834 results on '"Joao A.C. Lima"'
Search Results
2. Hepatocyte Growth Factor and 10-Year Change in Left Ventricular Structure: The Multi-Ethnic Study of Atherosclerosis (MESA)
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Richard A. Ferraro, Oluseye Ogunmoroti, Di Zhao, Chiadi E. Ndumele, Joao A.C. Lima, Vinithra Varadarajan, Vinita Subramanya, Ambarish Pandey, Nicholas B. Larson, Suzette J. Bielinski, and Erin D. Michos
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Cardiology and Cardiovascular Medicine - Published
- 2023
3. Associations of urinary isoprostanes with measures of subclinical atherosclerosis: The Multi-Ethnic Study of Atherosclerosis (MESA)
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Ryan L. Wallace, Oluseye Ogunmoroti, Di Zhao, Dhananjay Vaidya, Amir Heravi, Eliseo Guallar, Chiadi E. Ndumele, Joao A.C. Lima, Pamela Ouyang, Matthew J. Budoff, Matthew Allison, Isac Thomas, Oluwaseun E. Fashanu, Ron Hoogeveen, Wendy S. Post, and Erin D. Michos
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Aging ,Heart Disease ,Good Health and Well Being ,Clinical Research ,Prevention ,Internal Medicine ,Atherosclerosis ,Cardiovascular ,Cardiology and Cardiovascular Medicine ,Heart Disease - Coronary Heart Disease - Abstract
BackgroundUrinary isoprostanes are markers of systemic oxidative stress, which is implicated in the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). Coronary artery calcium (CAC), thoracic aortic calcium (TAC) and carotid plaque are measure subclinical atherosclerosis and prognosticate ASCVD risk. We examined the associations between urinary isoprostane levels and measures of plaque prevalence, burden, incidence and progression across three vascular beds in a cohort from the Multi-Ethnic Study of Atherosclerosis.MethodsUrinary levels of 8-isoprostane and 2,3-dinor-8-F2-isoprostane were measured in 1089 participants (mean±SD 62±8 years, 48% women) at baseline. Participants underwent computed tomography for CAC and TAC, and duplex ultrasound for carotid plaque. TAC and CAC were reassessed at 2.4 and 10 years, respectively. Regression models were adjusted for CVD risk factors.ResultsIn adjusted models, there were no significant associations between isoprostane levels with CAC prevalence or progression. Highest versus lowest tertile of 8-isoprostane was associated with 28% lower prevalence of descending TAC at baseline [prevalence ratio (PR) 0.72 95% CI (0.56, 0.94)], while 1-SD higher 2,3-dinor-8-F2-isoprostane was associated with 96% higher incident ascending TAC at follow-up [Relative Risk 1.96 (1.24, 3.09)]. Highest versus lowest tertile of isoprostane measures were associated with 22% higher prevalence of carotid plaque [(PR 1.22 (1.04, 1.45)] and 14% difference [3,26] in greater extent of carotid plaque at baseline.ConclusionsHigher urinary isoprostanes were inconsistently associated with some measures of subclinical atherosclerosis by imaging. This suggests a limited role of urinary isoprostane levels as a prognostic marker for the development of ASCVD.Trial registrationThe MESA cohort design is registered at clinicaltrials.gov as follows: https://clinicaltrials.gov/ct2/show/NCT00005487.
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- 2023
4. Oxidative Stress and Menopausal Status: The Coronary Artery Risk Development in Young Adults Cohort Study
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Amir S. Heravi, Erin D. Michos, Di Zhao, Bharath Ambale-Venkatesh, Henrique Doria De Vasconcellos, Donald Lloyd-Jones, Pamela J. Schreiner, Jared P. Reis, Colin Wu, Cora E. Lewis, James M. Shikany, Stephen Sidney, Eliseo Guallar, Chiadi E. Ndumele, Pamela Ouyang, Ron C. Hoogeveen, Joao A.C. Lima, Dhananjay Vaidya, and Wendy S. Post
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Cohort Studies ,Oxidative Stress ,Young Adult ,Cardiovascular Diseases ,Creatinine ,Humans ,Female ,General Medicine ,Original Articles ,Menopause ,Coronary Vessels ,Aged - Abstract
BACKGROUND: Low endogenous estrogen concentrations after menopause may contribute to higher oxidative stress and greater cardiovascular disease (CVD) risk. However, differences in oxidative stress between similarly aged premenopausal and postmenopausal women are not well-characterized on a population level. We hypothesized that urinary isoprostane concentrations, a standard measure of systemic oxidative stress, are higher in women who have undergone menopause compared to premenopausal women. METHODS AND RESULTS: We examined differences in urinary 8-isoprostane (iPF(2α)-III) and 2,3-dinor-8-isoprostane (iPF(2α)-III-M) indexed to urinary creatinine between 279 postmenopausal and 196 premenopausal women in the Coronary Artery Risk Development in Young Adults (CARDIA) study, using linear regression with progressive adjustment for sociodemographic factors and traditional CVD risk factors. Unadjusted iPF(2α)-III-M concentrations were higher among postmenopausal compared to premenopausal women (Median [25th, 75th percentile]: 1762 [1178, 2974] vs. 1535 [1067, 2462] ng/g creatinine; p = 0.01). Menopause was associated with 25.5% higher iPF(2α)-III-M (95% confidence interval [6.5–47.9]) adjusted for age, race, college education, and field center. Further adjustments for tobacco use (21.2% [2.9–42.6]) and then CVD risk factors (18.8% [0.1–39.6]) led to additional partial attenuation. Menopause was associated with higher iPF(2α)-III in Black but not White women. CONCLUSIONS: We conclude that postmenopausal women had higher oxidative stress, which may contribute to greater CVD risk. ClinicalTrials.gov Identifier: NCT00005130.
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- 2023
5. Perivascular fat attenuation for predicting adverse cardiac events in stable patients undergoing invasive coronary angiography
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Devina Chatterjee, Benjamin L. Shou, Matthew B. Matheson, Mohammad R. Ostovaneh, Carlos Rochitte, Marcus Y. Chen, Marc Dewey, Jason Ortman, Christopher Cox, Joao A.C. Lima, and Armin Arbab-Zadeh
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Adipose Tissue ,Predictive Value of Tests ,Computed Tomography Angiography ,Humans ,Radiology, Nuclear Medicine and imaging ,Coronary Artery Disease ,Middle Aged ,Coronary Angiography ,Cardiology and Cardiovascular Medicine ,Coronary Vessels - Abstract
Inflammation surrounding the coronary arteries can be non-invasively assessed using pericoronary adipose tissue attenuation (PCAT). While PCAT holds promise for further risk stratification of patients with low coronary artery disease (CAD) prevalence, its value in higher risk populations remains unknown.CORE320 enrolled patients referred for invasive coronary angiography with known or suspected CAD. Coronary computed tomography angiography (CCTA) images were collected for 381 patients for whom clinical outcomes were assessed 5 years after enrollment. Using semi-automated image analysis software, PCAT was obtained and normalized for the right coronary (RCA), left anterior descending (LAD), and left circumflex arteries (LCx). The association between PCAT and major adverse cardiovascular events (MACE) during follow up was assessed using Cox regression models.Thirty-seven patients were excluded due to technical failure. For the remaining 344 patients, median age was 62 (interquartile range, 55-68) with 59% having ≥1 coronary artery stenosis of ≥50% by quantitative coronary angiography. Mean attenuation values for PCAT in RCA, LAD, and LCx were -74.9, -74.2, and -71.2, respectively. Hazard ratios and 95% confidence intervals (CI) for normalized PCAT in the RCA, LAD, and LCx for MACE were 0.96 (CI: 0.75-1.22, p = 0.71), 1.31 (95% CI: 0.96-1.78, p = 0.09), and 0.98 (95% CI: 0.78-1.22, p = 0.84), respectively. For death, stroke, or myocardial infarction only, hazard ratios were 0.68 (0.44-1.07), 0.85 (0.56-1.29), and 0.57 (0.41-0.80), respectively.In patients referred for invasive coronary angiography with suspected CAD, PCAT did not predict MACE during long term follow up. Further studies are needed to understand the relationship of PCAT with CAD risk.
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- 2022
6. Technical Considerations for Dynamic Myocardial Computed Tomography Perfusion as Part of a Comprehensive Evaluation of Coronary Artery Disease Using Computed Tomography
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Mathias B. Møller, Joanne D. Schuijf, Noriko Oyama-Manabe, Jesper J. Linde, Jørgen T. Kühl, Joao A.C. Lima, and Klaus F. Kofoed
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Pulmonary and Respiratory Medicine ,Radiology, Nuclear Medicine and imaging - Published
- 2022
7. Supranormal Left Ventricular Ejection Fraction, Stroke Volume, and Cardiovascular Risk
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Sonia Shah, Matthew W. Segar, Nitin Kondamudi, Colby Ayers, Alvin Chandra, Susan Matulevicius, Kartik Agusala, Ron Peshock, Suhny Abbara, Erin D. Michos, Mark H. Drazner, Joao A.C. Lima, W.T. Longstreth, and Ambarish Pandey
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Cardiology and Cardiovascular Medicine - Published
- 2022
8. Resistin and risks of incident heart failure subtypes and cardiac fibrosis: the Multi‐Ethnic Study of Atherosclerosis
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Xinjiang Cai, Matthew A. Allison, Bharath Ambale‐Venkatesh, Neal W. Jorgensen, Joao A.C. Lima, Evan D. Muse, Robyn L. McClelland, Steven Shea, and Djamel Lebeche
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Male ,Heart Failure ,Aging ,Cardiac fibrosis ,Prevention ,Stroke Volume ,Heart failure ,Middle Aged ,Cardiorespiratory Medicine and Haematology ,Atherosclerosis ,Cardiovascular ,Fibrosis ,Troponin ,Heart Disease ,Cardiovascular Diseases ,Clinical Research ,Ethnicity ,Humans ,2.1 Biological and endogenous factors ,Female ,Resistin ,Aetiology ,Cardiology and Cardiovascular Medicine ,Biomarkers - Abstract
AimsResistin is a circulating inflammatory biomarker that is associated with cardiovascular disease. We investigated the associations of resistin and incident heart failure (HF) and its subtypes, as well as specific measures of subclinical HF (myocardial fibrosis and relevant biomarkers).MethodsWe analysed data from 1968 participants in the Multi-Ethnic Study of Atherosclerosis with measurements of plasma resistin levels at clinic visits from 2002 to 2005. Participants were subsequently followed for a median of 10.5years for HF events. The associations between resistin levels and incident HF, HF with reduced ejection fraction (HFrEF), and HF with preserved ejection fraction (HFpEF) were examined using multivariable Cox proportional hazards models. Linear regression models assessed the associations between resistin levels and myocardial fibrosis from cardiac magnetic resonance imaging, as well as hs-cTnT and NT-proBNP.ResultsThe mean age of the cohort was 64.7years, and 50.0% were female. Seventy-four participants (4%) developed incident HF during follow-up. In a Cox proportional hazards model adjusted for age, gender, education level, race/ethnicity, and traditional risk factors, higher resistin levels were significantly associated with incident HF (HR 1.44, CI 1.18-1.75, P=0.001) and HFrEF (HR 1.47, CI 1.07-2.02, P=0.016), but not with HFpEF (HR 1.25, CI 0.89-1.75, P=0.195). Resistin levels showed no significant associations with myocardial fibrosis, NT-proBNP, or hs-cTnT levels.ConclusionsIn a multi-ethnic cohort free of cardiovascular disease at baseline, elevated resistin levels were associated with incident HF, more prominently with incident HFrEF than HFpEF, but not with subclinical myocardial fibrosis or biomarkers of HF.
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- 2022
9. Insulin Resistance Is Associated with Right Ventricular Dysfunction
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Wei Yang, Mary E. Putt, Alain G. Bertoni, Sanjiv J. Shah, Lauren Beussink-Nelson, Benjamin H. Freed, Joao A.C. Lima, R. Graham Barr, Steven M. Kawut, Jeff Min, and Nadine Al-Naamani
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Pulmonary and Respiratory Medicine ,Adult ,medicine.medical_specialty ,Ventricular function ,business.industry ,Ventricular Dysfunction, Right ,medicine.disease ,Right ventricular dysfunction ,medicine.anatomical_structure ,Insulin resistance ,Ventricle ,Echocardiography ,Internal medicine ,medicine ,Cardiology ,Ventricular Function, Right ,Humans ,Insulin Resistance ,business ,Retrospective Studies ,Original Research - Abstract
RATIONALE: The effect of insulin resistance on left ventricular function is well documented; however, less is known regarding its effect on the right ventricle (RV). OBJECTIVES: To evaluate the association between insulin resistance and RV function by echocardiography in a cohort of adults without baseline cardiovascular disease. METHODS: We performed a retrospective cohort study in the MESA (Multi-Ethnic Study of Atherosclerosis). Linear regression was used to examine the association between overall insulin resistance measured by the mean triglyceride (TG) to high-density lipoprotein (HDL) cholesterol ratio (TG:HDL) and change in TG:HDL over time for each participant with echocardiographic RV function. Logistic regression was used to calculate the odds ratios (ORs) of RV systolic and diastolic dysfunction. RESULTS: Among 3,032 participants, higher mean TG:HDL was associated with lower (worse) absolute RV longitudinal strain (β, −0.38; 95% confidence interval [CI], −0.64 to −0.13; P
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- 2023
10. Evaluation of liver T1 using MOLLI gradient echo readout under the influence of fat
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Chia Ying Liu, Chikara Noda, Joao A.C. Lima, Bharath Ambale-Venkatesh, David A. Bluemke, and Yoshimori Kassai
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Adult ,Physics ,Phantoms, Imaging ,Liver fibrosis ,Biomedical Engineering ,Biophysics ,Reproducibility of Results ,Inversion recovery ,Middle Aged ,Magnetic Resonance Imaging ,Imaging phantom ,Out of phase ,Nuclear magnetic resonance ,Liver ,Linear Models ,Humans ,Female ,Radiology, Nuclear Medicine and imaging ,Fat fraction ,Gradient echo - Abstract
The effect of hepatic steatosis on the gradient-echo (GRE) based Modified Look-Locker Inversion Recovery (MOLLI) technique for T1 mapping has not been evaluated. The purpose of this study was to evaluate a GRE based MOLLI technique for hepatic T1 mapping and determine the relationship of T1 differences (ΔT1) on in-phase (IP) and out-of-phase (OP) to fat fraction (FF) measurement.3 T MRI included MOLLI T1 mapping with TE = 1.3 (OP), 2.4 (IP), and 1.8 ms, and chemical-shift-encoded sequence with spectral modeling of fat to generate FF map as a reference. Bloch simulations and oil/water phantoms were used to characterize the response of the MOLLI T1 in various FF 30% since MOLLI T1 estimation was erratic beyond this limit. Curve fit between ΔT1 and FF from simulation was applied to validate the phantom and the in-vivo results. Thirty-eight normal volunteers were included (16 women, Age 44 ± 12 years, BMI 27 ± 5.3 kg/mPhantom results were consistent with the Bloch simulations. The simulated relationship between FF (0-30%) and ΔT1 could be modeled precisely by a cubic equation with R2 = 1. In-vivo MOLLI ΔT1 and estimated FF were correlated to the reference FF (both R2 ≥ 0.96 and P 0.001). TE = 1.8 ms demonstrated less T1 bias (-1.34%) compared to TE = OP (5.32%) or IP (-3.8%, both P 0.001).At 3 T, TE of 1.8 ms can be used to reduce the T1 bias and deliver consistent T1 values when FF is30%.
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- 2022
11. Physical activity and the progression of coronary artery calcification
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Seung Jae Lee, Di Zhao, Joao A.C. Lima, Yun Soo Hong, Juhee Cho, Seungho Ryu, Ki Chul Sung, Eliseo Guallar, Jong-Young Lee, and Yoosoo Chang
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Adult ,Male ,medicine.medical_specialty ,Physical activity ,Coronary Artery Disease ,Coronary Angiography ,Coronary artery disease ,Primary outcome ,Risk Factors ,Coronary Circulation ,Internal medicine ,Multidetector Computed Tomography ,Republic of Korea ,Prevalence ,medicine ,Humans ,Prospective Studies ,Vascular Calcification ,Prospective cohort study ,Exercise ,Health screening ,business.industry ,medicine.disease ,Coronary Vessels ,Confidence interval ,Coronary artery calcium ,Coronary artery calcification ,Disease Progression ,Calcium ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
BackgroundThe association of physical activity with the development and progression of coronary artery calcium (CAC) scores has not been studied. This study aimed to evaluate the prospective association between physical activity and CAC scores in apparently healthy adults.MethodsProspective cohort study of men and women free of overt cardiovascular disease who underwent comprehensive health screening examinations between 1 March 2011 and 31 December 2017. Baseline physical activity was measured using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and categorised into three groups (inactive, moderately active and health-enhancing physically active (HEPA)). The primary outcome was the difference in the 5-year change in CAC scores by physical activity category at baseline.ResultsWe analysed 25 485 participants with at least two CAC score measurements. The proportions of participants who were inactive, moderately active and HEPA were 46.8%, 38.0% and 15.2%, respectively. The estimated adjusted average baseline CAC scores (95% confidence intervals) in participants who were inactive, moderately active and HEPA were 9.45 (8.76, 10.14), 10.20 (9.40, 11.00) and 12.04 (10.81, 13.26). Compared with participants who were inactive, the estimated adjusted 5-year average increases in CAC in moderately active and HEPA participants were 3.20 (0.72, 5.69) and 8.16 (4.80, 11.53). Higher physical activity was association with faster progression of CAC scores both in participants with CAC=0 at baseline and in those with prevalent CAC.ConclusionWe found a positive, graded association between physical activity and the prevalence and the progression of CAC, regardless of baseline CAC scores.
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- 2021
12. Right ventricular function as assessed by cardiac magnetic resonance imaging‐derived strain parameters compared to high‐fidelity micromanometer catheter measurements
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Paul M. Hassoun, Ryan J. Tedford, Todd M. Kolb, Rubina M. Khair, Tomoki Fujii, Ela Chamera, Steven Hsu, Stefan L. Zimmerman, David A. Kass, Catherine E. Simpson, Ichizo Tsujino, Rachel L. Damico, Stephen C. Mathai, Christopher J Mullin, Bharath Ambale-Venkatesh, Takahiro Sato, Joao A.C. Lima, Celia P. Corona-Villalobos, Valentina Mercurio, Sato, Takahiro, Ambale-Venkatesh, Bharath, Zimmerman, Stefan L, Tedford, Ryan J, Hsu, Steven, Chamera, Ela, Fujii, Tomoki, Mullin, Christopher J, Mercurio, Valentina, Khair, Rubina, Corona-Villalobos, Celia P, Simpson, Catherine E, Damico, Rachel L, Kolb, Todd M, Mathai, Stephen C, Lima, Joao A C, Kass, David A, Tsujino, Ichizo, and Hassoun, Paul M
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Diseases of the respiratory system ,Cardiac magnetic resonance imaging ,pulmonary arterial hypertension ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,In patient ,Original Research Article ,tau ,cardiovascular diseases ,RC705-779 ,medicine.diagnostic_test ,Strain (chemistry) ,Ventricular function ,business.industry ,strain and strain rate ,right ventricular failure ,pressure volume loop ,Strain rate ,medicine.disease ,Pulmonary hypertension ,Catheter ,RC666-701 ,cardiovascular system ,Cardiology ,business ,Cardiac magnetic resonance - Abstract
Right ventricular function has prognostic significance in patients with pulmonary hypertension. We evaluated whether cardiac magnetic resonance-derived strain and strain rate parameters could reliably reflect right ventricular systolic and diastolic function in precapillary pulmonary hypertension. End-systolic elastance and the time constant of right ventricular relaxation tau, both derived from invasive high-fidelity micromanometer catheter measurements, were used as gold standards for assessing systolic and diastolic right ventricular function, respectively. Nineteen consecutive precapillary pulmonary hypertension patients underwent cardiac magnetic resonance and right heart catheterization prospectively. Cardiac magnetic resonance data were compared with those of 19 control subjects. In pulmonary hypertension patients, associations between strain- and strain rate-related parameters and invasive hemodynamic parameters were evaluated. Longitudinal peak systolic strain, strain rate, and early diastolic strain rate were lower in PAH patients than in controls; peak atrial-diastolic strain rate was higher in pulmonary hypertension patients. Similarly, circumferential peak systolic strain rate was lower and peak atrial-diastolic strain rate was higher in pulmonary hypertension. In pulmonary hypertension, no correlations existed between cardiac magnetic resonance-derived and hemodynamically derived measures of systolic right ventricular function. Regarding diastolic parameters, tau was significantly correlated with peak longitudinal atrial-diastolic strain rate ( r = −0.61), deceleration time ( r = 0.75), longitudinal systolic to diastolic time ratio ( r = 0.59), early diastolic strain rate ( r = −0.5), circumferential peak atrial-diastolic strain rate ( r = −0.52), and deceleration time ( r = 0.62). Strain analysis of the right ventricular diastolic phase is a reliable non-invasive method for detecting right ventricular diastolic dysfunction in PAH.
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- 2021
13. Left Atrioventricular Coupling Index as a Prognostic Marker of Cardiovascular Events: The MESA Study
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Norrina B. Allen, Henrique Doria de Vasconcellos, Joao A.C. Lima, Bharath Ambale Venkatesh, Susan R. Heckbert, Théo Pezel, Yoko Kato, Steven J Shea, Eric Xie, David A. Bluemke, Wendy S. Post, Mahsima Shabani, Colin O. Wu, and Karol E. Watson
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education.field_of_study ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Population ,Hazard ratio ,Atrial fibrillation ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Left atrial ,Internal medicine ,Heart failure ,Internal Medicine ,Cardiology ,Medicine ,030212 general & internal medicine ,Myocardial infarction ,business ,education - Abstract
Both left atrial and left ventricular functional parameters influence the prognosis of patients with cardiovascular diseases. This study aimed to investigate the prognostic value of a novel left atrioventricular coupling index (LACI) in a population without history of cardiovascular diseases at baseline. Participants of the Multi-Ethnic Study of Atherosclerosis who underwent a baseline cardiovascular magnetic resonance study were analyzed. LACI was defined by the ratio of the left atrial end-diastolic volume divided by the left ventricular end-diastolic volume. Cox proportional hazard models were used to evaluate the association between LACI and atrial fibrillation, heart failure, coronary heart disease death, and hard cardiovascular disease defined by myocardial infarction, resuscitated cardiac arrest, fatal and nonfatal stroke, or coronary heart disease death. Among the 4124 participants (61.5±10.1 years, 47.4% men), 1074 cardiovascular events were observed (mean follow-up, 13.0±3.2 years). Greater LACI was independently associated with atrial fibrillation (hazard ratio, 1.86 [95% CI, 1.69–2.04]), heart failure (hazard ratio, 1.50 [95% CI, 1.38–1.62]), hard cardiovascular disease (1.23 [95% CI, 1.13–1.34]), and coronary heart disease death (hazard ratio, 1.29 [95% CI, 1.15–1.45]; all P
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- 2021
14. Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a primary prevention study
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Michael Y. Tsai, Christie M. Ballantyne, Isha Lamba, John T. Wilkins, Seth S. Martin, Roger S. Blumenthal, Stephen J. Nicholls, Renato Quispe, Steven R. Jones, Rishi Puri, Anum Saeed, Sarah Nomura, Mohamed B. Elshazly, Erin D Michos, and Joao A.C. Lima
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Adult ,medicine.medical_specialty ,Percentile ,Apolipoprotein B ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Clinical Research ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Young adult ,Aged ,Apolipoproteins B ,biology ,Cholesterol ,business.industry ,Proportional hazards model ,Cholesterol, HDL ,Hazard ratio ,Middle Aged ,Confidence interval ,Primary Prevention ,chemistry ,Cardiovascular Diseases ,biology.protein ,Cardiology ,Female ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Emerging evidence suggests that remnant cholesterol (RC) promotes atherosclerotic cardiovascular disease (ASCVD). We aimed to estimate RC-related risk beyond low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) in patients without known ASCVD. Methods and results We pooled data from 17 532 ASCVD-free individuals from the Atherosclerosis Risk in Communities study (n = 9748), the Multi-Ethnic Study of Atherosclerosis (n = 3049), and the Coronary Artery Risk Development in Young Adults (n = 4735). RC was calculated as non-high-density lipoprotein cholesterol (non-HDL-C) minus calculated LDL-C. Adjusted Cox models were used to estimate the risk for incident ASCVD associated with log RC levels. We also performed discordance analyses examining relative ASCVD risk in RC vs. LDL-C discordant/concordant groups using difference in percentile units (>10 units) and clinically relevant LDL-C targets. The mean age of participants was 52.3 ± 17.9 years, 56.7% were women and 34% black. There were 2143 ASCVD events over the median follow-up of 18.7 years. After multivariable adjustment including LDL-C and apoB, log RC was associated with higher ASCVD risk [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.45–1.89]. Moreover, the discordant high RC/low LDL-C group, but not the low RC/high LDL-C group, was associated with increased ASCVD risk compared to the concordant group (HR 1.21, 95% CI 1.08–1.34). Similar results were shown when examining discordance across clinical cutpoints. Conclusions In ASCVD-free individuals, elevated RC levels were associated with ASCVD independent of traditional risk factors, LDL-C, and apoB levels. The mechanisms of RC association with ASCVD, surprisingly beyond apoB, and the potential value of targeted RC-lowering in primary prevention need to be further investigated.
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- 2021
15. Randomized, Placebo-Controlled Phase 2b Study to Evaluate the Safety and Efficacy of Recombinant Human Lecithin Cholesterol Acyltransferase in Acute ST-Segment-Elevation Myocardial Infarction: Results of REAL-TIMI 63B
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Marc P. Bonaca, David A. Morrow, Brian A. Bergmark, David D. Berg, Joao A.C. Lima, Udo Hoffmann, Yoko Kato, Michael T. Lu, Julia Kuder, Sabina A. Murphy, Jindrich Spinar, Ton Oude Ophuis, Róbert G. Kiss, Jose Lopez-Sendon, Oleg Averkov, Stephen B. Wheatcroft, Jacek Kubica, Jose Carlos Nicolau, Remo H.M. Furtado, Liron Abuhatzira, Boaz Hirshberg, Sami A. Omar, Andrea L. Vavere, Yi-Ting Chang, Richard T. George, and Marc S. Sabatine
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Male ,Middle Aged ,Phosphatidylcholine-Sterol O-Acyltransferase ,Cholesterol ,Treatment Outcome ,Physiology (medical) ,Lecithins ,Humans ,ST Elevation Myocardial Infarction ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,Lipoproteins, HDL ,Anterior Wall Myocardial Infarction ,Sterol O-Acyltransferase - Abstract
Background: High-density lipoprotein plays a key role in reverse cholesterol transport. In addition, high-density lipoprotein particles may be cardioprotective and reduce infarct size in the setting of myocardial injury. Lecithin-cholesterol acyltransferase is a rate-limiting enzyme in reverse cholesterol transport. MEDI6012 is a recombinant human lecithin-cholesterol acyltransferase that increases high-density lipoprotein cholesterol. Administration of lecithin-cholesterol acyltransferase has the potential to reduce infarct size and regress coronary plaque in acute ST-segment–elevation myocardial infarction. Methods: REAL-TIMI 63B (A Randomized, Placebo‑controlled Phase 2b Study to Evaluate the Safety and Efficacy of MEDI6012 in Acute ST Elevation Myocardial Infarction) was a phase 2B multinational, placebo-controlled, randomized trial. Patients with ST-segment–elevation myocardial infarction within 6 hours of symptom onset and planned for percutaneous intervention were randomly assigned 2:1 to MEDI6012 (2- or 6-dose regimen) or placebo and followed for 12 weeks. The primary outcome was infarct size as a percentage of left ventricular mass by cardiac MRI at 10 to 12 weeks, with the primary analysis in patients with TIMI Flow Grade 0 to 1 before percutaneous intervention who received at least 2 doses of MEDI6012. The secondary outcome was change in noncalcified plaque volume on coronary computed tomographic angiography from baseline to 10 to 12 weeks with the primary analysis in patients who received all 6 doses of MEDI6012. Results: A total of 593 patients were randomly assigned. Patients were a median of 62 years old, 77.9% male, and 95.8% statin naive. Median time from symptom onset to randomization was 146 (interquartile range [IQR], 103–221) minutes and from hospitalization to randomization was 12.7 (IQR, 6.6–24.0) minutes, and the first dose of drug was administered a median of 8 (IQR, 3–13) minutes before percutaneous intervention. The index myocardial infarction was anterior in 69.6% and TIMI Flow Grade 0 to 1 in 65.1% of patients. At 12 weeks, infarct size did not differ between treatment groups (MEDI6012: 9.71%, IQR 4.79–16.38; placebo: 10.48%, [IQR, 4.92–16.61], 1-sided P =0.79. There was also no difference in noncalcified plaque volume (geometric mean ratio, 0.96 [95% CI, NA–1.10], 1-sided P =0.30). There was no significant difference in treatment emergent serious adverse events. Conclusions: Administration of MEDI6012 in patients with acute ST-segment–elevation myocardial infarction did not result in a significant reduction in infarct size or noncalcified plaque volume at 12 weeks. MEDI6012 was well tolerated with no excess in overall serious adverse events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03578809.
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- 2022
16. Racial and Ethnic Differences in All-Cause and Cardiovascular Disease Mortality: The MESA Study
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Wendy S. Post, Karol E. Watson, Spencer Hansen, Aaron R. Folsom, Moyses Szklo, Steven Shea, R. Graham Barr, Gregory Burke, Alain G. Bertoni, Norrina Allen, James S. Pankow, Joao A.C. Lima, Jerome I. Rotter, Joel D. Kaufman, W. Craig Johnson, Richard A. Kronmal, Ana V. Diez-Roux, and Robyn L. McClelland
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Adult ,Cardiovascular Diseases ,Risk Factors ,Social Determinants of Health ,Physiology (medical) ,Ethnic and Racial Minorities ,Ethnicity ,Humans ,Health Status Disparities ,Hispanic or Latino ,Cardiology and Cardiovascular Medicine ,White People - Abstract
Background: Despite improvements in population health, marked racial and ethnic disparities in longevity and cardiovascular disease (CVD) mortality persist. This study aimed to describe risks for all-cause and CVD mortality by race and ethnicity, before and after accounting for socioeconomic status (SES) and other factors, in the MESA study (Multi-Ethnic Study of Atherosclerosis). Methods: MESA recruited 6814 US adults, 45 to 84 years of age, free of clinical CVD at baseline, including Black, White, Hispanic, and Chinese individuals (2000–2002). Using Cox proportional hazards modeling with time-updated covariates, we evaluated the association of self-reported race and ethnicity with all-cause and adjudicated CVD mortality, with progressive adjustments for age and sex, SES (neighborhood SES, income, education, and health insurance), lifestyle and psychosocial risk factors, clinical risk factors, and immigration history. Results: During a median of 15.8 years of follow-up, 22.8% of participants (n=1552) died, of which 5.3% (n=364) died of CVD. After adjusting for age and sex, Black participants had a 34% higher mortality hazard (hazard ratio [HR], 1.34 [95% CI, 1.19–1.51]), Chinese participants had a 21% lower mortality hazard (HR, 0.79 [95% CI, 0.66–0.95]), and there was no mortality difference in Hispanic participants (HR, 0.99 [95% CI, 0.86–1.14]) compared with White participants. After adjusting for SES, the mortality HR for Black participants compared with White participants was reduced (HR, 1.16 [95% CI, 1.01–1.34]) but still statistically significant. With adjustment for SES, the mortality hazards for Chinese and Hispanic participants also decreased in comparison with White participants. After further adjustment for additional risk factors and immigration history, Hispanic participants (HR, 0.77 [95% CI, 0.63–0.94]) had a lower mortality risk than White participants, and hazard ratios for Black participants (HR, 1.08 [95% CI, 0.92–1.26]) and Chinese participants (HR, 0.81 [95% CI, 0.60–1.08]) were not significantly different from those of White participants. Similar trends were seen for CVD mortality, although the age- and sex-adjusted HR for CVD mortality for Black participants compared with White participants was greater than all-cause mortality (HR, 1.72 [95% CI, 1.34–2.21] compared with HR, 1.34 [95% CI, 1.19–1.51]). Conclusions: These results highlight persistent racial and ethnic differences in overall and CVD mortality, largely attributable to social determinants of health, and support the need to identify and act on systemic factors that shape differences in health across racial and ethnic groups.
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- 2022
17. Association between proteomic biomarkers and myocardial fibrosis measured by MRI: the multi-ethnic study of atherosclerosis
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Hooman Bakhshi, Sam A. Michelhaugh, Scott A. Bruce, Stephen L. Seliger, Xiaoxiao Qian, Bharath Ambale Venkatesh, Vinithra Varadarajan, Pramita Bagchi, Joao A.C. Lima, and Christopher deFilippi
- Subjects
General Medicine ,General Biochemistry, Genetics and Molecular Biology - Published
- 2023
18. Associations between menopause, cardiac remodeling, and diastolic function: the CARDIA study
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Pamela J. Schreiner, Jared P. Reis, Stephen Sidney, Vinita Subramanya, Pamela Ouyang, Erin D. Michos, Henrique Doria de Vasconcellos, Bharath Ambale-Venkatesh, Donald M. Lloyd-Jones, Wendy S. Post, Cora E. Lewis, Joao A.C. Lima, Wendy Ying, Chike C. Nwabuo, Dhananjay Vaidya, and Chiadi E Ndumele
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Male ,medicine.medical_specialty ,General Mathematics ,Doppler echocardiography ,Ventricular Dysfunction, Left ,Young Adult ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Young adult ,Heart Failure ,Ventricular Remodeling ,medicine.diagnostic_test ,business.industry ,Applied Mathematics ,Obstetrics and Gynecology ,Stroke Volume ,medicine.disease ,Menopause ,Cross-Sectional Studies ,medicine.anatomical_structure ,Blood pressure ,Cardiology ,Female ,Heart failure with preserved ejection fraction ,business ,Body mass index ,Artery - Abstract
Heart failure with preserved ejection fraction (HFpEF) affects more women than men. Menopause may influence HFpEF development in women. We assessed cross-sectional and longitudinal associations between menopause and echocardiographic measures of left ventricular (LV) function and cardiac remodeling.We studied 1,723 women with available echo data from at least two of: year 5 (Y5) (1990-1991), Y25 (2010-2011), or Y30 (2015-2016) in the Coronary Artery Risk Development in Young Adults study. Cardiac structure and function were measured using 2D and Doppler echocardiography. Cross-sectional associations between menopausal status and repeated echo measures at Y25 and Y30 were analyzed using linear mixed models. Two-segmented models were used to compare longitudinal changes in echocardiographic measures in the premenopausal period to changes in the postmenopausal period.Mean ± SD age (years) at enrollment was 27 ± 3 in those with menopause by Y25, 25 ± 3 in those with menopause between Y25 and Y30, and 21 ± 3 in those premenopausal at Y30. There were no significant differences in race, body mass index, systolic blood pressure, or diabetes between the groups. Postmenopausal women had higher early diastolic mitral inflow (E) to annular (e') velocity ratio than premenopausal after adjusting for demographics and risk factors (P 0.05). Menopause was associated with relative increases in the rates of change in LV mass and left atrial volume, even after adjustment. Change in E/e' ratio was similar before and after menopause.Menopause is associated cross-sectionally with worse diastolic function and longitudinally with adverse LV and left atrial remodeling. This may contribute to the increased HFpEF risk in postmenopausal women.Video Summary:http://links.lww.com/MENO/A787.
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- 2021
19. Warranty Period of a Calcium Score of Zero
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Omar Dzaye, Michael J. Blaha, Moyses Szklo, Matthias Duebgen, Ron Blankstein, Joao A.C. Lima, Zeina Dardari, Khurram Nasir, Miguel Cainzos-Achirica, Joseph Yeboah, Matthew J. Budoff, Arthur S. Agatston, and Roger S. Blumenthal
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medicine.medical_specialty ,endocrine system diseases ,030204 cardiovascular system & hematology ,Mesa ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Family history ,Survival analysis ,computer.programming_language ,business.industry ,Warranty ,nutritional and metabolic diseases ,medicine.disease ,Coronary artery calcium ,cardiovascular system ,Cardiology ,population characteristics ,Cardiology and Cardiovascular Medicine ,business ,Risk assessment ,computer - Abstract
Objectives This study sought to quantify and model conversion of a normal coronary artery calcium (CAC) scan to an abnormal CAC scan. Background Although the absence of CAC is associated with excellent prognosis, progression to CAC >0 confers increased risk. The time interval for repeated scanning remains poorly defined. Methods This study included 3,116 participants from the MESA (Multi-Ethnic Study of Atherosclerosis) with baseline CAC = 0 and follow-up scans over 10 years after baseline. Prevalence of incident CAC, defined by thresholds of CAC >0, CAC >10, or CAC >100, was calculated and time to progression was derived from a Weibull parametric survival model. Warranty periods were modeled as a function of sex, race/ethnicity, cardiovascular risk, and desired yield of repeated CAC testing. Further analysis was performed of the proportion of coronary events occurring in participants with baseline CAC = 0 that preceded and followed repeated CAC testing at different time intervals. Results Mean participants’ age was 58 ± 9 years, with 63% women, and mean 10-year cardiovascular risk of 14%. Prevalence of CAC >0, CAC >10, and CAC >100 was 53%, 36%, and 8%, respectively, at 10 years. Using a 25% testing yield (number needed to scan [NNS] = 4), the estimated warranty period of CAC >0 varied from 3 to 7 years depending on sex and race/ethnicity. Approximately 15% of participants progressed to CAC >10 in 5 to 8 years, whereas 10-year progression to CAC >100 was rare. Presence of diabetes was associated with significantly shorter warranty period, whereas family history and smoking had small effects. A total of 19% of all 10-year coronary events occurred in CAC = 0 prior to performance of a subsequent scan at 3 to 5 years, whereas detection of new CAC >0 preceded 55% of future events and identified individuals at 3-fold higher risk of coronary events. Conclusions In a large population of individuals with baseline CAC = 0, study data provide a robust estimation of the CAC = 0 warranty period, considering progression to CAC >0, CAC >10, and CAC >100 and its impact on missed versus detectable 10-year coronary heart disease events. Beyond age, sex, race/ethnicity, diabetes also has a significant impact on the warranty period. The study suggests that evidence-based guidance would be to consider rescanning in 3 to 7 years depending on individual demographics and risk profile.
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- 2021
20. Blood Pressure Levels in Young Adulthood and Midlife Stroke Incidence in a Diverse Cohort
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Deborah Levine, Yuichiro Yano, Joao A.C. Lima, Lihui Zhao, Jared P. Reis, Kiang Liu, Cora E. Lewis, David R. Jacobs, Stephen Sidney, Jamal S. Rana, Mai N. Nguyen-Huynh, and Yariv Gerber
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Blood Pressure ,030204 cardiovascular system & hematology ,Article ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Primary prevention ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,Young adult ,business.industry ,Incidence ,Middle Aged ,Stroke ,Blood pressure ,Cohort ,Female ,business ,Stroke incidence ,030217 neurology & neurosurgery ,Cohort study - Abstract
We examined the longitudinal association between blood pressure (BP) and stroke incidence in young and middle-aged adults. BP measured during 9 examinations of the CARDIA study (Coronary Artery Risk Development in Young Adults) from 1985-1986 to 2015-2016 was used to classify participants (n=5079) according to the 2017 Hypertension Clinical Practice Guidelines. We used the highest BP obtained through the third examination (1990–1991) to define baseline BP categories; time-dependent categories (accounting for change in BP over time) were determined incorporating follow-up measurements. BP groups at ages 30 and 40 years were also defined. Stroke events were adjudicated until 2018. Mean age at baseline was 29.8 years. Stroke occurred in 100 participants. Stroke incidence (per 100 000 person-years) was higher ( P
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- 2021
21. Clinical Correlates of Early-Onset Hypertension
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Karri Suvila, Susan Cheng, Teemu J. Niiranen, and Joao A.C. Lima
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Ajhype/Ajh-08 ,Adult ,Male ,medicine.medical_specialty ,hypertension ,030204 cardiovascular system & hematology ,Brief Communication ,Odds ,Young Adult ,03 medical and health sciences ,age of onset ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Epidemiology ,Internal Medicine ,medicine ,Humans ,AcademicSubjects/MED00200 ,030212 general & internal medicine ,Risk factor ,Young adult ,10. No inequality ,business.industry ,blood pressure ,Odds ratio ,Middle Aged ,Confidence interval ,3. Good health ,Blood pressure ,AcademicSubjects/SCI00960 ,epidemiology ,Female ,Age of onset ,business - Abstract
BACKGROUND Early-onset hypertension has been established as a heritable trait and a risk factor for cardiovascular disease outcomes. However, the clinical correlates of early-onset hypertension remain unidentified. METHODS In this study, we assessed the demographic characteristics and lifestyle factors related to hypertension onset age in a sample of 3,286 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (mean baseline age 25 ± 4 years, 57% women). We examined the association between the participants’ baseline characteristics and age of hypertension onset subgroups (, Graphical Abstract Graphical Abstract
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- 2021
22. A Phase <scp>II</scp> study of autologous mesenchymal stromal cells and c‐kit positive cardiac cells, alone or in combination, in patients with ischaemic heart failure: the <scp>CCTRN CONCERT‐HF</scp> trial
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Michael P. Murphy, Ketty Bacallao, Lara M. Simpson, Aisha Khan, Joshua M. Hare, Bharath Ambale-Venkatesh, Judy Bettencourt, Dejian Lai, David P. Lee, Gregory D. Lewis, Timothy D. Henry, Bangon Longsomboon, Ray F. Ebert, Keith L. March, Mohammad R. Ostovaneh, Michelle Cohen, Ivonne Hernandez Schulman, Rachel W. Vojvodic, Carl J. Pepine, Krystalenia Valasaki, Lem Moyé, Shelly L. Sayre, Sohail Ikram, Robert D. Simari, Doris A. Taylor, Catalin Loghin, James T. Willerson, Roberto Bolli, Phillip C. Yang, David Aguilar, Barry R. Davis, Emerson C. Perin, Connor O'Brien, Adrian P. Gee, Sara Richman, Joao A.C. Lima, Raul D. Mitrani, and Jay H. Traverse
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medicine.medical_specialty ,Minnesota ,Phases of clinical research ,030204 cardiovascular system & hematology ,Mesenchymal Stem Cell Transplantation ,Placebo ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,Humans ,Medicine ,Heart Failure ,Ejection fraction ,business.industry ,Mesenchymal stem cell ,Mesenchymal Stem Cells ,Stroke Volume ,medicine.disease ,Clinical trial ,Treatment Outcome ,Heart failure ,Quality of Life ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
AIMS CONCERT-HF is an NHLBI-sponsored, double-blind, placebo-controlled, Phase II trial designed to determine whether treatment with autologous bone marrow-derived mesenchymal stromal cells (MSCs) and c-kit positive cardiac cells (CPCs), given alone or in combination, is feasible, safe, and beneficial in patients with heart failure (HF) caused by ischaemic cardiomyopathy. METHODS AND RESULTS Patients were randomized (1:1:1:1) to transendocardial injection of MSCs combined with CPCs, MSCs alone, CPCs alone, or placebo, and followed for 12 months. Seven centres enrolled 125 participants with left ventricular ejection fraction of 28.6 ± 6.1% and scar size 19.4 ± 5.8%, in New York Heart Association class II or III. The proportion of major adverse cardiac events (MACE) was significantly decreased by CPCs alone (-22% vs. placebo, P = 0.043). Quality of life (Minnesota Living with Heart Failure Questionnaire score) was significantly improved by MSCs alone (P = 0.050) and MSCs + CPCs (P = 0.023) vs. placebo. Left ventricular ejection fraction, left ventricular volumes, scar size, 6-min walking distance, and peak oxygen consumption did not differ significantly among groups. CONCLUSIONS This is the first multicentre trial assessing CPCs and a combination of two cell types from different tissues in HF patients. The results show that treatment is safe and feasible. Even with maximal guideline-directed therapy, both CPCs and MSCs were associated with improved clinical outcomes (MACE and quality of life, respectively) in ischaemic HF without affecting left ventricular function or structure, suggesting possible systemic or paracrine cellular mechanisms. Combining MSCs with CPCs was associated with improvement in both these outcomes. These results suggest potential important beneficial effects of CPCs and MSCs and support further investigation in HF patients.
- Published
- 2021
23. Age-Related Development of Cardiac Remodeling and Dysfunction in Young Black and White Adults: The Coronary Artery Risk Development in Young Adults Study
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Joao A.C. Lima, Amanda M. Perak, Cora E. Lewis, Samuel S. Gidding, Jared P. Reis, Laura A. Colangelo, Donald M. Lloyd-Jones, Anderson C. Armstrong, Sadiya S. Khan, Pamela J. Schreiner, and Stephen Sidney
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medicine.medical_specialty ,Proportional hazards model ,business.industry ,Hazard ratio ,Diastole ,Concentric hypertrophy ,Odds ratio ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Heart failure ,Internal medicine ,Cohort ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Young adult ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Little is known about the timing of preclinical heart failure (HF) development, particularly among blacks. The primary aims of this study were to delineate age-related left ventricular (LV) structure and function evolution in a biracial cohort and to test the hypothesis that young-adult LV parameters within normative ranges would be associated with incident stage B–defining LV abnormalities over 25 years, independent of cumulative risk factor burden. Methods Data from the Coronary Artery Risk Development in Young Adults study were analyzed. Participants (n = 2,833) had a mean baseline age of 30.1 years; 45% were black, and 56% were women. Generalized estimating equation logistic regression was used to estimate age-related probabilities of stage B LV abnormalities (remodeling, hypertrophy, or dysfunction) and logistic regression to examine risk factor–adjusted associations between baseline LV parameters and incident abnormalities. Cox regression was used to assess whether baseline LV parameters associated with incident stage B LV abnormalities were also associated with incident clinical (stage C/D) HF events over >25 years’ follow-up. Results Probabilities of stage B LV abnormalities at ages 25 and 60 years were 10.5% (95% CI, 9.4%–11.8%) and 45.0% (95% CI, 42.0%–48.1%), with significant race-sex disparities (e.g., at age 60, black men 52.7% [95% CI, 44.9%–60.3%], black women 59.4% [95% CI, 53.6%–65.0%], white men 39.1% [95% CI, 33.4%–45.0%], and white women 39.1% [95% CI, 33.9%–44.6%]). Over 25 years, baseline LV end-systolic dimension indexed to height was associated with incident systolic dysfunction (adjusted odds ratio per 1 SD higher, 2.56; 95% CI, 1.87–3.52), eccentric hypertrophy (1.34; 95% CI, 1.02–1.75), concentric hypertrophy (0.69; 95% CI, 0.51–0.91), and concentric remodeling (0.68; 95% CI, 0.58–0.79); baseline LV mass indexed to height2.7 was associated with incident eccentric hypertrophy (1.70; 95% CI, 1.25–2.32]), concentric hypertrophy (1.63; 95% CI, 1.19–2.24), and diastolic dysfunction (1.24; 95% CI, 1.01–1.52). Among the entire cohort with baseline echocardiographic data available (n = 4,097; 72 HF events), LV end-systolic dimension indexed to height and LV mass indexed to height2.7 were significantly associated with incident clinical HF (adjusted hazard ratios per 1 SD higher, 1.56 [95% CI, 1.26–1.93] and 1.42 [95% CI, 1.14–1.75], respectively). Conclusions Stage B LV abnormalities and related racial disparities were present in young adulthood, increased with age, and were associated with baseline variation in indexed LV end-systolic dimension and mass. Baseline indexed LV end-systolic dimension and mass were also associated with incident clinical HF. Efforts to prevent the LV abnormalities underlying clinical HF should start from a young age.
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- 2021
24. Risk Factors for Incident Coronary Artery Calcium in Younger (Age 32 to 45 Years) Versus Intermediate (46 to 64 Years) Versus Older (65 to 84 Years) Persons
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Alexander C. Razavi, Norrina B. Allen, Omar Dzaye, Erin D. Michos, Matthew J. Budoff, Joao A.C. Lima, James M. Shikany, Kiang Liu, Wendy S. Post, Roger S. Blumenthal, Michael J. Blaha, J. Jeffrey Carr, and Seamus P. Whelton
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Aged, 80 and over ,Adult ,Male ,Coronary Artery Disease ,Middle Aged ,Atherosclerosis ,Risk Assessment ,Young Adult ,Risk Factors ,Humans ,Female ,Calcium ,Cardiology and Cardiovascular Medicine ,Vascular Calcification ,Aged - Abstract
The prognostic value of traditional atherosclerotic cardiovascular disease (ASCVD) risk factors may decrease with age. We sought to determine whether the association between traditional ASCVD risk factors and incident coronary artery calcium (CAC) differs for younger versus older persons. We included 5,108 participants with baseline CAC = 0. Repeat CAC scoring occurred over 3 to 11 years of follow-up. Multivariable Cox proportional hazards regression assessed the association between traditional risk factors and incident CAC in young (32 to 45 years), middle-aged (46 to 64 years), and older adults (65 to 84 years). A total of 61% of the participants were women and 37% were Black. The proportion with incident CAC ranged from 22% among young adults, 34% for middle-aged adults, and 45% for older adults. In young adults, traditional risk factors were significantly associated with incident CAC except for diastolic blood pressure and high-density lipoprotein (HDL) cholesterol, whereas only total cholesterol/HDL cholesterol ≥3.5 (p = 0.04) was significantly associated with incident CAC in older persons. Non-HDL cholesterol (p = 0.02) was more strongly associated with incident CAC in young (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.09 to 1.31) and middle aged (HR 1.14, 95% CI 1.07 to 1.23) compared to older adults (HR 1.11, 95% CI 0.99 to 1.23). When added to demographics, traditional risk factors provided a greater C-statistic improvement for incident CAC prediction in young (0.752, +0.070, p0.001) versus middle-aged (0.645, +0.054, p0.001) and older adults (0.597,+0.025, p = 0.08). In conclusion, traditional risk factors more strongly predict incident CAC in young compared to older adults, underlining the importance of primordial prevention through middle age while identifying the challenges of ASCVD risk assessment in older persons.
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- 2022
25. References Values for Left Atrial Volumes, Emptying Fractions, Strains, and Strain Rates and Their Determinants by Age, Gender, and Ethnicity: The Multiethnic Study of Atherosclerosis (MESA)
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Ela Chamera, Mohammadali Habibi, Joao A.C. Lima, David A. Bluemke, Masamichi Imai, Theingi Tiffany Win, Seo Young Hong, Susan R. Heckbert, Xiaoying Yang, Henrique Doria de Vasconcellos, Bharath Ambale Venkatesh, Colin O. Wud, Ravi K. Sharma, Luisa Ciuffo, and Patrick Young
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medicine.medical_specialty ,Longitudinal strain ,Population ,Article ,Mesa ,Left atrial ,Internal medicine ,Atrial Fibrillation ,Ethnicity ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Heart Atria ,education ,Aged ,computer.programming_language ,Aged, 80 and over ,education.field_of_study ,business.industry ,Atrial fibrillation ,Middle Aged ,Atherosclerosis ,medicine.disease ,Reference values ,Cardiology ,Feature tracking ,Atrial Function, Left ,business ,Cardiac magnetic resonance ,computer - Abstract
Rationale and objectives Left Atrial (LA) adverse remodeling is an important predictor of morbidity and mortality in several cardiovascular (CV) diseases. Our goals were to quantify and provide reference ranges for LA structure and function using feature tracking cine cardiac magnetic resonance. Materials and methods 2526 participants of the Multiethnic Study of Atherosclerosis study who had feature tracking cine cardiac magnetic resonance derived LA data and were free of atrial fibrillation/flutter and prior CV events at year five follow-up examination (2010–2012) were included in this study. LA phasic indexed volumes: maximum (LAVi max), minimum (LAVi min), and preatrial contraction (LAVi preA); LA empty fractions: total, passive, and active (LAtEF, LApEF, and LAaEF); LA longitudinal strain: maximum and preatrial contraction (S max and S preA); and LA longitudinal strain rate: systolic (SR max) and early/late diastolic (SR e and SR a) were measured. Age, gender, and race/ethnicity-specific reference ranges were identified. Also, reference values in a select subgroup of healthy participants free of traditional CV risk factors at the time of exam date were reported. Results The mean ± SD for LAVi max, LAVi min, LAVi preA, S max, SR e, and SR a were in the 45–65-year-old participants: (33.8 ± 10 mL/m2), (14.5 ± 6.4 mL/m2), (24.8 ± 8.2 mL/m2), (34.6 ± 13.8 %), (−1.4 ± 0.7 s−1), (−2.1 ± 1 s−1) and in the ≥ 65-year-old participants: (35 ± 11.5 mL/m2), (16.6 ± 8.3 mL/m2), (27.6 ± 9.9 mL/m2), (31.2 ± 14.3 %), (−1 ± 0.6 s−1), (−2.1 ± 1 s−1) respectively. Younger individuals had Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation smaller LA volumes and better LA function compared to their older counterparts. Similar findings were observed in Chinese-Americans as compared to Whites. Conclusion This study provides reference values of LA structure and function parameters from a healthy multiethnic community-based population aged 53–94 years evaluated by FTMRI.
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- 2021
26. Electrocardiogram machine learning for detection of cardiovascular disease in African Americans: the Jackson Heart Study
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Solomon K. Musani, Larisa G. Tereshchenko, James D. Pollard, Elsayed Z. Soliman, Joseph F. Maher, Kazi T. Haq, Nichole M. Rogovoy, Kevin A. Paternostro, Katherine J. Lutz, and Joao A.C. Lima
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Elastic net regularization ,Receiver operating characteristic ,ECG ,business.industry ,Disease ,030204 cardiovascular system & hematology ,Cardiovascular disease ,Logistic regression ,Machine learning ,computer.software_genre ,QRS-T angle ,Confidence interval ,Random forest ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Lasso (statistics) ,Medicine ,Original Article ,cardiovascular diseases ,030212 general & internal medicine ,Artificial intelligence ,business ,computer - Abstract
Aims Almost half of African American (AA) men and women have cardiovascular disease (CVD). Detection of prevalent CVD in community settings would facilitate secondary prevention of CVD. We sought to develop a tool for automated CVD detection. Methods and results Participants from the Jackson Heart Study (JHS) with analysable electrocardiograms (ECGs) (n = 3679; age, 62 ± 12 years; 36% men) were included. Vectorcardiographic (VCG) metrics QRS, T, and spatial ventricular gradient vectors’ magnitude and direction, and traditional ECG metrics were measured on 12-lead ECG. Random forests, convolutional neural network (CNN), lasso, adaptive lasso, plugin lasso, elastic net, ridge, and logistic regression models were developed in 80% and validated in 20% samples. We compared models with demographic, clinical, and VCG input (43 predictors) and those after the addition of ECG metrics (695 predictors). Prevalent CVD was diagnosed in 411 out of 3679 participants (11.2%). Machine learning models detected CVD with the area under the receiver operator curve (ROC AUC) 0.69–0.74. There was no difference in CVD detection accuracy between models with VCG and VCG + ECG input. Models with VCG input were better calibrated than models with ECG input. Plugin-based lasso model consisting of only two predictors (age and peak QRS-T angle) detected CVD with AUC 0.687 [95% confidence interval (CI) 0.625–0.749], which was similar (P = 0.394) to the CNN (0.660; 95% CI 0.597–0.722) and better (P Conclusions Simple model (age and QRS-T angle) can be used for prevalent CVD detection in limited-resources community settings, which opens an avenue for secondary prevention of CVD in underserved communities.
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- 2021
27. Next-Generation Hardware Advances in CT: Cardiac Applications
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Alan C. Kwan, Amir Pourmorteza, David A. Bluemke, Joao A.C. Lima, and Dan Stutman
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Heart Diseases ,business.industry ,Contrast resolution ,Heart ,030218 nuclear medicine & medical imaging ,Visualization ,Radiation exposure ,03 medical and health sciences ,Reviews and Commentary ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Temporal resolution ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Tomography, X-Ray Computed ,business ,Material decomposition ,Image resolution ,Computer hardware - Abstract
Impending major hardware advances in cardiac CT include three areas: ultra-high-resolution (UHR) CT, photon-counting CT, and phase-contrast CT. Cardiac CT is a particularly demanding CT application that requires a high degree of temporal resolution, spatial resolution, and soft-tissue contrast in a moving structure. In this review, cardiac CT is used to highlight the strengths of these technical advances. UHR CT improves visualization of calcified and stented vessels but may result in increased noise and radiation exposure. Photon-counting CT uses multiple photon energies to reduce artifacts, improve contrast resolution, and perform material decomposition. Finally, phase-contrast CT uses x-ray refraction properties to improve spatial and soft-tissue contrast. This review describes these hardware advances in CT and their relevance to cardiovascular imaging. © RSNA, 2020
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- 2021
28. Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes
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Seamus P. Whelton, Tanika N. Kelly, Morgana Mongraw-Chaffin, Michael J. Blaha, Alexander C. Razavi, Joao A.C. Lima, Alain G. Bertoni, Lydia A. Bazzano, Nathan D. Wong, Moyses Szklo, Camilo Fernandez, Chris Defilippi, Roger S. Blumenthal, Jiang He, Matthew J. Budoff, and Joseph F. Polak
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medicine.medical_specialty ,business.industry ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Coronary artery calcium ,0302 clinical medicine ,Internal medicine ,Coronary artery calcification ,Diabetes mellitus ,Multidetector computed tomography ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Metabolic syndrome ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (Me...
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- 2021
29. ASSOCIATION BETWEEN LIVER AND HEART FIBROSIS IN WOMEN WITH OR AT RISK FOR HIV: THE WOMEN'S INTERAGENCY HIV STUDY (WIHS)
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Luisa Ciuffo, Yoko Kato, Bharath Ambale Venkatesh, Sanyog Shitole, Chia-Ying Liu, Jeffrey M. Levsky, Linda B. Haramati, Jason M. Lazar, Kathryn Anastos, Robert Kaplan, Joao A.C. Lima, and Jorge R. Kizer
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
30. PROTEOMIC PATHWAYS ASSOCIATED WITH INTERSTITIAL MYOCARDIAL FIBROSIS IN THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS
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Sam A. Michelhaugh, Hooman Bakhshi, Scott Bruce, Stephen L. Seliger, Xiaoxiao Qian, Bharath Ambale Venkatesh, Vinithra Varadarajan, Pramita Bagchi, Joao A.C. Lima, and Christopher R. DeFilippi
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
31. ASSOCIATION OF GLOBAL LONGITUDINAL STRAIN BY FEATURE TRACKING MRI WITH CARDIOVASCULAR OUTCOMES: THE DALLAS HEART STUDY
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Vinayak Subramanian, Neil Keshvani, Nitin Kondamudi, Alvin Chandra, Susan A. Matulevicius, Joao A.C. Lima, Erin D. Michos, and Ambarish Pandey
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Cardiology and Cardiovascular Medicine - Published
- 2023
32. PERIODONTAL DISEASE ASSOCIATED WITH INTERSTITIAL MYOCARDIAL FIBROSIS: THE MULTIETHNIC STUDY OF ATHEROSCLEROSIS
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Omar Chehab, Maria Doughan, Ralph Zeitoun, Henrique Doria De Vasconcellos, Vinithra Varadarajan, Colin O. Wu, Michael J. Blaha, David A. Bluemke, and Joao A.C. Lima
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Cardiology and Cardiovascular Medicine - Published
- 2023
33. DEEP PHENOTYPING OF DEMENTIA IN A MULTI-ETHNIC CARDIOVASCULAR COHORT: THE MULTIETHNIC STUDY OF ATHEROSCLEROSIS (MESA)
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Mohammad Ostovaneh, Timothy Hughes, Colin O. Wu, Robyn McClelland, Ramon Casanova, David A. Bluemke, Russell P. Tracy, Steven Shea, Susan R. Heckbert, Joao A.C. Lima, and Bharath Ambale Venkatesh
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
34. SEX-DIFFERENCE OF ASSOCIATION BETWEEN CIGARETTE SMOKING AND MYOCARDIAL FIBROSIS: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA)
- Author
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Elie W. Akl, Ralph Zeitoun, Omar Chehab, Haiou Li, Vinithra Varadarajan, Colin O. Wu, Alain Bertoni, Karol E. Watson, David A. Bluemke, Bharath Ambale Venkatesh, and Joao A.C. Lima
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
35. LEFT VENTRICULAR FLOW STATE IS ASSOCIATED WITH CARDIOVASCULAR DISEASE AND ALL-CAUSE MORTALITY IN AN ASYMPTOMATIC POPULATION WITH NORMAL LEFT VENTRICULAR FUNCTION
- Author
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Yifang Yuan, David M. Herrington, Joao A.C. Lima, Brandon Stacey, David Xiao-Ming Zhao, James D. Thomas, Mario J. Garcia, and Min Pu
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
36. INTERCELLULAR ADHESION MOLECULE-1, VASCULAR CELL ADHESION MOLECULE-1, AND CARDIAC STRUCTURE AND FUNCTION: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS
- Author
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Daniel Mathew, Graham Peigh, Joao A.C. Lima, Suzette J. Bielinski, Nicholas Larson, Matthew A. Allison, Sanjiv Jayendra Shah, and Ravi B. Patel
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
37. LEFT ATRIAL DIASTASIS STRAIN CURVE IS ASSOCIATED WITH LEFT VENTRICULAR DYSFUNCTION AND SCAR SIZE 6 MONTHS POST-STEMI: THE LAST-PASS STUDY
- Author
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Yoko Kato, Wei Hao Lee, Bharath Ambale Venkatesh, Elzbieta Chamera, Makoto Natsumeda, Yoshiaki Ohyama, Chikara Noda, Kensuke Takagi, Yuji Ikari, and Joao A.C. Lima
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
38. CORONARY ARTERY BYPASS GRAFT SURGERY OUTCOMES IN PATIENTS WITH AND WITHOUTCOVID-19 DURING THE PANDEMIC FIRST WAVE
- Author
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Bruna Scarpa Matuck, Henrique Pinesi, Eduardo Martins, Cibele Larrosa Garzillo, Marcos Pita Lottenberg, Joao A.C. Lima, Alexandre Segre, Desiderio Favarato, Eduardo Gomes Lima, Fabiana Hanna Rached, Fabio Grunspun Pitta, Luiz Augusto Lisboa, Fabio Biscegli Jatene, Roberto Kalil-Filho, and Carlos V. Serrano
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
39. REPRODUCTIVE FACTORS LINKED WITH MYOCARDIAL FIBROSIS: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS
- Author
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Omar Chehab, Ralph Zeitoun, Vinithra Varadarajan, Colin O. Wu, David A. Bluemke, Wendy S. Post, Erin D. Michos, and Joao A.C. Lima
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
40. Coronary Artery Calcium for the Allocation of GLP-1RA for Primary Prevention of Atherosclerotic Cardiovascular Disease
- Author
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Miguel Cainzos-Achirica, Roger S. Blumenthal, Parag H. Joshi, Renato Quispe, Amit Khera, Philip Greenland, Jamal S. Rana, Ron Blankstein, Rhanderson Cardoso, Kershaw V. Patel, Joao A.C. Lima, Michael J. Blaha, Márcio Sommer Bittencourt, Colby Ayers, and Khurram Nasir
- Subjects
medicine.medical_specialty ,Atherosclerotic cardiovascular disease ,business.industry ,MEDLINE ,Coronary Vessels ,Primary Prevention ,Coronary artery calcium ,Cardiovascular Diseases ,Predictive Value of Tests ,Primary prevention ,Internal medicine ,medicine ,Cardiology ,Humans ,Calcium ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
41. Comprehensive Metabolic Phenotyping Refines Cardiovascular Risk in Young Adults
- Author
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Donald M. Lloyd-Jones, Joao A.C. Lima, Jane E. Freedman, Venkatesh L. Murthy, Ravi V. Shah, Norrina B. Allen, Jared P. Reis, Ramachandran S. Vasan, Matthew Nayor, Clary B. Clish, Robert R. Kitchen, Alexander R. Pico, Gregory D. Lewis, and Mercedes R. Carnethon
- Subjects
Adult ,Male ,Adolescent ,Disease ,030204 cardiovascular system & hematology ,Bioinformatics ,Article ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Physiology (medical) ,Lipidomics ,Humans ,Metabolomics ,Medicine ,Prospective Studies ,Young adult ,Aged ,030304 developmental biology ,0303 health sciences ,business.industry ,Middle Aged ,Phenotype ,Cardiovascular Diseases ,Metabolome ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Whereas cardiovascular disease (CVD) metrics define risk in individuals >40 years of age, the earliest lesions of CVD appear well before this age. Despite the role of metabolism in CVD antecedents, studies in younger, biracial populations to define precise metabolic risk phenotypes are lacking. Methods: We studied 2330 White and Black young adults (mean age, 32 years; 45% Black) in the CARDIA study (Coronary Artery Risk Development in Young Adults) to identify metabolite profiles associated with an adverse CVD phenome (myocardial structure/function, fitness, vascular calcification), mechanisms, and outcomes over 2 decades. Statistical learning methods (elastic nets/principal components analysis) and Cox regression generated parsimonious, metabolite-based risk scores validated in >1800 individuals in the Framingham Heart Study. Results: In the CARDIA study, metabolite profiles quantified in early adulthood were associated with subclinical CVD development over 20 years, specifying known and novel pathways of CVD (eg, transcriptional regulation, brain-derived neurotrophic factor, nitric oxide, renin–angiotensin). We found 2 multiparametric, metabolite-based scores linked independently to vascular and myocardial health, with metabolites included in each score specifying microbial metabolism, hepatic steatosis, oxidative stress, nitric oxide modulation, and collagen metabolism. The metabolite-based vascular scores were lower in men, and myocardial scores were lower in Black participants. Over a nearly 25-year median follow-up in CARDIA, the metabolite-based vascular score (hazard ratio, 0.68 per SD [95% CI, 0.50–0.92]; P =0.01) and myocardial score (hazard ratio, 0.60 per SD [95% CI, 0.45–0.80]; P =0.0005) in the third and fourth decades of life were associated with clinical CVD with a synergistic association with outcome ( P interaction =0.009). We replicated these findings in 1898 individuals in the Framingham Heart Study over 2 decades, with a similar association with outcome (including interaction), reclassification, and discrimination. In the Framingham Heart Study, the metabolite scores exhibited an age interaction ( P =0.0004 for a combined myocardial–vascular score with incident CVD), such that young adults with poorer metabolite-based health scores had highest hazard of future CVD. Conclusions: Metabolic signatures of myocardial and vascular health in young adulthood specify known/novel pathways of metabolic dysfunction relevant to CVD, associated with outcome in 2 independent cohorts. Efforts to include precision measures of metabolic health in risk stratification to interrupt CVD at its earliest stage are warranted.
- Published
- 2020
42. Lung to finger circulation time in sleep study and coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis
- Author
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Michelle Reid, Sara Mariani, Joao A.C. Lima, Naresh M. Punjabi, Susan Redline, David R. Jacobs, Younghoon Kwon, and Vishesh K. Kapur
- Subjects
Male ,medicine.medical_specialty ,Polysomnography ,Left ventricular hypertrophy ,Carotid Intima-Media Thickness ,Article ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Humans ,Medicine ,Sleep study ,Lung ,Subclinical infection ,medicine.diagnostic_test ,business.industry ,Sleep apnea ,General Medicine ,Atherosclerosis ,medicine.disease ,Coronary Vessels ,respiratory tract diseases ,030228 respiratory system ,Apnea–hypopnea index ,Cohort ,Cardiology ,Sleep ,Risk assessment ,business ,030217 neurology & neurosurgery - Abstract
Background Lung to finger circulation time (LFCT) measured from sleep studies may represent a novel physiologic marker for cardiovascular risk in patients with sleep disordered breathing (SDB). We hypothesized that sleep study-derived LFCT would improve risk classification of markers of subclinical cardiovascular disease. Methods We included participants in the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep cohort with moderate-severe SDB (apnea hypopnea index [AHI] ≥ 15/hr) (N = 598). Results Those with average LFCT above the median (19.4 s) (vs. shorter LFCT) tended to be older, more obese and male. In multivariable analysis, no significant associations were found between average LFCT and subclinical cardiovascular markers including coronary artery calcium, carotid intima-media thickness or left ventricular hypertrophy. However, there was modest improvement in risk classification of coronary artery calcification as compared with AHI alone when average LFCT was added to AHI (C statistics 0.53 vs. 0.62, p = 0.0066). Conclusions In conclusion, LFCT may be a useful addition to conventional SDB metrics to improve cardiovascular risk assessment.
- Published
- 2020
43. Evaluation and Management of Patients With Stable Angina: Beyond the Ischemia Paradigm
- Author
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Jacqueline Latina, Armin Arbab-Zadeh, Steven R. Jones, Roger S. Blumenthal, Jeffrey C. Trost, Abdulhamied Alfaddagh, Michael J. Blaha, William E. Boden, Joao A.C. Lima, Valentin Fuster, Richard A. Ferraro, Garima Sharma, Erin D. Michos, and William S. Weintraub
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Ischemia ,030204 cardiovascular system & hematology ,Revascularization ,medicine.disease ,Thrombosis ,Angina ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,medicine ,030212 general & internal medicine ,Risk factor ,Cardiology and Cardiovascular Medicine ,Adverse effect ,business ,Intensive care medicine ,Artery - Abstract
Coronary heart disease is a chronic, systemic disease with a wide range of associated symptoms, clinical outcomes, and health care expenditure. Adverse events from coronary heart disease can be mitigated or avoided with lifestyle and risk factor modifications, and medical therapy. These measures are effective in slowing the progression of atherosclerotic disease and in reducing the risk of thrombosis in the setting of plaque disruptions. With increasing effectiveness of prevention and medical therapy, the role of coronary artery revascularization has decreased and is largely confined to subgroups of patients with unacceptable angina, severe left ventricular systolic dysfunction, or high-risk coronary anatomy. There is a compelling need to allocate resources appropriately to improve prevention. Herein, we review the scientific evidence in support of medical therapy and revascularization for the management of patients with stable coronary heart disease and discuss implications for the evaluation of patients with stable angina and public policy.
- Published
- 2020
44. Allogeneic Mesenchymal Cell Therapy in Anthracycline-Induced Cardiomyopathy Heart Failure Patients
- Author
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Sohail Ikram, Kathy D. Miller, Adrian P. Gee, Joshua M. Hare, Jay H. Traverse, Bharath Ambale-Venkatesh, Emerson C. Perin, Connor O'Brien, Judy Bettencourt, Ray F. Ebert, Timothy D. Henry, Roberto Bolli, Joao A.C. Lima, Carl J. Pepine, Dejian Lai, David P. Lee, Phillip C. Yang, Shelly L. Sayre, Keith L. March, Michelle Cohen, Lara M. Simpson, Sara Richman, Michael P. Murphy, Doris A. Taylor, Mohammad R. Ostovaneh, Lem Moyé, Raul D. Mitrani, Rachel W. Vojvodic, Robert D. Simari, Catalin Loghin, Jean-Bernard Durand, James T. Willerson, David Aguilar, and Barry R. Davis
- Subjects
Oncology ,medicine.medical_specialty ,Chemotherapy ,Poor prognosis ,Anthracycline ,business.industry ,medicine.medical_treatment ,Mesenchymal stem cell ,Cardiomyopathy ,medicine.disease ,Internal medicine ,Heart failure ,medicine ,Stem cell ,Young adult ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Anthracycline-induced cardiomyopathy (AIC) may be irreversible with a poor prognosis, disproportionately affecting women and young adults. Administration of allogeneic bone marr...
- Published
- 2020
45. Biventricular Pressure-Volume Loop Assessment Before and After Pulmonary Valve Replacement in Tetralogy of Fallot
- Author
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Edem Binka, Jin Zhang, Felicia Seemann, Vivek Jani, Benjamin Barnes, Lasya Gaur, Joao A.C. Lima, Bharath Ambale Venkatesh, Marcus Carlsson, and Shelby Kutty
- Subjects
Adult ,Heart Valve Prosthesis Implantation ,Male ,Pulmonary and Respiratory Medicine ,Pulmonary Valve ,Adolescent ,Pulmonary Valve Insufficiency ,Young Adult ,Treatment Outcome ,Tetralogy of Fallot ,Humans ,Female ,Radiology, Nuclear Medicine and imaging ,Cardiac Surgical Procedures ,Child - Abstract
Patients with tetralogy of Fallot (TOF) may undergo pulmonary valve replacement (PVR) after initial full repair. We investigated indices of biventricular function, work and efficiency of TOF patients' using noninvasive pressure-volume (PV) loop analysis on cardiovascular magnetic resonance (CMR) images and compared pre-and post PVR groups. Biventricular segmentations of steady state free precession CMR images were performed using custom validated software (Segment version 2.0 R7067). Brachial cuff pressure estimated left ventricular (LV) systolic pressure. Right ventricular (RV) inputs were obtained from pre-PVR cardiac catheterization data. Biventricular PV loops were then derived using a time-varying elastance model. Twenty seven patients were studied: (22 pre-PVR, 5 post-PVR), mean age of 20±10.5 years and 83% male. RV stroke volume significantly differed before and after PVR (73.2±25 ml vs. 41±10 mL, P =0.01). RV stroke work (SW) and mean external power (MEP) were significantly less post-PVR, but there were no significant differences in the LV hemodynamic indices. TOF patients have reduced RV SW and MEP post-PVR suggesting improved hemodynamics. Noninvasive biventricular PV loop analysis shows potential for integration into standard CMR imaging of TOF and provides hemodynamic data that could influence management decisions.
- Published
- 2022
46. RESISTIN AND RISK OF SUBCLINICAL HEART FAILURE AND CARDIAC FIBROSIS: THE MULTIETHNIC STUDY OF ATHEROSCLEROSIS (MESA) STUDY
- Author
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Xinjiang Cai, Matthew A. Allison, Bharath Ambale Venkatesh, Neal Jorgensen, Joao A.C. Lima, Evan D. Muse, Robyn McClelland, Steven Shea, and Djamel Lebeche
- Subjects
Cardiovascular System & Hematology ,Public Health and Health Services ,Cardiorespiratory Medicine and Haematology ,Cardiology and Cardiovascular Medicine - Published
- 2022
47. Change in left atrioventricular coupling index to predict incident atrial fibrillation: the multi-ethnic study of atherosclerosis (MESA)
- Author
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H.D. De Vasconcellos, Thiago Quinaglia, Colin Wu, Théo Pezel, David A. Bluemke, Susan R. Heckbert, Yoko Kato, Wendy S. Post, B. Ambale Venkatesh, Patrick Henry, and Joao A.C. Lima
- Subjects
Male ,medicine.medical_specialty ,Population ,Diastole ,Mesa ,Left atrial ,Internal medicine ,Atrial Fibrillation ,Ethnicity ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Heart Atria ,education ,Survival analysis ,computer.programming_language ,Original Research ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Atrial fibrillation ,Mean age ,General Medicine ,Middle Aged ,medicine.disease ,Atherosclerosis ,carbohydrates (lipids) ,Cardiology ,bacteria ,Female ,business ,Cardiology and Cardiovascular Medicine ,computer - Abstract
Funding Acknowledgements Type of funding sources: None. BACKGROUND Left atrial (LA) and left ventricular (LV) structural and functional parameters have independent prognostic values as predictors of atrial fibrillation (AF). PURPOSE To investigate the prognostic value of a left atrioventricular coupling index (LACI) and average annualized change in LACI measured by cardiac MRI to predict incident AF in a population-based sample from the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS In a secondary analysis of the prospective Multi-Ethnic Study of Atherosclerosis (MESA) study, 1,911 study participants, free of clinically recognized AF and cardiovascular disease at baseline, had LACI assessed with cardiac MRI at baseline (Exam 1, 2000-2002), and ten years later (Exam 5, 2010-2012). LACI was defined as the ratio of LA to LV end-diastolic volumes. Univariable and multivariable Cox proportional hazard models were used to evaluate the associations of LACI and average annualized change in LACI (ΔLACI) with incident AF. RESULTS Among the 1,911 participants (mean age 59 ± 9 years and 907 men), 87 incident AF events occurred over 3.9 ± 0.9 years following the second imaging (Exam 5). After adjustment for traditional risk factors, greater LACI and ΔLACI were independently associated with AF (HR 1.69, 95% CI[1.46-1.96] and HR 1.71, 95% CI[1.50-1.94], respectively; both p CONCLUSIONS Atrioventricular coupling (LACI) and coupling change (ΔLACI) were strong predictors for AF in a multi-ethnic population. Both had incremental prognostic value for predicting AF over traditional risk factors, and superior discrimination compared to the CHARGE-AF score and to individual LA or LV parameters. ClinicalTrials.gov Identifier: NCT00005487 Abstract Figure. Kaplan-Meier curves by change in LACI Abstract Figure. Kaplan-Meier curves by ΔLACI and LACI
- Published
- 2022
48. Genetic variation in sodium glucose co-transporter 1 and cardiac structure and function at middle age
- Author
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Aakash Bavishi, Laura A. Colangelo, Laura J. Rasmussen‐Torvik, Joao A.C. Lima, Drew R. Nannini, Muthiah Vaduganathan, Ambarish Pandey, Donald M. Lloyd‐Jones, Sanjiv J. Shah, and Ravi B. Patel
- Subjects
Male ,Young Adult ,Glucose ,Echocardiography ,Sodium ,Genetic Variation ,Humans ,Female ,Heart ,Middle Aged ,Cardiology and Cardiovascular Medicine - Abstract
The effects of inhibition of sodium glucose cotransporter (SGLT)-1, as opposed to SGLT2, on cardiovascular structure and function are not well known. We assessed the associations of a missense genetic variant of SGLT1 with cardiac structure and function.We evaluated associations of a functionally modifying variant of SLC5A1 (rs17683011 [p.Asn51Ser]), the gene that encodes SGLT1, with cardiac structure and function on echocardiography among middle-aged adults in the Coronary Artery Risk Development in Young Adults Study. Of 1904 participants (55.3 ± 3.5 years, 57% female, 34% Black), 166 (13%) White participants and 18 (3%) Black participants had at least one copy of rs17683011. There were no significant differences in age, sex, body mass index, glucose, or diabetes status by the presence of the rs17683011 variant. In Black participants, the presence of at least one copy of the rs17683011 variant was significantly associated with better GLS compared with those without a copy of the variant after covariate adjustment (-15.8 ± 0.7% vs. -14.0 ± 0.1%, P = 0.02). Although the direction of effect was consistent, the association between the presence of at least one copy of rs17683011 and GLS was not statistically significant in White participants (-15.1 ± 0.2% vs. -14.8 ± 0.1%, P = 0.16). There were no significant associations between rs17683011 and other measures of LV structure, systolic function, or diastolic function.The rs17683011 variant, a functionally modifying variant of the SGLT1 gene, was associated with higher GLS among middle-age adults. These exploratory findings require further validation and suggest that SGLT1 inhibition may have beneficial effects upon LV systolic function.
- Published
- 2022
49. Contributors
- Author
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Elena Aikawa, S.G. Anderson, Livia Silva Araújo Passos, Samsul Arefin, Per M. Arvidsson, Alberto Avolio, Martin Bachler, Magnus Bäck, Michael J. Bashline, Dakota Becker-Greene, Jamie Bellinge, Amar Bennasroune, Sébastien Blaise, Barry A. Borlaug, Pierre Boutouyrie, Y. Breet, Jerome W. Breslin, Matthew J. Budoff, Mark Butlin, Marina Cecelja, Chen-Huan Chen, Hao-Min Cheng, Yi-Bang Cheng, Julio A. Chirinos, Phil Chowienczyk, Shao-Yuan Chuang, Marie-Annick Clavel, Jordana B. Cohen, Alexis M. Corcoran, William K. Cornwell, Vicente F. Corrales–Medina, Nancy Côté, Thais Coutinho, James Cox, J.K. Cruickshank, Lu Dai, Stella S. Daskalopoulou, Kevin P. Davy, Marc L. De Buyzere, Paul B. Dieffenbach, Laurent Duca, Girish Dwivedi, David G. Edwards, William B. Farquhar, Bo Fernhall, John S. Floras, Laura E. Fredenburgh, Masafumi Fukumitsu, L. Gafane-Matemane, Nestor Gahungu, Ahmed K. Ghanem, Thierry C. Gillebert, Philippe Gillery, Delphine Gomez, Ezequiel Guzzetti, Bernhard Hametner, Junichiro Hashimoto, Kevin S. Heffernan, Brooks A. Hibner, Sam Hobson, Nien-Wen Hu, T.M. Hughes, Jay D. Humphrey, Stéphane Jaisson, Nadjia Kachenoura, Kazuomi Kario, Prasad V.G. Katakam, Goro Katsuumi, Avinash Kondiboyina, Sándor J. Kovács, R. Kruger, Karolina Kublickiene, Patrick Lacolley, Muriel Laffargue, Arinola O. Lampejo, Agne Laucyte-Cibulskiene, Stéphane Laurent, Hae-Young Lee, Wesley K. Lefferts, Elizabeth C. Lefferts, Adelino F. Leite-Moreira, Chee H. Liew, Joao A.C. Lima, André P. Lourenço, Kaisa Maki-Petaja, Marcy Maracle, Laurent Martiny, Pascal Maurice, Christopher C. Mayer, Barry J. McDonnell, John W. McEvoy, M.L. Meyer, Jean-Baptiste Michel, Philip J. Millar, Tohru Minamino, Gary F. Mitchell, Walter L. Murfee, Jonathan P. Mynard, Massimo Nardone, Peter M. Nilsson, Kevin O'Gallagher, Yoshiaki Ohyama, Kazunori Omote, Jeong Bae Park, Shayn M. Peirce, Philippe Pibarot, Gary L. Pierce, Stuart B. Prenner, Athanase Protogerou, Reed E. Pyeritz, Michael A. Quail, Yogesh N.V. Reddy, Alban Redheuil, Véronique Regnault, Rakhshinda Rehman, Ernst R. Rietzschel, Béatrice Romier-Crouzet, Jasjit Rooprai, Lucia Salvi, Paolo Salvi, Hervé Sartelet, Christian E.H. Schmelzer, A.E. Schutte, Angelina Schwarz, Patrick Segers, James E. Sharman, Ippei Shimizu, Marc A. Simon, Piera Sosa, Bart Spronck, Peter Stenvinkel, Eric J. Stöhr, M. Strauss-Kruger, Ariana Suarez-Martinez, Masayoshi Suda, Shih-Hsien Sung, Isabella Tan, Dimitrios Terentes-Printzios, Raymond R. Townsend, Andrew H. Tran, Elaine M. Urbina, Bharath Ambale Venkatesh, Charalambos Vlachopoulos, Anton Vonk Noordegraaf, Amandine Wahart, Ji-Guang Wang, Siegfried Wassertheurer, Andrew James Webb, Thomas Weber, Berend E. Westerhof, Ian B. Wilkinson, and Yohko Yoshida
- Published
- 2022
50. MRI for the assessment of aortic stiffness and pulsatile hemodynamics
- Author
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Yoshiaki Ohyama, Alban Redheuil, Nadjia Kachenoura, Bharath Ambale Venkatesh, and Joao A.C. Lima
- Published
- 2022
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