1,033 results on '"Joao A.C. Lima"'
Search Results
2. Associations of Circulating Vascular Cell Adhesion Molecule‐1 and Intercellular Adhesion Molecule‐1 With Long‐Term Cardiac Function
- Author
-
Daniel T. Mathew, Graham Peigh, Joao A.C. Lima, Suzette J. Bielinski, Nicholas B. Larson, Matthew A. Allison, Sanjiv J. Shah, and Ravi B. Patel
- Subjects
atrial fibrillation ,cellular adhesion molecule ,heart failure ,interstitial fibrosis ,left atrial strain ,myocardial scar ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Although VCAM‐1 (vascular cell adhesion molecule‐1) and ICAM‐1 (intercellular adhesion molecule‐1) have been associated with incident heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF), the associations of VCAM‐1 and ICAM‐1 with sensitive measures of cardiac structure/function are unclear. The objective of this study is to evaluate associations between VCAM‐1, ICAM‐1, and measures of cardiac structure and function as potential pathways through which cellular adhesion molecules promote HFpEF and AF risk. Methods and Results In MESA (Multi‐Ethnic Study of Atherosclerosis), we evaluated the associations of circulating VCAM‐1 and ICAM‐1 at examination 2 (2002–2004) with measures of cardiac structure/function on cardiac magnetic resonance imaging at examination 5 (2010–2011) after multivariable adjustment. Mediation analysis of left atrial (LA) strain on the association between VCAM‐1 or ICAM‐1 and AF or HFpEF was also performed. Overall, 2304 individuals (63±10 years; 47% men) with VCAM‐1 or ICAM‐1, cardiac magnetic resonance imaging, and covariate data were included in analysis. Higher VCAM‐1 and ICAM‐1 were associated with lower LA peak longitudinal strain and worse global circumferential left ventricular strain but were not associated with left ventricular myocardial scar or interstitial fibrosis. Lower LA peak longitudinal strain mediated 8% (95% CI, 2–30) of the relationship between VCAM‐1 and HFpEF and 9% (95% CI, 2–21) of the relationship between VCAM‐1 and AF. Conclusions Higher VCAM‐1 and ICAM‐1 were associated with lower LA function and left ventricular systolic function but were not associated with myocardial scar or interstitial fibrosis. VCAM‐1 and ICAM‐1 may promote HFpEF and AF risk through impaired LA reservoir function.
- Published
- 2024
- Full Text
- View/download PDF
3. Hepatocyte Growth Factor and 10-Year Change in Left Ventricular Structure: The Multi-Ethnic Study of Atherosclerosis (MESA)
- Author
-
Richard A. Ferraro, MD, Oluseye Ogunmoroti, MD, MPH, Di Zhao, PhD, Chiadi E. Ndumele, MD, PhD, Joao A.C. Lima, MD, Vinithra Varadarajan, MBBS, Vinita Subramanya, MBBS, MPH, Ambarish Pandey, MD, Nicholas B. Larson, PhD, Suzette J. Bielinski, PhD, and Erin D. Michos, MD, MHS
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Hepatocyte growth factor (HGF) is a cytokine linked to incident heart failure (HF), particularly HF with preserved ejection fraction (HFpEF). Increases in left ventricular (LV) mass and concentric remodelling defined by increasing mass-to-volume (M:V) ratios are imaging risk markers for HFpEF. We aimed to determine if HGF is associated with adverse LV remodelling. Methods: We studied 4907 participants in the Multi-Ethnic Study of Atherosclerosis (MESA), free of cardiovascular disease and HF at baseline, who had HGF measured and cardiac magnetic resonance imaging (CMR) performed at baseline. Of these, 2921 completed a second CMR at 10 years. We examined the cross-sectional and longitudinal associations of HGF and LV structural parameters using multivariable-adjusted linear mixed-effect models, adjusting for cardiovascular disease risk factors and N-terminal pro B-type natriuretic peptide. Results: The mean (SD) for age was 62 (10) years; 52% were female. Median (interquartile range) for HGF level was 890 pg/mL (745-1070). At baseline, the highest HGF tertile, compared to the lowest, was associated with a greater M:V ratio (relative difference 1.94 [95% confidence interval [CI]: 0.72, 3.17]) and lower LV end-diastolic volume (–2.07 mL [95% CI: –3.72, –0.42)]. In longitudinal analysis, the highest HGF tertile was associated with increasing M:V ratio (10-year difference: 4.68 [95% CI: 2.64, 6.72]) and decreasing LV end-diastolic volume (–4.74 [95% CI: –6.87, –2.62]). Conclusions: In a community-based cohort, higher HGF levels were independently associated with a concentric LV remodelling pattern of increasing M:V ratio and decreasing LV end-diastolic volume by CMR over 10 years. These associations may reflect an intermediate phenotype explaining the association of HGF with HFpEF risk. Résumé: Contexte: Le facteur de croissance des hépatocytes (hepatocyte growth factor; HGF) est une cytokine associée à l’insuffisance cardiaque (IC), particulièrement l’IC avec fraction d’éjection préservée (ICFEP). Une augmentation de la masse du ventricule gauche (VG) et un remodelage concentrique du VG, défini par une augmentation du ratio masse/volume (M:V), sont des marqueurs de risque d’ICFEP à l’examen d’imagerie. Nous souhaitions déterminer si le taux de HGF est associé à un remodelage préjudiciable du VG. Méthodologie: Nous avons étudié 4 907 participants à l’étude multiethnique sur l’athérosclérose (Multi-Ethnic Study of Atherosclerosis; MESA) qui, au départ, ne présentaient pas de maladie cardiovasculaire ni d’IC et pour qui le taux de HGF avait été mesuré et une imagerie cardiaque par résonance magnétique (IRMc) avait été réalisée. Parmi ces personnes, 2 921 ont subi une seconde IRMc à 10 ans. Nous avons examiné les associations intersectionnelles et longitudinales entre le taux de HGF et les paramètres structurels du VG à l’aide de modèles linéaires à effets mixtes multivariés, ajustés pour les facteurs de risque de maladie cardiovasculaire et les propeptides natriurétiques de type B N-terminal. Résultats: L’âge moyen des participants était de 62 ans (écart type : 10), et 52 % étaient des femmes. Le taux de HGF médian était de 890 pg/ml (écart interquartile : 745 à 1070). Au départ, comparativement au tertile inférieur du taux de HGF, le tertile supérieur était associé à un ratio M:V plus important (différence relative : 1,94; intervalle de confiance [IC] à 95 % : 0,72 à 3,17) et à un volume diastolique final du VG plus faible (-2,07 ml; IC à 95 % : -3,72 à -0,42). À l’analyse longitudinale, le tertile supérieur du taux de HGF était associé à un ratio M:V plus élevé (différence sur 10 ans : 4,68; IC à 95 % : 2,64 à 6,72) et à une réduction du volume diastolique final du VG (-4,74; IC à 95 % : -6,87 à -2,62). Conclusions: Dans une cohorte représentative de la population, un taux de HGF plus élevé était associé de manière indépendante à un schéma de remodelage concentrique du VG présentant une augmentation du ratio M:V et à une diminution du volume diastolique final du VG à l’IRMc sur 10 ans. Ces associations pourraient être représentatives d’un phénotype intermédiaire expliquant l’association entre le taux de HGF et le risque d’ICFEP.
- Published
- 2023
- Full Text
- View/download PDF
4. Associations of urinary isoprostanes with measures of subclinical atherosclerosis: The Multi-Ethnic Study of Atherosclerosis (MESA)
- Author
-
Ryan L. Wallace, Oluseye Ogunmoroti, Di Zhao, Dhananjay Vaidya, Amir Heravi, Eliseo Guallar, Chiadi E. Ndumele, Joao A.C. Lima, Pamela Ouyang, Matthew J. Budoff, Matthew Allison, Isac Thomas, Oluwaseun E. Fashanu, Ron Hoogeveen, Wendy S. Post, and Erin D. Michos
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Urinary isoprostanes are markers of systemic oxidative stress, which is implicated in the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). Coronary artery calcium (CAC), thoracic aortic calcium (TAC) and carotid plaque are measure subclinical atherosclerosis and prognosticate ASCVD risk. We examined the associations between urinary isoprostane levels and measures of plaque prevalence, burden, incidence and progression across three vascular beds in a cohort from the Multi-Ethnic Study of Atherosclerosis. Methods: Urinary levels of 8-isoprostane and 2,3-dinor-8-F2-isoprostane were measured in 1089 participants (mean ± SD 62 ± 8 years, 48% women) at baseline. Participants underwent computed tomography for CAC and TAC, and duplex ultrasound for carotid plaque. TAC and CAC were reassessed at 2.4 and 10 years, respectively. Regression models were adjusted for CVD risk factors. Results: In adjusted models, there were no significant associations between isoprostane levels with CAC prevalence or progression. Highest versus lowest tertile of 8-isoprostane was associated with 28% lower prevalence of descending TAC at baseline [prevalence ratio (PR) 0.72 95% CI (0.56, 0.94)], while 1-SD higher 2,3-dinor-8-F2-isoprostane was associated with 96% higher incident ascending TAC at follow-up [Relative Risk 1.96 (1.24, 3.09)]. Highest versus lowest tertile of isoprostane measures were associated with 22% higher prevalence of carotid plaque [(PR 1.22 (1.04, 1.45)] and 14% difference [3,26] in greater extent of carotid plaque at baseline. Conclusions: Higher urinary isoprostanes were inconsistently associated with some measures of subclinical atherosclerosis by imaging. This suggests a limited role of urinary isoprostane levels as a prognostic marker for the development of ASCVD. Trial registration: The MESA cohort design is registered at clinicaltrials.gov as follows: https://clinicaltrials.gov/ct2/show/NCT00005487.
- Published
- 2023
- Full Text
- View/download PDF
5. Resistin and risks of incident heart failure subtypes and cardiac fibrosis: the Multi‐Ethnic Study of Atherosclerosis
- Author
-
Xinjiang Cai, Matthew A. Allison, Bharath Ambale‐Venkatesh, Neal W. Jorgensen, Joao A.C. Lima, Evan D. Muse, Robyn L. McClelland, Steven Shea, and Djamel Lebeche
- Subjects
Cardiac fibrosis ,Heart failure ,Resistin ,Troponin ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Resistin is a circulating inflammatory biomarker that is associated with cardiovascular disease. We investigated the associations of resistin and incident heart failure (HF) and its subtypes, as well as specific measures of subclinical HF (myocardial fibrosis and relevant biomarkers). Methods We analysed data from 1968 participants in the Multi‐Ethnic Study of Atherosclerosis with measurements of plasma resistin levels at clinic visits from 2002 to 2005. Participants were subsequently followed for a median of 10.5 years for HF events. The associations between resistin levels and incident HF, HF with reduced ejection fraction (HFrEF), and HF with preserved ejection fraction (HFpEF) were examined using multivariable Cox proportional hazards models. Linear regression models assessed the associations between resistin levels and myocardial fibrosis from cardiac magnetic resonance imaging, as well as hs‐cTnT and NT‐proBNP. Results The mean age of the cohort was 64.7 years, and 50.0% were female. Seventy‐four participants (4%) developed incident HF during follow‐up. In a Cox proportional hazards model adjusted for age, gender, education level, race/ethnicity, and traditional risk factors, higher resistin levels were significantly associated with incident HF (HR 1.44, CI 1.18–1.75, P = 0.001) and HFrEF (HR 1.47, CI 1.07–2.02, P = 0.016), but not with HFpEF (HR 1.25, CI 0.89–1.75, P = 0.195). Resistin levels showed no significant associations with myocardial fibrosis, NT‐proBNP, or hs‐cTnT levels. Conclusions In a multi‐ethnic cohort free of cardiovascular disease at baseline, elevated resistin levels were associated with incident HF, more prominently with incident HFrEF than HFpEF, but not with subclinical myocardial fibrosis or biomarkers of HF.
- Published
- 2022
- Full Text
- View/download PDF
6. Association between proteomic biomarkers and myocardial fibrosis measured by MRI: the multi-ethnic study of atherosclerosisResearch in context
- Author
-
Hooman Bakhshi, Sam A. Michelhaugh, Scott A. Bruce, Stephen L. Seliger, Xiaoxiao Qian, Bharath Ambale Venkatesh, Vinithra Varadarajan, Pramita Bagchi, Joao A.C. Lima, and Christopher deFilippi
- Subjects
Myocardial fibrosis ,Interstitial fibrosis ,Replacement fibrosis ,Proteomic ,Biomarkers ,Cardiac MRI ,Medicine ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Cardiac magnetic resonance imaging (CMR) determines the extent of interstitial fibrosis, measured by increased extracellular volume (ECV), and replacement fibrosis with late gadolinium myocardial enhancement (LGE). Despite advances in detection, the pathophysiology of subclinical myocardial fibrosis is incompletely understood. Targeted proteomic discovery technologies enable quantification of low abundance circulating proteins to elucidate cardiac fibrosis mechanisms. Methods: Using a cross-sectional design, we selected 92 LGE+ cases and 92 LGE− demographically matched controls from the Multi-Ethnic Study of Atherosclerosis. Similarly, we selected 156 cases from the highest ECV quartile and matched with 156 cases from the lowest quartile. The plasma serum proteome was analyzed using proximity extension assays to determine differential regulation of 92 proteins previously implicated with cardiovascular disease. Results were analyzed using volcano plots of statistical significance vs. magnitude of change and Bayesian additive regression tree (BART) models to determine importance. Findings: After adjusting for false discovery, higher ECV was significantly associated with 17 proteins. Using BART, Plasminogen activator inhibitor 1, Insulin-like growth factor-binding protein 1, and N-terminal pro-B-type natriuretic peptide were associated with higher ECV after accounting for other proteins and traditional cardiovascular risk factors. In contrast, no circulating proteins were associated with replacement fibrosis. Interpretations: Our results suggest unique circulating proteomic signatures associated with interstitial fibrosis emphasizing its systemic influences. With future validation, protein panels may identify patients who may develop interstitial fibrosis with progression to heart failure. Funding: This research was supported by contracts and grants from NHLBI, NCATS and the Inova Heart and Vascular Institute.
- Published
- 2023
- Full Text
- View/download PDF
7. Genetic variation in sodium glucose co‐transporter 1 and cardiac structure and function at middle age
- Author
-
Aakash Bavishi, Laura A. Colangelo, Laura J. Rasmussen‐Torvik, Joao A.C. Lima, Drew R. Nannini, Muthiah Vaduganathan, Ambarish Pandey, Donald M. Lloyd‐Jones, Sanjiv J. Shah, and Ravi B. Patel
- Subjects
Sodium‐glucose cotransporter 1 ,Heart failure ,Genetics ,Echocardiography ,Subclinical ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims The effects of inhibition of sodium glucose cotransporter (SGLT)‐1, as opposed to SGLT2, on cardiovascular structure and function are not well known. We assessed the associations of a missense genetic variant of SGLT1 with cardiac structure and function. Methods and results We evaluated associations of a functionally modifying variant of SLC5A1 (rs17683011 [p.Asn51Ser]), the gene that encodes SGLT1, with cardiac structure and function on echocardiography among middle‐aged adults in the Coronary Artery Risk Development in Young Adults Study. Of 1904 participants (55.3 ± 3.5 years, 57% female, 34% Black), 166 (13%) White participants and 18 (3%) Black participants had at least one copy of rs17683011. There were no significant differences in age, sex, body mass index, glucose, or diabetes status by the presence of the rs17683011 variant. In Black participants, the presence of at least one copy of the rs17683011 variant was significantly associated with better GLS compared with those without a copy of the variant after covariate adjustment (−15.8 ± 0.7% vs. −14.0 ± 0.1%, P = 0.02). Although the direction of effect was consistent, the association between the presence of at least one copy of rs17683011 and GLS was not statistically significant in White participants (−15.1 ± 0.2% vs. −14.8 ± 0.1%, P = 0.16). There were no significant associations between rs17683011 and other measures of LV structure, systolic function, or diastolic function. Conclusions The rs17683011 variant, a functionally modifying variant of the SGLT1 gene, was associated with higher GLS among middle‐age adults. These exploratory findings require further validation and suggest that SGLT1 inhibition may have beneficial effects upon LV systolic function.
- Published
- 2022
- Full Text
- View/download PDF
8. Right ventricular function as assessed by cardiac magnetic resonance imaging‐derived strain parameters compared to high‐fidelity micromanometer catheter measurements
- Author
-
Takahiro Sato, Bharath Ambale‐Venkatesh, Stefan L. Zimmerman, Ryan J. Tedford, Steven Hsu, Ela Chamera, Tomoki Fujii, Christopher J. Mullin, Valentina Mercurio, Rubina Khair, Celia P. Corona‐Villalobos, Catherine E. Simpson, Rachel L. Damico, Todd M. Kolb, Stephen C. Mathai, Joao A.C. Lima, David A. Kass, Ichizo Tsujino, and Paul M. Hassoun
- Subjects
pulmonary arterial hypertension ,strain and strain rate ,right ventricular failure ,pressure volume loop ,tau ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Diseases of the respiratory system ,RC705-779 - Abstract
Right ventricular function has prognostic significance in patients with pulmonary hypertension. We evaluated whether cardiac magnetic resonance‐derived strain and strain rate parameters could reliably reflect right ventricular systolic and diastolic function in precapillary pulmonary hypertension. End‐systolic elastance and the time constant of right ventricular relaxation tau, both derived from invasive high‐fidelity micromanometer catheter measurements, were used as gold standards for assessing systolic and diastolic right ventricular function, respectively. Nineteen consecutive precapillary pulmonary hypertension patients underwent cardiac magnetic resonance and right heart catheterization prospectively. Cardiac magnetic resonance data were compared with those of 19 control subjects. In pulmonary hypertension patients, associations between strain‐ and strain rate‐related parameters and invasive hemodynamic parameters were evaluated. Longitudinal peak systolic strain, strain rate, and early diastolic strain rate were lower in PAH patients than in controls; peak atrial‐diastolic strain rate was higher in pulmonary hypertension patients. Similarly, circumferential peak systolic strain rate was lower and peak atrial‐diastolic strain rate was higher in pulmonary hypertension. In pulmonary hypertension, no correlations existed between cardiac magnetic resonance‐derived and hemodynamically derived measures of systolic right ventricular function. Regarding diastolic parameters, tau was significantly correlated with peak longitudinal atrial‐diastolic strain rate (r = −0.61), deceleration time (r = 0.75), longitudinal systolic to diastolic time ratio (r = 0.59), early diastolic strain rate (r = −0.5), circumferential peak atrial‐diastolic strain rate (r = −0.52), and deceleration time (r = 0.62). Strain analysis of the right ventricular diastolic phase is a reliable non‐invasive method for detecting right ventricular diastolic dysfunction in PAH.
- Published
- 2021
- Full Text
- View/download PDF
9. Right ventricular longitudinal strain on CMR predicts ventricular arrhythmias and mortality in cardiac sarcoidosis
- Author
-
Bibin Varghese, Tarek Zghaib, Eric Xie, Stefan L. Zimmerman, Nisha A. Gilotra, David R. Okada, Joao A.C. Lima, and Jonathan Chrispin
- Subjects
Cardiac sarcoidosis ,Ventricular arrhythmias ,Right ventricular global longitudinal strain ,Late gadolinium enhancement ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Right ventricular (RV) dysfunction and late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) are associated with ventricular arrhythmias (VA) and mortality in cardiac sarcoidosis (CS). However, image resolution limits the detection of RV LGE. Global longitudinal RV strain (RVS) correlates to RV scar on electroanatomical mapping and RV function. Objective: We evaluated the association between RVS on CMR and VA/death (combined-primary-endpoint (CPE)) in patients with CS. Methods: RVS and RV LGE on MRI were retrospectively compared to variables known to predict outcomes in 66 patients with CS. Outcomes were obtained from electronic medical records and implantable cardioverter defibrillator (ICD) interrogations over median [IQR] 3.7[1.7, 6.3] years. Cox proportional hazard models were used to evaluate survival. Harrell's C-statistic was used to compare variables in risk prediction models. Results: 62.1 % of patients were male, with a mean age [SD] of 52.3 [9.6] years and left ventricular ejection fraction (LVEF) of 51.1[17.5]%. 9 patients with the primary endpoint were more likely to be Caucasian (p = 0.01) with prior VAs (p = 0.002), be on anti-arrhythmic drugs (p = 0.001) with an ICD (p = 0.002). In multivariable analyses adjusted for age, race, and history of VA, RVS (1.18 [1.05–1.31], p = 0.004), RV EDVI (1.08[1.01, 1.14], p = 0.02), and LV LGE (1.07[1.00, 1.13], p = 0.04) predicted the CPE. Risk prediction models including RVS (Cstatistic 0.94), outperformed those including RV and LV LGE (0.89–0.92). Conclusion: RVS on CMR was the best predictor of VA and mortality in CS.
- Published
- 2022
- Full Text
- View/download PDF
10. Association of immune cell subsets with cardiac mechanics in the Multi-Ethnic Study of Atherosclerosis
- Author
-
Arjun Sinha, Adovich S. Rivera, Margaret F. Doyle, Colleen Sitlani, Alison Fohner, Sally A. Huber, Nels C. Olson, Joao A.C. Lima, Joseph A. Delaney, Matthew J. Feinstein, Sanjiv J. Shah, Russel P. Tracy, and Bruce M. Psaty
- Subjects
Cardiology ,Immunology ,Medicine - Abstract
Background Immunomodulatory therapy may help prevent heart failure (HF). Data on immune cells and myocardial remodeling in older adults with cardiovascular risk factors are limited.Methods In the Multi-Ethnic Study of Atherosclerosis cohort, 869 adults had 19 peripheral immune cell subsets measured and underwent cardiac MRI during the baseline exam, of which 321 had assessment of left ventricular global circumferential strain (LV-GCS). We used linear regression with adjustment for demographics, cardiovascular risk factors, and cytomegalovirus serostatus to evaluate the cross-sectional association of immune cell subsets with left ventricular mass index (LVMI) and LV-GCS.Results The average age of the cohort was 61.6 ± 10.0 years and 53% were women. Higher proportions of γ/δ T cells were associated with lower absolute (worse) LV-GCS (–0.105% [95% CI –0.164%, –0.046%] per 1 SD higher proportion of γ/δ T cells, P = 0.0006). This association remained significant after Bonferroni’s correction. Higher proportions of classical monocytes were associated with worse absolute LV-GCS (–0.04% [95% CI –0.07%, 0.00%] per 1 SD higher proportion of classical monocytes, P = 0.04). This did not meet significance after Bonferroni’s correction. There were no other significant associations with LV-GCS or LVMI.Conclusion Pathways associated with γ/δ T cells may be potential targets for immunomodulatory therapy targeted at HF prevention in populations at risk.Funding Contracts 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 and grant R01 HL98077 from the National Heart, Lung, and Blood Institute/NIH and grants KL2TR001424, UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences/NIH.
- Published
- 2021
- Full Text
- View/download PDF
11. Coronary Computed Tomography Angiography Compared With Single Photon Emission Computed Tomography Myocardial Perfusion Imaging as a Guide to Optimal Medical Therapy in Patients Presenting With Stable Angina: The RESCUE Trial
- Author
-
Arthur E. Stillman, Constantine Gatsonis, Joao A.C. Lima, Tao Liu, Bradley S. Snyder, Jean Cormack, Vinay Malholtra, Mitchell D. Schnall, James E. Udelson, Udo Hoffmann, and Pamela K. Woodard
- Subjects
angina ,cardiovascular imaging ,coronary computed tomography angiography ,coronary revascularization ,ischemia ,nuclear medicine ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The RESCUE (Randomized Evaluation of Patients with Stable Angina Comparing Utilization of Noninvasive Examinations) trial was a randomized, controlled, multicenter, comparative efficacy outcomes trial designed to assess whether initial testing with coronary computed tomographic angiography (CCTA) is noninferior to single photon emission computed tomography (SPECT) myocardial perfusion imaging in directing patients with stable angina to optimal medical therapy alone or optimal medical therapy with revascularization. Methods and Results The end point was first major adverse cardiovascular event (MACE) (cardiac death or myocardial infarction), or revascularization. Noninferiority margin for CCTA was set a priori as a hazard ratio (HR) of 1.3 (95% CI=0, 1.605). One thousand fifty participants from 44 sites were randomized to CCTA (n=518) or SPECT (n=532). Mean follow‐up time was 16.2 (SD 7.9) months. There were no cardiac‐related deaths. In patients with a negative CCTA there was 1 acute myocardial infarction; in patients with a negative SPECT examination there were 2 acute myocardial infarctions; and for positive CCTA and SPECT, 1 acute myocardial infarction each. Participants in the CCTA arm had a similar rate of MACE or revascularization compared with those in the SPECT myocardial perfusion imaging arm, (HR, 1.03; 95% CI=0.61‐1.75) (P=0.19). CCTA segment involvement by a stenosis of ≥50% diameter was a better predictor of MACE and revascularization at 1 year (P=0.02) than the percent reversible defect size by SPECT myocardial perfusion imaging. Four (1.2%) patients with negative CCTA compared with 14 (3.2%) with negative SPECT had MACE or revascularization (P=0.03). Conclusions There was no difference in outcomes of patients who had stable angina and who underwent CCTA in comparison to SPECT as the first imaging test directing them to optimal medical therapy alone or with revascularization. CCTA was a better predictor of MACE and revascularization. Registration Information URL: https://www.clinicaltrials.gov/. Identifier: NCT01262625.
- Published
- 2020
- Full Text
- View/download PDF
12. A technique for quantitative measurement of myocardial blood flow using a combination of bolus tracking and time-registered helical multidetector CT angiography during adenosine stress
- Author
-
Takashi Ichihara, Richard T. George, Richard Mather, Joao A.C. Lima, and Albert C. Lardo
- Subjects
multidetector computed tomography ,myocardial blood flow ,perfusion ,adenosine stress ,two-compartment model ,Medicine (General) ,R5-920 - Abstract
Objectives: The purpose of this study was to develop a quantitative method for myocardial blood flow (MBF) measurement using contrast-enhanced multidetector computed tomography (MDCT) images with bolus tracking and helical scanning. Materials and Methods: Nine canine models of left anterior descending artery stenosis were prepared and underwent MDCT perfusion imaging during adenosine infusion to study a wide range of flow parameters. Neutron-activated microspheres were injected to document MBF during adenosine infusion. Six animals underwent dynamic MDCT perfusion imaging, and K1 and k2 (which represent the first-order transfer constants from left ventricular blood to myocardium and from myocardium to the vascular system, respectively) were measured using a two-compartment model. The results were compared against microsphere MBF measurements, and the extraction fraction (E) of contrast agent and the mean value of k1/k2 were calculated. Six animals then underwent helical CT perfusion imaging, and neutron-activated microspheres were injected to document MBF during adenosine infusion. For each animal, based on E, K1/k2, time-registered helical CT myocardial data, and arterial input function data, tables of myocardial CT values versus MBF were simulated for various MBF values to create look-up tables from the myocardial CT value to MBF. The CT-derived MBF values were compared against the microsphere MBF measurements. Results: A strong linear correlation was observed between the MDCT-derived MBF and the microsphere MBF (y = 1.065x – 0.616, R2 = 0.838). Conclusions: Regional MBF can be measured accurately using a combination of bolus tracking and time-registered helical CT data from contrast-enhanced MDCT scanning during adenosine stress.
- Published
- 2016
- Full Text
- View/download PDF
13. The impact of ambrisentan and tadalafil upfront combination therapy on cardiac function in scleroderma associated pulmonary arterial hypertension patients: cardiac magnetic resonance feature tracking study
- Author
-
Takahiro Sato, Bharath Ambale-Venkatesh, Joao A.C. Lima, Stefan L. Zimmerman, Ryan J. Tedford, Tomoki Fujii, Olivia L. Hulme, Erica H. Pullins, Celia P. Corona-Villalobos, Roham T. Zamanian, Omar A. Minai, Reda E. Girgis, Kelly Chin, Rubina Khair, Rachel L. Damico, Todd M. Kolb, Stephen C. Mathai, and Paul M. Hassoun
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Diseases of the respiratory system ,RC705-779 - Abstract
The aim of this study was to evaluate the effect of upfront combination therapy with ambrisentan and tadalafil on left ventricular (LV) and right ventricular (RV) function in patients with systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH). LV and RV peak longitudinal and circumferential strain and strain rate (SR), which consisted of peak systolic SR (SRs), peak early diastolic SR (SRe), and peak atrial-diastolic SR (SRa) were analyzed using cardiac magnetic resonance imaging (CMRI) data from the recently published ATPAHSS-O trial (ambrisentan and tadalafil upfront combination therapy in SSc-PAH). Twenty-one patients completed the study protocol. Measures of RV systolic function (RV free wall [RVFW] peak longitudinal strain [pLS], RVFW peak longitudinal SRs [pLSRs]) and RV diastolic function (RVFW peak longitudinal SRa [pLSRa], RVFW peak circumferential SRe) were improved after treatment. LV systolic function (LV peak global longitudinal strain [pGLS]) and diastolic function (LV peak global longitudinal SRe [pGLSRe]) were also significantly improved at follow-up. Increased 6-min walk distance was significantly correlated with RVFW pLS and pLSRs, while the decrease in N-terminal pro-brain natriuretic peptide was correlated with LV pGLS. Increased cardiac index was associated with improved LV pGLSRe, and reduction in mean right atrial pressure was correlated with improved RVFW pLS and pLSRa. Combination therapy was associated with a significant improvement in both RV and LV function as assessed by CMR-derived strain and SR. Importantly, the improvement in RV and LV strain and SR correlated with improvements in known prognostic markers of PAH. (Approved by clinicaltrials.gov [NCT01042158] before patient recruitment.)
- Published
- 2018
- Full Text
- View/download PDF
14. 'Malignant' Left Ventricular Hypertrophy Identifies Subjects at High Risk for Progression to Asymptomatic Left Ventricular Dysfunction, Heart Failure, and Death: MESA (Multi‐Ethnic Study of Atherosclerosis)
- Author
-
Matthew N. Peters, Stephen L. Seliger, Robert H. Christenson, Susie N. Hong‐Zohlman, Lori B. Daniels, Joao A.C. Lima, James A. de Lemos, Ian J. Neeland, and Christopher R. deFilippi
- Subjects
heart failure ,left ventricular dysfunction ,left ventricular hypertrophy ,mortality ,N‐terminal pro‐B‐type ,troponin T ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundAs heart failure (HF)‐associated morbidity and mortality continue to escalate, enhanced focus on prevention is increasingly important. “Malignant” left ventricular (LV) hypertrophy (LVH): LVH combined with an elevated cardiac biomarker reflecting either injury (high‐sensitivity cardiac troponin T), or strain (amino‐terminal pro‐B‐type natriuretic peptide) has predicted accelerated progression to HF. We sought to determine whether malignant LVH identified community‐dwelling adults initially free of cardiovascular disease at high risk of asymptomatic decline in LV ejection fraction or a clinical cardiovascular event. Methods and ResultsA total of 4985 of 6814 individuals without prevalent cardiovascular disease underwent baseline cardiac magnetic resonance for LVH in combination with measurement of plasma high‐sensitivity cardiac troponin T and amino‐terminal pro‐B‐type natriuretic peptide as part of MESA (Multi‐Ethnic Study of Atherosclerosis) and were subsequently divided into 4 groups: (1) No LVH, no elevated biomarkers (n=2206; 44.3%); (2) No LVH, ≥1 elevated biomarkers (n=2275; 45.7%); (3) LVH, no elevated biomarkers (n=153; 3.0%); and (4) LVH, ≥1 elevated biomarkers (malignant LVH; n=351; 7.0%). Cardiac magnetic resonance was repeated 10 years later (n=2831) for assessment of LV ejection fraction
- Published
- 2018
- Full Text
- View/download PDF
15. Influence of image acquisition settings on radiation dose and image quality in coronary angiography by 320-detector volume computed tomography: the CORE320 pilot experience
- Author
-
Armin Arbab-Zadeh, Joao A.C. Lima, Richard T. George, Melvin E. Clouse, Carlos E. Rochitte, Frank J. Rybicki, Hiroyuki Niinuma, Andrew E. Arai, Rukhsar Ahmed, Rodrigo Cerci, Andrea L. Vavere, and Kihei Yoneyama
- Subjects
CT angiography, image acquisition, image quality, radiation dose, body mass index, contrast to noise ratio ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The objective of this study was to investigate the impact of image acquisition settings and patients’ characteristics on image quality and radiation dose for coronary angiography by 320-row computed tomography (CT). CORE320 is a prospective study to investigate the diagnostic performance of 320-detector CT for detecting coronary artery disease and associated myocardial ischemia. A run-in phase in 65 subjects was conducted to test the adequacy of the computed tomography angiography (CTA) acquisition protocol. Tube current, exposure window, and number of cardiac beats per acquisition were adjusted according to subjects’ gender, heart rate, and body mass index (BMI). Main outcome measures were image quality, assessed by contrast/noise measurements and qualitatively on a 4-point scale, and radiation dose, estimated by the dose-length-product. Average heart rate at image acquisition was 55.0±7.3 bpm. Median Agatston calcium score was 27.0 (interquartile range 1-330). All scans were prospectively triggered. Single heart beat image acquisition was obtained in 61 of 65 studies (94%). Sixty-one studies (94%) and 437 of 455 arterial segments (96%) were of diagnostic image quality. Estimated radiation dose was significantly greater in obese (5.3±0.4 mSv) than normal weight (4.6±0.3 mSv) or overweight (4.7±0.3 mSv) subjects (P
- Published
- 2012
- Full Text
- View/download PDF
16. Association of Kidney Tubule Biomarkers With Cardiac Structure and Function in the Multiethnic Study of Atherosclerosis
- Author
-
Nicholas Wettersten, Ronit Katz, Jason H. Greenberg, Orlando M. Gutierrez, Joao A.C. Lima, Mark J. Sarnak, Sarah Schrauben, Rajat Deo, Joseph Bonventre, Ramachandran S. Vasan, Paul L. Kimmel, Michael Shlipak, and Joachim H. Ix
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
17. Oxidative Stress and Menopausal Status: The Coronary Artery Risk Development in Young Adults Cohort Study
- Author
-
Amir S. Heravi, Erin D. Michos, Di Zhao, Bharath Ambale-Venkatesh, Henrique Doria De Vasconcellos, Donald Lloyd-Jones, Pamela J. Schreiner, Jared P. Reis, Colin Wu, Cora E. Lewis, James M. Shikany, Stephen Sidney, Eliseo Guallar, Chiadi E. Ndumele, Pamela Ouyang, Ron C. Hoogeveen, Joao A.C. Lima, Dhananjay Vaidya, and Wendy S. Post
- Subjects
Cohort Studies ,Oxidative Stress ,Young Adult ,Cardiovascular Diseases ,Creatinine ,Humans ,Female ,General Medicine ,Original Articles ,Menopause ,Coronary Vessels ,Aged - Abstract
BACKGROUND: Low endogenous estrogen concentrations after menopause may contribute to higher oxidative stress and greater cardiovascular disease (CVD) risk. However, differences in oxidative stress between similarly aged premenopausal and postmenopausal women are not well-characterized on a population level. We hypothesized that urinary isoprostane concentrations, a standard measure of systemic oxidative stress, are higher in women who have undergone menopause compared to premenopausal women. METHODS AND RESULTS: We examined differences in urinary 8-isoprostane (iPF(2α)-III) and 2,3-dinor-8-isoprostane (iPF(2α)-III-M) indexed to urinary creatinine between 279 postmenopausal and 196 premenopausal women in the Coronary Artery Risk Development in Young Adults (CARDIA) study, using linear regression with progressive adjustment for sociodemographic factors and traditional CVD risk factors. Unadjusted iPF(2α)-III-M concentrations were higher among postmenopausal compared to premenopausal women (Median [25th, 75th percentile]: 1762 [1178, 2974] vs. 1535 [1067, 2462] ng/g creatinine; p = 0.01). Menopause was associated with 25.5% higher iPF(2α)-III-M (95% confidence interval [6.5–47.9]) adjusted for age, race, college education, and field center. Further adjustments for tobacco use (21.2% [2.9–42.6]) and then CVD risk factors (18.8% [0.1–39.6]) led to additional partial attenuation. Menopause was associated with higher iPF(2α)-III in Black but not White women. CONCLUSIONS: We conclude that postmenopausal women had higher oxidative stress, which may contribute to greater CVD risk. ClinicalTrials.gov Identifier: NCT00005130.
- Published
- 2023
18. Perivascular fat attenuation for predicting adverse cardiac events in stable patients undergoing invasive coronary angiography
- Author
-
Devina Chatterjee, Benjamin L. Shou, Matthew B. Matheson, Mohammad R. Ostovaneh, Carlos Rochitte, Marcus Y. Chen, Marc Dewey, Jason Ortman, Christopher Cox, Joao A.C. Lima, and Armin Arbab-Zadeh
- Subjects
Adipose Tissue ,Predictive Value of Tests ,Computed Tomography Angiography ,Humans ,Radiology, Nuclear Medicine and imaging ,Coronary Artery Disease ,Middle Aged ,Coronary Angiography ,Cardiology and Cardiovascular Medicine ,Coronary Vessels - Abstract
Inflammation surrounding the coronary arteries can be non-invasively assessed using pericoronary adipose tissue attenuation (PCAT). While PCAT holds promise for further risk stratification of patients with low coronary artery disease (CAD) prevalence, its value in higher risk populations remains unknown.CORE320 enrolled patients referred for invasive coronary angiography with known or suspected CAD. Coronary computed tomography angiography (CCTA) images were collected for 381 patients for whom clinical outcomes were assessed 5 years after enrollment. Using semi-automated image analysis software, PCAT was obtained and normalized for the right coronary (RCA), left anterior descending (LAD), and left circumflex arteries (LCx). The association between PCAT and major adverse cardiovascular events (MACE) during follow up was assessed using Cox regression models.Thirty-seven patients were excluded due to technical failure. For the remaining 344 patients, median age was 62 (interquartile range, 55-68) with 59% having ≥1 coronary artery stenosis of ≥50% by quantitative coronary angiography. Mean attenuation values for PCAT in RCA, LAD, and LCx were -74.9, -74.2, and -71.2, respectively. Hazard ratios and 95% confidence intervals (CI) for normalized PCAT in the RCA, LAD, and LCx for MACE were 0.96 (CI: 0.75-1.22, p = 0.71), 1.31 (95% CI: 0.96-1.78, p = 0.09), and 0.98 (95% CI: 0.78-1.22, p = 0.84), respectively. For death, stroke, or myocardial infarction only, hazard ratios were 0.68 (0.44-1.07), 0.85 (0.56-1.29), and 0.57 (0.41-0.80), respectively.In patients referred for invasive coronary angiography with suspected CAD, PCAT did not predict MACE during long term follow up. Further studies are needed to understand the relationship of PCAT with CAD risk.
- Published
- 2022
19. Technical Considerations for Dynamic Myocardial Computed Tomography Perfusion as Part of a Comprehensive Evaluation of Coronary Artery Disease Using Computed Tomography
- Author
-
Mathias B. Møller, Joanne D. Schuijf, Noriko Oyama-Manabe, Jesper J. Linde, Jørgen T. Kühl, Joao A.C. Lima, and Klaus F. Kofoed
- Subjects
Pulmonary and Respiratory Medicine ,Radiology, Nuclear Medicine and imaging - Published
- 2022
20. Supranormal Left Ventricular Ejection Fraction, Stroke Volume, and Cardiovascular Risk
- Author
-
Sonia Shah, Matthew W. Segar, Nitin Kondamudi, Colby Ayers, Alvin Chandra, Susan Matulevicius, Kartik Agusala, Ron Peshock, Suhny Abbara, Erin D. Michos, Mark H. Drazner, Joao A.C. Lima, W.T. Longstreth, and Ambarish Pandey
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
21. Insulin Resistance Is Associated with Right Ventricular Dysfunction
- Author
-
Wei Yang, Mary E. Putt, Alain G. Bertoni, Sanjiv J. Shah, Lauren Beussink-Nelson, Benjamin H. Freed, Joao A.C. Lima, R. Graham Barr, Steven M. Kawut, Jeff Min, and Nadine Al-Naamani
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,medicine.medical_specialty ,Ventricular function ,business.industry ,Ventricular Dysfunction, Right ,medicine.disease ,Right ventricular dysfunction ,medicine.anatomical_structure ,Insulin resistance ,Ventricle ,Echocardiography ,Internal medicine ,medicine ,Cardiology ,Ventricular Function, Right ,Humans ,Insulin Resistance ,business ,Retrospective Studies ,Original Research - Abstract
RATIONALE: The effect of insulin resistance on left ventricular function is well documented; however, less is known regarding its effect on the right ventricle (RV). OBJECTIVES: To evaluate the association between insulin resistance and RV function by echocardiography in a cohort of adults without baseline cardiovascular disease. METHODS: We performed a retrospective cohort study in the MESA (Multi-Ethnic Study of Atherosclerosis). Linear regression was used to examine the association between overall insulin resistance measured by the mean triglyceride (TG) to high-density lipoprotein (HDL) cholesterol ratio (TG:HDL) and change in TG:HDL over time for each participant with echocardiographic RV function. Logistic regression was used to calculate the odds ratios (ORs) of RV systolic and diastolic dysfunction. RESULTS: Among 3,032 participants, higher mean TG:HDL was associated with lower (worse) absolute RV longitudinal strain (β, −0.38; 95% confidence interval [CI], −0.64 to −0.13; P
- Published
- 2023
22. Evaluation of liver T1 using MOLLI gradient echo readout under the influence of fat
- Author
-
Chia Ying Liu, Chikara Noda, Joao A.C. Lima, Bharath Ambale-Venkatesh, David A. Bluemke, and Yoshimori Kassai
- Subjects
Adult ,Physics ,Phantoms, Imaging ,Liver fibrosis ,Biomedical Engineering ,Biophysics ,Reproducibility of Results ,Inversion recovery ,Middle Aged ,Magnetic Resonance Imaging ,Imaging phantom ,Out of phase ,Nuclear magnetic resonance ,Liver ,Linear Models ,Humans ,Female ,Radiology, Nuclear Medicine and imaging ,Fat fraction ,Gradient echo - Abstract
The effect of hepatic steatosis on the gradient-echo (GRE) based Modified Look-Locker Inversion Recovery (MOLLI) technique for T1 mapping has not been evaluated. The purpose of this study was to evaluate a GRE based MOLLI technique for hepatic T1 mapping and determine the relationship of T1 differences (ΔT1) on in-phase (IP) and out-of-phase (OP) to fat fraction (FF) measurement.3 T MRI included MOLLI T1 mapping with TE = 1.3 (OP), 2.4 (IP), and 1.8 ms, and chemical-shift-encoded sequence with spectral modeling of fat to generate FF map as a reference. Bloch simulations and oil/water phantoms were used to characterize the response of the MOLLI T1 in various FF 30% since MOLLI T1 estimation was erratic beyond this limit. Curve fit between ΔT1 and FF from simulation was applied to validate the phantom and the in-vivo results. Thirty-eight normal volunteers were included (16 women, Age 44 ± 12 years, BMI 27 ± 5.3 kg/mPhantom results were consistent with the Bloch simulations. The simulated relationship between FF (0-30%) and ΔT1 could be modeled precisely by a cubic equation with R2 = 1. In-vivo MOLLI ΔT1 and estimated FF were correlated to the reference FF (both R2 ≥ 0.96 and P 0.001). TE = 1.8 ms demonstrated less T1 bias (-1.34%) compared to TE = OP (5.32%) or IP (-3.8%, both P 0.001).At 3 T, TE of 1.8 ms can be used to reduce the T1 bias and deliver consistent T1 values when FF is30%.
- Published
- 2022
23. Temporal change in inflammatory biomarkers and risk of cardiovascular events: the Multi‐ethnic Study of Atherosclerosis
- Author
-
Matthew A. Allison, Bharath Ambale-Venkatesh, Mohammad R. Ostovaneh, Moyses Szklo, David A. Bluemke, Xiaoyang Ma, Colin O. Wu, Christopher Cox, Mary Cushman, Mahsima Shabani, Joao A.C. Lima, Matthew J. Budoff, David M. Herrington, Russell P. Tracy, Hooman Bakhshi, and Michael J. Blaha
- Subjects
Male ,Aging ,medicine.medical_specialty ,Statin ,medicine.drug_class ,Heart failure ,Disease ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Fibrinogen ,C-reactive protein ,Cohort Studies ,Clinical Research ,Original Research Articles ,Internal medicine ,Ethnicity ,medicine ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Original Research Article ,screening and diagnosis ,biology ,business.industry ,Prevention ,Repeated measures design ,Middle Aged ,Interleukin ,Atherosclerosis ,medicine.disease ,4.1 Discovery and preclinical testing of markers and technologies ,C‐reactive protein ,Detection ,Good Health and Well Being ,Heart Disease ,Longitudinal cohort study ,Cardiovascular Diseases ,RC666-701 ,Cohort ,biology.protein ,Biomarker (medicine) ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,medicine.drug - Abstract
Author(s): Shabani, Mahsima; Bakhshi, Hooman; Ostovaneh, Mohammad R; Ma, Xiaoyang; Wu, Colin O; Ambale-Venkatesh, Bharath; Blaha, Michael J; Allison, Matthew A; Budoff, Matthew J; Cushman, Mary; Tracy, Russell P; Herrington, David M; Szklo, Moyses; Cox, Christopher; Bluemke, David A; Lima, Joao AC | Abstract: AimsLittle is known about the association of temporal changes in inflammatory biomarkers and the risk of death and cardiovascular diseases. We aimed to evaluate the association between temporal changes in C-reactive protein (CRP), fibrinogen, and interleukin-6 (IL-6) and risk of heart failure (HF), cardiovascular disease (CVD), and all-cause mortality in individuals without a history of prior CVD.Methods and resultsParticipants from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort with repeated measures of inflammatory biomarkers and no CVD event prior to the second measure were included. Quantitative measures, annual change, and biomarker change categories were used as main predictors in Cox proportional hazard models stratified based on sex and statin use. A total of 2258 subjects (50.6% female, mean age of 62nyears) were studied over an average of 8.1nyears of follow-up. The median annual decrease in CRP levels was 0.08nmg/L. Fibrinogen and IL-6 levels increased by a median of 30nmg/dL and 0.24npg/mL annually. Temporal changes in CRP were positively associated with HF risk among females (HR: 1.18 per each standard deviation increase, Pnln0.001) and other CVD in both female (HR: 1.12, Pn=n0.004) and male participants (HR: 1.24, Pn=n0.003). The association of CRP change with HF and other CVD was consistently observed in statin users (HR: 1.23 per SD increase, Pn=n0.001 for HF and HR: 1.19 per SD increase, Pnln0.001 for other CVD). There were no significant associations between temporal changes of fibrinogen or IL-6 with HF or other CVD. Men with sustained high values of IL-6 had a 2.3-fold higher risk of all-cause mortality (Pnln0.001) compared with those with sustained low values.ConclusionsTemporal change in CRP is associated with HF only in women and statin users, and other CVD in both women and men, and statin users. Annual changes in fibrinogen and IL-6 were not predictive of cardiovascular outcomes in either sex.
- Published
- 2021
24. Physical activity and the progression of coronary artery calcification
- Author
-
Seung Jae Lee, Di Zhao, Joao A.C. Lima, Yun Soo Hong, Juhee Cho, Seungho Ryu, Ki Chul Sung, Eliseo Guallar, Jong-Young Lee, and Yoosoo Chang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physical activity ,Coronary Artery Disease ,Coronary Angiography ,Coronary artery disease ,Primary outcome ,Risk Factors ,Coronary Circulation ,Internal medicine ,Multidetector Computed Tomography ,Republic of Korea ,Prevalence ,medicine ,Humans ,Prospective Studies ,Vascular Calcification ,Prospective cohort study ,Exercise ,Health screening ,business.industry ,medicine.disease ,Coronary Vessels ,Confidence interval ,Coronary artery calcium ,Coronary artery calcification ,Disease Progression ,Calcium ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
BackgroundThe association of physical activity with the development and progression of coronary artery calcium (CAC) scores has not been studied. This study aimed to evaluate the prospective association between physical activity and CAC scores in apparently healthy adults.MethodsProspective cohort study of men and women free of overt cardiovascular disease who underwent comprehensive health screening examinations between 1 March 2011 and 31 December 2017. Baseline physical activity was measured using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and categorised into three groups (inactive, moderately active and health-enhancing physically active (HEPA)). The primary outcome was the difference in the 5-year change in CAC scores by physical activity category at baseline.ResultsWe analysed 25 485 participants with at least two CAC score measurements. The proportions of participants who were inactive, moderately active and HEPA were 46.8%, 38.0% and 15.2%, respectively. The estimated adjusted average baseline CAC scores (95% confidence intervals) in participants who were inactive, moderately active and HEPA were 9.45 (8.76, 10.14), 10.20 (9.40, 11.00) and 12.04 (10.81, 13.26). Compared with participants who were inactive, the estimated adjusted 5-year average increases in CAC in moderately active and HEPA participants were 3.20 (0.72, 5.69) and 8.16 (4.80, 11.53). Higher physical activity was association with faster progression of CAC scores both in participants with CAC=0 at baseline and in those with prevalent CAC.ConclusionWe found a positive, graded association between physical activity and the prevalence and the progression of CAC, regardless of baseline CAC scores.
- Published
- 2021
25. Right ventricular function as assessed by cardiac magnetic resonance imaging‐derived strain parameters compared to high‐fidelity micromanometer catheter measurements
- Author
-
Paul M. Hassoun, Ryan J. Tedford, Todd M. Kolb, Rubina M. Khair, Tomoki Fujii, Ela Chamera, Steven Hsu, Stefan L. Zimmerman, David A. Kass, Catherine E. Simpson, Ichizo Tsujino, Rachel L. Damico, Stephen C. Mathai, Christopher J Mullin, Bharath Ambale-Venkatesh, Takahiro Sato, Joao A.C. Lima, Celia P. Corona-Villalobos, Valentina Mercurio, Sato, Takahiro, Ambale-Venkatesh, Bharath, Zimmerman, Stefan L, Tedford, Ryan J, Hsu, Steven, Chamera, Ela, Fujii, Tomoki, Mullin, Christopher J, Mercurio, Valentina, Khair, Rubina, Corona-Villalobos, Celia P, Simpson, Catherine E, Damico, Rachel L, Kolb, Todd M, Mathai, Stephen C, Lima, Joao A C, Kass, David A, Tsujino, Ichizo, and Hassoun, Paul M
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Diseases of the respiratory system ,Cardiac magnetic resonance imaging ,pulmonary arterial hypertension ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,In patient ,Original Research Article ,tau ,cardiovascular diseases ,RC705-779 ,medicine.diagnostic_test ,Strain (chemistry) ,Ventricular function ,business.industry ,strain and strain rate ,right ventricular failure ,pressure volume loop ,Strain rate ,medicine.disease ,Pulmonary hypertension ,Catheter ,RC666-701 ,cardiovascular system ,Cardiology ,business ,Cardiac magnetic resonance - Abstract
Right ventricular function has prognostic significance in patients with pulmonary hypertension. We evaluated whether cardiac magnetic resonance-derived strain and strain rate parameters could reliably reflect right ventricular systolic and diastolic function in precapillary pulmonary hypertension. End-systolic elastance and the time constant of right ventricular relaxation tau, both derived from invasive high-fidelity micromanometer catheter measurements, were used as gold standards for assessing systolic and diastolic right ventricular function, respectively. Nineteen consecutive precapillary pulmonary hypertension patients underwent cardiac magnetic resonance and right heart catheterization prospectively. Cardiac magnetic resonance data were compared with those of 19 control subjects. In pulmonary hypertension patients, associations between strain- and strain rate-related parameters and invasive hemodynamic parameters were evaluated. Longitudinal peak systolic strain, strain rate, and early diastolic strain rate were lower in PAH patients than in controls; peak atrial-diastolic strain rate was higher in pulmonary hypertension patients. Similarly, circumferential peak systolic strain rate was lower and peak atrial-diastolic strain rate was higher in pulmonary hypertension. In pulmonary hypertension, no correlations existed between cardiac magnetic resonance-derived and hemodynamically derived measures of systolic right ventricular function. Regarding diastolic parameters, tau was significantly correlated with peak longitudinal atrial-diastolic strain rate ( r = −0.61), deceleration time ( r = 0.75), longitudinal systolic to diastolic time ratio ( r = 0.59), early diastolic strain rate ( r = −0.5), circumferential peak atrial-diastolic strain rate ( r = −0.52), and deceleration time ( r = 0.62). Strain analysis of the right ventricular diastolic phase is a reliable non-invasive method for detecting right ventricular diastolic dysfunction in PAH.
- Published
- 2021
26. Left Atrioventricular Coupling Index as a Prognostic Marker of Cardiovascular Events: The MESA Study
- Author
-
Norrina B. Allen, Henrique Doria de Vasconcellos, Joao A.C. Lima, Bharath Ambale Venkatesh, Susan R. Heckbert, Théo Pezel, Yoko Kato, Steven J Shea, Eric Xie, David A. Bluemke, Wendy S. Post, Mahsima Shabani, Colin O. Wu, and Karol E. Watson
- Subjects
education.field_of_study ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Population ,Hazard ratio ,Atrial fibrillation ,Disease ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Left atrial ,Internal medicine ,Heart failure ,Internal Medicine ,Cardiology ,Medicine ,030212 general & internal medicine ,Myocardial infarction ,business ,education - Abstract
Both left atrial and left ventricular functional parameters influence the prognosis of patients with cardiovascular diseases. This study aimed to investigate the prognostic value of a novel left atrioventricular coupling index (LACI) in a population without history of cardiovascular diseases at baseline. Participants of the Multi-Ethnic Study of Atherosclerosis who underwent a baseline cardiovascular magnetic resonance study were analyzed. LACI was defined by the ratio of the left atrial end-diastolic volume divided by the left ventricular end-diastolic volume. Cox proportional hazard models were used to evaluate the association between LACI and atrial fibrillation, heart failure, coronary heart disease death, and hard cardiovascular disease defined by myocardial infarction, resuscitated cardiac arrest, fatal and nonfatal stroke, or coronary heart disease death. Among the 4124 participants (61.5±10.1 years, 47.4% men), 1074 cardiovascular events were observed (mean follow-up, 13.0±3.2 years). Greater LACI was independently associated with atrial fibrillation (hazard ratio, 1.86 [95% CI, 1.69–2.04]), heart failure (hazard ratio, 1.50 [95% CI, 1.38–1.62]), hard cardiovascular disease (1.23 [95% CI, 1.13–1.34]), and coronary heart disease death (hazard ratio, 1.29 [95% CI, 1.15–1.45]; all P
- Published
- 2021
27. Remnant cholesterol predicts cardiovascular disease beyond LDL and ApoB: a primary prevention study
- Author
-
Michael Y. Tsai, Christie M. Ballantyne, Isha Lamba, John T. Wilkins, Seth S. Martin, Roger S. Blumenthal, Stephen J. Nicholls, Renato Quispe, Steven R. Jones, Rishi Puri, Anum Saeed, Sarah Nomura, Mohamed B. Elshazly, Erin D Michos, and Joao A.C. Lima
- Subjects
Adult ,medicine.medical_specialty ,Percentile ,Apolipoprotein B ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Clinical Research ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Young adult ,Aged ,Apolipoproteins B ,biology ,Cholesterol ,business.industry ,Proportional hazards model ,Cholesterol, HDL ,Hazard ratio ,Middle Aged ,Confidence interval ,Primary Prevention ,chemistry ,Cardiovascular Diseases ,biology.protein ,Cardiology ,Female ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Emerging evidence suggests that remnant cholesterol (RC) promotes atherosclerotic cardiovascular disease (ASCVD). We aimed to estimate RC-related risk beyond low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) in patients without known ASCVD. Methods and results We pooled data from 17 532 ASCVD-free individuals from the Atherosclerosis Risk in Communities study (n = 9748), the Multi-Ethnic Study of Atherosclerosis (n = 3049), and the Coronary Artery Risk Development in Young Adults (n = 4735). RC was calculated as non-high-density lipoprotein cholesterol (non-HDL-C) minus calculated LDL-C. Adjusted Cox models were used to estimate the risk for incident ASCVD associated with log RC levels. We also performed discordance analyses examining relative ASCVD risk in RC vs. LDL-C discordant/concordant groups using difference in percentile units (>10 units) and clinically relevant LDL-C targets. The mean age of participants was 52.3 ± 17.9 years, 56.7% were women and 34% black. There were 2143 ASCVD events over the median follow-up of 18.7 years. After multivariable adjustment including LDL-C and apoB, log RC was associated with higher ASCVD risk [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.45–1.89]. Moreover, the discordant high RC/low LDL-C group, but not the low RC/high LDL-C group, was associated with increased ASCVD risk compared to the concordant group (HR 1.21, 95% CI 1.08–1.34). Similar results were shown when examining discordance across clinical cutpoints. Conclusions In ASCVD-free individuals, elevated RC levels were associated with ASCVD independent of traditional risk factors, LDL-C, and apoB levels. The mechanisms of RC association with ASCVD, surprisingly beyond apoB, and the potential value of targeted RC-lowering in primary prevention need to be further investigated.
- Published
- 2021
28. Extracellular volume-guided late gadolinium enhancement analysis for non-ischemic cardiomyopathy: The Women’s Interagency HIV Study
- Author
-
Yoko Kato, Mohammad R. Ostovaneh, Rob J. van der Geest, Jason Lazar, Qi Peng, Bharath Ambale-Venkatesh, Joao A.C. Lima, and Jorge R. Kizer
- Subjects
Male ,medicine.medical_specialty ,Heart Diseases ,Extracellular volume fraction (ECV) ,Myocardial Ischemia ,Gadolinium ,030204 cardiovascular system & hematology ,ECV-guided LGE analysis ,Late gadolinium enhancement (LGE) ,030218 nuclear medicine & medical imaging ,Cohort Studies ,03 medical and health sciences ,Cicatrix ,0302 clinical medicine ,Text mining ,Internal medicine ,Extracellular fluid ,HIV Seropositivity ,medicine ,Medical technology ,Late gadolinium enhancement ,Cutoff ,Humans ,Radiology, Nuclear Medicine and imaging ,Magnetic resonance imaging (MRI) ,R855-855.5 ,Non-ischemic LGE ,Reproducibility ,business.industry ,Myocardium ,Reproducibility of Results ,Heart ,Human immunodeficiency virus (HIV) ,Women's Interagency HIV Study ,Middle Aged ,Image Enhancement ,Fibrosis ,Magnetic Resonance Imaging ,Scar quantification ,medicine.anatomical_structure ,Ventricle ,Cohort ,Cardiology ,Female ,business ,Cardiomyopathies ,Research Article - Abstract
Background Quantification of non-ischemic myocardial scar remains a challenge due to the patchy diffuse nature of fibrosis. Extracellular volume (ECV) to guide late gadolinium enhancement (LGE) analysis may achieve a robust scar assessment. Methods Three cohorts of 80 non-ischemic-training, 20 non-ischemic-validation, and 10 ischemic-validation were prospectively enrolled and underwent 3.0 Tesla cardiac MRI. An ECV cutoff to differentiate LGE scar from non-scar was identified in the training cohort from the receiver-operating characteristic curve analysis, by comparing the ECV value against the visually-determined presence/absence of the LGE scar at the highest signal intensity (SI) area of the mid-left ventricle (LV) LGE. Based on the ECV cutoff, an LGE semi-automatic threshold of n-times of standard-deviation (n-SD) above the remote-myocardium SI was optimized in the individual cases ensuring correspondence between LGE and ECV images. The inter-method agreement of scar amount in comparison with manual (for non-ischemic) or full-width half-maximum (FWHM, for ischemic) was assessed. Intra- and inter-observer reproducibility were investigated in a randomly chosen subset of 40 non-ischemic and 10 ischemic cases. Results The non-ischemic groups were all female with the HIV positive rate of 73.8% (training) and 80% (validation). The ischemic group was all male with reduced LV function. An ECV cutoff of 31.5% achieved optimum performance (sensitivity: 90%, specificity: 86.7% in training; sensitivity: 100%, specificity: 81.8% in validation dataset). The identified n-SD threshold varied widely (range 3 SD–18 SD), and was independent of scar amount (β = −0.01, p = 0.92). In the non-ischemic cohorts, results suggested that the manual LGE assessment overestimated scar (%) in comparison to ECV-guided analysis [training: 4.5 (3.2–6.4) vs. 0.92 (0.1–2.1); validation: 2.5 (1.2–3.7) vs. 0.2 (0–1.6); P P Conclusions ECV-guided LGE analysis is a robust scar quantification method for a non-ischemic cohort. Trial registration ClinicalTrials.gov; NCT00000797, retrospectively-registered 2 November 1999; NCT02501811, registered 15 July 2015.
- Published
- 2021
29. Randomized, Placebo-Controlled Phase 2b Study to Evaluate the Safety and Efficacy of Recombinant Human Lecithin Cholesterol Acyltransferase in Acute ST-Segment-Elevation Myocardial Infarction: Results of REAL-TIMI 63B
- Author
-
Marc P. Bonaca, David A. Morrow, Brian A. Bergmark, David D. Berg, Joao A.C. Lima, Udo Hoffmann, Yoko Kato, Michael T. Lu, Julia Kuder, Sabina A. Murphy, Jindrich Spinar, Ton Oude Ophuis, Róbert G. Kiss, Jose Lopez-Sendon, Oleg Averkov, Stephen B. Wheatcroft, Jacek Kubica, Jose Carlos Nicolau, Remo H.M. Furtado, Liron Abuhatzira, Boaz Hirshberg, Sami A. Omar, Andrea L. Vavere, Yi-Ting Chang, Richard T. George, and Marc S. Sabatine
- Subjects
Male ,Middle Aged ,Phosphatidylcholine-Sterol O-Acyltransferase ,Cholesterol ,Treatment Outcome ,Physiology (medical) ,Lecithins ,Humans ,ST Elevation Myocardial Infarction ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,Lipoproteins, HDL ,Anterior Wall Myocardial Infarction ,Sterol O-Acyltransferase - Abstract
Background: High-density lipoprotein plays a key role in reverse cholesterol transport. In addition, high-density lipoprotein particles may be cardioprotective and reduce infarct size in the setting of myocardial injury. Lecithin-cholesterol acyltransferase is a rate-limiting enzyme in reverse cholesterol transport. MEDI6012 is a recombinant human lecithin-cholesterol acyltransferase that increases high-density lipoprotein cholesterol. Administration of lecithin-cholesterol acyltransferase has the potential to reduce infarct size and regress coronary plaque in acute ST-segment–elevation myocardial infarction. Methods: REAL-TIMI 63B (A Randomized, Placebo‑controlled Phase 2b Study to Evaluate the Safety and Efficacy of MEDI6012 in Acute ST Elevation Myocardial Infarction) was a phase 2B multinational, placebo-controlled, randomized trial. Patients with ST-segment–elevation myocardial infarction within 6 hours of symptom onset and planned for percutaneous intervention were randomly assigned 2:1 to MEDI6012 (2- or 6-dose regimen) or placebo and followed for 12 weeks. The primary outcome was infarct size as a percentage of left ventricular mass by cardiac MRI at 10 to 12 weeks, with the primary analysis in patients with TIMI Flow Grade 0 to 1 before percutaneous intervention who received at least 2 doses of MEDI6012. The secondary outcome was change in noncalcified plaque volume on coronary computed tomographic angiography from baseline to 10 to 12 weeks with the primary analysis in patients who received all 6 doses of MEDI6012. Results: A total of 593 patients were randomly assigned. Patients were a median of 62 years old, 77.9% male, and 95.8% statin naive. Median time from symptom onset to randomization was 146 (interquartile range [IQR], 103–221) minutes and from hospitalization to randomization was 12.7 (IQR, 6.6–24.0) minutes, and the first dose of drug was administered a median of 8 (IQR, 3–13) minutes before percutaneous intervention. The index myocardial infarction was anterior in 69.6% and TIMI Flow Grade 0 to 1 in 65.1% of patients. At 12 weeks, infarct size did not differ between treatment groups (MEDI6012: 9.71%, IQR 4.79–16.38; placebo: 10.48%, [IQR, 4.92–16.61], 1-sided P =0.79. There was also no difference in noncalcified plaque volume (geometric mean ratio, 0.96 [95% CI, NA–1.10], 1-sided P =0.30). There was no significant difference in treatment emergent serious adverse events. Conclusions: Administration of MEDI6012 in patients with acute ST-segment–elevation myocardial infarction did not result in a significant reduction in infarct size or noncalcified plaque volume at 12 weeks. MEDI6012 was well tolerated with no excess in overall serious adverse events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03578809.
- Published
- 2022
30. Racial and Ethnic Differences in All-Cause and Cardiovascular Disease Mortality: The MESA Study
- Author
-
Wendy S. Post, Karol E. Watson, Spencer Hansen, Aaron R. Folsom, Moyses Szklo, Steven Shea, R. Graham Barr, Gregory Burke, Alain G. Bertoni, Norrina Allen, James S. Pankow, Joao A.C. Lima, Jerome I. Rotter, Joel D. Kaufman, W. Craig Johnson, Richard A. Kronmal, Ana V. Diez-Roux, and Robyn L. McClelland
- Subjects
Adult ,Cardiovascular Diseases ,Risk Factors ,Social Determinants of Health ,Physiology (medical) ,Ethnic and Racial Minorities ,Ethnicity ,Humans ,Health Status Disparities ,Hispanic or Latino ,Cardiology and Cardiovascular Medicine ,White People - Abstract
Background: Despite improvements in population health, marked racial and ethnic disparities in longevity and cardiovascular disease (CVD) mortality persist. This study aimed to describe risks for all-cause and CVD mortality by race and ethnicity, before and after accounting for socioeconomic status (SES) and other factors, in the MESA study (Multi-Ethnic Study of Atherosclerosis). Methods: MESA recruited 6814 US adults, 45 to 84 years of age, free of clinical CVD at baseline, including Black, White, Hispanic, and Chinese individuals (2000–2002). Using Cox proportional hazards modeling with time-updated covariates, we evaluated the association of self-reported race and ethnicity with all-cause and adjudicated CVD mortality, with progressive adjustments for age and sex, SES (neighborhood SES, income, education, and health insurance), lifestyle and psychosocial risk factors, clinical risk factors, and immigration history. Results: During a median of 15.8 years of follow-up, 22.8% of participants (n=1552) died, of which 5.3% (n=364) died of CVD. After adjusting for age and sex, Black participants had a 34% higher mortality hazard (hazard ratio [HR], 1.34 [95% CI, 1.19–1.51]), Chinese participants had a 21% lower mortality hazard (HR, 0.79 [95% CI, 0.66–0.95]), and there was no mortality difference in Hispanic participants (HR, 0.99 [95% CI, 0.86–1.14]) compared with White participants. After adjusting for SES, the mortality HR for Black participants compared with White participants was reduced (HR, 1.16 [95% CI, 1.01–1.34]) but still statistically significant. With adjustment for SES, the mortality hazards for Chinese and Hispanic participants also decreased in comparison with White participants. After further adjustment for additional risk factors and immigration history, Hispanic participants (HR, 0.77 [95% CI, 0.63–0.94]) had a lower mortality risk than White participants, and hazard ratios for Black participants (HR, 1.08 [95% CI, 0.92–1.26]) and Chinese participants (HR, 0.81 [95% CI, 0.60–1.08]) were not significantly different from those of White participants. Similar trends were seen for CVD mortality, although the age- and sex-adjusted HR for CVD mortality for Black participants compared with White participants was greater than all-cause mortality (HR, 1.72 [95% CI, 1.34–2.21] compared with HR, 1.34 [95% CI, 1.19–1.51]). Conclusions: These results highlight persistent racial and ethnic differences in overall and CVD mortality, largely attributable to social determinants of health, and support the need to identify and act on systemic factors that shape differences in health across racial and ethnic groups.
- Published
- 2022
31. Associations between menopause, cardiac remodeling, and diastolic function: the CARDIA study
- Author
-
Pamela J. Schreiner, Jared P. Reis, Stephen Sidney, Vinita Subramanya, Pamela Ouyang, Erin D. Michos, Henrique Doria de Vasconcellos, Bharath Ambale-Venkatesh, Donald M. Lloyd-Jones, Wendy S. Post, Cora E. Lewis, Joao A.C. Lima, Wendy Ying, Chike C. Nwabuo, Dhananjay Vaidya, and Chiadi E Ndumele
- Subjects
Male ,medicine.medical_specialty ,General Mathematics ,Doppler echocardiography ,Ventricular Dysfunction, Left ,Young Adult ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Young adult ,Heart Failure ,Ventricular Remodeling ,medicine.diagnostic_test ,business.industry ,Applied Mathematics ,Obstetrics and Gynecology ,Stroke Volume ,medicine.disease ,Menopause ,Cross-Sectional Studies ,medicine.anatomical_structure ,Blood pressure ,Cardiology ,Female ,Heart failure with preserved ejection fraction ,business ,Body mass index ,Artery - Abstract
Heart failure with preserved ejection fraction (HFpEF) affects more women than men. Menopause may influence HFpEF development in women. We assessed cross-sectional and longitudinal associations between menopause and echocardiographic measures of left ventricular (LV) function and cardiac remodeling.We studied 1,723 women with available echo data from at least two of: year 5 (Y5) (1990-1991), Y25 (2010-2011), or Y30 (2015-2016) in the Coronary Artery Risk Development in Young Adults study. Cardiac structure and function were measured using 2D and Doppler echocardiography. Cross-sectional associations between menopausal status and repeated echo measures at Y25 and Y30 were analyzed using linear mixed models. Two-segmented models were used to compare longitudinal changes in echocardiographic measures in the premenopausal period to changes in the postmenopausal period.Mean ± SD age (years) at enrollment was 27 ± 3 in those with menopause by Y25, 25 ± 3 in those with menopause between Y25 and Y30, and 21 ± 3 in those premenopausal at Y30. There were no significant differences in race, body mass index, systolic blood pressure, or diabetes between the groups. Postmenopausal women had higher early diastolic mitral inflow (E) to annular (e') velocity ratio than premenopausal after adjusting for demographics and risk factors (P 0.05). Menopause was associated with relative increases in the rates of change in LV mass and left atrial volume, even after adjustment. Change in E/e' ratio was similar before and after menopause.Menopause is associated cross-sectionally with worse diastolic function and longitudinally with adverse LV and left atrial remodeling. This may contribute to the increased HFpEF risk in postmenopausal women.Video Summary:http://links.lww.com/MENO/A787.
- Published
- 2021
32. Warranty Period of a Calcium Score of Zero
- Author
-
Omar Dzaye, Michael J. Blaha, Moyses Szklo, Matthias Duebgen, Ron Blankstein, Joao A.C. Lima, Zeina Dardari, Khurram Nasir, Miguel Cainzos-Achirica, Joseph Yeboah, Matthew J. Budoff, Arthur S. Agatston, and Roger S. Blumenthal
- Subjects
medicine.medical_specialty ,endocrine system diseases ,030204 cardiovascular system & hematology ,Mesa ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Family history ,Survival analysis ,computer.programming_language ,business.industry ,Warranty ,nutritional and metabolic diseases ,medicine.disease ,Coronary artery calcium ,cardiovascular system ,Cardiology ,population characteristics ,Cardiology and Cardiovascular Medicine ,business ,Risk assessment ,computer - Abstract
Objectives This study sought to quantify and model conversion of a normal coronary artery calcium (CAC) scan to an abnormal CAC scan. Background Although the absence of CAC is associated with excellent prognosis, progression to CAC >0 confers increased risk. The time interval for repeated scanning remains poorly defined. Methods This study included 3,116 participants from the MESA (Multi-Ethnic Study of Atherosclerosis) with baseline CAC = 0 and follow-up scans over 10 years after baseline. Prevalence of incident CAC, defined by thresholds of CAC >0, CAC >10, or CAC >100, was calculated and time to progression was derived from a Weibull parametric survival model. Warranty periods were modeled as a function of sex, race/ethnicity, cardiovascular risk, and desired yield of repeated CAC testing. Further analysis was performed of the proportion of coronary events occurring in participants with baseline CAC = 0 that preceded and followed repeated CAC testing at different time intervals. Results Mean participants’ age was 58 ± 9 years, with 63% women, and mean 10-year cardiovascular risk of 14%. Prevalence of CAC >0, CAC >10, and CAC >100 was 53%, 36%, and 8%, respectively, at 10 years. Using a 25% testing yield (number needed to scan [NNS] = 4), the estimated warranty period of CAC >0 varied from 3 to 7 years depending on sex and race/ethnicity. Approximately 15% of participants progressed to CAC >10 in 5 to 8 years, whereas 10-year progression to CAC >100 was rare. Presence of diabetes was associated with significantly shorter warranty period, whereas family history and smoking had small effects. A total of 19% of all 10-year coronary events occurred in CAC = 0 prior to performance of a subsequent scan at 3 to 5 years, whereas detection of new CAC >0 preceded 55% of future events and identified individuals at 3-fold higher risk of coronary events. Conclusions In a large population of individuals with baseline CAC = 0, study data provide a robust estimation of the CAC = 0 warranty period, considering progression to CAC >0, CAC >10, and CAC >100 and its impact on missed versus detectable 10-year coronary heart disease events. Beyond age, sex, race/ethnicity, diabetes also has a significant impact on the warranty period. The study suggests that evidence-based guidance would be to consider rescanning in 3 to 7 years depending on individual demographics and risk profile.
- Published
- 2021
33. Blood Pressure Levels in Young Adulthood and Midlife Stroke Incidence in a Diverse Cohort
- Author
-
Deborah Levine, Yuichiro Yano, Joao A.C. Lima, Lihui Zhao, Jared P. Reis, Kiang Liu, Cora E. Lewis, David R. Jacobs, Stephen Sidney, Jamal S. Rana, Mai N. Nguyen-Huynh, and Yariv Gerber
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Blood Pressure ,030204 cardiovascular system & hematology ,Article ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Primary prevention ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,Young adult ,business.industry ,Incidence ,Middle Aged ,Stroke ,Blood pressure ,Cohort ,Female ,business ,Stroke incidence ,030217 neurology & neurosurgery ,Cohort study - Abstract
We examined the longitudinal association between blood pressure (BP) and stroke incidence in young and middle-aged adults. BP measured during 9 examinations of the CARDIA study (Coronary Artery Risk Development in Young Adults) from 1985-1986 to 2015-2016 was used to classify participants (n=5079) according to the 2017 Hypertension Clinical Practice Guidelines. We used the highest BP obtained through the third examination (1990–1991) to define baseline BP categories; time-dependent categories (accounting for change in BP over time) were determined incorporating follow-up measurements. BP groups at ages 30 and 40 years were also defined. Stroke events were adjudicated until 2018. Mean age at baseline was 29.8 years. Stroke occurred in 100 participants. Stroke incidence (per 100 000 person-years) was higher ( P
- Published
- 2021
34. Clinical Correlates of Early-Onset Hypertension
- Author
-
Karri Suvila, Susan Cheng, Teemu J. Niiranen, and Joao A.C. Lima
- Subjects
Ajhype/Ajh-08 ,Adult ,Male ,medicine.medical_specialty ,hypertension ,030204 cardiovascular system & hematology ,Brief Communication ,Odds ,Young Adult ,03 medical and health sciences ,age of onset ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Epidemiology ,Internal Medicine ,medicine ,Humans ,AcademicSubjects/MED00200 ,030212 general & internal medicine ,Risk factor ,Young adult ,10. No inequality ,business.industry ,blood pressure ,Odds ratio ,Middle Aged ,Confidence interval ,3. Good health ,Blood pressure ,AcademicSubjects/SCI00960 ,epidemiology ,Female ,Age of onset ,business - Abstract
BACKGROUND Early-onset hypertension has been established as a heritable trait and a risk factor for cardiovascular disease outcomes. However, the clinical correlates of early-onset hypertension remain unidentified. METHODS In this study, we assessed the demographic characteristics and lifestyle factors related to hypertension onset age in a sample of 3,286 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (mean baseline age 25 ± 4 years, 57% women). We examined the association between the participants’ baseline characteristics and age of hypertension onset subgroups (, Graphical Abstract Graphical Abstract
- Published
- 2021
35. A Phase <scp>II</scp> study of autologous mesenchymal stromal cells and c‐kit positive cardiac cells, alone or in combination, in patients with ischaemic heart failure: the <scp>CCTRN CONCERT‐HF</scp> trial
- Author
-
Michael P. Murphy, Ketty Bacallao, Lara M. Simpson, Aisha Khan, Joshua M. Hare, Bharath Ambale-Venkatesh, Judy Bettencourt, Dejian Lai, David P. Lee, Gregory D. Lewis, Timothy D. Henry, Bangon Longsomboon, Ray F. Ebert, Keith L. March, Mohammad R. Ostovaneh, Michelle Cohen, Ivonne Hernandez Schulman, Rachel W. Vojvodic, Carl J. Pepine, Krystalenia Valasaki, Lem Moyé, Shelly L. Sayre, Sohail Ikram, Robert D. Simari, Doris A. Taylor, Catalin Loghin, James T. Willerson, Roberto Bolli, Phillip C. Yang, David Aguilar, Barry R. Davis, Emerson C. Perin, Connor O'Brien, Adrian P. Gee, Sara Richman, Joao A.C. Lima, Raul D. Mitrani, and Jay H. Traverse
- Subjects
medicine.medical_specialty ,Minnesota ,Phases of clinical research ,030204 cardiovascular system & hematology ,Mesenchymal Stem Cell Transplantation ,Placebo ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,Humans ,Medicine ,Heart Failure ,Ejection fraction ,business.industry ,Mesenchymal stem cell ,Mesenchymal Stem Cells ,Stroke Volume ,medicine.disease ,Clinical trial ,Treatment Outcome ,Heart failure ,Quality of Life ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
AIMS CONCERT-HF is an NHLBI-sponsored, double-blind, placebo-controlled, Phase II trial designed to determine whether treatment with autologous bone marrow-derived mesenchymal stromal cells (MSCs) and c-kit positive cardiac cells (CPCs), given alone or in combination, is feasible, safe, and beneficial in patients with heart failure (HF) caused by ischaemic cardiomyopathy. METHODS AND RESULTS Patients were randomized (1:1:1:1) to transendocardial injection of MSCs combined with CPCs, MSCs alone, CPCs alone, or placebo, and followed for 12 months. Seven centres enrolled 125 participants with left ventricular ejection fraction of 28.6 ± 6.1% and scar size 19.4 ± 5.8%, in New York Heart Association class II or III. The proportion of major adverse cardiac events (MACE) was significantly decreased by CPCs alone (-22% vs. placebo, P = 0.043). Quality of life (Minnesota Living with Heart Failure Questionnaire score) was significantly improved by MSCs alone (P = 0.050) and MSCs + CPCs (P = 0.023) vs. placebo. Left ventricular ejection fraction, left ventricular volumes, scar size, 6-min walking distance, and peak oxygen consumption did not differ significantly among groups. CONCLUSIONS This is the first multicentre trial assessing CPCs and a combination of two cell types from different tissues in HF patients. The results show that treatment is safe and feasible. Even with maximal guideline-directed therapy, both CPCs and MSCs were associated with improved clinical outcomes (MACE and quality of life, respectively) in ischaemic HF without affecting left ventricular function or structure, suggesting possible systemic or paracrine cellular mechanisms. Combining MSCs with CPCs was associated with improvement in both these outcomes. These results suggest potential important beneficial effects of CPCs and MSCs and support further investigation in HF patients.
- Published
- 2021
36. Age-Related Development of Cardiac Remodeling and Dysfunction in Young Black and White Adults: The Coronary Artery Risk Development in Young Adults Study
- Author
-
Joao A.C. Lima, Amanda M. Perak, Cora E. Lewis, Samuel S. Gidding, Jared P. Reis, Laura A. Colangelo, Donald M. Lloyd-Jones, Anderson C. Armstrong, Sadiya S. Khan, Pamela J. Schreiner, and Stephen Sidney
- Subjects
medicine.medical_specialty ,Proportional hazards model ,business.industry ,Hazard ratio ,Diastole ,Concentric hypertrophy ,Odds ratio ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Heart failure ,Internal medicine ,Cohort ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Young adult ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Little is known about the timing of preclinical heart failure (HF) development, particularly among blacks. The primary aims of this study were to delineate age-related left ventricular (LV) structure and function evolution in a biracial cohort and to test the hypothesis that young-adult LV parameters within normative ranges would be associated with incident stage B–defining LV abnormalities over 25 years, independent of cumulative risk factor burden. Methods Data from the Coronary Artery Risk Development in Young Adults study were analyzed. Participants (n = 2,833) had a mean baseline age of 30.1 years; 45% were black, and 56% were women. Generalized estimating equation logistic regression was used to estimate age-related probabilities of stage B LV abnormalities (remodeling, hypertrophy, or dysfunction) and logistic regression to examine risk factor–adjusted associations between baseline LV parameters and incident abnormalities. Cox regression was used to assess whether baseline LV parameters associated with incident stage B LV abnormalities were also associated with incident clinical (stage C/D) HF events over >25 years’ follow-up. Results Probabilities of stage B LV abnormalities at ages 25 and 60 years were 10.5% (95% CI, 9.4%–11.8%) and 45.0% (95% CI, 42.0%–48.1%), with significant race-sex disparities (e.g., at age 60, black men 52.7% [95% CI, 44.9%–60.3%], black women 59.4% [95% CI, 53.6%–65.0%], white men 39.1% [95% CI, 33.4%–45.0%], and white women 39.1% [95% CI, 33.9%–44.6%]). Over 25 years, baseline LV end-systolic dimension indexed to height was associated with incident systolic dysfunction (adjusted odds ratio per 1 SD higher, 2.56; 95% CI, 1.87–3.52), eccentric hypertrophy (1.34; 95% CI, 1.02–1.75), concentric hypertrophy (0.69; 95% CI, 0.51–0.91), and concentric remodeling (0.68; 95% CI, 0.58–0.79); baseline LV mass indexed to height2.7 was associated with incident eccentric hypertrophy (1.70; 95% CI, 1.25–2.32]), concentric hypertrophy (1.63; 95% CI, 1.19–2.24), and diastolic dysfunction (1.24; 95% CI, 1.01–1.52). Among the entire cohort with baseline echocardiographic data available (n = 4,097; 72 HF events), LV end-systolic dimension indexed to height and LV mass indexed to height2.7 were significantly associated with incident clinical HF (adjusted hazard ratios per 1 SD higher, 1.56 [95% CI, 1.26–1.93] and 1.42 [95% CI, 1.14–1.75], respectively). Conclusions Stage B LV abnormalities and related racial disparities were present in young adulthood, increased with age, and were associated with baseline variation in indexed LV end-systolic dimension and mass. Baseline indexed LV end-systolic dimension and mass were also associated with incident clinical HF. Efforts to prevent the LV abnormalities underlying clinical HF should start from a young age.
- Published
- 2021
37. Risk Factors for Incident Coronary Artery Calcium in Younger (Age 32 to 45 Years) Versus Intermediate (46 to 64 Years) Versus Older (65 to 84 Years) Persons
- Author
-
Alexander C. Razavi, Norrina B. Allen, Omar Dzaye, Erin D. Michos, Matthew J. Budoff, Joao A.C. Lima, James M. Shikany, Kiang Liu, Wendy S. Post, Roger S. Blumenthal, Michael J. Blaha, J. Jeffrey Carr, and Seamus P. Whelton
- Subjects
Aged, 80 and over ,Adult ,Male ,Coronary Artery Disease ,Middle Aged ,Atherosclerosis ,Risk Assessment ,Young Adult ,Risk Factors ,Humans ,Female ,Calcium ,Cardiology and Cardiovascular Medicine ,Vascular Calcification ,Aged - Abstract
The prognostic value of traditional atherosclerotic cardiovascular disease (ASCVD) risk factors may decrease with age. We sought to determine whether the association between traditional ASCVD risk factors and incident coronary artery calcium (CAC) differs for younger versus older persons. We included 5,108 participants with baseline CAC = 0. Repeat CAC scoring occurred over 3 to 11 years of follow-up. Multivariable Cox proportional hazards regression assessed the association between traditional risk factors and incident CAC in young (32 to 45 years), middle-aged (46 to 64 years), and older adults (65 to 84 years). A total of 61% of the participants were women and 37% were Black. The proportion with incident CAC ranged from 22% among young adults, 34% for middle-aged adults, and 45% for older adults. In young adults, traditional risk factors were significantly associated with incident CAC except for diastolic blood pressure and high-density lipoprotein (HDL) cholesterol, whereas only total cholesterol/HDL cholesterol ≥3.5 (p = 0.04) was significantly associated with incident CAC in older persons. Non-HDL cholesterol (p = 0.02) was more strongly associated with incident CAC in young (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.09 to 1.31) and middle aged (HR 1.14, 95% CI 1.07 to 1.23) compared to older adults (HR 1.11, 95% CI 0.99 to 1.23). When added to demographics, traditional risk factors provided a greater C-statistic improvement for incident CAC prediction in young (0.752, +0.070, p0.001) versus middle-aged (0.645, +0.054, p0.001) and older adults (0.597,+0.025, p = 0.08). In conclusion, traditional risk factors more strongly predict incident CAC in young compared to older adults, underlining the importance of primordial prevention through middle age while identifying the challenges of ASCVD risk assessment in older persons.
- Published
- 2022
38. References Values for Left Atrial Volumes, Emptying Fractions, Strains, and Strain Rates and Their Determinants by Age, Gender, and Ethnicity: The Multiethnic Study of Atherosclerosis (MESA)
- Author
-
Ela Chamera, Mohammadali Habibi, Joao A.C. Lima, David A. Bluemke, Masamichi Imai, Theingi Tiffany Win, Seo Young Hong, Susan R. Heckbert, Xiaoying Yang, Henrique Doria de Vasconcellos, Bharath Ambale Venkatesh, Colin O. Wud, Ravi K. Sharma, Luisa Ciuffo, and Patrick Young
- Subjects
medicine.medical_specialty ,Longitudinal strain ,Population ,Article ,Mesa ,Left atrial ,Internal medicine ,Atrial Fibrillation ,Ethnicity ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Heart Atria ,education ,Aged ,computer.programming_language ,Aged, 80 and over ,education.field_of_study ,business.industry ,Atrial fibrillation ,Middle Aged ,Atherosclerosis ,medicine.disease ,Reference values ,Cardiology ,Feature tracking ,Atrial Function, Left ,business ,Cardiac magnetic resonance ,computer - Abstract
Rationale and objectives Left Atrial (LA) adverse remodeling is an important predictor of morbidity and mortality in several cardiovascular (CV) diseases. Our goals were to quantify and provide reference ranges for LA structure and function using feature tracking cine cardiac magnetic resonance. Materials and methods 2526 participants of the Multiethnic Study of Atherosclerosis study who had feature tracking cine cardiac magnetic resonance derived LA data and were free of atrial fibrillation/flutter and prior CV events at year five follow-up examination (2010–2012) were included in this study. LA phasic indexed volumes: maximum (LAVi max), minimum (LAVi min), and preatrial contraction (LAVi preA); LA empty fractions: total, passive, and active (LAtEF, LApEF, and LAaEF); LA longitudinal strain: maximum and preatrial contraction (S max and S preA); and LA longitudinal strain rate: systolic (SR max) and early/late diastolic (SR e and SR a) were measured. Age, gender, and race/ethnicity-specific reference ranges were identified. Also, reference values in a select subgroup of healthy participants free of traditional CV risk factors at the time of exam date were reported. Results The mean ± SD for LAVi max, LAVi min, LAVi preA, S max, SR e, and SR a were in the 45–65-year-old participants: (33.8 ± 10 mL/m2), (14.5 ± 6.4 mL/m2), (24.8 ± 8.2 mL/m2), (34.6 ± 13.8 %), (−1.4 ± 0.7 s−1), (−2.1 ± 1 s−1) and in the ≥ 65-year-old participants: (35 ± 11.5 mL/m2), (16.6 ± 8.3 mL/m2), (27.6 ± 9.9 mL/m2), (31.2 ± 14.3 %), (−1 ± 0.6 s−1), (−2.1 ± 1 s−1) respectively. Younger individuals had Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation smaller LA volumes and better LA function compared to their older counterparts. Similar findings were observed in Chinese-Americans as compared to Whites. Conclusion This study provides reference values of LA structure and function parameters from a healthy multiethnic community-based population aged 53–94 years evaluated by FTMRI.
- Published
- 2021
39. Acute Kidney Injury After Repeated Exposure to Contrast Material for Coronary Angiography
- Author
-
Jeffrey A. Brinker, Matthew B. Matheson, Mohammad R. Ostovaneh, Armin Arbab-Zadeh, Christopher Cox, Aisha Betoko, Joao A.C. Lima, and Julie M. Miller
- Subjects
medicine.medical_specialty ,CAAKI, contrast-associated acute kidney injury ,medicine.medical_treatment ,Population ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Iodinated contrast ,Interquartile range ,medicine ,030212 general & internal medicine ,education ,IQR, interquartile range ,Cardiac catheterization ,Computed tomography angiography ,education.field_of_study ,PCI, percutaneous coronary intervention ,lcsh:R5-920 ,medicine.diagnostic_test ,SE, standard error ,business.industry ,ICA, invasive coronary angiography ,Acute kidney injury ,Percutaneous coronary intervention ,medicine.disease ,Angiography ,Original Article ,Radiology ,CTA, computed tomography angiography ,business ,lcsh:Medicine (General) - Abstract
Objective To assess the incidence of contrast-associated acute kidney injury (CAAKI) after repeated exposure to contrast material for computed tomography (CT) and conventional coronary angiography within short intervals. Methods We studied 651 patients enrolled in the CorE-64 (November 5, 2005–January 30, 2007) and CORE320 (October 21, 2009–August 17, 2011) multicenter studies. Participants with suspected obstructive coronary heart disease were referred for diagnostic cardiac catheterization and underwent coronary CT angiography for research before invasive angiography. Nonionic, low-osmolality iodinated contrast material was used for all imaging. Results The median age of the patients was 62 years, and 190 (29%) were women. Major risk factors for acute kidney injury were present in 277 of 651 (43%) patients. The median interval between CT imaging and invasive angiography was 3.1 days (interquartile range, 0.9-8.0 days). The median volume of contrast material was 100 mL for each test. In 16 (2.5%) of 651 patients, CAAKI developed. Of these cases, 1 occurred after the CT scan, whereas 6 were documented after invasive angiography (compared with post-CT creatinine concentration assessment). In 9 patients, CAAKI was found in comparing creatinine concentration after completion of both tests with baseline values (but not compared with post-CT imaging). Conclusion Acute kidney injury after repeated exposure to iodinated contrast media within a few days is uncommon even in a population of patients with highly prevalent risk factors. Withholding of clinically indicated contrast-enhanced imaging may therefore not be justified in this setting.
- Published
- 2021
40. Electrocardiogram machine learning for detection of cardiovascular disease in African Americans: the Jackson Heart Study
- Author
-
Solomon K. Musani, Larisa G. Tereshchenko, James D. Pollard, Elsayed Z. Soliman, Joseph F. Maher, Kazi T. Haq, Nichole M. Rogovoy, Kevin A. Paternostro, Katherine J. Lutz, and Joao A.C. Lima
- Subjects
Elastic net regularization ,Receiver operating characteristic ,ECG ,business.industry ,Disease ,030204 cardiovascular system & hematology ,Cardiovascular disease ,Logistic regression ,Machine learning ,computer.software_genre ,QRS-T angle ,Confidence interval ,Random forest ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Lasso (statistics) ,Medicine ,Original Article ,cardiovascular diseases ,030212 general & internal medicine ,Artificial intelligence ,business ,computer - Abstract
Aims Almost half of African American (AA) men and women have cardiovascular disease (CVD). Detection of prevalent CVD in community settings would facilitate secondary prevention of CVD. We sought to develop a tool for automated CVD detection. Methods and results Participants from the Jackson Heart Study (JHS) with analysable electrocardiograms (ECGs) (n = 3679; age, 62 ± 12 years; 36% men) were included. Vectorcardiographic (VCG) metrics QRS, T, and spatial ventricular gradient vectors’ magnitude and direction, and traditional ECG metrics were measured on 12-lead ECG. Random forests, convolutional neural network (CNN), lasso, adaptive lasso, plugin lasso, elastic net, ridge, and logistic regression models were developed in 80% and validated in 20% samples. We compared models with demographic, clinical, and VCG input (43 predictors) and those after the addition of ECG metrics (695 predictors). Prevalent CVD was diagnosed in 411 out of 3679 participants (11.2%). Machine learning models detected CVD with the area under the receiver operator curve (ROC AUC) 0.69–0.74. There was no difference in CVD detection accuracy between models with VCG and VCG + ECG input. Models with VCG input were better calibrated than models with ECG input. Plugin-based lasso model consisting of only two predictors (age and peak QRS-T angle) detected CVD with AUC 0.687 [95% confidence interval (CI) 0.625–0.749], which was similar (P = 0.394) to the CNN (0.660; 95% CI 0.597–0.722) and better (P Conclusions Simple model (age and QRS-T angle) can be used for prevalent CVD detection in limited-resources community settings, which opens an avenue for secondary prevention of CVD in underserved communities.
- Published
- 2021
41. Next-Generation Hardware Advances in CT: Cardiac Applications
- Author
-
Alan C. Kwan, Amir Pourmorteza, David A. Bluemke, Joao A.C. Lima, and Dan Stutman
- Subjects
Heart Diseases ,business.industry ,Contrast resolution ,Heart ,030218 nuclear medicine & medical imaging ,Visualization ,Radiation exposure ,03 medical and health sciences ,Reviews and Commentary ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Temporal resolution ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Tomography, X-Ray Computed ,business ,Material decomposition ,Image resolution ,Computer hardware - Abstract
Impending major hardware advances in cardiac CT include three areas: ultra-high-resolution (UHR) CT, photon-counting CT, and phase-contrast CT. Cardiac CT is a particularly demanding CT application that requires a high degree of temporal resolution, spatial resolution, and soft-tissue contrast in a moving structure. In this review, cardiac CT is used to highlight the strengths of these technical advances. UHR CT improves visualization of calcified and stented vessels but may result in increased noise and radiation exposure. Photon-counting CT uses multiple photon energies to reduce artifacts, improve contrast resolution, and perform material decomposition. Finally, phase-contrast CT uses x-ray refraction properties to improve spatial and soft-tissue contrast. This review describes these hardware advances in CT and their relevance to cardiovascular imaging. © RSNA, 2020
- Published
- 2021
42. Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes
- Author
-
Seamus P. Whelton, Tanika N. Kelly, Morgana Mongraw-Chaffin, Michael J. Blaha, Alexander C. Razavi, Joao A.C. Lima, Alain G. Bertoni, Lydia A. Bazzano, Nathan D. Wong, Moyses Szklo, Camilo Fernandez, Chris Defilippi, Roger S. Blumenthal, Jiang He, Matthew J. Budoff, and Joseph F. Polak
- Subjects
medicine.medical_specialty ,business.industry ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Coronary artery calcium ,0302 clinical medicine ,Internal medicine ,Coronary artery calcification ,Diabetes mellitus ,Multidetector computed tomography ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,Metabolic syndrome ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (Me...
- Published
- 2021
43. ASSOCIATION BETWEEN LIVER AND HEART FIBROSIS IN WOMEN WITH OR AT RISK FOR HIV: THE WOMEN'S INTERAGENCY HIV STUDY (WIHS)
- Author
-
Luisa Ciuffo, Yoko Kato, Bharath Ambale Venkatesh, Sanyog Shitole, Chia-Ying Liu, Jeffrey M. Levsky, Linda B. Haramati, Jason M. Lazar, Kathryn Anastos, Robert Kaplan, Joao A.C. Lima, and Jorge R. Kizer
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
44. PROTEOMIC PATHWAYS ASSOCIATED WITH INTERSTITIAL MYOCARDIAL FIBROSIS IN THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS
- Author
-
Sam A. Michelhaugh, Hooman Bakhshi, Scott Bruce, Stephen L. Seliger, Xiaoxiao Qian, Bharath Ambale Venkatesh, Vinithra Varadarajan, Pramita Bagchi, Joao A.C. Lima, and Christopher R. DeFilippi
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
45. ASSOCIATION OF GLOBAL LONGITUDINAL STRAIN BY FEATURE TRACKING MRI WITH CARDIOVASCULAR OUTCOMES: THE DALLAS HEART STUDY
- Author
-
Vinayak Subramanian, Neil Keshvani, Nitin Kondamudi, Alvin Chandra, Susan A. Matulevicius, Joao A.C. Lima, Erin D. Michos, and Ambarish Pandey
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
46. PERIODONTAL DISEASE ASSOCIATED WITH INTERSTITIAL MYOCARDIAL FIBROSIS: THE MULTIETHNIC STUDY OF ATHEROSCLEROSIS
- Author
-
Omar Chehab, Maria Doughan, Ralph Zeitoun, Henrique Doria De Vasconcellos, Vinithra Varadarajan, Colin O. Wu, Michael J. Blaha, David A. Bluemke, and Joao A.C. Lima
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
47. DEEP PHENOTYPING OF DEMENTIA IN A MULTI-ETHNIC CARDIOVASCULAR COHORT: THE MULTIETHNIC STUDY OF ATHEROSCLEROSIS (MESA)
- Author
-
Mohammad Ostovaneh, Timothy Hughes, Colin O. Wu, Robyn McClelland, Ramon Casanova, David A. Bluemke, Russell P. Tracy, Steven Shea, Susan R. Heckbert, Joao A.C. Lima, and Bharath Ambale Venkatesh
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
48. SEX-DIFFERENCE OF ASSOCIATION BETWEEN CIGARETTE SMOKING AND MYOCARDIAL FIBROSIS: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA)
- Author
-
Elie W. Akl, Ralph Zeitoun, Omar Chehab, Haiou Li, Vinithra Varadarajan, Colin O. Wu, Alain Bertoni, Karol E. Watson, David A. Bluemke, Bharath Ambale Venkatesh, and Joao A.C. Lima
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
49. LEFT VENTRICULAR FLOW STATE IS ASSOCIATED WITH CARDIOVASCULAR DISEASE AND ALL-CAUSE MORTALITY IN AN ASYMPTOMATIC POPULATION WITH NORMAL LEFT VENTRICULAR FUNCTION
- Author
-
Yifang Yuan, David M. Herrington, Joao A.C. Lima, Brandon Stacey, David Xiao-Ming Zhao, James D. Thomas, Mario J. Garcia, and Min Pu
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
50. INTERCELLULAR ADHESION MOLECULE-1, VASCULAR CELL ADHESION MOLECULE-1, AND CARDIAC STRUCTURE AND FUNCTION: THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS
- Author
-
Daniel Mathew, Graham Peigh, Joao A.C. Lima, Suzette J. Bielinski, Nicholas Larson, Matthew A. Allison, Sanjiv Jayendra Shah, and Ravi B. Patel
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.