold greater than individuals with a LASr ≥18.5% (HR, 3.95; 95% CI, 1.76–8.86; p < 0.001). Conclusions: An enlarged left atrium (LAVImin) and impaired ResF (LASr) are strongly associated with long-term outcomes in T2DM patients complicated with early CKD. LASr showed the strongest associations with the occurrence of MACEs.

Resveratrol (RES), a natural polyphenolic compound, has garnered significant attention for its therapeutic potential in various pathological conditions. This review explores how RES modulates mitophagy-the selective autophagic degradation of mitochondria essential for maintaining cellular homeostasis. RES promotes the initiation and execution of mitophagy by enhancing PINK1/Parkin-mediated mitochondrial clearance, reducing reactive oxygen species production, and mitigating apoptosis, thereby preserving mitochondrial integrity. Additionally, RES regulates mitophagy through the activation of key molecular targets such as AMP-activated protein kinase (AMPK), the mechanistic target of rapamycin (mTOR), deacetylases (SIRT1 and SIRT3), and mitochondrial quality control (MQC) pathways, demonstrating substantial therapeutic effects in multiple disease models. We provide a detailed account of the biosynthetic pathways, pharmacokinetics, and metabolic characteristics of RES, focusing on its role in mitophagy modulation and implications for medical applications. Potential adverse effects associated with its clinical use are also discussed. Despite its promising therapeutic properties, the clinical application of RES is limited by issues of bioavailability and pharmacokinetic profiles. Future research should concentrate on enhancing RES bioavailability and developing derivatives that precisely modulate mitophagy, thereby unlocking new avenues for disease therapy.

Clinical observations indicate an attenuation of giant negative T-waves (GNTWs) in some patients with apical hypertrophic cardiomyopathy (ApHCM), a condition frequently comorbid with type 2 diabetes mellitus (T2DM). The objective of this study was to examine the effect of T2DM on the GNTWs amplitude in ApHCM. A retrospective cohort of 124 ApHCM patients from Changzhou First People's Hospital (2021-2024) was categorized into T2DM (n = 30) and non-T2DM (n = 94) groups per American Diabetes Association criteria. A comparative analysis of baseline characteristics was conducted using Kruskal-Wallis and χ2 tests. The association between T2DM and maximal negative T-wave voltage (Tmax) was assessed via multivariable linear regression, while nonlinear relationships were explored with generalized additive models (GAM). The T2DM subgroup exhibited a higher prevalence of hypertension (83.3 % vs. 60.6 %, p = 0.022) and coronary artery disease (44.8 % vs. 19.4 %, p = 0.006). The T2DM group demonstrated significantly lower absolute magnitude of both R-waves [3.000 (2.118, 3.775) mV vs. 3.625 (2.615, 4.400) mV, p = 0.045] and GNTWs (Tmax) [- 0.600 (-0.700, 0.400) mV vs. -0.750 (-1.100, 0.500) mV, p = 0.016]. Multivariable analysis identified T2DM as an independent predictor of attenuated GNTWs (β = 0.272, p = 0.016). GAM confirmed a significant nonlinear inverse correlation between T2DM and T-wave amplitude (p < 0.05). In conclusion, T2DM is independently associated with lower absolute magnitude of GNTWs in ApHCM, potentially obscuring characteristic electrocardiographic features. It is incumbent upon clinicians to take these diabetes-related confounding effects into account during diagnostic evaluation.

OBJECTIVES:To assess the preliminary efficacy and safety of a dose-intensified C5VD regimen (cisplatin, 5-fluorouracil, vincristine, and doxorubicin) in children with locally advanced hepatoblastoma. METHODS:This prospective study enrolled 24 children with newly diagnosed, locally advanced hepatoblastoma who received the dose-intensified C5VD regimen at Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, and Shanghai Children's Hospital between January 2020 and December 2023. Clinical characteristics, treatment outcomes, and chemotherapy-related toxicities were analyzed. RESULTS:Of the 24 patients, 13 were male and 11 were female, with a median age at diagnosis of 18.7 months (range: 3.5-79.4 months). All patients achieved complete macroscopic resection of hepatic lesions without liver transplantation. Serum alpha-fetoprotein levels decreased significantly after two chemotherapy cycles. During a median follow-up of 38.4 months (range: 15.8-50.7 months), all patients maintained continuous complete remission, with 3-year event-free survival and overall survival rates of 100%. Across 144 chemotherapy cycles, the incidence rates of grade 3-4 neutropenia, thrombocytopenia, and infections were 97%, 77%, and 71%, respectively; no treatment-related deaths occurred. Notably, 5 patients (21%) developed Brock grade ≥3 hearing loss, of whom 1 required a hearing aid. CONCLUSIONS:The dose-intensified C5VD regimen demonstrates significant efficacy with an overall favorable safety profile in the treatment of newly diagnosed, locally advanced pediatric hepatoblastoma. Grade 3-4 myelosuppression and infection are the predominant toxicities. However, high‑dose cisplatin-induced ototoxicity remains a concern, highlighting the need for improved otoprotective strategies.

Whispering is a common adverse hearing condition. However, it is still unclear whether older adults have more difficulty perceiving emotions in whispered speech, and whether hearing loss contributes to these difficulties. To fill this research gap, we compared emotional prosody perception under phonated and whispered conditions in three groups of participants (younger adults, and older adults with and without hearing loss). The results revealed that both older adult groups were less accurate when processing emotions in whispered speech. Moreover, older adults with hearing loss performed worse than normal-hearing peers and younger adults in both phonated and whispered conditions. This study presented the first empirical data on the ability of older adults with hearing loss to recognize emotions in whispered speech. The findings highlighted the negative impact of whispering on emotional prosody recognition among older adults, with hearing loss exacerbating these difficulties.

To quantitatively assess the alterations in left atrial morphology and function in patients with asymptomatic type 2 diabetes mellitus (T2DM) via 4D-Auto Left Atrial Quantification analysis (4D Auto LAQ), investigate their correlation with diabetic nephropathy (DN), and evaluate the predictive value for major adverse cardiovascular event (MACE). A cohort of 449 asymptomatic T2DM patients was categorized into four groups: those without DN(G0) and those with DN, which was further subdivided into stages G1, G2, and G3. Through 4D-Auto LAQ analysis, we quantified the left atrial (LA) volume as well as the longitudinal and circumferential strains during the reservoir, conduit, and contraction phases. Additionally, we investigated the association between LA volume, strain parameters, and glomerular filtration rate (GFR). Among the participants, 190 patients in the DN group were followed up. The primary endpoint for follow-up was defined as the first occurrence of non-fatal acute myocardial infarction, stroke, congestive heart failure, or cardiac death. (1) Analysis of variance indicated no statistically significant differences in echocardiographic data for left ventricular size or function across groups. (2) Correlation analysis after multivariable adjustment revealed that the LA minimal volume index (LAVImin) increased with the progression of DN, while the absolute value of the LA strain index(reservoir and conduit period) decreased as renal damage worsened, exhibiting a highly significant correlation with the GFR (P < 0.01). (3) Univariate and multivariate Cox regression analyses revealed that: LAVmin, LASr, GFR, and HbA1c were associated with MACEs in patients with DN. Incorporating LAVmin and LASr into the basic model significantly enhanced the predictive value for MACEs in DN patients (with an area under the curve (AUC) of 0.818, sensitivity of 78.6

The estuarine area of Luanhe River is an important fisheries ground in China’s Bohai Sea. In 2016, Tangshan Marine Ranching Co., Ltd. constructed a 2 km2 artificial oyster–macroalgae reef area by placing artificial reefs on the seabed adjacent to the Luanhe River Estuary. This action resulted in sustainable annual economic outputs through the fishing and sea cucumber put-and-take fishery. Although Luanhe River runoff and reef construction are important to the local phytoplankton community and fisheries’ production, little is known about how these factors affect phytoplankton community structure in the local coastal ecosystem. In this study, we conducted field surveys to investigate the spatiotemporal variations in species composition, abundance, dominant species, diversity indexes, niche width and overlap, and interspecific connection of the phytoplankton community in the ecosystem of oyster–macroalgal reefs. From July 2016 to August 2017, we collected data before and after reef construction in areas inside and outside of the benthic reefs in both the flood and dry seasons of Luanhe River runoff. We found a total of 79 species, with the majority represented by diatoms and dinoflagellates. The dominant species were Paralia sulcata and Coscinodiscus sp. The total species number and abundance increased from May to September. The species number in the reef area was greater than that outside the reef. Species abundance from August to September was greater in the reef area than in the control area, which was opposite the situation from May to June. We found more phytoplankton abundance in the flood season compared with that in the dry season. Our results suggest that reef construction can benefit the local phytoplankton community and that further studies of the relationship among oysters, macroalgae, and phytoplankton in the system are warranted. Moreover, we provide baseline data about variations in the phytoplankton community in a sea ranch area.

INTRODUCTION:Hepatoblastoma (HB) with hepatocellular carcinoma (HCC) features (HBHF) is a rare liver malignancy. Due to its rarity and diverse histological presentations, the prognosis of HBHF remains controversial, and diagnostic differentiation poses significant challenges. To enable more accurate outcome evaluation and targeted therapeutic strategies, rapid, comprehensive, and cost-effective methods are needed to complement histopathological evaluation. METHODS:In this study, we conducted transcriptomic profiling on an HBHF cohort from our center and developed a machine-learning algorithm to quantify HCC-like expression features in HB tumors. Given overlapping histopathological and molecular charateristicss between HBHF and HCC, we further investigated shared risk factors associated with HBHF prognosis. RESULTS:Significantly poorer outcomes in HBHF patients suggest fundamental biological distinctions from classical HB. Transcriptomic analysis revealed comparable somatic mutation profiles between HB and HBHF cohorts but identified inflammation activation, rather than specific mutations, as a key high-risk factor in HBHF. Clinical outcomes aligned with risk stratification generated by our quantification model. CONCLUSIONS:HBHF represents a distinct transitional entity between HB and HCC, exhibiting markedly worse clinical outcomes than HB. Our transcriptome-based computational model effectively discriminates HBHF and predicts its prognostic risk. Importantly, inflammatory activation emerges as a critical driver of tumor aggressiveness in this subtype.

Rhabdomyosarcoma represents a prevalent type of soft tissue sarcoma encountered in pediatric patients. Despite multimodal intensified therapies encompassing surgical intervention, chemotherapy, and radiotherapy, the prognosis for patients with high-risk rhabdomyosarcoma remains notably unfavorable. To date, no definitive and efficacious molecularly targeted therapies have been established. This report describes the first documented case of a rhabdomyosarcoma patient harboring a positive BCR-ABL1 fusion gene. At the time of initial diagnosis, the patient presented with a primary tumor in the right thigh and extensive metastatic involvement affecting both lungs, pleura, mediastinum, pelvic cavity, and the right inguinal region, resulting in the classification of the case as high-risk. In addition to conventional multimodal therapy, early intervention using tyrosine kinase inhibitors was implemented, leading to the achievement of an early complete response.

Background : To explore the importance of a predictive model, we combined the proportion of time in atrial fibrillation (AF) recorded by 24-hour dynamic electrocardiogram (DCG) with left ventricular function data. This study evaluated the probability of premature recurrence following circumferential pulmonary vein ablation (CPVA) in individuals with paroxysmal atrial fibrillation (PAF). Methods : A total of 237 PAF patients who were scheduled to undergo the first CPVA were selected, and the following patient data were collected: (1) Transthoracic echocardiographic assessment of left ventricular ejection fraction (LVEF) using the biplane Simpson technique; (2) Atrial fibrillation burden parameters obtained by 24-hour DCG, including the total time of AF, number of AF arrays, and proportion of time in AF; (3) Based on DCG findings obtained 3-6 months post-procedure, participants were categorized into either the sinus rhythm cohort or the recurrence cohort. Multivariate logistic regression analysis was subsequently performed to identify significant predictors influencing PAF recurrence following CPVA intervention; (4) An integrated forecasting framework was developed, with predictive capabilities evaluated through receiver operating characteristic (ROC) curve assessments to determine model efficacy. Results : (1) Among 224 participants undergoing CPVA for PAF, follow-up assessments at 3-6 months identified 20 cases (8.9%) with arrhythmia recurrence. Comparative analysis revealed elevated values for brain natriuretic peptide (BNP), left ventricular diastolic dimension (LVDD), SDNN Index (representing two R waves, RR interval variability), and atrial fibrillation burden in the recurrence cohort versus those maintaining sinus rhythm (all p < 0.05). Conversely, the recurrence group demonstrated reduced LVEF, minimum heart rate (MinHR), maximun heart rate (MaxHR), and minute meter slowest heart rate compared to the rhythm-controlled population (all p < 0.05). (2) Multivariate logistic regression analysis showed that BNP, MaxHR, and proportion of time in AF were independent influencing factors for PAF recurrence (all p < 0.05). (3) An integrated forecasting framework incorporating biomarkers including BNP, LVEF, and atrial fibrillation burden metrics was developed. Receiver operating characteristic analysis demonstrated superior predictive capability for the composite model (area under the curve, AUC = 0.874) when compared to atrial fibrillation burden assessment alone (AUC = 0.744) (p = 0.014). Conclusion : The proportion of time in AF combined with LVEF has good predictive value for early recurrence in PAF patients after CPVA.

In the present study, we aimed to explore the association between left atrial appendage emptying velocity (LAAEV) measured by transesophageal echocardiography and atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA) in patients with early persistent atrial fibrillation (PeAF). We retrospectively analyzed patients with early PeAF who underwent their initial ablation procedure. The echocardiographic and clinical data of the enrolled patients were collected and recorded prior to the operation. Following adjustment for confounding factors, we investigated the relationship between the LAAEV and AF recurrence in patients with early PeAF after radiofrequency ablation. The proportions of AF recurrence in the low, medium, and high LAAEV groups were 48.8