135 results on '"Colombo P. C."'
Search Results
2. Nitrite Generating and Depleting Capacity of the Oral Microbiome and Cardiometabolic Risk: Results from ORIGINS
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Goh, Charlene E, Bohn, Bruno, Marotz, Clarisse, Molinsky, Rebecca, Roy, Sumith, Paster, Bruce J, Chen, Ching‐Yuan, Rosenbaum, Michael, Yuzefpolskaya, Melana, Colombo, Paolo C, Desvarieux, Moïse, Papapanou, Panos N, Jacobs, David R, Knight, Rob, and Demmer, Ryan T
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Dental/Oral and Craniofacial Disease ,Genetics ,Human Genome ,Clinical Research ,Infection ,Adult ,Bacteria ,Cardiovascular Diseases ,Female ,Humans ,Male ,Microbiota ,Nitrates ,Nitric Oxide ,Nitrites ,Nitrogen ,Nitrogen Dioxide ,RNA ,Ribosomal ,16S ,16S rNA sequencing ,blood pressure ,epidemiology ,insulin resistance ,metagenomics ,nitric oxide ,oral microbiome ,Cardiorespiratory Medicine and Haematology - Abstract
Background The enterosalivary nitrate-nitrite-nitric oxide (NO3-NO2-NO) pathway generates NO following oral microbiota-mediated production of salivary nitrite, potentially linking the oral microbiota to reduced cardiometabolic risk. Nitrite depletion by oral bacteria may also be important for determining the net nitrite available systemically. We examine if higher abundance of oral microbial genes favoring increased oral nitrite generation and decreased nitrite depletion is associated with a better cardiometabolic profile cross-sectionally. Methods and Results This study includes 764 adults (mean [SD] age 32 [9] years, 71% women) enrolled in ORIGINS (Oral Infections, Glucose Intolerance, and Insulin Resistance Study). Microbial DNA from subgingival dental plaques underwent 16S rRNA gene sequencing; PICRUSt2 was used to estimate functional gene profiles. To represent the different components and pathways of nitrogen metabolism in bacteria, predicted gene abundances were operationalized to create summary scores by (1) bacterial nitrogen metabolic pathway or (2) biochemical product (NO2, NO, or ammonia [NH3]) formed by the action of the bacterial reductases encoded. Finally, nitrite generation-to-depletion ratios of gene abundances were created from the above summary scores. A composite cardiometabolic Z score was created from cardiometabolic risk variables, with higher scores associated with worse cardiometabolic health. We performed multivariable linear regression analysis with cardiometabolic Z score as the outcome and the gene abundance summary scores and ratios as predictor variables, adjusting for sex, age, race, and ethnicity in the simple adjusted model. A 1 SD higher NO versus NH3 summary ratio was inversely associated with a -0.10 (false discovery rate q=0.003) lower composite cardiometabolic Z score in simple adjusted models. Higher NH3 summary score (suggestive of nitrite depletion) was associated with higher cardiometabolic risk, with a 0.06 (false discovery rate q=0.04) higher composite cardiometabolic Z score. Conclusions Increased net capacity for nitrite generation versus depletion by oral bacteria, assessed through a metagenome estimation approach, is associated with lower levels of cardiometabolic risk.
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- 2022
3. Early microbial markers of periodontal and cardiometabolic diseases in ORIGINS
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Marotz, Clarisse, Molinsky, Rebecca, Martino, Cameron, Bohn, Bruno, Roy, Sumith, Rosenbaum, Michael, Desvarieux, Moïse, Yuzefpolskaya, Melana, Paster, Bruce J, Jacobs, David R, Colombo, Paolo C, Papapanou, Panos N, Knight, Rob, and Demmer, Ryan T
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Microbiology ,Biological Sciences ,Ecology ,Clinical Research ,Diabetes ,Infectious Diseases ,Dental/Oral and Craniofacial Disease ,Metabolic and endocrine ,Oral and gastrointestinal ,Good Health and Well Being ,Bacteria ,Cardiovascular Diseases ,Humans ,Microbiota ,Periodontitis ,Saliva - Abstract
Periodontitis affects up to 50% of individuals worldwide, and 8.5% are diagnosed with diabetes. The high-comorbidity rate of these diseases may suggest, at least in part, a shared etiology and pathophysiology. Changes in oral microbial communities have been documented in the context of severe periodontitis and diabetes, both independently and together. However, much less is known about the early oral microbial markers of these diseases. We used a subset of the ORIGINS project dataset, which collected detailed periodontal and cardiometabolic information from 787 healthy individuals, to identify early microbial markers of periodontitis and its association with markers of cardiometabolic health. Using state-of-the-art compositional data analysis tools, we identified the log-ratio of Treponema to Corynebacterium bacteria to be a novel Microbial Indicator of Periodontitis (MIP), and found that this MIP correlates with poor periodontal health and cardiometabolic markers early in disease pathogenesis in both subgingival plaque and saliva.
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- 2022
4. It’s time to talk about the hidden human cost of the green transition
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Prieto, Manuel and Zanetta-Colombo, Nicolás C.
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- 2024
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5. Alterations in the kallikrein-kinin system predict death after heart transplant
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Giangreco, Nicholas P., Lebreton, Guillaume, Restaino, Susan, Farr, Maryjane, Zorn, Emmanuel, Colombo, Paolo C., Patel, Jignesh, Soni, Rajesh Kumar, Leprince, Pascal, Kobashigawa, Jon, Tatonetti, Nicholas P., and Fine, Barry M.
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- 2022
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6. The use of biomimetic tools for water quality monitoring: passive samplers versus sentinel organisms
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Morrone, M., Cappelletti, N. E., Tatone, L. M., Astoviza, M. J., and Colombo, J. C.
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- 2021
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7. Sodium nitroprusside in acute heart failure: A multicenter historic cohort study
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Garatti, L, Frea, S, Bocchino, P, Angelini, F, Cingolani, M, Sacco, A, Rondinara, G, Bagnardi, V, Sala, I, Kapur, N, Colombo, P, De Ferrari, G, Morici, N, Garatti L., Frea S., Bocchino P. P., Angelini F., Cingolani M., Sacco A., Rondinara G. M., Bagnardi V., Sala I. M., Kapur N. K., Colombo P. C., De Ferrari G. M., Morici N., Garatti, L, Frea, S, Bocchino, P, Angelini, F, Cingolani, M, Sacco, A, Rondinara, G, Bagnardi, V, Sala, I, Kapur, N, Colombo, P, De Ferrari, G, Morici, N, Garatti L., Frea S., Bocchino P. P., Angelini F., Cingolani M., Sacco A., Rondinara G. M., Bagnardi V., Sala I. M., Kapur N. K., Colombo P. C., De Ferrari G. M., and Morici N.
- Abstract
Aims: Despite evidence of hemodynamic benefit of sodium nitroprusside (SNP) treatment for acute heart failure (AHF), there are limited data about its efficacy and safety. This study aimed to assess the effectiveness and safety of SNP treatment, to explore the impact of N-terminal pro-B natriuretic peptide (NT-proBNP) reduction on clinical endpoints and to identify possible predictors of clinical response. Methods and results: Multicenter retrospective cohort study of 200 patients consecutively admitted for AHF in 2 Italian Centers. Primary endpoint was the reduction of NT-proBNP levels ≥25% from baseline values within 48 h from the onset of SNP infusion. Secondary and safety endpoints included all-cause mortality, rehospitalization for HF at 1, 3 and 6 months, length of hospital stay (LOS) and severe hypotension. 131 (66%) patients experienced a NT-proBNP reduction ≥25% within 48 h from treatment onset, irrespective of initial systolic blood pressure (SBP). Left ventricular end diastolic diameter (LVEDD) was the only independent predictor of treatment efficacy. Patients who achieved the primary endpoint (i.e., ‘responders’) had lower LOS (median 15 [IQR:10–27] vs 19 [IQR:12–35] days, p-value = 0.033) and a lower incidence of all-cause mortality and rehospitalization for HF at 1 and 3 months compared to “non responders” (p-value <0.050). Severe hypotension was observed in 10 (5%) patients, without any adverse clinical consequence. Conclusion: SNP is a safe and effective treatment of AHF, particularly in patients with dilated left ventricle. Reduced NT-proBNP levels in response to SNP is associated to shorter LOS and lower risk of 1- and 3-month re-hospitalizations for HF. Clinical trial registration. http://www.clinicaltrials.gov. Unique identifier: NCT05027360
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- 2022
8. Performance of the new seedless grape ‘BRS Isis' grown in subtropical area
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Ahmed Saeed, Roberto Sergio R., Colombo Ronan C., Koyama Renata, Shahab Muhammad, and Souza Reginaldo T.
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Microbiology ,QR1-502 ,Physiology ,QP1-981 ,Zoology ,QL1-991 - Abstract
‘BRS Isis' is a new colored seedless table grape tolerant to downy mildew, the main vine disease in subtropical humid areas. This new seedless cultivar is an interspecific hybrid from the crossing of CNPUV 681–29 [Arkansas 1976 X CNPUV 147–3 (‘Niagara Branca' x ‘Venus')] x ‘BRS Linda', and was recently released by Embrapa Grape and Wine, Brazil. The performance of ‘BRS Isis' seedless grape was evaluated in an experimental vineyard in 2016 located in a subtropical area at Marialva city, state of Parana, Brazil. The vines were grafted onto ‘IAC 766 Campinas' rootstock and trained in an overhead trellising system spaced at 2× 5 m. Vines were cane-pruning in late winter of July 2016, and for assessments, 20 representative vines were selected in the area. As ‘BRS Isis' is a very fruitful grape, presenting 4 bunches per shoot, a load adjustment was performed after fruitset removing 50% of bunches per shoot, leaving 2 bunches per shoot, equivalent to a density of 10 bunches.m−2. The duration in days of the main phenological stages from pruning to harvest, and the physicochemical and yield characteristics of ‘BRS Isis' seedless grape were subjected to evaluation. It was determined that the cycle is 144 days. The means of berry and bunch weight was 6.7 ± 1.0 g and 500.0 ± 0.04 g, respectively, and the color index of berries (CIRG) was 4.3 ± 1.3. The means of total soluble solids (TSS), titratable acidity (TA) and maturity index (TSS/TA) observed were 14.2 ± 0.3° Brix, 0.6 ± 0.04% of tartaric acid and 24.1 ± 1.5, respectively, while the yield was 49.0 ± 5.7 tons.ha−1. The yield observed is considered high to keep a sustainable crop over time, thus, in order to obtain grapes of ‘BRS Isis' with regular yield, and possibly, with a higher content of soluble solids, it is desirable to keep only 1 bunch per shoot (5 bunches.m−2) after fruitset.
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- 2017
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9. Development of De Novo Aortic Insufficiency in Patients With HeartMate 3.
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Malick, Alyyah, Ning, Yuming, Kurlansky, Paul A., Melehy, Andrew, Yuzefpolskaya, Melana, Colombo, Paolo C., Sayer, Gabriel, Uriel, Nir, Naka, Yoshifumi, and Takeda, Koji
- Abstract
De novo aortic insufficiency (AI) is a common adverse event after continuous-flow left ventricular assist device (LVAD) placement and is associated with morbidity and mortality. This study aims to compare the development of de novo AI between HeartMate 3 (Abbott) and HeartMate II LVAD recipients. A retrospective review was conducted of clinical characteristics and serial echocardiograms (1 month, 6 months, and 1 year postimplantation) of HeartMate 3 patients implanted between November 2014 and March 2019 and of HeartMate II patients implanted between April 2004 and December 2015 at Columbia University Irving Medical Center. One hundred twenty-two patients were excluded from analysis for a history of aortic valve surgery, concomitant aortic valve surgery with LVAD implant, or more than trace preoperative AI left untreated. De novo AI was defined as development of more than mild AI after LVAD implant. Included in the study were 121 HeartMate 3 patients and 270 HeartMate II patients. After accounting for competing risks of death and transplantation, there was no significant difference in the development of de novo AI by 1 year postimplantation between HeartMate II and HeartMate 3 patients (P =.68). There was no significant difference in severity of AI developed up to 1 year post-implantation between HeartMate II and HeartMate 3 patients. Development of de novo AI is comparable between HeartMate 3 and HeartMate II patients. There is no significant difference in severity of AI between HeartMate II and HeartMate 3 patients. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Periodontal Status, C-Reactive Protein, NT-proBNP, and Incident Heart Failure
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Molinsky, Rebecca L., Yuzefpolskaya, Melana, Norby, Faye L., Yu, Bing, Shah, Amil M., Pankow, James S., Ndumele, Chiadi E., Lutsey, Pamela L., Papapanou, Panos N., Beck, James D., Colombo, Paolo C., and Demmer, Ryan T.
- Abstract
Periodontal disease (PD), resulting from inflammatory host response to dysbiotic subgingival microbiota, has been linked to cardiovascular disease; however, its relationship to heart failure (HF) and its subtypes (heart failure with reduced ejection fraction [HFrEF] and heart failure with preserved ejection fraction [HFpEF]) is unexplored.
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- 2022
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11. Chromosome polymorphisms and natural selection inLeptysma argentina (Orthoptera): external phenotype affected by a centric fusion predicts adult survival
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Norry, F. M. and Colombo, P. C.
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- 1999
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12. Non-effect of p22-phox −930A/G polymorphism on end-organ damage in Brazilian hypertensive patients
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Sales, M L, Ferreira, M C S, Leme, Jr, C A, Velloso, L A, Gallani, M C J, Colombo, R C R, Franchini, K G, and Nadruz, Jr, W
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- 2007
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13. Regulation of ILT3 Gene Expression by Processing of Precursor Transcripts in Human Endothelial Cells
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Kim-Schulze, S., Seki, T., Vlad, G., Scotto, L., Fan, J., Colombo, P. C., Liu, J., Cortesini, R., and Suciu-Foca, N.
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- 2006
14. The state of european science and technology in the late middle ages
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Corradino, Astengo and Colombo, Corso C.
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- 1992
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15. Chromosomal Polymorphism, Morphometric Traits and Mating Success in Leptysma argentina Bruner (Orthoptera)
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Colombo, P. C., Pensel, S., and Isabel, R. M.
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- 2004
16. Chromosome Inversion Polymorphisms Influence Morphological Traits in Trimerotropis Pallidipennis (Orthoptera)
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Colombo, P. C.
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- 2002
17. Chromosomal polymorphism, morphological traits and male mating success in Leptysma argentina (Orthoptera)
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Colombo, P. C., Pensel, S. M., and Remis, M. I.
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- 2001
18. Levels of Trimethylamine N-Oxide Remain Elevated Long Term After Left Ventricular Assist Device and Heart Transplantation and Are Independent From Measures of Inflammation and Gut Dysbiosis .
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Yuzefpolskaya, Melana, Bohn, Bruno, Javaid, Azka, Mondellini, Giulio M., Braghieri, Lorenzo, Pinsino, Alberto, Onat, Duygu, Cagliostro, Barbara, Kim, Andrea, Takeda, Koji, Naka, Yoshifumi, Farr, Maryjane, Sayer, Gabriel T., Uriel, Nir, Nandakumar, Renu, Mohan, Sumit, Colombo, Paolo C., and Demmer, Ryan T.
- Abstract
Trimethylamine N-oxide (TMAO)—a gut-derived metabolite—is elevated in heart failure (HF) and linked to poor prognosis. We investigated variations in TMAO in HF, left ventricular assist device (LVAD), and heart transplant (HT) and assessed its relation with inflammation, endotoxemia, oxidative stress, and gut dysbiosis. METHODS: We enrolled 341 patients. TMAO, CRP (C-reactive protein), IL (interleukin)-6, TNF-α (tumor necrosis factor alpha), ET-1 (endothelin-1), adiponectin, lipopolysaccharide, soluble CD14, and isoprostane were measured in 611 blood samples in HF (New York Heart Association class I–IV) and at multiple time points post-LVAD and post-HT. Gut microbiota were assessed via 16S rRNA sequencing among 327 stool samples. Multivariable regression models were used to assess the relationship between TMAO and (1) New York Heart Association class; (2) pre- versus post-LVAD or post-HT; (3) biomarkers of inflammation, endotoxemia, oxidative stress, and microbial diversity. RESULTS: ln-TMAO was lower among HF New York Heart Association class I (1.23 [95% CI, 0.52–1.94] µM) versus either class II, III, or IV (1.99 [95% CI, 1.68–2.30], 1.97 [95% CI, 1.71–2.24], and 2.09 [95% CI, 1.83–2.34] µM, respectively; all P<0.05). In comparison to class II–IV, ln-TMAO was lower 1 month post-LVAD (1.58 [95% CI, 1.32–1.83] µM) and 1 week and 1 month post-HT (0.97 [95% CI, 0.60–1.35] and 1.36 [95% CI, 1.01–1.70] µM). ln-TMAO levels in long-term LVAD (>6 months: 1.99 [95% CI, 1.76–2.22] µM) and HT (>6 months: 1.86 [95% CI, 1.66–2.05] µM) were not different from symptomatic HF. After multivariable adjustments, TMAO was not associated with biomarkers of inflammation, endotoxemia, oxidative stress, or microbial diversity. CONCLUSIONS: TMAO levels are increased in symptomatic HF patients and remain elevated long term after LVAD and HT. TMAO levels were independent from measures of inflammation, endotoxemia, oxidative stress, and gut dysbiosis. [ABSTRACT FROM AUTHOR]
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- 2021
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19. Impact of Temporary Percutaneous Mechanical Circulatory Support Before Transplantation in the 2018 Heart Allocation System
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Clerkin, Kevin J., Salako, Oluwafeyijimi, Fried, Justin A., Griffin, Jan M., Raikhelkar, Jayant, Jain, Rashmi, Restaino, Susan, Colombo, Paolo C., Takeda, Koji, Farr, Maryjane A., Sayer, Gabriel, Uriel, Nir, and Topkara, Veli K.
- Abstract
This analysis sought to investigate the waitlist and post-transplant outcomes of individuals bridged to transplantation by using temporary percutaneous endovascular mechanical circulatory support (tMCS) through a status 2 designation (cardiogenic shock and exception).
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- 2022
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20. Exophenotypic effects of chromosomal change: the case of Leptysma argentina (Orthoptera)
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COLOMBO, P. C.
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- 1997
21. Chiasma interference is blind to centromeres*
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COLOMBO, P. C. and JONES, G. H.
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- 1997
22. Methylene Blue Does Not Improve Vasoplegia After Left Ventricular Assist Device Implantation.
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Saha, Amit, Jennings, Douglas L., Ning, Yuming, Kurlansky, Paul, Miltiades, Andrea N., Spellman, Jessica L., Sanchez, Joseph, Yuzefpolskaya, Melana, Colombo, Paolo C., Takayama, Hiroo, Naka, Yoshifumi, and Takeda, Koji
- Abstract
Vasoplegia is a frequent complication of left ventricular assist device (LVAD) implantation. We investigated the effectiveness of methylene blue (MB) for vasoplegia in LVAD recipients. Twenty-seven patients received MB for vasoplegia after LVAD implantation and met study criteria between March 2015 and May 2018. Propensity score inverse probability weighting identified 41 controls who did not receive MB for post-LVAD vasoplegia. Clinical outcomes were compared between control and MB groups and between patients who received doses during (n = 15) and after surgery (n = 12). Hemodynamics and vasopressor requirements were analyzed using analysis of covariance. Median total MB dose was 1.9 mg/kg (interquartile range, 1.2-2.2 mg/kg). Methylene blue recipients experienced a transient initial decline in norepinephrine requirement from 141 ng/kg per min (95% confidence interval [CI], 81-201 ng/kg per min) to 117 ng/kg per min (95% CI, 58-176 ng/kg per min; P =.022) and a delayed decline in vasopressin from 4.8 U/h (95% CI, 3.8-5.8 U/h) to 4.0 U/h (95% CI, 2.8-5.1 U/h) (P =.004). In-hospital mortality, postoperative complications, and end-organ dysfunction did not differ from those of controls. There were no observed differences in mean arterial pressure, vasopressor requirements, or outcomes between patients who received doses during or after surgery. Weighted overall mortality in the entire study cohort was 8.8%. Although MB may affect vasopressor requirements, clinical outcomes in vasoplegia after LVAD implantation did not improve and were not affected by the timing of administration. [ABSTRACT FROM AUTHOR]
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- 2021
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23. Effect of Pulmonary Hypertension on Transplant Outcomes in Patients With Ventricular Assist Devices.
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Ando, Masahiko, Takayama, Hiroo, Kurlansky, Paul A., Han, Jiho, Garan, Arthur R., Topkara, Veli K., Yuzefpolskaya, Melana, Colombo, Paolo C., Farr, Maryjane, Naka, Yoshifumi, and Takeda, Koji
- Abstract
Although extremely high pulmonary vascular resistance (PVR) is a relative contraindication for heart transplantation (HTx), recent data with continuous-flow left ventricular assist devices (LVADs) indicate HTx outcomes may be different when high PVR is managed with an LVAD. This study clarifies the contemporary association between PVR at HTx and posttransplant survival in LVAD vs non-LVAD cohorts. We reviewed the United Network for Organ Sharing registry for adults who received a transplant from 2008 to 2015. In those with continuous-flow LVADs and those with no VADs at HTx, (non-VAD), we grouped patients by low PVR (PVR <3), intermediate PVR (PVR 3 to <6), and high PVR (PVR ≥6) groups. Adjusted hazard ratios (aHRs) for death after HTx were calculated by Cox regression. The non-LVAD cohort included 6270 patients (4385 in low, 1643 in intermediate, and 242 in high PVR), and the LVAD cohort included 4111 patients (3227 in low, 798 in intermediate, and 86 in high PVR). The high PVR LVAD group had the worst survival, which was not significant, likely to low power (P =.300). The aHR for death in non-LVAD was 1.047 (95% confidence interval, 1.010-1.088) and in LVAD was 1.063 (95% confidence interval, 1.010-1.119). Cubic spline analysis demonstrated nonlinear associations between PVR and the aHR, especially in the LVAD cohort. There was no significant evidence to conclude the effect of pretransplant PVR on posttransplant survival is higher in LVAD vs non-LVAD patients, based on analysis of the United Network for Organ Sharing database. However, further investigations are indicated to clarify HTx candidacy in those with extremely high PVR even after LVAD. [ABSTRACT FROM AUTHOR]
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- 2020
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24. Biochemical and Functional Aspects of Gonadal Biosynthesis of Steroid Hormones in Teleost Fishes
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L Colombo, P C Belvedere and A Marconato
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carbohydrates (lipids) ,endocrine system ,urogenital system ,food and beverages ,lcsh:Q ,sense organs ,lcsh:Science - Abstract
Biochemical and Functional Aspects of Gonadal Biosynthesis of Steroid Hormones in Teleost Fishes
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- 2015
25. Profiling non‐HLA antibody responses in antibody‐mediated rejection following heart transplantation
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See, Sarah B., Mantell, Benjamin S., Clerkin, Kevin J., Ray, Bryan, Vasilescu, E.Rodica, Marboe, Charles C., Naka, Yoshifumi, Restaino, Susan, Colombo, Paolo C., Addonizio, Linda J., Farr, Maryjane A., and Zorn, Emmanuel
- Abstract
Antibody‐mediated rejection (AMR) driven by the development of donor‐specific antibodies (DSA) directed against mismatched donor human leukocyte antigen (HLA) is a major risk factor for graft loss in cardiac transplantation. Recently, the relevance of non‐HLA antibodies has become more prominent as AMR can be diagnosed in the absence of circulating DSA. Here, we assessed a single‐center cohort of 64 orthotopic heart transplant recipients transplanted between 1994 and 2014. Serum collected from patients with ≥ pAMR1 (n = 43) and non‐AMR (n = 21) were tested for reactivity against a panel of 44 non‐HLA autoantigens. The AMR group had a significantly greater percentage of patients with elevated reactivity to autoantigens compared to non‐AMR (P= .002) and healthy controls (n = 94, P< .0001). DSA‐positive AMR patients exhibited greater reactivity to autoantigens compared to DSA‐negative (P< .0001) and AMR patients with DSA and PRA > 10% were identified as the subgroup with significantly elevated responses. Reactivity to 4 antigens, vimentin, beta‐tubulin, lamin A/C, and apolipoprotein L2, was significantly different between AMR and non‐AMR patients. Moreover, increased reactivity to these antigens was associated with graft failure. These results suggest that antibodies to non‐HLA are associated with DSA‐positive AMR although their specific role in mediating allograft injury is not yet understood. Non‐HLA antibodies are associated with antibody‐mediated rejection after cardiac transplantation, particularly in patients with donor‐ specific and panel‐reactive antibodies.
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- 2020
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26. Midterm Outcomes of Bridge-to-Recovery Patients After Short-Term Mechanical Circulatory Support.
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Cheng, Yi-Tso, Garan, Arthur R., Sanchez, Joseph, Kurlansky, Paul, Ando, Masahiko, Cevasco, Marisa, Yuzefpolskaya, Melana, Colombo, Paolo C., Naka, Yoshifumi, Takayama, Hiroo, and Takeda, Koji
- Abstract
The use of short-term mechanical circulatory support (ST-MCS) has increased for refractory cardiogenic shock. However, there are scant data about bridge-to-recovery patients. We retrospectively reviewed 502 patients with cardiogenic shock who received venoarterial extracorporeal membrane oxygenation or a temporary surgical ventricular assist device as ST-MCS between 2010 and 2016. There were 178 patients (35.5%) who survived through device explantation. Of these, 149 patients (29.7%) survived to discharge and were included for analysis. The primary outcome was midterm survival without undergoing heart replacement therapy. In our bridge-to-recovery cohort, 101 patients (67.8%) were men, and the median age was 59 years (interquartile range, 51 to 67 years). Etiology of cardiogenic shock included postcardiotomy shock in 35.6% of patients (n = 53), allograft failure in 26.8% (n = 40), acute myocardial infarction (AMI) in 24.2% (n = 36), and other acute decompensated heart failure in 14.4% (n = 20). There were 24 major events (16.1%) recorded, including 21 patients who died and 3 patients who received heart replacement therapy during median follow-up of 306 days (interquartile range, 58.25 to 916.75 days). Overall freedom from event at 3 years was 74.2%. In subgroup analysis, AMI patients had a significantly worse freedom-from-event rate at 40.4% (p < 0.001). By univariate Cox analysis, AMI etiology (p = 0.003), length of ST-MCS (p = 0.06), blood urea nitrogen (p = 0.012), and left ventricular ejection fraction (p = 0.005) at discharge were predictors for adverse events. The overall midterm outcome of patients explanted from ST-MCS is favorable except for AMI patients. [ABSTRACT FROM AUTHOR]
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- 2019
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27. Methods of aril removal and lightness conditions on seeds physiological quality of sour passion fruits.
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Colombo, R. C., Costa, D. S., Carvalho, D. U., Cruz, M. A., and Roberto, S. R.
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GERMINATION ,SEED quality ,PASSION fruit ,SEEDS ,SEEDLINGS ,LIGHT - Abstract
Copyright of Brazilian Journal of Biology is the property of Instituto Internacional de Ecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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28. Impact of Sharing O Heart With Non-O Recipients: Simulation in the United Network for Organ Sharing Registry.
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Ando, Masahiko, Takeda, Koji, Kurlansky, Paul A., Han, Jiho, Garan, Arthur R., Topkara, Veli K., Yuzefpolskaya, Melana, Colombo, Paolo C., Farr, Maryjane, Naka, Yoshifumi, and Takayama, Hiroo
- Abstract
Background Blood type O heart transplant recipients wait longer than non-O recipients and frequently require bridging left ventricular assist devices (LVADs). However, rarely has the effect of this disparity been shown in a large registry. This study used Markov simulation to clarify the outcome difference between O and non-O candidates and how allocation change could affect survival. Methods We reviewed the United Network for Organ Sharing registry for adults listed for heart transplantation from 2008 to 2015. Cumulative incidences of death or transplant and survival after listing were compared between O and non-O using propensity matching. A four-state Markov model—waiting without LVAD, waiting with LVAD, transplantation, and death—was created to simulate survival after listing. Sensitivity analysis was performed to see how the percentage of O hearts in non-O recipients would affect survivals. Results A total of 8,187 O and non-O candidates were included after matching. The cumulative incidence of transplantation was lower in O (p < 0.001), and death after listing was significantly higher (p < 0.001). During a median follow-up of 2.1 years, 69.6% of non-O candidates were transplanted, compared with 54.9% of O candidates (p < 0.001). Despite this disparity, 19% of non-O recipients received O hearts. Our simulated survival demonstrated that decreasing the O heart percentage in non-O recipients from the current 19% to 5% would provide similar survival in O and non-O after listing. Conclusions Under the current strategy, there are death and transplant rate differences between O and non-O candidates. Our simulation-based allocation strategy might aid in mitigating this discrepancy across blood types. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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29. Effects of centric fusions on chiasma frequency and position in Leptysma argentina (Acrididae: Orthoptera) I. Spontaneous and stable polymorphic centric fusions
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Colombo, P. C.
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- 1987
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30. Ventricular Assist Device Utilization in Heart Transplant Candidates: Nationwide Variability and Impact on Waitlist Outcomes.
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Truby, Lauren K., Garan, A. Reshad, Givens, Raymond C., Koji Takeda, Hiroo Takayama, Trinh, Pauline N., Yuzefpolskaya, Melana, Farr, Maryjane A., Yoshifumi Naka, Colombo, Paolo C., and Topkara, Veli K.
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BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVADs) have become a standard treatment choice in advanced heart failure patients. We hypothesized that practice patterns with regards to CF-LVAD utilization vary significantly among transplant centers and impact waitlist outcomes. METHODS AND RESULTS: The United Network for Organ Sharing registry was queried to identify adult patients who were waitlisted for heart transplantation (HT) between 2008 and 2015. Each patient was assigned a propensity score based on likelihood of receiving a durable CF-LVAD before or while waitlisted. The primary outcomes of interest were death or delisting for worsening status and HT at 1 year. A total of 22 863 patients from 92 centers were identified. Among these, 9013 (39.4%) were mechanically supported. CF-LVAD utilization varied significantly between and within United Network for Organ Sharing regions. Freedom from waitlist death or delisting was significantly lower in propensity-score--matched patients who were mechanically supported versus medically managed (83.5% versus 79.2%; P<0.001). However, cumulative incidence of HT was also lower in mechanically supported patients (53.3% versus 63.6%; P<0.001). Congruous mechanical and medical bridging strategies based on clinical risk profile were associated with lower risk of death or delisting (hazard ratio, 0.88; P=0.027) and higher likelihood of HT (hazard ratio, 1.14; P<0.001). CONCLUSIONS: CF-LVAD utilization may lower waitlist mortality at the expense of lower likelihood of HT. Decision to use CF-LVAD and timing of transition should be individualized based on patient-, center-, and regionlevel risk factors to achieve optimal outcomes. [ABSTRACT FROM AUTHOR]
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- 2018
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31. Impact of Obesity on Readmission in Patients With Left Ventricular Assist Devices.
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Han, Jiho, Mauro, Christine M., Kurlansky, Paul A., Fukuhara, Shinichi, Yuzefpolskaya, Melana, Topkara, Veli K., Garan, A. Reshad, Colombo, Paolo C., Takayama, Hiroo, Naka, Yoshifumi, and Takeda, Koji
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Background Hospital readmissions have an adverse effect on the quality of life in patients with end-stage heart failure. We examined the temporal pattern, predictors, and outcomes of readmission in continuous flow left ventricular assist device–supported patients. Methods We retrospectively reviewed inpatient data of 350 consecutive patients who received a continuous-flow left ventricular assist device at our center between May 2004 and December 2014. A total time–restricted model was used to estimate hazard ratios for readmission, and the Nelson nonparametric method was used to estimate mean cumulative function for each cause of readmission. Results The mean age was 57 ± 13 years, 82.6% received a HeartMate II (Abbott Laboratories, Chicago, IL), and 26.3% were destination therapy. The 30-day readmission rate was 21.7%, and 264 readmissions (41.1%) occurred within the first 6 months of support. The leading cause of readmission was bleeding (0.74 mean cumulative events per person), followed by infection (0.7), device failure (0.52), arrhythmia (0.3), and right heart failure (0.28) at 3 years. The number of readmissions did not have an adverse effect on survival (hazard ratio, 1.03; 95% confidence interval, 0.92 to 1.17; p = 0.58). Increase in each body mass index unit was associated with 1.029 times the rate of overall readmission ( p = 0.041). Patients with a body mass index of 30 kg/m 2 or higher had increased readmissions for device failure ( p = 0.008) and right heart failure ( p = 0.03). Conclusions Readmission burden is highest during the first few months of continuous-flow left ventricular assist device support, but survival is not affected. Patients with an elevated body mass index are at increased risk for readmissions for device failure and right heart failure. [ABSTRACT FROM AUTHOR]
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- 2018
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32. Socioeconomic Disparities in Adherence and Outcomes After Heart Transplant: A UNOS (United Network for Organ Sharing) Registry Analysis.
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Wayda, Brian, Clemons, Autumn, Givens, Raymond C., Koji Takeda, Hiroo Takayama, Latif, Farhana, Restaino, Susan, Yoshifumi Naka, Farr, Maryjane A., Colombo, Paolo C., and Topkara, Veli K.
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BACKGROUND: There is mixed evidence of racial and socioeconomic disparities in heart transplant outcomes. Their underlying cause--and whether individual- or community-level traits are most influential--remains unclear. The current study aimed to characterize socioeconomic disparities in outcomes and identify time trends and mediators of these disparities. METHODS AND RESULTS: We used United Network for Organ Sharing registry data and included 33 893 adult heart transplant recipients between 1994 and 2014. Socioeconomic status (SES) indicators included insurance, education, and neighborhood SES measured using a composite index. Black race and multiple indicators of low SES were associated with the primary outcome of death or retransplant, independent of baseline clinical characteristics. Blacks had lower HLA and race matching, but further adjustment for these and other graft characteristics only slightly attenuated the association with black race (HR, 1.25 after adjustment). This and the associations with neighborhood SES (HR, 1.19 for lowest versus highest decile), Medicare (HR, 1.17), Medicaid (HR, 1.29), and college education (HR, 0.90) remained significant after full adjustment. When comparing early (1994-2000) and late (2001-2014) cohorts, the disparities associated with the middle (second and third) quartiles significantly decreased over time, but those associated with lowest SES quartile and black race persisted. Low neighborhood SES was also associated with higher risks of noncompliance (HR, 1.76), rejection (HR, 1.28), hospitalization (HR, 1.13), and infection (HR, 1.10). CONCLUSIONS: Racial and socioeconomic disparities exist in heart transplant outcomes, but the latter may be narrowing over time. These disparities are not explained by differences in clinical or graft characteristics. [ABSTRACT FROM AUTHOR]
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- 2018
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33. Mechanical Circulatory Support Device Utilization and Heart Transplant Waitlist Outcomes in Patients With Restrictive and Hypertrophic Cardiomyopathy.
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Sridharan, Lakshmi, Wayda, Brian, Truby, Lauren K., Latif, Farhana, Restaino, Susan, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Colombo, Paolo C., Maurer, Mathew, Farr, Maryjane A., and Topkara, Veli K.
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BACKGROUND: Patients with restrictive cardiomyopathy (RCM) and hypertrophic cardiomyopathy (HCM) generally are considered poor candidates for mechanical circulatory support devices (MCSDs) and often not able to be bridged mechanically to heart transplantation. This study characterized MCSD utilization and transplant waitlist outcomes in patients with RCM/HCM under the current allocation system and discusses changes in the era of the new donor allocation system. METHODS AND RESULTS: Patients waitlisted from 2006 to 2016 in the United Network for Organ Sharing registry were stratified by RCM/ HCM versus other diagnoses. MCSD utilization and waitlist duration were analyzed by propensity score models. Waitlist outcomes were assessed by cumulative incidence functions with competing events. Predictors of waitlist mortality or delisting for worsening status in patients with RCM/ HCM were identified by proportional hazards model. Of 30 608 patients on the waitlist, 5.1% had RCM/HCM. Patients with RCM/HCM had 31 fewer waitlist days (P<0.01) and were ≈26% less likely to receive MCSD (P<0.01). Cumulative incidence of waitlist mortality was similar between cohorts; however, patients with RCM/HCM had higher incidence of heart transplantation. Predictors of waitlist mortality or delisting for worsening status in patients with RCM/HCM without MCSD support included estimated glomerular filtration rate <60 mL/min per 1.73 m², pulmonary capillary wedge pressure >20 mm Hg, inotrope use, and subjective frailty. CONCLUSIONS: Patients with RCM/HCM are less likely to receive MCSD but have similar waitlist mortality and slightly higher incidence of transplantation compared with other patients. The United Network for Organ Sharing RCM/HCM risk model can help identify patients who are at high risk for clinical deterioration and in need of expedited heart transplantation. [ABSTRACT FROM AUTHOR]
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- 2018
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34. Incidence and risk factors of groin lymphocele formation after venoarterial extracorporeal membrane oxygenation in cardiogenic shock patients.
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Salna, Michael, Takayama, Hiroo, Garan, Arthur R., Kurlansky, Paul, Farr, Maryjane A., Colombo, Paolo C., Imahiyerobo, Thomas, Morrissey, Nicholas, Naka, Yoshifumi, and Takeda, Koji
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Objective Venous-arterial extracorporeal membrane oxygenation (VA-ECMO) is a well-established therapy for refractory cardiopulmonary failure. Femoral cannulation offers a quick and effective means of providing circulatory support but is not without complication. Inflammation or lymphatic disruption at the site of cannulation can cause the formation of lymphoceles, leading to the patient's discomfort and possibly necessitating intervention. The purpose of this study was to evaluate the incidence of in-hospital lymphocele formation in VA-ECMO patients and to identify predictors for their development. Methods We conducted a single-center retrospective review of 192 patients who underwent femoral VA-ECMO insertion and subsequent decannulation from March 2007 to August 2016 for cardiogenic shock. Baseline demographics, risk factors, and cannulation strategies were examined. Groin lymphocele formation was assessed as the primary outcome. Results Median age was 58 years (interquartile range, 48-67 years) with a median duration of support of 4 days (interquartile range, 2-6 days). Lymphocele formation was identified in 31 patients (16%). Patients who developed lymphoceles were more likely to have post-heart transplantation primary graft dysfunction (PGD) as an indication for ECMO support compared with those who did not (54.2% vs 8%; P < .001). ECMO duration was similar between groups, but lymphocele patients were more likely to have undergone femoral cutdown procedures (68% vs 42%; P = .010). Compared with those PGD patients who did not develop lymphoceles, PGD lymphocele patients had higher rates of diabetes mellitus preoperatively (62% vs 8%; P = .006). Thirteen (42%) patients required surgical incision and drainage, and 4 of these patients (31%) required repeated surgical intervention. Conclusions Lymphocele formation is relatively common after femoral VA-ECMO. There was a significantly higher incidence of lymphocele formation in diabetic patients requiring support for PGD after heart transplantation. [ABSTRACT FROM AUTHOR]
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- 2018
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35. Abciximab/Heparin Therapy for Left Ventricular Assist Device Implantation in Patients With Heparin-Induced Thrombocytopenia.
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Lee, Chia-Ling, Colombo, Paolo C., Eisenberger, Andrew, Diuguid, David, Jennings, Douglas L., Han, Jiho, Salna, Michael P., Takeda, Koji, Kurlansky, Paul A., Yuzefpolskaya, Melana, Garan, Arthur R., Naka, Yoshifumi, and Takayama, Hiroo
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Background Optimal anticoagulation strategy remains uncertain in patients with heparin-induced thrombocytopenia (HIT) and undergoing left ventricular assist device (LVAD) implantation. We describe our protocol of abciximab and heparin in these patients. Methods Our protocol is to administer abciximab, 0.25 mg/kg loading dose, followed by continuous infusion of 0.125 μg · kg −1 · min −1 throughout cardiopulmonary bypass. Full-dose heparin is then given with subsequent additional doses to maintain an activated clotting time of 400 seconds or longer. The abciximab infusion is stopped 15 minutes after heparin reversal with protamine, and platelets are transfused. Results Six patients underwent LVAD implantation with this protocol in our program. HIT was confirmed in 4 patients was suspected in 2, which was negative after the operation. One patient received a HeartMate XVE (Thoratec Corp, Pleasanton, CA) and the others received HeartMate II (Thoratec Corp). There were no thromboembolic complications. One patient required chest reexploration for bleeding and temporary right VAD support. Postoperative anticoagulation with argatroban was restarted on median postoperative day 3 (range, days 1 to 6) and warfarin was started on day 5 (range, days 3 to 12). Median postoperative intensive care unit stay was 9 days (range, 5 to 76 days), and hospital stay was 22 days (range, 18 to 132 days). After the initial LVAD implantation, 1 patient required HeartMate XVE LVAD exchange to HeartMate II and subsequent heart transplant, both of which were performed with the abciximab/heparin protocol. A HeartMate II device was explanted in another patient after myocardial recovery. The remaining 4 patients are alive on device support. Conclusions This is the first report of a novel abciximab/heparin protocol for LVAD implantation in patients with HIT. The preliminary results suggest the feasibility and safety of this protocol. [ABSTRACT FROM AUTHOR]
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- 2018
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36. Multicenter Evaluation of Octreotide as Secondary Prophylaxis in Patients With Left Ventricular Assist Devices and Gastrointestinal Bleeding.
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Shah, Keyur B., Gunda, Sampath, Emani, Sitaramesh, Kanwar, Manreet K., Uriel, Nir, Colombo, Paolo C., Uber, Patricia A., Sears, Melissa L., Chuang, Joyce, Farrar, David J., Brophy, Donald F., and Smallfield, George B.
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BACKGROUND: Gastrointestinal (GI) bleeding is one of the most common complications after continuous-flow left ventricular assist device implantation. More than one third of patients with incident bleed go on to develop recurrent GI bleeding. Octreotide, a somatostatin analog, is proposed to reduce the risk of recurrent GI bleeding in this population. METHODS AND RESULTS: This multicenter, retrospective analysis evaluated 51 continuous-flow left ventricular assist device patients who received secondary prophylaxis with octreotide after their index GI bleed from 2009 to 2015. All patients had a hospitalization for GI bleed and received octreotide after discharge. Patient demographics, medical and medication history, and clinical characteristics of patients who rebled after receiving octreotide were compared with non-rebleeders. These data were also compared with matched historical control patients previously enrolled in the HMII (HeartMate II) clinical trials, none of whom received octreotide, to provide a context for the bleeding rates. Twelve patients (24%) who received secondary octreotide prophylaxis developed another GI bleed, whereas 39 (76%) did not. There were similar intergroup demographics; however, significantly more bleeders had a previous GI bleeding history before left ventricular assist device placement (33% versus 5%; P=0.02) and greater frequency of angiodysplasia confirmed during endoscopy (58% versus 23%; P=0.03). Fewer patients in this study experienced a recurrent GI bleed compared with a matched historical control group that did not receive octreotide (24% versus 43%; P=0.04). CONCLUSIONS: Patients with continuous-flow left ventricular assist device receiving secondary prophylaxis with octreotide had a significantly lower GI bleed recurrence compared with historical controls not treated with octreotide. Additional prospective studies are needed to confirm these data. [ABSTRACT FROM AUTHOR]
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- 2017
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37. Does lateral approach preserve the right ventricular function after HeartMate 3 insertion?
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Hayashi, Hideyuki, Kirschner, Michael, Vinogradsky, Alice, Zhao, Yanling, Sun, Jocelyn, Kurlansky, Paul, Yuzefpolskaya, Melana, Colombo, Paolo C, Sayer, Gabriel T, Uriel, Nir, Naka, Yoshifumi, and Takeda, Koji
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Minimally invasive cardiac surgery is employed in many cardiac surgical procedures [1, 2].
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- 2023
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38. Changes in End-Organ Function in Patients With Prolonged Continuous-Flow Left Ventricular Assist Device Support.
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Yoshioka, Daisuke, Takayama, Hiroo, Colombo, Paolo C., Yuzefpolskaya, Melana, Garan, Arthur R., Topkara, Veli K., Han, Jiho, Kurlansky, Paul, Naka, Yoshifumi, and Takeda, Koji
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Background Few studies have evaluated the long-term effects of continuous blood flow with reduced pulsatility on end-organ function. Methods Between May 2004 and December 2015, 469 patients underwent continuous-flow left ventricular assist device (LVAD) implantation at our center. Our study included 59 (13%) patients who were supported with an LVAD for a minimum of 3 years. We evaluated postoperative renal function and hepatic function at 1 and 6 months, and 1, 2, and 3 years after implantation in those 59 patients. Results The patients’ mean age was 63 ± 13 years, 81% were male, 53% had an ischemic cause of heart failure, and 68% underwent LVAD implantation as destination therapy. All laboratory determinations showed significant improvements at 1 month after the procedure. Hepatic values remained in a normal range for up to 3 years, although renal function improvement was predominantly transient. One month after implantation, the mean estimated glomerular filtration rate (eGFR) was improved from 58.2 ± 27.9 to 77.7 ± 33.5 mL/min/1.73 m 2 . However, 46 (78%) patients showed a gradual decline in eGFR to only 1.7% above the preoperative value after 3 years ( p = 0.67 vs baseline). The risk factors for impaired renal function after long-term support were age 60 years or older, ischemic cause, and late right heart failure. Conclusions Continuous-flow LVAD improves renal and hepatic functions in patients with advanced heart failure. However, in most, the initial improvement in renal function is largely transient and returns to baseline after a prolonged support period. [ABSTRACT FROM AUTHOR]
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- 2017
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39. Ryanodine Receptor Calcium Leak in Circulating B-Lymphocytes as a Biomarker in Heart Failure
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Kushnir, Alexander, Santulli, Gaetano, Reiken, Steven R., Coromilas, Ellie, Godfrey, Sarah J., Brunjes, Danielle L., Colombo, Paolo C., Yuzefpolskaya, Melana, Sokol, Seth I., Kitsis, Richard N., and Marks, Andrew R.
- Abstract
Supplemental Digital Content is available in the text.
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- 2018
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40. MicroRNA-195 Regulates Metabolism in Failing Myocardium Via Alterations in Sirtuin 3 Expression and Mitochondrial Protein Acetylation
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Zhang, Xiaokan, Ji, Ruiping, Liao, Xianghai, Castillero, Estibaliz, Kennel, Peter J., Brunjes, Danielle L., Franz, Marcus, Möbius-Winkler, Sven, Drosatos, Konstantinos, George, Isaac, Chen, Emily I., Colombo, Paolo. C., and Schulze, P. Christian
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Supplemental Digital Content is available in the text.
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- 2018
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41. Effect of entomopathogens on Africanized Apis melliferaL. (Hymenoptera: Apidae)
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Potrich, Michele, Silva, Rita T.L. da, Maia, Fabiana M.C., Lozano, Everton R., Rossi, Robson M., Colombo, Fernanda C., Tedesco, Flavia G., and Gouvea, Alfredo de
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This study aimed to evaluate the effect of commercially used entomopathogens on Africanized Apis melliferaL. (Hymenoptera: Apidae). Four bioassays were performed: 1) pulverized entomopathogens on A. mellifera; 2) entomopathogens sprayed on a smooth surface; 3) entomopathogens sprayed on soy leaves; and 4) entomopathogens mixed with candy paste (sugar syrup). Five treatments were prepared: sterile distilled water (control), distilled water sterilized with Tween®80 (0.01%), and the commercial entomopathogens Metarhizium anisopliaeE9 (1.0×109conidiamL−1), Beauveria bassianaPL63 (1.0×108conidia mL−1) and Bacillus thuringiensisvar. kurstaki HD-1 (3.0×108sporesmL−1). Each treatment consisted of five repetitions, with 20 workers per repetition, which were stored in a plastic box and, later, in a biological oxygen demand (B.O.D.) incubator (27±2°C, RH of 60%±10%, 12-h photophase). The mortality of the workers was evaluated from 1h to 240h, and the data were analyzed using Bayesian inference. The workers killed by the ingestion of candy paste contaminated with the pathogens (products) were randomly separated and selected for the removal of the midgut. Each midgut was fixed in Bouin's solution and prepared for histology. B. bassianawas verified to reduce the survival of A. melliferaworkers in all bioassays. Moreover, M. anisopliaereduced the survival of A. melliferaworkers directly sprayed, on a smooth surface and mixed with candy. B. thuringiensisreduced A. melliferasurvival on a smooth surface and mixed with candy paste. However, its effects were lower than that observed by B. bassiana.The treatments with the biological products did not induce morphometric alterations in the midgut of A. mellifera.
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- 2018
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42. Peripheral venous congestion causes inflammation, neurohormonal, and endothelial cell activation
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Colombo, P. C., primary, Onat, D., additional, Harxhi, A., additional, Demmer, R. T., additional, Hayashi, Y., additional, Jelic, S., additional, LeJemtel, T. H., additional, Bucciarelli, L., additional, Kebschull, M., additional, Papapanou, P., additional, Uriel, N., additional, Schmidt, A. M., additional, Sabbah, H. N., additional, and Jorde, U. P., additional
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- 2013
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43. Impact of Socioeconomic Status on Patients Supported With a Left Ventricular Assist Device.
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Clerkin, Kevin J., Garan, Arthur Reshad, Wayda, Brian, Givens, Raymond C., Yuzefpolskaya, Melana, Shunichi Nakagawa, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Mancini, Donna M., Colombo, Paolo C., and Topkara, Veli K.
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Background—Low socioeconomic status (SES) is a known risk factor for heart failure, mortality among those with heart failure, and poor post heart transplant (HT) outcomes. This study sought to determine whether SES is associated with decreased waitlist survival while on left ventricular assist device (LVADs) support and after HT. Methods and Results—A total of 3361 adult patients bridged to primary HT with an LVAD between May 2004 and April 2014 were identified in the UNOS database (United Network for Organ Sharing). SES was measured using the Agency for Healthcare Research and Quality SES index using data from the 2014 American Community Survey. In the study cohort, SES did not have an association with the combined end point of death or delisting on LVAD support (P=0.30). In a cause-specific unadjusted model, those in the top (hazard ratio, 1.55; 95% confidence interval, 1.14–2.11; P=0.005) and second greatest SES quartile (hazard ratio 1.50; 95% confidence interval, 1.10–2.04; P=0.01) had an increased risk of death on device support compared with the lowest SES quartile. Adjusting for clinical risk factors mitigated the increased risk. There was no association between SES and complications. Post-HT survival, both crude and adjusted, was decreased for patients in the lowest quartile of SES index compared with all other SES quartiles. Conclusions—Freedom from waitlist death or delisting was not affected by SES. Patients with a higher SES had an increased unadjusted risk of waitlist mortality during LVAD support, which was mitigated by adjusting for increased comorbid conditions. Low SES was associated with worse post-HT outcomes. Further study is needed to confirm and understand a differential effect of SES on post-transplant outcomes that was not seen during LVAD support before HT. [ABSTRACT FROM AUTHOR]
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- 2016
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44. Recovery of Serum Cholesterol Predicts Survival After Left Ventricular Assist Device Implantation.
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Vest, Amanda R., Kennel, Peter J., Maldonado, Dawn, Young, James B., Mountis, Maria M., Yoshifumi Naka, Colombo, Paolo C., Mancini, Donna M., Starling, Randall C., and Schulze, P. Christian
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Background--Advanced systolic heart failure is associated with myocardial and systemic metabolic abnormalities, including low levels of total cholesterol and low-density lipoprotein. Low cholesterol and low-density lipoprotein have been associated with greater mortality in heart failure. Implantation of a left ventricular assist device (LVAD) reverses some of the metabolic derangements of advanced heart failure. Methods and Results--A cohort was retrospectively assembled from 2 high-volume implantation centers, totaling 295 continuous-flow LVAD recipients with ≥2 cholesterol values available. The cohort was predominantly bridge-totransplantation (67%), with median age of 59 years and 49% ischemic heart failure cause. Total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels all significantly increased after LVAD implantation (median values from implantation to 3 months post implantation 125-150 mg/dL, 67-85 mg/dL, 32-42 mg/dL, and 97-126 mg/ dL, respectively). On Cox proportional hazards modeling, patients achieving recovery of total cholesterol levels, defined as a median or greater change from pre implantation to 3 months post-LVAD implantation, had significantly better unadjusted survival (hazard ratio, 0.445; 95% confidence interval, 0.212-0.932) and adjusted survival (hazard ratio, 0.241; 95% confidence interval, 0.092-0.628) than those without cholesterol recovery after LVAD implantation. The continuous variable of total cholesterol at 3 months post implantation and the cholesterol increase from pre implantation to 3 months were also both significantly associated with survival during LVAD support. Conclusions--Initiation of continuous-flow LVAD support was associated with significant recovery of all 4 lipid variables. Patients with a greater increase in total cholesterol by 3 months post implantation had superior survival during LVAD support. [ABSTRACT FROM AUTHOR]
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- 2016
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45. Myocardial Recovery in Patients Receiving Contemporary Left Ventricular Assist Devices Results From the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS).
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Topkara, Veli K., Garan, A. Reshad, Fine, Barry, Godier-Furnémont, Amandine F., Breskin, Alexander, Cagliostro, Barbara, Yuzefpolskaya, Melana, Takeda, Koji, Takayama, Hiroo, Mancini, Donna M., Naka, Yoshifumi, and Colombo, Paolo C.
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Background--Time course and predictors of myocardial recovery on contemporary left ventricular assist device support are poorly defined because of limited number of recovery patients at any implanting center. This study sought to investigate myocardial recovery using multicenter data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Methods and Results--Thirteen thousand four hundred fifty-four adult patients were studied. Device explant rates for myocardial recovery were 0.9% at 1-year, 1.9% at 2-year, and 3.1% at 3-year follow-up. Independent predictors of device explantation for recovery were age <50 years (odds ratio [OR] 2.5), nonischemic etiology (OR 5.4), time since initial diagnosis <2 years (OR 3.4), suboptimal heart failure therapy before implant (OR 2.2), left ventricular end-diastolic diameter <6.5 cm (OR 1.7), pulmonary systolic artery pressure <50 mm Hg (OR 2.0), blood urea nitrogen <30 mg/dL (OR 3.3), and axial-flow device (OR 7.6). Patients with myocarditis (7.7%), postpartum cardiomyopathy (4.4%), and adriamycin-induced cardiomyopathy (4.1%) had highest rates of device explantation for recovery. Use of neurohormonal blockers on left ventricular assist device support was significantly higher in patients who were explanted for recovery. Importantly, 9% of all left ventricular assist device patients who were not explanted for recovery have demonstrated substantial improvement in left ventricular ejection fraction (partial recovery) and had remarkable overlap in clinical characteristic profile compared with patients who were explanted for recovery (complete recovery). Complete and partial recovery rates have declined in parallel with recent changes observed in device indications and technology. Conclusions--Myocardial recovery is a spectrum of improvement rather than a binary clinical end point. One in every 10 left ventricular assist device patients demonstrates partial or complete myocardial recovery and should be targeted for functional assessment and optimization. [ABSTRACT FROM AUTHOR]
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- 2016
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46. Watchful Waiting in Continuous-Flow Left Ventricular Assist Device Patients With Ongoing Hemolysis Is Associated With an Increased Risk for Cerebrovascular Accident or Death.
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Levin, Allison P., Saeed, Omar, Willey, Joshua Z., Levin, Charles J., Fried, Justin A., Patel, Snehal R., Sims, Daniel B., Nguyen, Jenni D., Shin, Julia J., Topkara, Veli K., Colombo, Paolo C., Goldstein, Daniel J., Yoshifumi Naka, Takayama, Hiroo, Uriel, Nir, and Jorde, Ulrich P.
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Background--Management of hemolysis in the setting of suspected device thrombosis in continuous-low left ventricular assist device patients varies widely, ranging from watchful waiting with intensified antithrombotic therapy to early surgical device exchange. The aim of this study was to compare the outcomes of hemolysis events treated with surgical interventions versus medical management alone. Methods and Results--A retrospective review of Heartmate II continuous-low left ventricular assist device patients at 2 centers from January 2009 to September 2014 was completed. Patients were categorized as surgical management if hemolysis refractory to intensification of standard antithrombotic therapy was treated surgically. The primary end point was the first occurrence of cerebrovascular accident (CVA) or death. Sixty-four hemolysis events occurred in 49/367 patients implanted with Heartmate II continuous-low left ventricular assist devices. Of 49 primary hemolysis events, 24 were treated with surgical interventions. After surgical treatment, 1 patient died and 2 experienced CVAs, as compared with 3 deaths and 9 CVAs in the 25 patients who remained on intensified antithrombotic therapy alone. The 1-year freedom from CVA or death was 87.5% and 49.5% in the surgical and medical cohorts, respectively (P=0.027). Resolution of a primary hemolysis event without CVA or death occurred in 21/24 patients treated with surgical interventions and in 13/25 who remained on medical therapy alone. A similar association between treatment and outcome was noted in the 15 recurrent hemolysis events. Conclusions--Hemolysis refractory to intensification of antithrombotic therapy identifies continuous-low left ventricular assist device patients at major risk for CVA and death. Early device exchange should be considered to minimize these risks. [ABSTRACT FROM AUTHOR]
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- 2016
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47. Physical characterization of Rhipsalis (Cactaceae) fruits and seeds germination in different temperatures and light regimes.
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Lone, A. B., Colombo, R. C., Andrade, B. L. G., Takahashi, L. S. A., and Faria, R. T.
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CACTUS ,GERMINATION ,EFFECT of temperature on plants ,EFFECT of light on plants ,PLANTS ,PHOTOPERIODISM - Abstract
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- 2016
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48. Hemocompatibility-Related Outcomes in the MOMENTUM 3 Trial at 6 Months
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Uriel, Nir, Colombo, Paolo C., Cleveland, Joseph C., Long, James W., Salerno, Christopher, Goldstein, Daniel J., Patel, Chetan B., Ewald, Gregory A., Tatooles, Antone J., Silvestry, Scott C., John, Ranjit, Caldeira, Christiano, Jeevanandam, Valluvan, Boyle, Andrew J., Sundareswaran, Kartik S., Sood, Poornima, and Mehra, Mandeep R.
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- 2017
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49. Abstract P342: Periodontal Disease is Associated With Elevated Prediabetes Prevalence and Glucose Levels Among Non-Diabetic Adults. Results From Oral Infections, Glucose Intolerance and Insulin Resistance Study
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Adam, Hamdi S, Molinsky, Rebecca L, Roy, Sumith, Rosenbaum, Michael, Paster, Bruce, Yuzefpolskaya, Melana, Colombo, Paolo C, Papapanou, Panos N, Desvarieux, Moise, Jacobs, David R, and Demmer, Ryan T
- Abstract
Background:Periodontitis (a bacterially-driven, inflammatory disease) is a plausible risk factor for prediabetes and diabetes. We studied the association between clinical attachment loss (CAL – a cumulative measure of tooth-supporting tissues lost due to periodontitis), prediabetes, and glucose levels among non-diabetic younger adults.Hypothesis:We hypothesize that greater CAL is associated with higher levels of biomarkers of cardiometabolic risk cross-sectionally.Methods:We included n=1071 non-diabetic participants from the Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS) who underwent full-mouth periodontal examinations and provided fasting blood at baseline. Baseline enrollment occurred in two waves: Wave 1 (2011-2013; n=293) and Wave 2 (2016-2020; n=778). HbA1c and glucose were measured during clinical exams. Prediabetes was defined as fasting glucose between 100-125 mg/dL or HbA1c between 5.7-6.4% per American Diabetes Association guidelines. We computed prevalence ratios and 95% confidence intervals of prediabetes among 2ndand 3rdCAL tertiles (vs. 1sttertile) via multivariable Poisson regression with robust variance estimation. Multivariable linear regression was used to assess the association between CAL tertiles (independent variable) and estimates of glucose and HbA1c. We adjusted for demographics, health variables, and study wave.Results:The mean age(SD) of participants was 32.3(9.6) years and 28% were male. Prediabetes prevalence was 8.7%. Multivariable adjusted prevalence ratios (95%CIs) for prediabetes in tertiles 2 and 3 (vs. 1) were 1.45(0.79,2.67) and 1.91(0.99,3.67), respectively, consistent with p for trend = 0.05 and stronger associations with continuous glucose and HbA1c (see Table).Conclusion:CAL, a cumulative measure of periodontitis, was cross-sectionally associated with increased prediabetes prevalence, glucose and HbA1c.
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- 2023
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50. Abstract P174: The Association Between Infection-Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study
- Author
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Molinsky, Rebecca L, Shah, Amil M, Yuzefpolskaya, Melana, Yu, Bing, Misialek, Jeffrey, Bohn, Bruno, Vock, David, Maclehose, Richard, Colombo, Paolo C, Ndumele, Chiadi E, Ishigami, Junichi, Matsushita, Kuni, Lutsey, Pamela L, and Demmer, Ryan
- Abstract
Introduction:Infections are associated with worse clinical outcomes among patients with heart failure (HF). However, little is known about the influence of infection-related hospitalizations on development of incident HF and its subtype.Hypothesis:We hypothesize that those with an infection-related hospitalization (hereafter ‘infection’) compared to those without infection, will experience an increased rate of incident HF events (any HF, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF)).Methods:We examined 14,398 participants enrolled in the Atherosclerosis Risk in Communities Study who were HF free at visit 1 (1987-1989). Hospitalized infections and HF were identified via participant self-report and active surveillance of hospitalizations. Among the hospitalized, infection was further defined using ICD-9/10 codes in the first five positions of hospital records. A subset of HF events was further classified as HFpEF or HFrEF via chart abstraction and adjudication by centrally trained and certified physicians. Infection was treated as a time-varying exposure and the co-occurrence of infection and HF in the same hospital visit were excluded. Multivariable-adjusted Cox proportional hazards models assessed the association between infection and incident HF, HFrEF, and HFpEF.Results:The overall baseline sample was 54% (7,835 of 14,398) female, 26% (3,688 of 14,398) Black and had a mean(SD) age of 54(5.8). Mean(SD) time to infection was 16.1(8.7) years, and 2.3(7.5) years from infection to incident HF. Average follow-up among the full sample was 23.0(8.5). Overall, 46% (6,603 of 14,398) had an infection and 3,561 developed any HF. Among participants with subtype adjudication, 470 had HFpEF and 450 had HFrEF. Infection-related hospitalization was associated with an increased risk for both HFpEF and HFrEF (Table).Conclusion:Infection-related hospitalization was associated with both incident HFpEF and HFrEF. A stronger effect is seen among those with HFpEF.
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- 2023
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