41 results on '"Skali, Hicham"'
Search Results
2. Stages of Valvular Heart Disease Among Older Adults in the Community: The Atherosclerosis Risk in Communities Study
- Author
-
Shelbaya, Khaled, Claggett, Brian, Dorbala, Pranav, Skali, Hicham, Solomon, Scott D., Matsushita, Kunihiro, Konety, Suma, Mosley, Thomas H., and Shah, Amil M.
- Published
- 2023
- Full Text
- View/download PDF
3. Sex and Race Differences in N-Terminal Pro–B-type Natriuretic Peptide Concentration and Absolute Risk of Heart Failure in the Community
- Author
-
Myhre, Peder L., Claggett, Brian, Yu, Bing, Skali, Hicham, Solomon, Scott D., Røsjø, Helge, Omland, Torbjørn, Wiggins, Kerri L., Psaty, Bruce M., Floyd, James S., Selvin, Elizabeth, Ballantyne, Christie M., and Shah, Amil M.
- Abstract
IMPORTANCE: Sex- and race-based differences in N-terminal pro–B-type natriuretic peptide (NT-proBNP) concentrations are poorly understood. Clinical decisions are often informed by absolute—as opposed to relative—risk, but absolute risk of incident heart failure (HF) associated with NT-proBNP concentration across these important demographic categories is unclear. OBJECTIVE: To determine whether physiologic determinants of NT-proBNP concentrations account for sex and race differences, and to more uniformly predict HF risk using NT-proBNP in these demographic subgroups. DESIGN, SETTING, AND PARTICIPANTS: In the longitudinal Atherosclerosis Risk in Communities epidemiologic prospective community-based cohort study, the association of NT-proBNP concentration with relative and absolute risk of HF by sex- and race-based categories was assessed at study visit 2 (1990-1992) and study visit 5 (2011-2013) using Cox and Poisson regression. These data were analyzed from June 2018 to October 2021. The contribution of clinical, anthropometric, echocardiographic, and laboratory parameters to sex- and race-based differences in NT-proBNP concentration was assessed at visit 5 using linear regression. Participants included were free of HF in midlife (visit 2; a total of 12 750 participants) and late life (visit 5; a total of 5191 participants). EXPOSURES: NT-proBNP concentration. MAIN OUTCOMES AND MEASURES: Incident HF or death. RESULTS: Among the 5191 HF-free participants at visit 5, the mean (SD) age was 76.0 (5.2) years, 2104 (41%) were male, 1043 (20%) were Black, and the median (IQR) NT-proBNP concentration was 124 (64-239) pg/. In both midlife and late life, NT-proBNP concentration was lowest in Black men (median [IQR] concentration: visit 2, 30 [14-67] pg/mL; visit 5, 74 [34-153] pg/mL) and highest in White women (median [IQR] concentration: visit 2, 70 [42-111] pg/mL; visit, 5, 154 [82-268] pg/mL). Sex and race differences in NT-proBNP concentration persisted after accounting for age, income, education, area deprivation index, cardiovascular diseases, left ventricular structure (LV), LV function, LV wall stress, weight and fat mass, and estimated glomerular filtration rate. Substantial differences in the absolute risk of incident HF or death existed across the sex- and race-based categories at any NT-proBNP concentration (eg, 7-fold [rate ratio, 6.7; 95% CI, 4.6-9.9] and 3-fold [rate ratio, 2.7; 95% CI, 1.7-4.1] difference at visit 2 and visit 5, respectively, at guideline-recommended thresholds) with higher risk consistently observed among Black men and lower risk in White women. Results were replicated in a cohort of participants from the Cardiovascular Health Study. CONCLUSIONS AND RELEVANCE: In this study, sex- and race-based differences in NT-proBNP persisted after accounting for known physiologic determinants. Absolute risk associated with a given value of NT-proBNP varied substantially by sex and race. Consideration of NT-proBNP values in the context of sex and race allows for more uniform prediction of absolute risk across important demographic subgroups.
- Published
- 2022
- Full Text
- View/download PDF
4. Impact of diabetes on mortality in patients with myocardial infarction and left ventricular dysfunction
- Author
-
Murcia, Alvaro M., Hennekens, Charles H., Lamas, Gervasio A., Jimenez-Navarro, Manuel, Rouleau, Jean L., Flaker, Greg C., Goldman, Steven, Skali, Hicham, Braunwald, Eugene, and Pfeffer, Marc A.
- Subjects
Diabetes -- Health aspects ,Heart attack -- Risk factors ,Coronary heart disease -- Risk factors ,Health - Published
- 2004
5. Factors Associated With Coronary Angiography Performed Within 6 Months of Randomization to the Conservative Strategy in the ISCHEMIA Trial
- Author
-
Pracoń, Radosław, Spertus, John A., Broderick, Samuel, Bangalore, Sripal, Rockhold, Frank W., Ruzyllo, Witold, Demchenko, Elena, Nageh, Thuraia, Grossman, Gabriel Blacher, Mavromatis, Kreton, Manjunath, Cholenahally N., Smanio, Paola E.P., Stone, Gregg W., Mancini, G.B. John, Boden, William E., Newman, Jonathan D., Reynolds, Harmony R., Hochman, Judith S., Maron, David J., Doan, John, Linefsky, Jason, Lee, Raven, Patel, Risha, Miller, Todd, Yang Cho, So, Milbrandt, Susan, Shelstad, Dawn, Banerjee, Subhash, Kamath, Preeti, Tejani, Ishita, Cobos, Stanley E., Quiles, Kirsten J., Dwyer, Raven R., Donnino, Robert M., Espinosa, Dalisa, Phillips, Lawrence M., Saric, Muhamed, Abdul-Nour, Khaled, Schley, Allison, Golden, Heather, Stone, Peter H., Osseni, Hermine, Wiyarand, Charlene, Douglass, Peter, Pomeroy, Hayley, Craft, Alexandra, Harvey, Bethany, Jang, James J., Anaya, Olivia, Yee, Gennie, Goold, Phoebe, Weitz, Steven, Giovannone, Steven, Pritchard, Lori, Arnold, Suzanne, Gans, Rosann, Henry O’Keefe, James, Jr, Kennedy, Paul, Shapiro, Michael D., Ganesan, Shobana, Schlichting, David, Naher, Aynun, El-Hajjar, Mohammad, Sidhu, Mandeep S., Fein, Steven A., Stewart, Wendy L., Torosoff, Mikhail T., Salmi, Kristin M., Lyubarova, Radmila, Mookherjee, Sulagna, Drzymalski, Krzysztof, McFalls, Edward O., Garcia, Santiago A., Bertog, Stefan C., Johnson, Debra K., Siddiqui, Rizwan A., Herrmann, Rebekah R., Ishani, Areef, Hansen, Ronnell A., Georges Khouri, Michel, Arges, Kristine, LeFevre, Melissa, Tomfohr, Jennifer, Goldberg, Jonathan L., Ann Byrne, Kimberly, Zappernick, Taissa, Goldweit, Richard, Canada, Sallie, Kakade, Meghana, Mieses, Patricia, Cobos, Stanley E., Dwyer, Raven R., Cohen, Ronny A., Espinosa, Dalisa, Mirrer, Brooks, Quiles, Kirsten J., Navarro, Victor, Rantinella, Magdalena, Rodriguez, Jessica, Mancilla, Olivia, Winchester, David E., Stinson, Susan, Kronenberg, Marvin, Weyand, Terry, Rogal, Philip, Crook, Sherron C., McFarren, Christopher, Heitner, John F., Ho, Jean, Khan, Saadat, Mohamed, Mahmoud, Dauber, Ira M., Soltau, Mary R., Rose, Delsa K., Wimmer, Rebecca J., Siegel, Kathy E., Derbyshire, Susan, Cannan, Charles, Dixon, Michelle, Leonard, Gerald, Sudarshan, Sriram, Heard, Ciarra, Gabriel, Viviana, Desire, Sukie, Mehta, Puja K., McDaniel, Michael, Rashid, Fauzia, Lerakis, Stamatios, Asier, Senait, Quyyumi, Arshed, Patel, Keyur, Wenger, Nanette K., Hedgepeth, Chester M., Gillis, Jennifer, Hurlburt, Heather, Manocchia, Megan, Rosen, Alan, Moore, Susan, Congdon, Elizabeth, Sahul, Zakir, Brandt, Gail, Marchelletta, Nora, Wippler, Kristina, Booth, David, Taul, Yvonne, Leung, Steve, Isaacs, Jennifer, Abdel-Latif, Ahmed, Bulkley, Viktoria, Reda, Hassan, Rodgers, Caroline, Ziada, Khaled, Setty, Sampoornima, Halverson, Kimberly E., Roraff, Christine, Thorsen, Jonean, Barua, Rajat S., Ojajuni, Amarachi, Olurinde, Oni, Surineni, Kamalakar, Hage, Fadi, Valaiyapathi, Badhma, Caldeira, Christiano, Davies, James E., Leesar, Massoud, Heo, Jaekyeong, Iskandrian, Amy, Al Solaiman, Firas, Singh, Satinder, Dajani, Khaled, Kartje, Carol M., El-Hajjar, Mohammad, Mesropian, Paul Der, Sacco, Joseph, Rawlins, Michele, McCandless, Brian, Thomson, Jennifer, Orgera, Marisa, Sidhu, Mandeep S., Colleen Rogge, Mary, Arif, Imran, Bunke, Julie, Kerr, Hanan, Unterbrink, Kendra, Fannon, Jacqueline, Burman, Cynthia, Trejo, Jorge F., Dubin, Marcia F., Fletcher, Gerald, Lane, Gary E., Neeson, Lynn M., Parikh, Pragnesh P., Pollak, Peter M., Shapiro, Brian P., Landolfo, Kevin, Gemignani, Anthony, Beaudry, Sarah, O’Rourke, Daniel, Meadows, Judith L., Tirado, Stephanie A., Halliday, Janet, Julian, Pamela, Call, Jason T., Stephanie, Lane, M., Stanford, Jennifer L., Hannan, Joseph, Bojar, Robert, Arsenault, Patricia, Kumar, Deepti, Sigel, Pamela, Mukai, John, Martin, Edward T., Brooks, Miriam, Vorobiof, Gabriel, Douangvila, Ladda, Gevorgyan, Rubine, Moorman, Alec, Ranjbaran, Fatima, Smith, Bryn, Ohmart, Carly, Kinlay, Scott, Hamburger, Robert J., Rocco, Thomas P., Ly, Samantha, Bhatt, Deepak L., Quinn, Margot C., Croce, Kevin, Temiyasathit, Sara, Quin, Jacquelyn A, Do, Jacquelyn, Anumpa, Jati, Tobin, Desiree, Zenati, Marco, Faxon, David P, Rayos, Glenn, Langdon, Jennifer, Werner Bayer, Marcia, Seedhom, Ashraf, O’Malley, Amanda, Sullenberger, Lance, Orvis, Erin, Kumkumian, Gregory, Murphy, Mandy, Greenberg, Ann, Iraola, Margaret, Sedlis, Steven P., Maranan, Leandro C., Donnino, Robert M., Lorin, Jeffrey, Tamis-Holland, Jacqueline E., Malinay, Ammy, Kornberg, Robert, Leber, Robert, Saba, Souheil, Edillo, Candice P., Lee, Michael W., Small, Delano R., Nona, Wassim, Alexander, Patrick B., Rehman, Iram, Badami, Umesh, Ostrander, Ann, Wasmiller, Stephanie, Marzo, Kevin, Drewes, Wendy, Patel, Dipti, Robbins, Inga H., Levite, Howard A., White, Jackie M, Shetty, Sanjay, Hallam, Alison, Patel, Mayuri, Hamroff, Glenn S., Spooner, Benjamin J, Hollenweger, Linda M, Little, Raymond W., Little, Holly, Zimbelman, Brandi D., Little, Tiffany, Lui, Charles Y., Eskelson, Nona A, Smith, Brigham R., Vezina, Daniel P., Khor, Lillian L., Abraham, Josephine D., Bull, David A., McKellar, Stephen H., Booth, David, Taul, Yvonne, Kotter, John, Rodgers, Caroline, Abdel-Latif, Ahmed, Isaacs, Jennifer, Bulkley, Viktoria, Hu, Bob, Kaneshiro, Renee, Labovitz, Arthur J., Berlowitz, Michael, Kirby, Bonnie J., Rogal, Philip, Tran, Nhi N., McFarren, Christopher, Jahrsdorfer, Catherine, Matar, Fadi, Caldeira, Christiano, Rodriguez, Fatima, Yunis, Reem, Schnittger, Ingela, Patro, Jhina, Fearon, William F., Deedwania, Prakash, Vega, Antonia, Reddy, Kiran, Sweeny, Joseph, Bloise-Adames, Hugo, Jimenez, Santa, Saint Vrestil, Nicole, Bhandari, Reyna, Spizzieri, Christopher, Schade, Danielle, Yost, Roxanne, Hochberg, Claudia P, Beardsley, Paula, Fine, Denise, Salerno, William D., Tancredi, Jana, Arakelian, Patricia, Mathus, Susan, O’Neill, Deborah, Wyman, Ray, Burkhardt, Joy, Hosino, Suellen, Lubyanaya, Oksana A., Salas, Jose D., Zarka, Amer, Aguirre, Maria, Shah, Anil V., Dhawan, Manu, Parra, Diana, Tran, Tri, Haldis, Thomas, Weick, Catherine, Fowler-Lehman, Katie, Spitzer, Natalie, Riedberger, Casey, Weick, Catherine, Kohn, Jeffrey A., Cobos, Stanley E., Dwyer, Raven R., Espinosa, Dalisa, Quiles, Kirsten J., Girotra, Saket, Drum, Carrie, Miller-Cox, Kimberly, Ollinger, Amy, Almousalli, Omar, Capasso-Gulve, Elizabeth, Melanie Loehr, Alaine, Mosley, Marlowe, Krishnam, Mayil S., Heydari, Shirin, Milliken, Jeffrey C., Lundeen, Andrea M., Patel, Pranav M., Karanjah, Edgar, Seto, Arnold H., Marfori, Wanda C., Harley, Kevin T., Hernandez-Rangel, Eduardo, Gibson, Michael A., Singh, Pam, Allen, Byron J., Coram, Rita, Marie Webb, Anne, Fridell, Ellie, Wilson, Heidi, Thomas, Sabu, Kim, Angela, Schwartz, Ronald G, Wilmot, Patrick, Chen, Wei, El Shahawy, Mahfouz, Stevens, Ramona, Stafford, James, Black, Loriane, Abernethy, William B., Hull, Amber B., Lim, Olivia J., Tucker, Helen C., Putnam, Natasha C., Hall, Linda L., Cauthren, Tia, Tucker, Trish, Zurick, Andrew, Horton, Hollie, Orga, Jan, Meyer, Thomas M., White, Joyce R., Morford, Ronald G., Baumann, Cynthia, Rutkin, Bruce, Seeratan, Vidya, Bokhari, Sabahat, Jimenez, Magnolia, Sokol, Seth I., Schultz, Cidney, Meisner, Jay, Russo, Jeanne, Hamzeh, Ihab, Misra, Arunima, Huda, Zohra, Wall Jr., Matthew, Boan, Araceli, Lenges De Rosen, Veronica, Alam, Mahboob, Turner, Michael C., Hinton, Christine R, Mulhearn, Thomas J., Good, Arnold P., Archer, Beth A., Dionne, Julia S., Allardyce, Cheryl A., Sikora, Lindsey N., Czerniak, Jennifer H., Mull, Jennifer A., Ferguson, Elizabeth, Laube, Frances, Shammas, Nicolas W., Shammas, Gail A, Christensen, Lori, Park, Holly, Chilton, Robert, Hecht, Joan, Nguyen, Patricia K., Vo, Davis, Hirsch, James, Jezior, Matthew, Bindeman, Jody, Salkind, Sara, Espinosa, Dalisa, Desimone, Lori-Ann, Gordon, Paul C., Felix-Stern, Lina, Crain, Thomas, Gomes, Jassira, Gordon, Catherine, Stenberg, Robert, Mann, Aimee, McCreary, Theresa, Pedalino, Ronald P., Cobos, Stanley E., Dwyer, Raven R., Espinosa, Dalisa, Quiles, Kirsten J., Wiesel, Joseph, Cobos, Stanley E., Dwyer, Raven R., Espinosa, Dalisa, Quiles, Kirsten J., Juang, George J., Gopaul, Candace, Hultberg, Karen, Huk, Tauqir, Hussain, Afshan, Al-Amoodi, Mohammed, Zambrano, Yesenia, Medina Rodriguez, Sarah, Milner, Trudie, Wohns, David, Mulder, Abbey, Van Oosterhout, Stacie, Lader, Ellis W., Meyer, Martha, Mumma, Michael, Clapp, Nancy L., Barrentine, Heather, Dharmarajan, Lekshmi, Jose, Jenne M., Cobos, Stanley E., Dwyer, Raven R., Espinosa, Dalisa, Quiles, Kirsten J., Manchery, Jenne, McGarvey Jr, Joseph F.X., McKinney, Vera, Schwarz, Linda, Downes, Thomas R., Kaczkowski, Scott M., Luckasen, Gary J., Jaskowiak, Adam J., Klitch, Joel, Cheong, Benjamin, Dees, Debra, Potluri, Srinivasa, Vasquez, Precilia, Mastouri, Ronald A., Breall, Jeffery A., Hannemann, Elise L., Revtyak, George E., Mae Foltz, Judy, Bazeley, Jonathan W., Li, Dayuan, DeRosa, Emily, Jorgenson, Beth, Riestenberg-Smith, Joyce, Giedd, Kenneth, Old, Wayne, Bariciano, Rebecca, Burt, Francis, Sokhon, Kozhaya, Waldron, Jessica, Mayon, Michelle, Gopal, Deepika, Valeti, Uma S., Ann Peichel, Gretchen, Kobashigawa, Jon, Starks, Brandy, Garcia, Lucilla, Thottam, Maria, Bhargava, Balram, Anand, Anjali, Chakanalil Govindan, Sajeev, Raj, Janitha, Gopalan Nair, Rajesh, Ravindran, Reshma, Rajalekshmi, VS, Nataraj, Nandita, Moorthy, Nagaraja, Nayak, Soundarya, Mylarappa, Mahevamma, Narayanappa, Suryaprakash, Pandit, Neeraj, Bajaj, Sheromani, Kumar Nath, Ranjit, Yadav, Vandana, Mishra, Girish, Dwivedi, S.K., Tewari, Roma, Narain, V.S., Mishra, Meenakshi, Chandra, Sharad, Patel, Shivali, Singh, Suman, Wander, Gurpreet S., Tandon, Rohit, Ralhan, Sarju, Kaur, Baljeet, Aslam, Naved, Gupta, Sonika, Goyal, Abhishek, Bhargava, Balram, Suvarna, Chandini, Karthikeyan, G., Ramakrishnan, S., Seth, Sandeep, Yadav, Rakesh, Singh, Sandeep, Roy, Ambuj, Parakh, Neeraj, Kumar Verma, Sunil, Narang, Rajiv, Mishra, Sundeep, Naik, Nitish, Sharma, Gautam, Kumar Choudhary, Shiv, Patel, Chetan, Gulati, Gurpreet, Sharma, Sanjeev, Bahl, V K, Mathew, Anoop, Mannekkattukudy Kurian, Binoy, Punnoose, Eapen, Avdhoot Gadkari, Milind, Rupesh Karwa, Sheetal, Gadage, Siddharth, Kolhe, Suvarna, Umesh Pillay, Tapan, Satheesh, Santhosh, Vindhya, R. J., Jain, Peeyush, Seth, Ashok, Singh Meharwal, Zile, Mathur, Atul, Verma, Atul, Kaul, Upendra, Bhatia, Mona, Sachdeva, Ankush, Indira Devi, Thounaojam, Jungla, Nungshi, Christopher, Johann, Manjula Rani, K., Menon, Rajeev, Sowjanya Reddy, M., Kumar, Nirmal, Preethi, K., Oomman, Abraham, sidh, Rinu R, Mao, Robert, Ramakrishnan, T., Solomon, Hilda, Francis, Rajesh, Naik, Sudhir, Vamshi, Priya P., Parveen Khan, Sajeeda, Christopher, Johann, Preethi, Kotiboinna, Kumar, Nirmal, Grant, Purvez, Hande, Shweta, Sonawane, Poonam, Kachru, Ranjan, Dubey, Abhishek, Rawat, Kavita, Kumar, Ajit, Ganapathi, Sanjay, K, Jayakumar, CP, Vineeth, Sivadasanpillai, Harikrishnan, Chacko, Manas, Sasidharan, Bijulal, Babu, Suresh, TR, Kapilamoorthy, Christopher, Johann, Reddy, Sowjanya, Polamuri, Praneeth, Rani, Manjula, Kaul, Upendra, Arambam, Priyadarshani, Singh, Bebek, Senior, Roxy, Fox, Keith AA, Young, Grace M., Carruthers, Kathryn, Senior, Roxy, Elghamaz, Ahmed, Gurunathan, Sothinathan, Karogiannis, Nikolaos, Young, Grace M., Shah, Benoy N, Kinsey, Christopher, Trimlett, Richard HJ, Kavalakkat, Raisa, Rubens, Michael B, Evans, Jo, Nicol, Edward D, Hassan, Ikraam, Mittal, Tarun K, Hampson, Reinette, Andreas Gamma, Reto, Williams, Sarah, Holland, Kim, Swan, Karen, de Belder, Mark A, Atkinson, Bev, Thambyrajah, Jeet, Kunhunny, Swapna, Davies, John R, Lindsay, Steven J., Atkinson, Craig, Kurian, John, Krannila, Carita, Jamil, Haqeel, Vinod, Manitha, Raheem, Osama, Hoye, Angela, Chaytor, Lisa, Cox, Leanne, Morrow, Julie, Rowe, Kay, Donnelly, Patrick, Kelly, Stephanie, Valecka, Bernardas, Regan, Susan, Turnbull, Dawn, Chauhan, Anoop, Fleming, Catherine, Ghosh, Arijit, Gratrix, Karen, Preston, Stephen, Barr, Craig, Cartwright, Anne, Alfakih, Khaled, Knighton, Abigail, Byrne, Jonathan, Martin, Katherine, Webb, Ian, Henriksen, Peter, Flint, Laura, Harrison, James, OKane, Peter, Lakeman, Nicki, Ljubez, Anja, de Silva, Ramesh, Conway, Dwayne S. G., Wright, Judith, Exley, Donna, Sirker, Alexander A, Andiapen, Mervyn, Richards, Amy J., Hoole, Stephen P, Wong, Lisa, Witherow, Fraser N., Munro, Melanie J., Johnston, Nicola, Harbinson, Mark, McEvoy, Michelle, Walsh, Simon, Brown, Caroline, Douglas, Hanna, Luckie, Matthew, Charles, Thabitha, Kolakaluri, Laurel, Phillips, Hannah, Sobolewska, Jolanta, Morby, Louise, Hallett, Karen, Corbett, Carolyn, Winstanley, Lynne, Jeetley, Paramjit, Smit, Angelique, Patel, Niket, Kotecha, Tushar, Travill, Christopher, Gent, Susan, Karimullah, Iqbal, Hussain, Nafisa, Al-Bustami, Mahmud, Braganza, Denise, Haines, Fiona, Taaffe, Joanne, Henderson, Robert, Burton, Jane, Pointon, Kate, Colton, Maria, Naik, Surendra, King, Rachel, Mathew, Thomas, Brown, Ammani, Docherty, Andrew, Berry, Colin, McCloy, Lisa, Collison, Damien, Robb, Kate, Roditi, Giles, Paterson, Craig, Crawford, Wenda, Kelly, Joanne, McGregor, Lorraine, Moriarty, Andrew J, Mackin, Anne, Glover, Jason D., Knight, Janet P, Pradhan, Jiwan, Mikhail, Ghada, Bose, Tuhina, Francis, Darrel P., Dzavik, Vladimir, Goodman, Shaun, Gosselin, Gilbert, Gosselin, Gilbert, Proietti, Anna, Brousseau, Myriam, Corfias, Magalie, Blaise, Patricia, Harvey, Luc, Diaz, Ariel, Rheault, Philippe, Barrero, Miguel, Gagné, Carl-Éric, Alarie, Patricia, Pépin-Dubois, Yanek, Arcand, Linda, Costa, Ricardo, Roy, Isabelle, Tung Sia, Ying, Montpetit, Estelle, Lemay, Catherine, Gisbert, Alejandro, Gervais, Pierre, Rheault, Alain, Drouin, Katia, Carl Phaneuf, Denis, Bergeron, Christine, Gosselin, Gilbert, Shelley, Christine, Masson, Christine, Garg, Pallav, Carr, Sandy, Bone, Catherine, Chow, Benjamin J.W., Moga, Ermina, Hessian, Renee C., Kourzenkova, Janetta, Beanlands, Rob S., Walter, Olga, Davies, Richard F., Bainey, Kevin R., Hogg, Norma, Welsh, Suzanne, Cheema, Asim N., Bagai, Akshay, Wald, Ron, Goodman, Shaun, Kushniriuk, Khrystyna, Joseph Graham, John, Hussain, Mohammed, Peterson, Mark, Bello, Olugbenga, Chow, Chi-Ming, Abramson, Beth, Nazir Cheema, Asim, Syed, Ishba, Hussain, Mohammed, Kushniriuk, Khrystyna, Cha, James, Otis, Judy, Otis, Rebecca, Howarth, Andrew G, Seib, Michelle M, Rivest, Sandra M, Sandonato, Rosa, Wong, Graham, Chow, Jackie, Starovoytov, Andrew, Uchida, Naomi, Meadows, Ngaire, Uxa, Amar, Asif, Nadia, Tavares, Suzana, Galiwango, Paul, Bozek, Bev, Kassam, Saleem, Shier, Maria, Mukherjee, Ashok, Larmand, Lori-Ann, Ricci, A. Joseph, Janmohamed, Amir, Hart, Brenda, Lam, Andy, Marucci, Jane, Tai, Sharon, Mehta, Shamir, Brons, Sonya, Beck, Chris, Wong, Glenda, Etherington, Krystal, Arumairajah, Thippeekaa, Udell, Jacob, Aprile, Maria, Karlsson, Sara, Webber, Susan, Généreux, Philippe, Mercure, Chantale, Hameed, Adnan, Aedy, Nancy, Daba, Ledjalem, Farquharson, Fran, Siddiqui, Anam, Carlos Carvalho, Antonio, Lopes, Renato D., Hueb, Whady, Emy Takiuti, Myrthes, Cury Rezende, Paulo, Eustáquio Ribeiro Silva, Expedito, Ciappina Hueb, Alexandre, Pizzol Caetano, Leonardo, Schaan de Quadros, Alexandre, Abdala Karam Kalil, Renato, Peixoto Deiro, Aline, Luiz da Costa Vieira, José, Manica Muller, Alice, Antonieta Pereira de Moraes, Maria, Píccaro de Oliveira, Pedro, Maria Ascoli, Bruna, Bridi, Leonardo, Zottis Poletti, Sílvia, Savaris, Simone, Vitola, João V, Cerci, Rodrigo J, Zier, Sandra S., Farias, Fabio R, Veiga Jr, Vilmar, Fernandes, Miguel M, Antonio Marin-Neto, José, Schmidt, André, de Oliveira Lima Filho, Moysés, Franca da Cunha, Diego, Mendes Oliveira, Ricardo, Reynaldo Abbud Chierice, João, Polanczyk, Carísi A., Rucatti, Guilherme G, Furtado, Mariana V., Igansi, Fernanda, Smidt, Luis F., Haeffner, Mauren P, Carlos Carvalho, Antonio, Almeida, Viviane, Pucci, Gustavo, Sanchez de Souza, Gabriela, Lyra, Flavio, Rabelo Alves Junior, Alvaro, Almeida, Mayana, dos Santos, Viviane, Dracoulakis, Marianna D. A., Oliveira, Natalia S, Lima, Rodolfo G. S. D, Figueiredo, Estevao, Edilena Paulino Azevedo, Bruna, Ricardo Caramori, Paulo, Bizzaro Santos, Marco, Germann, Amanda, Gomes, Vitor, Homem, Rosa, Magedanz, Ellen, Tumelero, Rogerio, Laimer, Rosane, Tognon, Alexandre, Dall’Orto, Frederico, Mesquita, Claudio T., Santos, Roberta P, Colafranseschi, Alexandre S., Oliveira Jr., Amarino C., Carvalho, Luiz A., Palazzo, Isabella C., Sousa, Andre S., Eustáquio Ribeiro da Silva, Expedito, Gabriel Melo de Barros e Silva, Pedro, Yumi Okada, Mariana, de Pádua Silva Baptista, Luciana, Paula Batista, Ana, Jamus Rodrigues, Marcelo, Nogueira Rabaça, Aline, Valério Coimbra de Resende, Marcos, Francisco Saraiva, Jose, Miranda Trama, Larissa, Silva, Talita, Thais de Souza Ormundo, Camila, Vicente, Carla, Costantini, Costantino, Pinheiro, Caroline, Komar, Daniele, Szwed, Hanna, Demkow, Marcin, Kepka, Cezary, Teresinska, Anna, Walesiak, Olga, Kryczka, Karolina, Malinowska, Katarzyna, Henzel, Jan, Solecki, Mateusz, Kaczmarska, Edyta, Mazurek, Tomasz, Maksym, Jakub, Wojtera, Karolina, Fojt, Anna, Szczerba, Ewa, Drozdz, Jaroslaw, Czarniak, Bartosz, Frach, Malgorzata, Szymczyk, Konrad, Niedzwiecka, Iwona, Sobczak, Sebastian, Ciurus, Tomasz, Jakubowski, Piotr, Misztal-Teodorczyk, Magdalena, Teodorczyk, Dawid, Swiderek, Marta, Fratczak, Aleksandra, Wojtala, Ewelina, Szkopiak, Marcin, Lebioda, Patrycja, Wlodarczyk, Michal, Plachcinska, Anna, Kusmierek, Jacek, Miller, Magdalena, Marciniak, Halina, Wojtczak-Soska, Karolina, Łuczak, Katarzyna, Tarchalski, Tomasz, Cichocka-Radwan, Anna, Szwed, Hanna, Karwowski, Jaroslaw, Anna Szulczyk, Grazyna, Witkowski, Adam, Kukuła, Krzysztof, Celińska-Spodar, Małgorzta, Zalewska, Joanna, Gajos, Grzegorz, Bury, Krzysztof, Pruszczyk, Piotr, Łabyk, Andrzej, Roik, Marek, Szramowska, Agnieszka, Zdończyk, Olga, Łoboz-Grudzień, Krystyna, Jaroch, Joanna, Sokalski, Leszek, Brzezińska, Barbara, Lesiak, Maciej, Łanocha, Magdalena, Reczuch, Krzysztof W., Kolodziej, Adam, Kalarus, Zbigniew, Swiatkowski, Andrzej, Szulik, Mariola, Musial, Wlodzimierz J., Marcinkiewicz-Siemion, Marta, Bockeria, Olga, Bockeria, Leo, Bockeria, Olga, Petrosyan, Karen, Kudzoeva, Zalina, Trifonova, Tatiana, Aripova, Nodira, Chernyavskiy, Alexander M., Naryshkin, Ivan A., Kretov, Evgeniy I., Kuleshova, Alena, Grazhdankin, Igor O., Malaev, Dastan, Bershtein, Leonid L., Sayganov, Sergey A., Subbotina, Irina, Kuzmina-Krutetskaya, Anastasia M., Gumerova, Victoria, Zbyshevskaya, Elizaveta V., Katamadze, Nana O., Nikolaeva, Olga B., Kozlov, Pavel S., Kozulin, Vikentiy Y., Lubinskaya, Ekaterina I., Luis Lopez-Sendon, Jose, Castro, Almudena, Lopez-Sendon, Jose, Fernández-Figares, Virginia, Castro, Almudena, Refoyo Salicio, Elena, Guzman, Gabriela, Galeote, Gabriel, Valbuena, Silvia, Peteiro, Jesús, Dolores Martínez-Ruíz, María, Pérez-Fernández, Ruth, Blanco-Calvo, Moisés, Cuenca-Castillo, José J, Alonso-Álvarez, Encarnación, Flores-Ríos, Xacobe, García-González, Paula, Prada-Delgado, Óscar, Barge-Caballero, Gonzalo, Ramon Gonzalez Juanatey, Jose, Seijas Amigo, Jose, Souto Bayarri, Miguel, Pubull Nuñez, Virginia, Ocaranza Sanchez, Raymundo, Cid Alvarez, Belen, Peña Gil, Carlos, Martinez Monzonis, Amparo, Sionis, Alessandro, Fernández Martínez, Ana, Vila Perales, Montserrat, Maria Padró, Josep, Serra Peñaranda, Antonio, García Picart, Joan, Ginel Iglesias, Antonino, Garcia-Moll Marimon, Xavier, Pons Lladó, Guillem, Carreras Costa, Francesc, Miro, Vicente, Igual, Begoña, Diez, Jose L, Calvillo, Pilar, Ortuño, F. Marin, Valdés Chávarri, M., Quintana Giner, M., Tello Montolliu, A., Romero Aniorte, A.I., Pinar Bermudez, E., Rivera Caravaca, JM., De La Morena, G., Gracida Blancas, Montserrat, Cañavate, Olga, Guerrero, Sonia, Riera, Silvia, Enrique Castillo Luena, Jose, Enrique Castillo Luena, Jose, Lasala, Maria, Fernandez-Aviles, Francisco, Lorenzo, Maria, Sobrino, Olga, Vazquez, Alexandra, Jiang, Lixin, Chen, Jiyan, Dong, Haojian, He, Peiyu, Xia, Chunli, Yang, Junqing, Zhong, Qi, Wu, Yongjian, Tian, Yanmeng, Li, Dongze, Ma, Yitong, Li, Xiaomei, Yang, Yining, Ma, Xiang, Yu, Zixiang, Zhao, Qian, Ji, Zheng, Li, Chunguang, Zhang, Lei, Zhao, Yu, Zhu, Bolin, Yang, Xinchun, Chen, Mulei, Chi, Hongjie, Wang, Yang, Zhang, Jing, Lin, Wenhua, Jing, Rui, Liu, Jingjing, Zeng, Hesong, Zhou, Qiang, Xu, Chang, Li, Zhuxi, Li, Junhua, Xiong, Luyang, Fu, Xin, Gao, Dan, Jiang, Dengke, Leng, Ran, Wang, Xutong, Yuan, Qianqian, Zhang, Lili, Yang, Bin, Bai, Ziliang, Li, Jianhua, Qi, Jie, Wang, Fei, Wang, Haitao, Yang, Bin, Yue, Zhou, Zhang, Zhulin, Wang, Songtao, Dong, Yumei, Mao, Jiajia, Zhang, Bin, Cheng, Gong, Li, Xiuhong, Yao, Xiaowei, Zhong, Nier, Zhou, Ning, Zhao, Yulan, Huang, Yaping, Zhou, Panpan, Fang, Xuehua, Su, Wei, Zeng, Qiutang, Kunwu, Yu, Peng, Yudong, Su, Xin, Su, Xi, Wang, Chen, Zhao, Yunhai, Li, Qingxian, Geng, Yaming, Wang, Yanfu, Nie, Shao-ping, Fan, Jing-yao, Feng, Si-ting, Wang, Xiao, Yan, Yan, Zhang, Hui-min, Yu, Qin, Chi, Lingping, Liu, Fang, Wang, Jian’an, Chen, Han, Jiang, Jun, Li, Huajun, Wang, Jian’an, Han, Yechen, Xu, Lihong, Zhang, Shuyang, Liu, Zhenyu, Liu, Zhenyu, Chen, Gang, Hu, Rongrong, Maggioni, Aldo P., Piero Perna, Gian, Pietrucci, Francesca, Marini, Marco, Gabrielli, Gabriele, Provasoli, Stefano, Di Donato, Anna, Verna, Edoardo, Monti, Lorenzo, Nardi, Barbara, Di Chiara, Antonio, Pezzetta, Francesca, Mortara, Andrea, Casali, Valentina, Galvani, Marcello, Attanasio, Chiara, Ottani, Filippo, Sicuro, Marco, Leone, Gianpiero, Pisano, Francesco, Bare, Cristina, Calabro, Paolo, Fimiani, Fabio, Formisano, Tiziana, Tarantini, Giuseppe, Barioli, Alberto, Cucchini, Umberto, Ramani, Federica, Luigi Andres, Anto, Racca, Emanuela, Rolfo, Fabrizio, Goletto, Cecilia, Briguori, Carlo, De Micco, Francesca, Amati, Roberto, Di Marco, Stefano, Vergoni, William, Tricoli, Martina, Russo, Aldo, Villella, Massimo, Fanelli, Raffaele, Douglas White, Harvey, Alsweiler, Caroline, Poh, Kian-Keong, Chai, Ping, Lau, Titus, Loh, Joshua P., Tay, Edgar L., Teoh, Kristine, Tan, Sik-Yin V, Teo, Lynette L., Sia, Winnie C, Ong, Ching-Ching, Leong, Audrey W, Wong, Raymond C., Loh, Poay-Huan, Kofidis, Theodoros, Xian Chan, Wan, Hui Chan, Koo, Foo, David, Hai Yan, Li, Loh Kwok Kong, Jason, Min Er, Ching, Haider Jafary, Fahim, Chua, Terrance, Ismail, Nasrul, Tun Kyaw, Min, Yip, Deborah, Doerr, Rolf, Doerr, Rolf, Stumpf, Juergen, Grahl, Dorit, Matschke, Klaus, Guenther, Franziska, Simonis, Gregor, Bonin, Kerstin, Kadalie, Clemens T., Sechtem, Udo, Wenzelburger, Ina, Ong, Peter, Gruensfelder, Susanne, Christian Schulze, P., Goebel, Bjoern, Lenk, Karsten, Nickenig, Georg, Sinning, Jan-Malte, Weber, Marcel, Werner, Nikos, Marthe Lang, Irene, Huber, Kurt, Schuchlenz, Herwig, Steinmaurer, Gudrun, Weikl, Stefan, Marthe Lang, Irene, Winter, Max-Paul, Andric, Tijana, Huber, Kurt, Tscharre, Maximilian, Jakl-Kotauschek, Gabriele, Wegmayr, Claudia, Jäger, Bernhard, Egger, Florian, Keltai, Matyas, Vertes, Andras, Sebo, Judit, Davidovits, Zoltan, Matics, Laszlone, Varga, Albert, Ágoston, Gergely, Fontos, Geza, Dekany, Gabor, Merkely, Bela, Bartykowszki, Andrea, Maurovich-Horvat, Pal, Kerecsen, Gabor, Jakal, Agnes, Hinic, Sasa, Djokic, Jelena, Zdravkovic, Marija, Mudrenovic, Vladan, Crnokrak, Bogdan, Beleslin, Branko D., Boskovic, Nikola N., Djordjevic-Dikic, Ana D., Petrovic, Marija T., Giga, Vojislav L., Dobric, Milan R., Stepanovic, Jelena J., Markovic, Zeljko Z., Mladenovic, Ana S., Cemerlic-Adjic, Nada, Velicki, Lazar, Kamenica, Sremska, Pupic, Ljiljana, Davidović, Goran, Simović, Stefan M., Vučić, Rada, Dekleva, Milica Nikola, Martinovic, Miroslav Stevo, Stevanovic, Gordana, Stankovic, Goran, Dobric, Milan, Apostolovic, Svetlana, Martinovic, Sonja Salinger, Stanojevic, Dragana, Escobedo, Jorge, Jesús-Pérez, Ramon de, Juarez, Benito, Baleón-Espinosa, Rubén, Campos-Santaolalla, Arturo S, Durán-Cortés, Elihú, Flores-Palacios, José M, García-Rincón, Andrés, Jiménez-Santos, Moisés, Peñafiel, Joaquín V, Ortega-Ramírez, José A, Valdespino-Estrada, Aquiles, Rosas, Erick Alexánderson, Canales Brassetti, María Fernanda, Vences Anaya, Diego Adrián, García, María Pérez, Carvajal Juarez, Isabel Estela, Rovalo, Magdalena Madero, Morales Rodríguez, Erick Donato, Selvanayagam, Joseph B., Rankin, Jamie, Murphy, Deirdre, Selvanayagam, Joseph B., Lee, Sau, Joseph, Majo X., Thomas, Prince, Thambar, Suku T., Chaplin, Melissa D, Boer, Stephanie C, Beltrame, John F., Stansborough, Jeanette K., Black, Marilyn, Hillis, Graham S., Bonner, Michelle M., Ireland, Kim F., Venn-Edmonds, Clare, Steg, Philippe-Gabriel, Abergel, Helene, Juliard, Jean-Michel, Thobois, Corine, Pasteur, C.H. Louis, Thuaire, Christophe, Tachot, Emilie, Dutoiu, Téodora, Laure, Christophe, Vassaliere, Christel, Steg, Philippe Gabriel, Abergel, Helene, Juliard, Jean-Michel, Fuentes, Axelle, Slama, Michel S., Eliahou, Ludivine, Cedex, Clamart, El Mahmoud, Rami, Dubourg, Olivier, Michaud, Pierre, Nicollet, Eric, Hadjih, Sarah, Cedex, Corbeil-Essonnes, Goube, Pascal, Brito, Patricia, Barone-Rochette, Gilles, Barone-Rochette, Gilles, Furber, Alain, Cornet, Charles, Bière, Loïc, Rautureau, Jeremy, Juceviciene, Agne, Kalibataite-Rutkauskiene, Irma, Keinaite, Laura, Laucevicius, Aleksandras, Laukyte, Monika, Celutkiene, Jelena, Mikolaitiene, Gelmina, Smigelskaite, Akvile, Tamasauskiene, Ilona, Urboniene, Agne, Kedhi, Elvin, Klinieken, Isala, Timmer, Jorik, Bouwhuis, Ilse, Hermanides, Rik, Nijmeijer, Lia, Kaplan, Eliza, Riezebos, Robert K., Samadi, Pouneh, Jeannette, Schoep, J. M., Dongen, Elise van, Elisabeth, Janzen, M., Niehe, Sander R., Suryapranata, Harry, Ahoud, Sandra, Vugt, Stijn van, Ramos, Ruben, Santa Marta, Hospital de, Cacela, Duarte, Santana, Ana, Fiarresga, Antonio, Sousa, Lidia, Marques, Hugo, Patricio, Lino, Selas, Mafalda, Bernanrdes, Luis, Silva, Filipa, Rio, Pedro, Freixo, Cláudia, Carvalho, Ramiro, Ferreira, Rui, Silva, Tiago, Rodrigues, Ines, Modas, Pedro, Portugal, Guilherme, Fragata, Jose, Pinto, Fausto J., Cabrita, Inês Zimbarra, Menezes, Miguel Nobre, Rocha, Andreia, Lopes, Guilhermina Cantinho, Figueiras, Francisca Patuleia, Almeida, Ana Gomes, Coelho, Andreia, CanVas Silva, Pedro, Capinha, Marta, Nobre, Angelo, Caetano, Maria Inês, Francisco, Ana Rita, Silva, Susana, Ferreira, Nuno, de Gaia, Vila Nova, Lopes, Ricardo L., Diaz, Rafael, Guzman, Luis, Tinnirello, Veronica, Figal, Julio César, Nicolás Mungo, Matías, Buenos Aires, Ciudad Autonoma de, Méndiz, Oscar, Cortés, Claudia, Favaloro, Roberto René, Alvarez, Carlos, Garcia, Marina, Blanca, Bahia, Courtis, Javier, Godoy, Valeria, Zeballos, Gabriela, Schiavi, Lilia, Actis, Maria Victoria, Rubio, Mariano, Scaro, Graciela, White, Harvey Douglas, Alsweiler, Caroline, Devlin, Gerard Patrick, Low, Liz, Fisher, Raewyn, Scales, Jayne, Abercrombie, Kirsty, Stewart, Ralph Alan Huston, Howell, Leah, White, Harvey Douglas, Patten, Cathrine, Benatar, Jocelyne, Kedev, Sasko, Mitevska, Irena Peovska, Kostovska, Elizabeta Srbinovska, Pejkov, Hristo, Held, Claes, Held, Claes, Eggers, Kai, Frostfelt, Gunnar, Björklund, Christina, Johnston, Nina, Andreasson, Maria, Olsowka, Maciej, Essermark, Marie, Åkerblom, Axel, Soveri, Inga, Aspberg, Johannes, Persson, Liselotte, Beyar, Rafael, Sharir, Tali, Nikolsky, Eugenia, Sharir, Tali, Harel, Or, Elian, Dan, Kerner, Arthur, Bentzvi, Margalit, Massalha, Samia, Helmer, Ludmila, Kohsaka, Shun, Fukuda, Keiichi, Ueda, Ikuko, Kohsaka, Shun, Fujita, Jun, Yasuda, Satoshi, Furukawa, Akemi, Hirase, Kanae, Nagai, Toshiyuki, Otsuka, Fumiyuki, Nishimura, Shigeyuki, Nakano, Shintaro, de Werf, Frans Van, Goetschalckx, Kaatje, Goetschalckx, Kaatje, Robesyn, Valerie, de Werf, Frans Van, Claes, Kathleen, White, Harvey Douglas, Alsweiler, Caroline, Hung, Chung-Lieh, Yang, Yi-Hsuan, Yun, Chun-Ho, Hou, Charles Jia-Yin, Kuo, Jen-Yuan, Yeh, Hung-I, Hung, Ta-Chuan, Li, Jiun-Yi, Chien, Chen-Yen, Tsai, Cheng-Ting, Liu, Chun-Chieh, Yu, Fa-Chang, Lin, Yueh-Hung, Lan, Wei-Ren, Yen, Chih-Hsuan, Tsai, Jui-Peng, Sung, Kuo-Tzu, Ntsekhe, Mpiko, Pandie, Shaheen, Philander (Nee Talliard), Constance, Viljoen, Charle A, Mtana, Noloyiso, De Andrade, Marianne, Maggioni, Aldo P., Moccetti, Tiziano, Anesini, Adriana, Rossi, M.Grazia, Maspoli, Simona, Mombelli, Manuela, Abdelhamid, Magdy, Talaat, Ahmed, Adel, Ahmed, Kamal, Ahmed, Mahrous, Hossam, Kaffas, Sameh El, Fishawy, Hussien El, Pop, Calin, Claudia, Matei, Popescu, Bogdan A., Ginghina, Carmen, Rosca, Monica, Deleanu, Dan, Beladan, Carmen C., Iliescu, Vlad A., Al-Mallah, Mouaz H., Zahrani, Sarah, Aljzeeri, Ahmed, Najm, Hani, Alghamdi, Ali, Mogrovejo Ramos, Walter Enrique, Monsalve Davila, Marco Antonio, White, Harvey Douglas, Alsweiler, Caroline, Kuanprasert, Srun, Mai, Chiang, Prommintikul, Arintaya, Nawarawong, Weerachai, Khwakhong, Supatchara, Woragidpoonpol, Surin, Chaiyasri, Anong, Tepsuwan, Thitipong, Mekara, Warangkana, Taksaudom, Noppon, Kulthawong, Supap, Rimsukcharoenchai, Chataroon, Amaritakomol, Anong, Euathrongchit, Juntima, Wannasopha, Yutthaphan, Yamwong, Sukit, Panpunuan, Pachara, Sritara, Piyamitr, Aramcharoen, Suthara, Meemuk, Krissada, White, Harvey Douglas, Alsweiler, Caroline, Khairuddin, Ahmad, Mokhtar, Noor Syamira, Hadi, Hafidz Abd, Basri, Nor Asiah, Yahaya, Shaiful Azmi, Yusnida, Irni, Hashim, Humayrah, Harrington, Robert, Williams, David, Alexander, Karen P., Berger, Jeffrey, Harrington, Robert, Mark, Daniel, O’Brien, Sean M., Rosenberg, Yves, Shaw, Leslee J., Ballantyne, Christie, Berman, Daniel, Beyar, Rafael, Bhargava, Balram, Buller, Chris, (Tony) Carvalho*, Antonio, Chaitman, Bernard R., Diaz, Rafael, Doerr, Rolf, Dzavik, Vladimir, Goodman, Shaun, Gosselin, Gilbert, Hachamovitch, Rory, Hamm, Christian, Held, Claes, Helm, Malte, Huber, Kurt, Jiang, Lixin, Keltai, Matyas, Kohsaka, Shun, Lang, Irene, Lopes, Renato, Lopez-Sendon, Jose, Maggioni, Aldo, Bairey Merz, C. Noel, Min, James, Peterson, Eric, Picard, Michael H., Selvanayagam, Joseph, Senior, Roxy, Sharir, Tali, Steg, Gabriel, Szwed, Hanna, de Werf, Frans Van, Weintraub, William, White, Harvey, Williams, David, Ballantyne, Christie, Calfas*, Karen, Chaitman, Bernard R., Champagne, Mary Ann, Davidson, Michael, Fleg, Jerome, McCullough, Peter A., Stone, Peter, Menasche, Philippe, Davidson*, Michael, Fremes, Stephen, Guyton, Robert, Mack, Michael, Mohr, Fred, Rao, Anupama, Sabik, Joe, Shapira, Oz, Taggart, David, Tatoulis, James, Williams, David, Blankenship, Jim, Brener, Sorin, Buller, Chris, Colombo, Antonio, Bruyne, Bernard de, Généreux, Philippe, Harrington, Robert, Kereiakes, Dean, Lefevre, Thierry, Moses, Jeffrey, Chaitman, Bernard R., Alexander, Karen P., Mahaffey, Ken, White, Harvey, Chaitman, Bernard R., Cruz-Flores, Salvador, Danchin, Nicholas, Feen, Eli, Garcia, Mario J., Hauptman, Paul, Laddu, Abhay A., Passamani, Eugene, Pina, Ileana L., Simoons, Maarten, Skali, Hicham, Thygesen, Kristian, Waters, David, Alexander, Karen P., Endsley, Patricia, Esposito, Gerard, Kanters, Jeffrey, Pownall, John, Stournaras, Dimitrios, Shaw, Leslee J., Berman, Daniel, Friedrich, Matthias, Hachamovitch, Rory, Kwong, Raymond, Min, James, Oliver, Dana, Picard, Michael H., Harrell, Frank, Blume, Jeffrey, Lee, Kerry, O’Brien, Sean M., Berger, Jeffrey, Held, Claes, Kullo, Iftikhar, McManus, Bruce, Newby, Kristin, Mark, Daniel, Cohen, David, Weintraub, William, Merz, C. Noel Bairey, Bugiardini, Raffaele, Celutkiene, Jelena, Escobedo, Jorge, Hoye, Angela, Lyubarova, Radmila, Mattina, Deirdre, Peteiro, Jesus, Alexander, Karen P., Berger, Jeffrey, Harrington, Robert, O’Brien, Sean M., Rosenberg, Yves, Mark, Daniel, Mark, Daniel, Shaw, Leslee J., Berman, Dan, Chaitman, Bernard R., Fleg, Jerome, Kwong, Raymond, Picard, Michael H., Senior, Roxy, Min, James, Leipsic, Jonathan, Ali, Ziad, Williams, David, Fleg, Jerome, Berger, Jeffrey, Chaitman, Bernard R., Alexander, Karen P., Alexander, Karen P., Fleg, Jerome, Mathew, Roy, O’Brien, Sean M., Sidhu, Mandeep, Friedman, Lawrence, Anderson, Jeffrey, Berg, Jessica, DeMets, David, Gibson, C. Michael, Lamas, Gervasio, Deming, Nicole, Himmelfarb, Jonathan, Ouyang, Pamela, Woodard, Pamela, Harrell, Frank, Nwosu, Samuel, Rosenberg, Yves, Fleg, Jerome, Kirby, Ruth, Jeffries, Neal, Berger, Jeffrey, Sidhu, Mandeep, Denaro*, Jean E., Mavromichalis, Stephanie, Chan, Kevin, Cobb, Gia, Contreras, Aira, Cukali, Diana, Ferket, Stephanie, Gabriel, Andre, Hansen, Antonietta, Roberts, Arline, Chang, Michelle, Islam, Sharder, Wayser, Graceanne, Yakubov, Solomon, Yee, Michelle, Callison, Caroline, Hogan, Isabelle, Qelaj, Albertina, Pirro, Charlotte, Loo, Kerrie Van, Wisniewski, Brianna, Gilsenan, Margaret, Lang, Bevin, Mohamed, Samaa, Esquenazi-Karonika, Shari, Mathews, Patenne, Naumova, Anna, Lyo, Jihyun, Setang, Vincent, Xavier, Mark, O’Brien, Sean M., Alexander, Karen P., Mark, Daniel B., Anstrom, Kevin, Baloch, Khaula, Blount, Janet, Cowper, Patricia, Davidson-Ray, Linda, Drew, Laura, Harding, Tina, Knight, J David, Liu, Diane Minshall, O’Neal, Betsy, Redick, Thomas, Jones, Philip, Nugent, Karen, Wang, Grace Jingyan, Shaw, Leslee J., Phillips, Lawrence, Goyal, Abhinav, Hetrick, Holly, Oliver, Dana, Berman, Daniel, Hayes, Sean W., Friedman, John D., Gerlach, R. James, Hyun, Mark, Miranda-Peats, Romalisa, Slomka, Piotr, Thomson, Louise, Kwong, Raymond Y., Friedrich, Matthias, Mongeon, Francois Pierre, Michael, Steven, Picard, Michael H., Hung, Judy, Scherrer-Crosbie, Marielle, Zeng, Xin, Chaitman, Bernard R., Eckstein, Jane, Guruge, Bandula, Streif, Mary, Ali, Ziad, Genereux, Philippe, Alfonso, Maria A., Corral, Maria P., Garcia, Javier J., Horst, Jennifer, Jankovic, Ivana, Konigstein, Maayan, Lustre, Mitchel B., Peralta, Yolayfi, Sanchez, Raquel, Min, James, Arsanjani, Reza, Budoff, Matthew, Elmore, Kimberly, Gomez, Millie, Hague, Cameron, Hindoyan, Niree, Leipsic, Jonathan, Nakanishi, Rine, Srichai-Parsia, M. Barbara, Yeoh, Eunice, Youn, Tricia, Maggioni, Aldo P., Bianchini, Francesca, Ceseri, Martina, Lorimer, Andrea, Magnoni, Marco, Orso, Francesco, Sarti, Laura, Tricoli, Martinia, Carvalho, Antonio, Lopes, Renato, Barbosa, Lilian Mazza, Duarte, Tauane Bello, Soares, Tamara Colaiácovo, Aveiro Morata, Julia de, Carvalho, Pedro, Carvalho Maffei, Natalia de, Egydio, Flávia, Kawakami, Anelise, Oliveira, Janaina, Piloto, Elissa Restelli, Pozzibon, Jaqueline, Goodman, Shaun, Camara, Diane, Mowafy, Neamat, Spindler, Caroline, Jiang, Lixin, Dai, Hao, Feng, Fang, Li, Jia, Li, Li, Liu, Jiamin, Xie, Qiulan, Zhang, Haibo, Zhang, Jianxin, Zhang, Lihua, Zhang, Liping, Zhang, Ning, Zhong, Hui, Diaz, Rafael, Escobar, Claudia, Martin, Maria Eugenia, Pascual, Andrea, Lopez-Sendon, José, Moraga, Paloma, Hernandez, Victoria, Castro, Almudena, Posada, Maria, Fernandez, Sara, Villanueva, José Luis Narro, Selgas, Rafael, Steg, Gabriel, Abergel, Helene, Juliard, Jean Michel, White, Harvey, Alsweiler, Caroline, de Werf, Frans Van, Claes, Kathleen, Goetschalckx, Kaatje, Luyten, Ann, Robesyn, Valerie, Selvanayagam, Joseph B., Murphy, Deirdre, Ahmed, Asker, Bhatt, Richa, Chadha, Nitika, Kumar, Vijay, Lubna, Sadath, Naik, Pushpa, Pandey, Shruti, Ramasamy, Karthik, Saleem, Mohammed, Sharma, Pratiksha, and Siddaram, Hemalata
- Published
- 2024
- Full Text
- View/download PDF
6. Physical and Psychological Well-being Effects of Cardiac Rehabilitation on Patients Following Mitral Valve and Aortic Valve Procedures
- Author
-
Jafri, S. Hammad, Hushcha, Pavel, Dorbala, Pranav, Bousquet, Gisele, Lutfy, Christine, Klein, Jodi, Mellett, Lauren, Sonis, Lindsay, Polk, Donna, and Skali, Hicham
- Abstract
Changes in physical and psychological well-being following participation in cardiac rehabilitation (CR) were compared between patients with surgical aortic and those with mitral valve procedures. After CR, improvements in 6-min walk distance and exercise min/wk were similar between the two groups. Changes in anxiety (General Anxiety Disorder-7), depression (Patient Health Questionnaire-9-9), and Dartmouth Cooperative Functional Assessment scores were also similar.
- Published
- 2022
- Full Text
- View/download PDF
7. Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life
- Author
-
Reimer Jensen, Anne Marie, Zierath, Rani, Claggett, Brian, Skali, Hicham, Solomon, Scott D., Matsushita, Kunihiro, Konety, Suma, Butler, Kenneth, Kitzman, Dalane W., Biering-Sørensen, Tor, and Shah, Amil M.
- Abstract
IMPORTANCE: Limited data exist regarding the association of subtle subclinical systolic dysfunction and incident heart failure (HF) in late life. OBJECTIVE: To assess the independent associations of subclinical impairments in systolic performance with incident HF in late life. DESIGN, SETTING, AND PARTICIPANTS: This study was a time-to-event analysis of participants without heart failure in the Atherosclerosis Risk in Communities (ARIC) study, a prospective, community-based cohort study, who underwent protocol echocardiography at the fifth study visit (January 1, 2011, to December 31, 2013). Findings were validated independently in participants in the Copenhagen City Heart Study (CCHS). Data analysis was performed from June 1, 2018, to February 28, 2020. EXPOSURES: Left ventricular ejection fraction (LVEF), longitudinal strain (LS), and circumferential strain (CS) measured by 2-dimensional and strain echocardiography. MAIN OUTCOMES AND MEASURES: Main outcomes were incident adjudicated HF and HF with preserved and reduced LVEF at a median follow-up of 5.5 years (interquartile range, 5.0-5.8 years). Cox proportional hazards regression models adjusted for demographics, hypertension, diabetes, obesity, smoking, coronary disease, estimated glomerular filtration rate, LV mass index, e′, E/e′, and left atrial volume index. Lower 10th percentile limits were determined in 374 participants free of cardiovascular disease or risk factors. RESULTS: Among 4960 ARIC participants (mean [SD] age, 75 [5] years; 2933 [59.0%] female; 965 [19%] Black), LVEF was less than 50% in only 76 (1.5%). In the 3552 participants with complete assessment of LVEF, LS, and CS, 983 (27.7%) had 1 or more of the following findings: LVEF less than 60%, LS less than 16.0%, or CS less than 23.7%. Modeled continuously or dichotomized, worse LVEF, LS, and CS were each independently associated with incident HF. The adjusted hazard ratio (HR) per SD decrease in LVEF was 1.41 (95% CI, 1.29-1.55); the HR for LVEF less than 60% was 2.59 (95% CI, 1.99-3.37). Similar findings were observed for continuous LS (HR, 1.37; 95% CI, 1.22-1.53) and dichotomized LS (HR, 1.93; 95% CI, 1.46-2.55) and for continuous CS (HR, 1.39; 95% CI, 1.22-1.57) and dichotomized CS (HR, 2.30; 95% CI, 1.64-3.22). Although the magnitude of risk for incident HF or death associated with impaired LVEF was greater using guideline (HR, 2.99; 95% CI, 2.19-4.09) compared with ARIC-based limits (HR, 1.88; 95% CI, 1.58-2.25), the number of participants classified as impaired was less (104 [2.1%] based on guideline thresholds compared with 692 [13.9%] based on LVEF <60%). The population-attributable risk associated with LVEF less than 60% was 11% compared with 5% using guideline-based limits, a finding replicated in 908 participants in the CCHS. CONCLUSIONS AND RELEVANCE: These findings suggest that relatively subtle impairments of systolic function (detected based on LVEF or strain) are independently associated with incident HF and HF with reduced LVEF in late life. Current recommended assessments of LV function may substantially underestimate the prevalence of prognostically important impairments in systolic function in this population.
- Published
- 2021
- Full Text
- View/download PDF
8. Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (SPin-D): a randomized, placebo-controlled, multiple dosage trial
- Author
-
Charytan, David M., Himmelfarb, Jonathan, Ikizler, T. Alp, Raj, Dominic S., Hsu, Jesse Y., Landis, J. Richard, Anderson, Amanda H., Hung, Adriana M., Mehrotra, Rajnish, Sharma, Shailendra, Weiner, Daniel E., Williams, Mark, DiCarli, Marcelo, Skali, Hicham, Kimmel, Paul L., Kliger, Alan S., Dember, Laura M., Kliger, Alan, Charytan, David M., Robinson, Emily, Williams, Mark, Weiner, Daniel E., Aurien-Blajeni, Ezra, Cinelli, Maria Angeles, Nizam, Tayyaba, Rim, Sookyung, Seok, Paul, Smith, Caroline, Rollins, Jasmine, Raj, Dominic, Regunathan-Shenk, Renu, Sharma, Shailendra, Ramezani, Ali, Andrews, Sarah, Dumadag, Michelle, Franco, Christina, Wing, Maria, Himmelfarb, Jonathan, Mehrotra, Rajnish, Anderson, Lisa, Linke, Lori, Manahan, Linda, Ikizler, T. Alp, Hung, Adriana, Cavanaugh, Kerri, Booker, Cindy, Brannon, Brigitte, Clagett, Adrienne, Ellis, Charles, Dember, Laura, Landis, J. Richard, Anderson, Amanda, Hsu, Jesse, Cifelli, Denise, Ballard, Shawn, Durborow, Marie, Howard, Tamara, Kuzla, Natalie, Nessel, Lisa, Tierney, Ann, Skali, Hicham, Solomon, Scott, Rad, Aria, Di Carli, Marcelo, Gaber, Masha, Foster, Courtney, Kimmel, Paul, and Kusek, John
- Abstract
The safety and efficacy of spironolactone is uncertain in end-stage renal disease. We randomized 129 maintenance hemodialysis patients to placebo (n=51) or spironolactone 12.5 mg (n=27), 25 mg (n=26), or 50 mg (n=25) daily for 36 weeks in a double-blind, placebo-controlled, multiple dosage trial to assess safety, tolerability and feasibility and to explore cardiovascular efficacy. The primary safety endpoints were hyperkalemia (potassium > 6.5 mEq/L) and hypotension requiring emergency department visit or hospitalization. Diastolic function was assessed by Doppler echocardiography. 125 participants (97%) completed dose escalation, with no significant difference in permanent study drug discontinuation between the groups (27.5% in placebo versus 16.7% in the combined spironolactone groups and 28% in the 50 mg group). Hyperkalemia frequency was similar between spironolactone and placebo (0.49 versus 0.50 events per patient-year) but demonstrated a significant linear trend due primarily to an increased event rate at the 50 mg dose (0.89 events per patient-year). The primary hypotension outcome was infrequent and similar with spironolactone and placebo (0.11 versus 0 events per patient-year). Gynecomastia was rare and did not differ significantly between groups. Change in diastolic function was similar with spironolactone and placebo. Spironolactone appears safe in carefully monitored maintenance hemodialysis patients, but did not affect cardiovascular parameters in this small study. Hyperkalemia occurs more frequently as dosage increases to 50 mg daily.
- Published
- 2019
- Full Text
- View/download PDF
9. Coronary Microvascular Dysfunction, Left Ventricular Remodeling, and Clinical Outcomes in Patients With Chronic Kidney Impairment
- Author
-
Bajaj, Navkaranbir S., Singh, Amitoj, Zhou, Wunan, Gupta, Ankur, Fujikura, Kana, Byrne, Christina, Harms, Hendrik J., Osborne, Michael T., Bravo, Paco, Andrikopolou, Efstathia, Divakaran, Sanjay, Bibbo, Courtney F., Hainer, Jon, Skali, Hicham, Taqueti, Viviany, Steigner, Michael, Dorbala, Sharmila, Charytan, David M., Prabhu, Sumanth D., Blankstein, Ron, Deo, Rahul C., Solomon, Scott D., and Di Carli, Marcelo F.
- Abstract
Supplemental Digital Content is available in the text.
- Published
- 2020
- Full Text
- View/download PDF
10. Natriuretic Peptides, Kidney Function, and Clinical Outcomes in Heart Failure With Preserved Ejection Fraction
- Author
-
Neuen, Brendon L., Vaduganathan, Muthiah, Claggett, Brian L., Beldhuis, Iris, Myhre, Peder, Desai, Akshay S., Skali, Hicham, Mc Causland, Finnian R., McGrath, Martina, Anand, Inder, Zile, Michael R., Pfeffer, Marc A., McMurray, John J.V., and Solomon, Scott D.
- Abstract
N-terminal pro–B-type natriuretic peptides (NT-proBNPs) are guideline-recommended biomarkers for risk stratification in patients with heart failure. However, NT-proBNP levels are often elevated in chronic kidney disease, introducing uncertainty about their prognostic relevance in persons across a broad range of estimated glomerular filtration rates (eGFRs).
- Published
- 2024
- Full Text
- View/download PDF
11. Outcomes and Safety of Transcaval Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis
- Author
-
Salihu, Adil, Ferlay, Clémence, Kirsch, Matthias, Shah, Pinak B., Skali, Hicham, Fournier, Stephane, Meier, David, Muller, Olivier, Hugelshofer, Sarah, Skalidis, Ioannis, Tzimas, Georgios, Monney, Pierre, Eeckhout, Eric, Arangalage, Dimitri, Rancati, Valentina, Antiochos, Panagiotis, and Lu, Henri
- Abstract
The transcaval (TCv) vascular approach is increasingly used in transcatheter aortic valve replacement (TAVR) in patients unsuitable for the gold-standard transfemoral approach. We aimed to evaluate the efficacy, safety, and clinical outcomes associated with TCv-TAVR.
- Published
- 2024
- Full Text
- View/download PDF
12. Association Between Circulating Troponin Concentrations, Left Ventricular Systolic and Diastolic Functions, and Incident Heart Failure in Older Adults
- Author
-
Myhre, Peder L., Claggett, Brian, Ballantyne, Christie M., Selvin, Elizabeth, Røsjø, Helge, Omland, Torbjørn, Solomon, Scott D., Skali, Hicham, and Shah, Amil M.
- Abstract
IMPORTANCE: Cardiac troponin is associated with incident heart failure and greater left ventricular (LV) mass. Its association with LV systolic and diastolic functions is unclear. OBJECTIVES: To define the association of high-sensitivity cardiac troponin T (hs-cTnT) with LV systolic and diastolic functions in the general population, and to evaluate the extent to which that association accounts for the correlation between hs-cTnT concentration and incident heart failure overall, heart failure with preserved LV ejection fraction (LVEF; HFpEF), and heart failure with LVEF less than 50%. DESIGN, SETTING, AND PARTICIPANTS: This analysis of the Atherosclerosis Risk in Communities (ARIC) Study, an ongoing epidemiologic cohort study in US communities, included participants without cardiovascular disease (n = 4111). Available hs-cTnT measurements for participants who attended ARIC Study visits 2 (1990 to 1992), 4 (1996 to 1998), and 5 (2011 to 2013) were assessed cross-sectionally against echocardiographic measurements taken at visit 5 and against incident health failure after visit 5. Changes in hs-cTnT concentrations from visits 2 and 4 were also examined. Data analyses were performed from August 2017 to July 2018. MAIN OUTCOMES AND MEASURES: Cardiac structure and function by echocardiography at visit 5, and incident heart failure during a median 4½ years follow-up after visit 5. RESULTS: Of the 6538 eligible participants, 4111 (62.9%) without cardiovascular disease were included. Among these participants, 2586 (62.9%) were female, and the mean (SD) age was 75 (5) years. Median (interquartile range) hs-cTnT concentration at visit 5 was 9 (7-14) ng/L and was detectable in 3946 participants (96.0%). After adjustment for demographic and clinical covariates, higher hs-cTnT levels were associated with greater LV mass index (adjusted mean [SE] for group 1: 33.8 [0.5] vs group 5: 40.1 [0.4]; P for trend < .001) and with worse diastolic function, including lower tissue Doppler imaging e’ (6.00 [0.07] vs 5.54 [0.06]; P for trend < .001), higher E/e’ ratio (11.4 [0.2] vs 12.9 [0.1]; P for trend < .001), and greater left atrial volume index (23.4 [0.4] vs 26.4 [0.3]; P for trend < .001), independent of LV mass index; hs-cTnT level was not associated with measures of LV systolic function. Accounting for diastolic function attenuated the association of hs-cTnT concentration with incident HFpEF by 41% and the association with combined heart failure with midrange and reduced ejection fraction combined (LVEF <50) by 17%. Elevated hs-cTnT concentration and diastolic dysfunction were additive risk factors for incident heart failure. For any value of late-life hs-cTnT levels, longer duration of detectable hs-cTnT from midlife to late life was associated with greater LV mass in late life but not with worse LV systolic or diastolic function. CONCLUSIONS AND RELEVANCE: This study shows that higher hs-cTnT concentrations were associated with worse diastolic function, irrespective of LV mass, but not with systolic function; these findings suggest that high levels of hs-cTnT may serve as an early marker of subclinical alterations in diastolic function that may lead to a predisposition to heart failure.
- Published
- 2019
- Full Text
- View/download PDF
13. Association between Nonalcoholic Fatty Liver Disease at CT and Coronary Microvascular Dysfunction at Myocardial Perfusion PET/CT
- Author
-
Vita, Tomas, Murphy, David J., Osborne, Michael T., Bajaj, Navkaranbir S., Keraliya, Abhishek, Jacob, Sophia, Martinez, Angel Joel Diaz, Nodoushani, Ariana, Bravo, Paco, Hainer, Jon, Bibbo, Courtney F., Steigner, Michael L., Taqueti, Viviany R., Skali, Hicham, Blankstein, Ron, Carli, Marcelo F. Di, and Dorbala, Sharmila
- Abstract
Patients who underwent myocardial perfusion PET/CT and showed evidence of nonalcoholic fatty liver disease at CT showed a higher risk of coronary microvascular dysfunction, which is an independent risk factor for major adverse cardiac events.
- Published
- 2019
- Full Text
- View/download PDF
14. Cardiovascular phenotype and prognosis of patients with heart failure induced by cancer therapy
- Author
-
Nadruz, Wilson, West, Erin, Sengeløv, Morten, Grove, Gabriela L, Santos, Mário, Groarke, John D, Forman, Daniel E, Claggett, Brian, Skali, Hicham, Nohria, Anju, and Shah, Amil M
- Abstract
ObjectiveThis study compared the clinical features, cardiac structure and function evaluated by echocardiography, cardiopulmonary response to exercise and long-term clinical outcomes between patients with heart failure (HF) induced by cancer therapy (CTHF) and heart failure not induced by cancer therapy (NCTHF).MethodsWe evaluated 75 patients with CTHF and 894 with NCTHF who underwent clinically indicated cardiopulmonary exercise testing, and followed these individuals for a median of 4.5 (3.0–5.8) years, during which 187 deaths and 256 composite events (death, heart transplantation and left ventricular (LV) assistant device implantation) occurred.ResultsCompared with NCTHF, patients with CTHF were younger, with lower prevalence of cardiovascular comorbidities, higher LV ejection fraction (LVEF), but similar global longitudinal strain. LV diastolic function (higher E/e′ ratio) and compliance (higher end-diastolic pressure/LV end-diastolic volume index ratio) were worse in CTHF and were both associated with adverse outcomes. Despite a favourable clinical profile, peak VO2and VE/VCO2slope were similarly impaired in CTHF and NCTHF. In multivariable Cox regression analysis including clinical characteristics, cardiopulmonary exercise testing variables and LVEF, CTHF was associated with a significantly higher risk of death (HR 2.64; 95% CI 1.53 to 4.55; p=0.001) and composite events (HR 1.79; 95% CI 1.10 to 2.91; p=0.019) compared with NCTHF.ConclusionsCTHF is characterised by a distinct clinical profile, better LVEF but worse LV diastolic properties, and similarly impaired global longitudinal strain, functional capacity and ventilatory efficiency. Accounting for differences in clinical characteristics, CTHF was associated with worse long-term prognosis than NCTHF.
- Published
- 2019
- Full Text
- View/download PDF
15. Pulmonary embolism with thrombus-in-transit across a patent foramen ovale
- Author
-
Ostrominski, John W, Wang, Christine J, Campia, Umberto, Connors, Jean M, Varelmann, Dirk J, Mladinov, Domagoj, Keshk, Mohamed, and Skali, Hicham
- Published
- 2023
- Full Text
- View/download PDF
16. Association of Resting Heart Rate and Temporal Changes in Heart Rate With Outcomes in Participants of the Atherosclerosis Risk in Communities Study
- Author
-
Vazir, Ali, Claggett, Brian, Cheng, Susan, Skali, Hicham, Shah, Amil, Agulair, David, Ballantyne, Christie Mitchell, Vardeny, Orly, and Solomon, Scott D.
- Abstract
IMPORTANCE: Time-updated heart rate (HR) and temporal change in HR (ΔHR) are associated with outcome in individuals with established heart failure (HF). Whether these factors are associated with outcomes in a community-based cohort is unclear. OBJECTIVE: To determine whether the time-updated analysis of resting HR, defined as the most recent HR value measured before occurrence of an event or the end of study, and ΔHR over time are associated with outcomes in a community-based cohort. DESIGN, SETTING, AND PARTICIPANTS: A total of 15 680 participants were enrolled in the Atherosclerosis Risk in Communities cohort study, with HR recorded at baseline and during 3 follow-up visits from 1987 to 1998, with a median interval between visits of 3.0 (interquartile range, 2.9-4.0) years. The ΔHR was calculated by assessing a change in HR from the preceding visit. Participants were followed up until December 31, 2014, equating to 28 years of follow-up. The present study was conducted from March 2014 to June 2016 with updated analysis. MAIN OUTCOMES AND MEASURES: Baseline HR, time-updated HR, and ΔHR associated with outcomes, adjusted for established baseline and time-updated risk factors and medications. The main outcomes measures included all-cause mortality, incident HF, incident myocardial infarction, stroke, and cardiovascular and noncardiovascular death. RESULTS: Of the 15 680 participants, 8656 (55.2%) were women, mean (SD) age was 54 (6) years, and 4218 (26.9%) were African American. Time-updated HR and ΔHR were associated with death, incident HF, incident myocardial infarction, stroke, and cardiovascular and noncardiovascular death compared with baseline HR. For example, a ΔHR from the preceding visit was significantly associated with increased risk of all-cause mortality (adjusted hazard ratio, 1.12; 95% CI, 1.10-1.15; P < .001 for every 5-bpm increase in HR from the preceding visit) and time-updated HR was also significantly associated with increased risk of all-cause mortality (adjusted hazard ratio, 1.14; 95% CI, 1.12-1.17; P < .001 for every 5-bpm higher time-updated HR). CONCLUSIONS AND RELEVANCE: In a community-based cohort, time-updated HR and ΔHR are associated with mortality and nonfatal outcomes of incident HF, myocardial infarction, and stroke.
- Published
- 2018
- Full Text
- View/download PDF
17. Coronary flow reserve is predictive of the risk of cardiovascular death regardless of chronic kidney disease stage
- Author
-
Charytan, David M., Skali, Hicham, Shah, Nishant R., Veeranna, Vikas, Cheezum, Michael K., Taqueti, Viviany R., Kato, Takashi, Bibbo, Courtney R., Hainer, Jon, Dorbala, Sharmila, Blankstein, Ron, and Di Carli, Marcelo F.
- Abstract
Microvascular rarefaction is found in experimental uremia, but data from patients with chronic kidney disease (CKD) are limited. We therefore quantified absolute myocardial blood flow and coronary flow reserve (the ratio of peak to resting flow) from myocardial perfusion positron emission tomography scans at a single institution. Individuals were classified into standard CKD categories based on the estimated glomerular filtration rate. Associations of coronary flow reserve with CKD stage and cardiovascular mortality were analyzed in models adjusted for cardiovascular risk factors. The coronary flow reserve was significantly associated with CKD stage, declining in early CKD, but it did not differ significantly among individuals with stage 4, 5, and dialysis-dependent CKD. Flow reserve with preserved kidney function was 2.01, 2.06 in stage 1 CKD, 1.91 in stage 2, 1.68 in stage 3, 1.54 in stage 4, 1.66 in stage 5, and 1.55 in dialysis-dependent CKD. Coronary flow reserve was significantly associated with cardiovascular mortality in adjusted models (hazard ratio 0.76, 95% confidence interval: 0.63-0.92 per tertile of coronary flow reserve) without evidence of effect modification by CKD. Thus, coronary flow reserve is strongly associated with cardiovascular risk regardless of CKD severity and is low in early stage CKD without further decrement in stage 5 or dialysis-dependent CKD. This suggests that CKD physiology rather than the effects of dialysis is the primary driver of microvascular disease. Our findings highlight the potential contribution of microvascular dysfunction to cardiovascular risk in CKD and the need to define mechanisms linking low coronary flow reserve to mortality.
- Published
- 2018
- Full Text
- View/download PDF
18. Abstract P199: Proteomic Markers of Aortic Stenosis: The Atherosclerosis Risk in Communities Study
- Author
-
Shelbaya, Khaled, Arthur, Victoria, Buckley, Leo, Claggett, Brian, Skali, Hicham, Ballantyne, Christie M, Coresh, Josef, Matsushita, Kuni, Yu, Bing, and Shah, Amil M
- Abstract
Introduction:Although prevalence of aortic stenosis (AS) is increasing, little is known regarding circulating proteins predictive of AS development.Hypothesis:Novel circulating proteins associated with AS hemodynamics and clinical outcomes can be discovered using plasma proteomics.Methods:In the community-based Atherosclerosis Risk in Communities study, we measured plasma proteomics using the SOMAscan aptamer-affinity assay (n=4,877 aptamers; Somalogic Inc.) at study Visits 3 (V3; 1992-94; n=11,430) and 5 (V5; 2011-2013; n=4,899). Multivariable linear regression was used to estimate cross-sectional associations of log-transformed proteins at V5 with aortic valve (AV) peak velocity (Vmax) assessed by protocol echocardiography at a false discovery rate (FDR) of <0.05. We then assessed the association of Vmax-related proteins at V3 with incident AV-related hospitalizations post-V3 using multivariable Cox proportional hazard models at FDR of <0.05. All models adjusted for cardiovascular risk factors and diseases at the time of visit.Results:At V5 (age 76 ± 5 years; 43% male; 18% Black adults), 946 proteins were cross-sectionally associated with Vmax. At V3, (age 60 ± 6 years; 46% male; 21% Black), 84 of these were associated with risk of AS-related hospitalization post-V3 (median follow-up 22.2 [IQR 14.4 - 24.8] years, n=912 events). Of these 84 proteins, 52 were also cross-sectionally associated with the Dimensionless index (DI) at V5. Hierarchical clustering based on V5 AV hemodynamic indices identified one cluster of 14 proteins associated with lower hemodynamic AS severity and risk of AV-related hospitalization (Figure). Proteins in the remaining three clusters were associated with higher Vmax, lower DI, and higher risk of AV-related hospitalization. The nine proteins in cluster 4 were also associated with lower indexed AV area.Conclusion:We identified 52 circulating proteins with robust associations with AV hemodynamics and hospitalization risk, providing potential novel biomarkers for AS risk.
- Published
- 2023
- Full Text
- View/download PDF
19. Abstract 13132: Uncontrolled Diabetes is Associated With Adverse Cardiovascular Disease Outcomes in Those With Stage B Heart Failure
- Author
-
Lee, Emmanuel P, Ndumele, Chiadi E, Zhang, Sui, Matsushita, Kuni, Skali, Hicham, Shah, Amil M, Selvin, Elizabeth, and Echouffo Tcheugui, Justin B
- Abstract
Background:Among persons with stage B heart failure (HF) (subclinical cardiac dysfunction), diabetes is associated with markedly increased risk of progression to clinical HF. Whether stage B HF indicates greater risk for other cardiovascular disease (CVD) outcomes in the presence of diabetes is unknown.Methods:We included ARIC Visit 5 (2011-13) participants without clinical HF who met criteria for stage A (HF risk factors) or stage B (subclinical cardiac dysfunction by echocardiogram or elevated cardiac biomarkers) HF. Across HF stages A and B, we calculated incidence rates and their differences and used Cox models to estimate hazard ratios for overall mortality, CVD mortality, coronary heart disease (CHD), and HF associated with controlled diabetes (HbA1c <7%) and uncontrolled diabetes (HbA1c ≥ 7%), compared to no diabetes.Results:4,774 participants (mean age 75.4, 58.3% women, 20.2% black) were followed for a median 7.3 years, with 867 deaths, 237 CVD deaths, 228 CHD events, and 470 HF events. There were significant additive interactions (increased absolute risk) associated with uncontrolled diabetes (vs. no diabetes) for total mortality, CVD death, CHD, and HF for stage B, but not stage A (Table). The incidence rate differences (per 1000 person-years) associated with uncontrolled diabetes (vs. no diabetes) were greater in stage B vs stage A for all outcomes (Table). In multivariable adjusted models, uncontrolled diabetes (vs. no diabetes) was associated with statistically significant hazard ratios (increased relative risk) for all CVD outcomes in stage B, but did not have significant associations with any CVD outcomes in stage A (Table).Conclusion:In stage B HF, diabetes is associated with global CVD risk. Intensive preventive efforts to avert various forms of CVD may be indicated for those with diabetes and subclinical cardiac dysfunction.
- Published
- 2022
- Full Text
- View/download PDF
20. Effect of single and dual renin-angiotensin blockade on stroke in patients with and without diabetes in VALIANT
- Author
-
Abdul-Rahim, Azmil H, Docherty, Kieran F, Skali, Hicham, Køber, Lars, Dickstein, Kenneth, Maggioni, Aldo P, Mareev, Viacheslav, Zannad, Faiez, Velazquez, Eric J, Califf, Robert M, Pfeffer, Marc A, Solomon, Scott D, Lees, Kennedy R, and McMurray, John JV
- Abstract
Introduction Concern has been raised about a possible increase in risk of stroke in patients with diabetes treated with the combination of the renin-inhibitor aliskiren and an angiotensin converting enzyme inhibitor or angiotensin receptor blocker. We compared the rate of stroke in patients with and without diabetes treated with single or dual renin-angiotensin system blockade after acute myocardial infarction.Patients and methods We performed a post hoc analysis of the Valsartan in Acute Myocardial Infarction trial in which 14,703 patients with heart failure, left ventricular systolic dysfunction or both, were randomised to captopril (C), valsartan (V) or both (C + V) after 0.5–10 days after acute myocardial infarction and followed for a median of 2.1 years. We used Cox proportional-hazard regression to estimate the hazard ratios [HR (95% CI)] of stroke in each treatment group.Results Among patients withdiabetes, 60/1303 (4.6%) receiving captopril, 60/1337 (4.5%) valsartan and 41/1340 (3.1%) valsartan plus captopril suffered a stroke: V + C versus V or C HR 0.68 (0.47–0.96), p= 0.03. The corresponding numbers in patients withoutdiabetes were 106/3606 (2.9%), 97/3572 (2.7%) and 99/3545 (2.8%): V + C versus V or C HR 0.99 (0.78–1.26), p = 0.92 (interaction p= 0.08).Conclusion The risk of stroke after myocardial infarction in patients with diabetes was lower in patients treated with both an angiotensin converting enzyme inhibitor and angiotensin receptor blocker than in patients receiving either monotherapy.
- Published
- 2016
- Full Text
- View/download PDF
21. Widening Racial Differences in Risks for Coronary Heart Disease
- Author
-
Nadruz, Wilson, Claggett, Brian, Henglin, Mir, Shah, Amil M., Skali, Hicham, Rosamond, Wayne D., Folsom, Aaron R., Solomon, Scott D., and Cheng, Susan
- Published
- 2018
- Full Text
- View/download PDF
22. Cardiac Structure and Function Across the Glycemic Spectrum in Elderly Men and Women Free of Prevalent Heart Disease
- Author
-
Skali, Hicham, Shah, Amil, Gupta, Deepak K., Cheng, Susan, Claggett, Brian, Liu, Jiankang, Bello, Natalie, Aguilar, David, Vardeny, Orly, Matsushita, Kunihiro, Selvin, Elizabeth, and Solomon, Scott
- Abstract
Individuals with diabetes mellitus and pre–diabetes mellitus are at particularly high risk of incident heart failure or death, even after accounting for known confounders. Nevertheless, the extent of impairments in cardiac structure and function in elderly individuals with diabetes mellitus and pre–diabetes mellitus is not well known. We aimed to assess the relationship between echocardiographic measures of cardiac structure and function and dysglycemia.
- Published
- 2015
- Full Text
- View/download PDF
23. Association of High-Sensitivity Cardiac Troponin T and Natriuretic Peptide With Incident ESRD: The Atherosclerosis Risk in Communities (ARIC) Study
- Author
-
Kim, Yuhree, Matsushita, Kunihiro, Sang, Yingying, Grams, Morgan E., Skali, Hicham, Shah, Amil M., Hoogeveen, Ron C., Solomon, Scott D., Ballantyne, Christie M., and Coresh, Josef
- Abstract
Epidemiologic data for cardiac abnormality predating decreased kidney function are sparse. We investigated the associations of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro–brain natriuretic peptide (NT-proBNP) with end-stage renal disease (ESRD) risk in a community-based cohort.
- Published
- 2015
- Full Text
- View/download PDF
24. Heart Failure Risk Across the Spectrum of Ankle-Brachial Index
- Author
-
Gupta, Deepak K., Skali, Hicham, Claggett, Brian, Kasabov, Rumen, Cheng, Susan, Shah, Amil M., Loehr, Laura R., Heiss, Gerardo, Nambi, Vijay, Aguilar, David, Wruck, Lisa Miller, Matsushita, Kunihiro, Folsom, Aaron R., Rosamond, Wayne D., and Solomon, Scott D.
- Abstract
The aim of this study was to describe the relationship between ankle brachial index (ABI) and the risk for heart failure (HF).
- Published
- 2014
- Full Text
- View/download PDF
25. Rationale and Design of a Multicenter Echocardiographic Study to Assess the Relationship Between Cardiac Structure and Function and Heart Failure Risk in a Biracial Cohort of Community-Dwelling Elderly Persons
- Author
-
Shah, Amil M., Cheng, Susan, Skali, Hicham, Wu, Justina, Mangion, Judy R., Kitzman, Dalane, Matsushita, Kunihiro, Konety, Suma, Butler, Kenneth R., Fox, Ervin R., Cook, Nakela, Ni, Hanyu, Coresh, Josef, Mosley, Thomas H., Heiss, Gerardo, Folsom, Aaron R., and Solomon, Scott D.
- Abstract
Heart failure is an important public health concern, particularly among persons >65 years of age. Women and blacks are critically understudied populations that carry a sizeable portion of the heart failure burden. Limited normative and prognostic data exist on measures of cardiac structure, diastolic function, and novel measures of systolic deformation in older adults living in the community.
- Published
- 2014
- Full Text
- View/download PDF
26. Hemoglobin Stability in Patients With Anemia, CKD, and Type 2 Diabetes: An Analysis of the TREAT (Trial to Reduce Cardiovascular Events With Aranesp Therapy) Placebo Arm
- Author
-
Skali, Hicham, Lin, Julie, Pfeffer, Marc A., Chen, Chao-Yin, Cooper, Mark E., McMurray, John J.V., Nissenson, Allen R., Remuzzi, Giuseppe, Rossert, Jerome, Parfrey, Patrick S., Scott-Douglas, Nairne W., Singh, Ajay K., Toto, Robert, Uno, Hajime, and Ivanovich, Peter
- Abstract
Sparse data are available about the natural history of hemoglobin (Hb) level trends in contemporary patients with anemia, chronic kidney disease (CKD), and type 2 diabetes mellitus. We intended to describe Hb level trends over time with no or minimal administration of erythropoiesis-stimulating agents.
- Published
- 2013
- Full Text
- View/download PDF
27. Abstract 10392: Association of Frailty with Incident Heart Failure with Preserved and Reduced Ejection Fraction in Late Life: The Aric Study
- Author
-
Ramonfaur, Diego, Skali, Hicham, Kitzman, Dalane W, Palta, Priya, Ndumele, Chiadi E, Claggett, Brian, Konety, Suma H, and Shah, Amil M
- Abstract
Introduction:The incidence and prevalence of both frailty and heart failure (HF) are greatest in late life, and both have been associated with inflammation and markers of myocardial injury. While frailty is cross-sectionally associated with HF, the association of frailty with incident HF, and HF with preserved (HFpEF) or reduced ejection fraction (HFrEF) is unclear.Methods:Among 5,517 participants in the Atherosclerosis Risk in Communities study with frailty assessment and free of HF at Visit 5 (2011-2013), frailty was ascertained using information on weight loss, low grip strength, exhaustion, low energy expenditure and slow gait. Frail was defined as the presence of >3 frailty components, pre-frail as 1-2 components, and robust as 0 components. HF was ascertained through adjudication of hospitalizations with related ICD codes. Multivariable Cox proportional hazard models were used to evaluate the association of frailty status at Visit 5 with incident HF overall, HFpEF (LVEF ≥50%), and HFrEF (LVEF <50%). Models were adjusted for age, race, gender, BMI, GFR, and history of stroke, MI, atrial fibrillation, hypertension and diabetes mellitus.Results:Mean age was 75 +/- 5 years, 58% were female, and 22% were Black. Forty-six percent were classified as robust, 48% as pre-frail, and 6% frail. Frail participants were older and had a higher prevalence of cardiovascular co-morbidities. Over a median follow-up of 7.1 (IQR 5.5-7.8) years, 525 participants developed incident HF (249 HFpEF, 209 HFrEF, 67 HF with unknown LVEF). Both pre-frailty and frailty were associated with heightened risk of incident HF compared to robust participants (Figure). The magnitude of risk associated with frailty status was similar for both HFpEF and HFrEF.Conclusions:Pre-frailty and frailty are both associated with heightened risk of incident HF in late life, independent of traditional cardiovascular risk factors. These associations are similar in magnitude for HFpEF and HFrEF.
- Published
- 2021
- Full Text
- View/download PDF
28. Abstract 9984: Stages of Valvular Heart Disease Among Older Adults in the Community: The Atherosclerosis Risk in Communities Study
- Author
-
Shelbaya, Khaled, Claggett, Brian, Dorbala, Pranav, Skali, Hicham, Solomon, Scott, Matsushita, Kuni, Konety, Suma H, Mosley, Thomas, and Shah, Amil M
- Abstract
Introduction:AHA/ACC guidelines endorse the conceptual framework of valvular heart disease (VHD) stages to emphasize the progressive nature of VHD. However, to our knowledge, no community-based estimates of the prevalence of VHD stages exist, particularly in late-life when VHD prevalence is highest.Methods:Among 6,118 participants in the community-based Atherosclerosis Risk in Communities (ARIC) study who underwent comprehensive echocardiography at the 5thstudy visit (2011-2013), VHD stages were defined based on AHA/ACC guideline recommendations. The association of the VHD stage with the incidence of heart failure (HF), myocardial infarction (MI), stroke, atrial fibrillation (AF), and death post-Visit 5 were assessed using multivariable Cox proportional hazard models. Models were adjusted for age, sex, race, Field Center, hypertension, diabetes, prior MI, HF, body mass index, and systolic blood pressure.Results:The mean age was 76±5 years; 58% were women, 22% were Black. Stage A VHD was present in 39%, stage B in 17%, stage C/D in 1 %, and 0.7% had previously undergone valve replacement or repair. Mild mitral regurgitation was the most common single valvular lesion in Stage A (42%), while isolated mild aortic regurgitation accounted for the majority of Stage B (51%), and aortic stenosis was the most common valvular lesion in Stage C/D (80%). Over a median follow-up of 5.5 (IQR 3.7-7.7 years), Stage A, B, and C/D VHD were each associated with a heightened risk of incident HF, MI, AF, and death in multivariable models (Figure 1). VHD stages were not associated with incident stroke.Conclusion:Among older adults in the community, at-risk (Stage A, 39%) and progressive (Stage B, 17%) VHD is prevalent. Stage A and Stage B VHD are associated with a heightened risk of incident cardiovascular events independent of traditional cardiovascular risk factors.Figure1: Forest plot for adjusted HR (95% CI) associated with stage A, B, and C/D (stage 0 was the reference group)
- Published
- 2021
- Full Text
- View/download PDF
29. PRAISE (Prospective Randomized Amlodipine Survival Evaluation) and Criticism∗
- Author
-
Pfeffer, Marc A. and Skali, Hicham
- Published
- 2013
- Full Text
- View/download PDF
30. Reducing Infarct Size With EPO in Patients With ST-Segment Elevation Myocardial Infarction
- Author
-
Skali, Hicham and Solomon, Scott D.
- Published
- 2011
- Full Text
- View/download PDF
31. Guidance and Best Practices for Nuclear Cardiology Laboratories During the COVID-19 Pandemic
- Author
-
Skali, Hicham, Murthy, Venkatesh L., Al-Mallah, Mouaz H., Bateman, Tim M., Beanlands, Rob, Better, Nathan, Calnon, Dennis A., Dilsizian, Vasken, Gimelli, Alessia, Pagnanelli, Robert, Polk, Donna M., Soman, Prem, Thompson, Randall C., Einstein, Andrew J., and Dorbala, Sharmila
- Abstract
Supplemental Digital Content is available in the text.
- Published
- 2020
- Full Text
- View/download PDF
32. Abstract 13308: Sex and Race Differences in Cardiac Structure and Function in Late Life: The Atherosclerosis Risk in Communities (ARIC) Study
- Author
-
Chandra, Alvin, Skali, Hicham, Claggett, Brian, Rossi, Joseph, Russell, Stuart D, Matsushita, Kunihiro, Kitzman, Dalane, Konety, Suma H, Mosley, Thomas, Solomon, Scott D, and Shah, Amil M
- Abstract
Introduction:Black Americans have larger left ventricular (LV) size, greater relative wall thickness (RWT), and worse LV systolic and diastolic function compared to other race/ethnic groups in early adulthood and mid-life. Limited data exist regarding race- and sex-based differences in cardiac structure and function in late life, when HF risk is highest.Hypothesis:Black Americans and men will demonstrate worse LV systolic and diastolic function in late-life than their counterparts.Methods:The study sample consisted of 5,149 participants in the ARIC study (a prospective epidemiologic cohort study) who attended 5thstudy visit (2011-2013, age range 66-90 years), underwent echocardiography, self-reported black or white race, and without previous diagnosis of HF. All echocardiographic studies were prospectively acquired on uniform machines by trained sonographers and were analyzed in a central core laboratory.Results:Mean age was 75?5 years, 41% were men, and 20% were black. Black race was associated with greater LV wall thickness, smaller cavity size, and greater concentricity in both men and women (Table), differences that persisted after adjusting for age, diabetes, hypertension, body mass index, history of coronary heart disease, and atrial fibrillation. Prevalence of LV hypertrophy did not differ by race in either men (p=0.10) or women (p=0.66). Black race was also associated with lower LV ejection fraction, global longitudinal strain, and circumferential strain in both sexes. No consistent race-based differences in LV diastolic measures were observed.Conclusion:Among persons free of prevalent HF in late-life, black race was independently associated with greater LV concentricity and lower LV systolic function in both men and women.
- Published
- 2019
- Full Text
- View/download PDF
33. Abstract 15423: Coronary Microvascular Dysfunction is Associated With Worse Outcomes in Patients With Thoracic Malignancy
- Author
-
Divakaran, Sanjay, Caron, Jesse P, Zhou, Wunan, Hainer, Jon, Klein, Josh, Bibbo, Courtney F, Skali, Hicham, Taqueti, Viviany R, Blankstein, Ron, Dorbala, Sharmila, Mehra, Mandeep R, Nohria, Anju, Groarke, John D, and Di Carli, Marcelo F
- Abstract
Introduction:Coronary microvascular dysfunction (CMD), defined as impaired coronary flow reserve (CFR) in the absence of flow-limiting CAD, is associated with an increased risk of adverse events. Previous studies investigating the relationship between CMD and all-cause mortality have excluded patients with malignancy.Hypothesis:We sought to test the prognostic usefulness of CMD, here reflecting a marker of vascular health, in patients with thoracic malignancy referred clinically for cardiac stress positron emission tomography (PET).Methods:Consecutive patients with thoracic malignancy who underwent cardiac PET, including CFR assessment, for evaluation of chest pain/dyspnea or pre-operative assessment from 2006 to 2017 were studied retrospectively. Patients with a history of CAD, LVEF <45%, or abnormal myocardial perfusion on PET were excluded.Results:Among the 191 patients (median age 66.4 years, 68.5% female, mean CFR 2.02) in the final cohort, 46% had breast cancer, 23% had lung cancer, 14% had mesothelioma, 11% had lymphoma (with thoracic involvement), and 7% had esophageal cancer. 32% had metastatic disease at the time of cancer diagnosis. 89% underwent surgery, 53% were treated with chemotherapy, and 63% were treated with chest irradiation. 36% percent had recurrence of their disease. There was no difference in mean CFR between cancer type or treatment groups. The median time between cancer diagnosis and PET was 4.48 years. Over a median follow-up of 6.68 years after PET, the lowest CFR tertile was associated with higher all-cause mortality after adjusting for age, sex, diabetes, BMI, metastatic disease, recurrent disease, time between cancer diagnosis and PET, and treatment with chemotherapy, chest irradiation, or surgery (HR 2.68; 95% CI 1.55 - 4.63; p<0.001) (Figure).Conclusions:In patients with thoracic malignancy, CMD was independently associated with worse outcomes. CFR may have utility as a marker of risk among patients with malignancy.
- Published
- 2019
- Full Text
- View/download PDF
34. Abstract 13684: Depressive Symptoms, Cardiac Function, and Risk of Heart Failure With Preserved or Reduced Ejection Fraction in Late Life: The Atherosclerosis Risk in Communities (ARIC) Study
- Author
-
Vu, Katja, Williams, Janice E, Claggett, Brian, John, Jenine E, Skali, Hicham, Solomon, Scott D, Mosley, Thomas, Kucharska-Newton, Anna, Biering-Soerensen, Tor, and Shah, Amil M
- Abstract
Background:Depressive symptoms are associated with heightened risk of heart failure (HF) independent of cardiovascular comorbidities, but their association with cardiac function and incident HF with preserved (HFpEF) and reduced (HFrEF) LVEF in late life is unclear.Objectives:Determine the association of depressive symptoms (CES-D scale) with LV systolic and diastolic function, and incident HFpEF and HFrEF in late life.Methods:We studied 5,086 HF-free participants in the ARIC longitudinal cohort study who attended the fifth study visit at which time they underwent echocardiography and completed the CES-D questionnaire. Associations of CES-D score with echocardiographic measures and incident adjudicated HFpEF, HFrEF and the composite outcomes HFpEF/death and HFrEF/death were assessed using multivariable linear and Cox PH regression respectively.Results:The mean age of the study population was 75.3? 5.1 years, 59% were women, and 20% were black. After adjusting for demographics and cardiovascular co-morbidities, CES-D score demonstrated a modest association with LV wall thickness (p=0.04) but was not associated with LV systolic or diastolic measures. Over 5.5 [IQR 5.1-6.0] year follow-up, higher CES-D score was independently associated with heightened risk of incident HFpEF, the composite outcomes, but not HFrEF (Figure). Further adjustment for echocardiographic measures, NT-proBNP, high sensitivity troponin T, and hsCRP did not appreciably attenuate this association (HR [95% CI] 1.07 [1.02 - 1.13], p = 0.014).Conclusions:While only modestly associated with LV structure, worse depressive symptoms are predictive of incident HFpEF in late life independent of common co-morbidities, cardiac structure and function, and prognostic biomarkers. Further studies are necessary to determine the utility of treating depression in late life to prevent HFpEF.
- Published
- 2019
- Full Text
- View/download PDF
35. Abstract 13166: Echocardiographic Correlates of Coronary Artery Disease and Subsequent Incident Heart Failure With Preserved Ejection Fraction: The Aric Study
- Author
-
John, Jenine E, Claggett, Brian, Skali, Hicham, Solomon, Scott D, Cunningham, Jonathan, Matsushita, Kunihiro, Konety, Suma H, Kitzman, Dalane, Mosley, Thomas, CLARK, Donald, Chang, Patricia, and Shah, Amil M
- Abstract
Introduction:Coronary artery disease (CAD) is a potent risk factor for heart failure (HF) with reduced ejection fraction. Patients with HF with preserved ejection fraction (HFpEF) also have a high prevalence of CAD, but little is known about the relationship between CAD and incident HFpEF.Hypothesis:CAD is a risk factor for incident HFpEF, and this risk is partially accounted for by associated impairments in cardiac structure and function.Methods:We evaluated 4,779 participants in the Atherosclerosis Risk in Communities (ARIC) cohort who were free of heart failure at Visit 5 (2011-2013) and followed them for a median of 5.5 years. Linear regression was used to assess the association of prevalent CAD (based on MI and revascularization) with echocardiographic parameters. Multivariable Cox proportional hazards models that were adjusted for age and stratified for sex, race, and field center were used to assess the association of prevalent CAD with subsequent incident HFpEF without or with inclusion of echocardiographic measures as model covariates.Results:The average age of participants was 75.3 ? 5.1 years, 59.3% were female, and 19.6% were black. There were 490 participants (10.3%) with prevalent CAD. CAD was associated with greater left ventricular (LV) mass index (85 ? 21 vs 77 ? 17 g/m2), lower LVEF (65?6% vs 66?5%), larger left atrial volume index (28?10 vs 25?8 ml/m2) and higher E/e? (13?5 vs 12?4), and these differences remained significant after adjustment for demographic and clinical co-morbidities (all p?0.01). Prevalent CAD was associated with heightened risk of incident HFpEF (Table), an association that was only modestly attenuated after accounting for LV structure, systolic function, and diastolic function.Conclusions:Prevalent CAD is associated with heightened risk of incident HFpEF. Differences in cardiac structure and function only modestly account for this association, suggesting alternative mechanisms linking CAD to HFpEF risk.
- Published
- 2019
- Full Text
- View/download PDF
36. Abstract 13392: Sex and Race Differences in Heart Failure Risk in Late Life: The Atherosclerosis Risk in Communities (ARIC) Study
- Author
-
Chandra, Alvin, Skali, Hicham, Claggett, Brian, Rossi, Joseph, Chang, Patricia, Russell, Stuart D, Matsushita, Kunihiro, Kitzman, Dalane W, Konety, Suma H, Mosley, Thomas, Solomon, Scott D, and Shah, Amil M
- Abstract
Introduction:Heart failure (HF) risk differs by race and sex, with black Americans demonstrating higher HF incidence in early adulthood and mid-life. Limited data is available regarding race- and sex-based differences in HF risk in late-life.Hypothesis:Black Americans and men will demonstrate higher incidence of HF, and HF with reduced LVEF (HFrEF) in particular, in late-life than their counterparts.Methods:The study sample consisted of 5,149 participants in the ARIC prospective epidemiologic cohort study who self-reported black or white race, attended the 5thstudy visit (2011-2013), and were free of HF at Visit 5. Participants were all ?66 years old and followed for a median 5.5 [IQR 5.0-6.0] years post-Visit 5 for incident HF or death. Hospitalized HF events were adjudicated, and LVEF at hospitalization abstracted from hospitalization records. Association of race and sex with incident HF was assessed using multivariable Cox proportional hazard models.Results:Mean age was 75?5 years, 59% were women, and 20% were black. Of 294 total incident HF events, 124 were HFrEF (LVEF<50%), 131 HF with preserved LVEF (HFpEF, LVEF?50%), and 39 with unknown LVEF. After adjusting for age, diabetes, hypertension, body mass index, history of coronary heart disease, and atrial fibrillation, black race was associated with higher incidence of HF overall and HFrEF in men but not women (P interaction = 0.02 and 0.03 respectively; Table). Neither race nor sex was associated with risk of incident HFpEF.Conclusion:In late life, black race is associated with heightened risk of HFrEF in men but not women. In contrast, risk of HFpEF is similar in all sex- and race-groups. Further studies are necessary to better understand the factors contributing to these sex- and race-based differences in HF risk.
- Published
- 2019
- Full Text
- View/download PDF
37. Diagnostic Accuracy of Advanced Imaging in Cardiac Sarcoidosis
- Author
-
Divakaran, Sanjay, Stewart, Garrick C., Lakdawala, Neal K., Padera, Robert F., Zhou, Wunan, Desai, Akshay S., Givertz, Michael M., Mehra, Mandeep R., Kwong, Raymond Y., Hedgire, Sandeep S., Ghoshhajra, Brian B., Taqueti, Viviany R., Skali, Hicham, Dorbala, Sharmila, Blankstein, Ron, and Di Carli, Marcelo F.
- Abstract
Supplemental Digital Content is available in the text.
- Published
- 2019
- Full Text
- View/download PDF
38. Complementary Value of Cardiac Magnetic Resonance Imaging and Positron Emission Tomography/Computed Tomography in the Assessment of Cardiac Sarcoidosis
- Author
-
Vita, Tomas, Okada, David R., Veillet-Chowdhury, Mahdi, Bravo, Paco E., Mullins, Erin, Hulten, Edward, Agrawal, Mukta, Madan, Rachna, Taqueti, Viviany R., Steigner, Michael, Skali, Hicham, Kwong, Raymond Y., Stewart, Garrick C., Dorbala, Sharmila, Di Carli, Marcelo F., and Blankstein, Ron
- Abstract
Supplemental Digital Content is available in the text.
- Published
- 2018
- Full Text
- View/download PDF
39. Heart Failure and Midrange Ejection Fraction
- Author
-
Nadruz, Wilson, West, Erin, Santos, Mário, Skali, Hicham, Groarke, John D., Forman, Daniel E., and Shah, Amil M.
- Abstract
Supplemental Digital Content is available in the text.
- Published
- 2016
- Full Text
- View/download PDF
40. Prognostic value of coronary CTA vs. exercise treadmill testing: results from the Partners registry
- Author
-
Cheezum, Michael K., Subramaniyam, Prem Srinivas, Bittencourt, Marcio S., Hulten, Edward A., Ghoshhajra, Brian B., Shah, Nishant R., Forman, Daniel E., Hainer, Jon, Leavitt, Marcia, Padmanabhan, Ram, Skali, Hicham, Dorbala, Sharmila, Hoffmann, Udo, Abbara, Suhny, Di Carli, Marcelo F., Gewirtz, Henry, and Blankstein, Ron
- Abstract
Aims We sought to compare the complementary prognostic value of exercise treadmill testing (ETT) and coronary computed tomographic angiography (CTA) among patients referred for both exams.Methods and results We studied 582 patients without known coronary artery disease (CAD) who were clinically referred for ETT and CTA within 6 months. Patients were followed for cardiovascular (CV) death, non-fatal myocardial infarction (MI), or late revascularization (>90 days), stratified by Duke Treadmill Score (DTS) and CAD severity (≥50% stenosis). Mean age was 54 ± 13 years (63% male). In median follow-up of 40 months, there were 3 CV deaths, 7 non-fatal MIs, and 26 late revascularizations. ETT was inconclusive in 23%, positive in 31%, and negative in 46%. CTA demonstrated no CAD in 37%, non-obstructive CAD in 28%, and obstructive CAD in 35%. Among low-risk ETT patients (n = 326), there were 3 MI, 10 late revascularizations, and the frequent presence of non-obstructive (32%, n = 105) and obstructive CAD (27%, n = 88). When present, ETT features (i.e. angina, DTS, ischaemic electrocardiogram changes, and exercise capacity) individually failed to predict CV death/MI after adjustment for Morise score. Conversely, both obstructive CAD [HR 4.9 (1.0–23.3), P = 0.048] and CAD extent by segment involvement score >4 [HR 3.9 (1.0–15.2), P = 0.049] predicted increased risk for CV death or MI.Conclusion Patients with a low-risk ETT have an excellent prognosis at 40 months, despite the frequent presence of non-obstructive (32%) and obstructive (27%) CAD. In patients with an intermediate- to high-risk ETT (DTS <5), CTA can provide incremental risk stratification for future CV events.- Published
- 2015
- Full Text
- View/download PDF
41. Response to Letter Regarding Article, “Cardiac Structure and Function Across the Glycemic Spectrum in Elderly Men and Women Free of Prevalent Heart Disease: The Atherosclerosis Risk In the Community Study”
- Author
-
Skali, Hicham, Shah, Amil, Gupta, Deepak K., Cheng, Susan, Claggett, Brian, Liu, Jiankang, Bello, Natalie, Aguilar, David, Vardeny, Orly, Matsushita, Kunihiro, Selvin, Elizabeth, and Solomon, Scott
- Published
- 2015
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.