236 results on '"Salvatore Carbone"'
Search Results
2. Interleukin‐1 blockade in heart failure: an on‐treatment and off‐treatment cardiorespiratory fitness analysis
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Francesco Moroni, Michele Golino, Salvatore Carbone, Cory Trankle, Marco Giuseppe Del Buono, Azita Talasaz, Ross Arena, Justin M. Canada, Giuseppe Biondi‐Zoccai, Benjamin Van Tassel, and Antonio Abbate
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Cardiorespiratory fitness ,C‐reactive protein ,Heart failure ,IL‐1 blockade ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Interleukin‐1 (IL‐1) blockade may improve exercise capacity in patients with heart failure (HF) patients. The extent of the improvement and its persistence beyond discontinuation of IL‐1 blockade is unknown. Methods and results The primary objective was to determine changes in cardiorespiratory fitness and cardiac function on‐treatment with IL‐1 blocker, anakinra, and off‐treatment, after treatment cessation. We performed cardiopulmonary exercise testing, Doppler echocardiography, and biomarkers in 73 patients with HF, 37 (51%) females, 52 (71%) Black–African–American, before and after treatment with anakinra 100 mg daily. In a subset of 46 patients, testing was also repeated after treatment cessation. Quality of life was assessed in each patient using standardized questionnaires. Data are presented as median and interquartile range. Treatment with anakinra for 4 [2–12] weeks was associated with a significant improvement in high‐sensitivity C‐reactive protein (from 6.2 [3.3–15.4] to 1.4 [0.8–3.4] mg/L, P
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- 2023
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3. Differential Response to Interleukin‐1 Blockade With Anakinra on Cardiorespiratory Fitness in Patients With Heart Failure With Preserved Ejection Fraction Stratified According to Left Ventricular Ejection Fraction
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Michele Golino, Francesco Moroni, Salvatore Carbone, Giuliana Corna, Cory Trankle, Hayley E. Billingsley, Marco G. Del Buono, Azita H. Talasaz, Georgia K. Thomas, Roberto De Ponti, Jeremy Turlington, Roshanak Markley, Ross Arena, Justin M. Canada, Benjamin Van Tassell, and Antonio Abbate
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anakinra ,cardiopulmonary exercise test ,heart failure ,diastolic ,interleukin‐1 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2023
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4. Influence of extracellular volume fraction on peak exercise oxygen pulse following thoracic radiotherapy
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Justin M. Canada, Elisabeth Weiss, John D. Grizzard, Cory R. Trankle, Leila Rezai Gharai, Franklin Dana, Leo F. Buckley, Salvatore Carbone, Dinesh Kadariya, Anthony Ricco, Jennifer H. Jordan, Ronald K. Evans, Ryan S. Garten, Benjamin W. Van Tassell, W. Gregory Hundley, and Antonio Abbate
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Peak exercise oxygen pulse ,Extracellular volume fraction ,Radiotherapy ,Cardiorespiratory fitness ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Radiation-induced myocardial fibrosis increases heart failure (HF) risk and is associated with a restrictive cardiomyopathy phenotype. The myocardial extracellular volume fraction (ECVF) using contrast-enhanced cardiac magnetic resonance (CMR) quantifies the extent of fibrosis which, in severe cases, results in a noncompliant left ventricle (LV) with an inability to augment exercise stroke volume (SV). The peak exercise oxygen pulse (O2Pulse), a noninvasive surrogate for exercise SV, may provide mechanistic insight into cardiac reserve. The relationship between LV ECVF and O2Pulse following thoracic radiotherapy has not been explored. Methods Patients who underwent thoracic radiotherapy for chest malignancies with significant incidental heart dose (≥5 Gray (Gy), ≥10% heart) without a pre-cancer treatment history of HF underwent cardiopulmonary exercise testing to determine O2Pulse, contrast-enhanced CMR, and N-terminal pro-brain natriuretic peptide (NTproBNP) measurement. Multivariable-analyses were performed to identify factors associated with O2Pulse normalized for age/gender/anthropometrics. Results Thirty patients (median [IQR] age 63 [57–67] years, 18 [60%] female, 2.0 [0.6–3.8] years post-radiotherapy) were included. The peak VO2 was 1376 [1057–1552] mL·min− 1, peak HR = 150 [122–164] bpm, resulting in an O2Pulse of 9.2 [7.5–10.7] mL/beat or 82 (66–96) % of predicted. The ECVF, LV ejection fraction, heart volume receiving ≥10 Gy, and NTproBNP were independently associated with %O2Pulse (P
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- 2022
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5. Effect of interleukin-1 blockade with anakinra on leukocyte count in patients with ST-segment elevation acute myocardial infarction
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Marco Giuseppe Del Buono, Juan Ignacio Damonte, Cory R. Trankle, Dinesh Kadariya, Salvatore Carbone, Georgia Thomas, Jeremy Turlington, Roshanak Markley, Justin M. Canada, Giuseppe G. Biondi‐Zoccai, Michael C. Kontos, Benjamin W. Van Tassell, and Antonio Abbate
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Medicine ,Science - Abstract
Abstract Leukocytosis is a common finding in patients with ST elevation myocardial infarction (STEMI) and portends a poor prognosis. Interleukin 1-β regulates leukopoiesis and pre-clinical studies suggest that anakinra (recombinant human interleukin-1 [IL-1] receptor antagonist) suppresses leukocytosis in myocardial infarction. However, the effect of IL-1 blockade with anakinra on leukocyte count in patients with STEMI is unknown. We reviewed the white blood cell (WBC) and differential count of 99 patients enrolled in a clinical trial of anakinra (n = 64) versus placebo (n = 35) for 14 days after STEMI. A complete blood cell count with differential count were obtained at admission, and after 72 h, 14 days and 3 months. After 72 h from treatment, anakinra compared to placebo led to a statistically significant greater percent reduction in total WBC count (− 35% [− 48 to − 24] vs. − 21% [− 34 to − 10], P = 0.008), absolute neutrophil count (− 48% [− 60 to − 22] vs. − 27% [− 46 to − 5], P = 0.004) and to an increase in absolute eosinophil count (+ 50% [0 to + 100] vs. 0% [− 50 to + 62], P = 0.022). These changes persisted while on treatment at 14 days and were no longer apparent at 3 months after treatment discontinuation. We found that in patients with STEMI IL-1 blockade with anakinra accelerates resolution of leukocytosis and neutrophilia. This modulation may represent one of the mechanisms by which IL-1 blockade improves clinical outcomes.
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- 2022
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6. The relationship between abdominal fat and change in left ventricular ejection fraction in cancer patients
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Kerryn W. Reding, Khristine Ghemigian, Salvatore Carbone, Ralph D'Agostino Jr., Jennifer H. Jordan, Giselle Meléndez, Zanetta S. Lamar, Heidi D. Klepin, Alexandra Thomas, Dale Langford, Sujethra Vasu, and W. Gregory Hundley
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body composition ,visceral fat ,Internal medicine ,RC31-1245 - Abstract
Abstract Objectives Prior studies have identified a relationship between body mass index (BMI) and intraperitoneal (IP) fat with heart failure; however, in prior studies of cancer patients receiving potentially cardiotoxic chemotherapy, elevations in BMI have not necessarily been associated with decrements in heart function. This study tested the hypothesis that IP fat may be associated with left ventricular ejection fraction (LVEF) decline among cancer patients receiving potentially cardiotoxic chemotherapy. Methods In this prospective study of 61 cancer patients (23 breast cancer, 32 lymphoma, and 6 sarcoma), IP fat and other assessments of body composition, and changes in LVEF from pre‐ to postcancer treatment using noninvasive magnetic resonance imaging was ascertained. Results After accounting for age, baseline LVEF, and confounding variables, pre‐ to 24‐month post‐treatment LVEF changes were inversely correlated with IP fat (r = −0.33; p = 0.02) and positively correlated with measures of subcutaneous (SQ) fat (r = 0.33; p = 0.01). These LVEF changes were not correlated with BMI (r = 0.12; p = 0.37). Conclusion Among patients receiving potentially cardiotoxic chemotherapy, pretreatment IP fat was associated with subsequent declines in LVEF. There was no association between BMI and LVEF decline. These findings may be related to a potential protective effect of SQ fat.
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- 2021
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7. Change in Eosinophil Count in Patients with Heart Failure Treated with Anakinra
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Michele Golino, Francesco Moroni, Marco Giuseppe Del Buono, Justin M. Canada, Azita H. Talasaz, Sebastian Piñel, James Mbualungu, Alessandra Vecchiè, Ai-Chen (Jane) Ho, Georgia K. Thomas, Salvatore Carbone, Hayley E. Billingsley, Jeremy Turlington, Roshanak Markley, Cory Trankle, Roberto De Ponti, Benjamin Van Tassell, and Antonio Abbate
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eosinophils ,heart failure ,interleukin-1 ,interleukin-1 receptor antagonist protein ,injection site reaction ,cardiorespiratory fitness ,Cytology ,QH573-671 - Abstract
Background: Interleukin-1 blockade with anakinra leads to a transient increase in eosinophil blood count (eosinophils) in patients with acute myocardial infarction. We aimed to investigate the effect of anakinra on changes in eosinophils in patients with heart failure (HF) and their correlation with cardiorespiratory fitness (CRF). Methods: We measured eosinophils in 64 patients with HF (50% females), 55 (51–63) years of age, before and after treatment, and, in a subset of 41 patients, also after treatment cessation. We also evaluated CRF, measuring peak oxygen consumption (VO2) with a treadmill test. Results: Treatment with anakinra significantly and transiently increased eosinophils, from 0.2 [0.1–0.3] to 0.3 [0.1–0.4] × 103 cells/µL (p < 0.001) and from 0.3 [0.2–0.5] to 0.2 [0.1–0.3] × 103 cells/µL, with suspension (p < 0.001). Changes in eosinophils correlated with the changes in peak VO2 (Spearman’s Rho = +0.228, p = 0.020). Eosinophils were higher in patients with injection site reactions (ISR) (n = 8, 13%; 0.5 [0.4–0.6] vs. 0.2 [0.1–0.4] × 103 cells/µL, p = 0.023), who also showed a greater increase in peak VO2 (3.0 [0.9–4.3] vs. 0.3 [−0.6–1.8] mLO2·kg−1·min−1, p = 0.015). Conclusion: Patients with HF treated with anakinra experience a transient increase in eosinophils, which is associated with ISR and a greater improvement in peak VO2.
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- 2023
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8. Acute Effects of Liothyronine Administration on Cardiovascular System and Energy Metabolism in Healthy Volunteers
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Shanshan Chen, George F. Wohlford, Alessandra Vecchie’, Salvatore Carbone, Sahzene Yavuz, Benjamin Van Tassell, Antonio Abbate, and Francesco S. Celi
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liothyronine ,rapid effects of thyroid hormone ,cardiovascular function ,energy expenditure ,pharmacokinetics ,pharmacodynamics ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
ContextThe pharmacokinetics of liothyronine causes concerns for cardiovascular toxicity. While the effects of sustained increase in serum T3 concentrations are well described, little is known on the effects of acute changes in T3 concentrations due to rapid action of thyroid hormone.ObjectiveTo assess the clinical relevance of transient increase of T3 levels on cardiovascular system and energy metabolism.SettingDouble-blind, three arms, placebo controlled, cross-over study (ClinicalTrials.gov Identifier: NCT03098433).Study ParticipantsTwelve volunteers (3 females, 9 males), age 27.7 ± 5.1 years.InterventionOral administration of liothyronine 0.7 mcg/kg, equimolar dose of levothyroxine (0.86 mcg/kg), or placebo in three identical study visits. Blood samples for total T3, free T4 were collected at times 0’, 60’ 120’ 180’ 240’. Continuous recording of heart rate, blood pressure, and hemodynamic data was performed using the volume clamp method. Resting energy expenditure was measured by indirect calorimetry. An echocardiogram was performed on each study visit at baseline and after the last blood sampling.Main Outcome MeasuresChanges in cardiovascular function and energy expenditure.ResultsFollowing the administration of liothyronine, serum T3 reached a Cmax of 421 ± 57 ng/dL with an estimated Tmax of 120 ± 26 minutes. No differences between study arms were observed in heart rate, blood pressure, hemodynamics parameters, energy expenditure, and in echocardiogram parameters.ConclusionsThe absence of measurable rapid effects on the cardiovascular system following a high dose of liothyronine supports the rationale to perform long-term studies to assess its safety and effectiveness in patients affected by hypothyroidism.
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- 2022
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9. Impaired Delivery of Cholesterol Effluxed From Macrophages to Hepatocytes by Serum From CKD Patients May Underlie Increased Cardiovascular Disease Risk
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Graham T. Gipson, Salvatore Carbone, Jing Wang, Dave L. Dixon, Ion S. Jovin, Daniel E. Carl, Todd W. Gehr, and Shobha Ghosh
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Introduction: Although chronic kidney disease (CKD) is associated with increased risk for coronary artery disease (CAD), the underlying mechanisms are not completely defined. In the present study, we tested the hypothesis that flux of cholesterol from macrophage foam cells to liver is impaired in subjects with CKD. Methods: Consecutive healthy patients, patients with at least 1 CAD risk factor, patients with established CAD, and patients with CKD stages G3 to G5 (n ≥ 15/group) were recruited prospectively. The ability of total patient serum without any modifications to (i) facilitate efflux of cholesterol from human THP1-macrophage foam cells under physiological conditions (cholesterol efflux capacity [CEC]) and (ii) to deliver this effluxed cholesterol to primary hepatocytes with physiological expression of high-density lipoprotein (HDL) receptor SR-BI (capacity to deliver cholesterol to hepatocytes [CDCH]) was evaluated. Results: Although healthy patients, patients with at least 1 CAD risk factor, and patients with established CAD all showed similar CEC, patients with CKD showed significantly higher CEC. CDCH was significantly lower in all groups compared with the healthy patients; however, when corrected for higher CEC, CDCH in patients with CKD was significantly lower than in patients with CAD. CDCH correlated with age, body mass index, metabolic parameters, inflammatory markers, and kidney function markers (estimated glomerular filtration rate [eGFR], serum creatinine, and serum cystatin C). Conclusions: These results suggest that aberrations in delivery of cholesterol effluxed from macrophage foam cells to liver for final elimination or the last step of reverse cholesterol transport, may underlie the increased risk of CAD in patients with CKD. Keywords: cardiovascular disease risk, chronic kidney disease, delivery of cholesterol to the liver, reverse cholesterol transport, serum cholesterol efflux capacity
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- 2020
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10. Increased C-reactive protein is associated with the severity of thoracic radiotherapy-induced cardiomyopathy
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Justin M. Canada, Georgia K. Thomas, Cory R. Trankle, Salvatore Carbone, Hayley Billingsley, Benjamin W. Van Tassell, Ronald K. Evans, Ryan Garten, Elisabeth Weiss, and Antonio Abbate
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Radiotherapy ,Cardiotoxicity ,Inflammation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Irradiation of the heart during cancer radiotherapy is associated with a dose-dependent risk of heart failure. Animal studies have demonstrated that irradiation leads to an inflammatory response within the heart as well as a reduction in cardiac reserve. In the current study we aimed to evaluate whether inflammatory biomarkers correlated with changes in cardiac function and reserve after radiotherapy for breast or lung cancer. Methods and results We studied 25 subjects with a history of breast or lung cancer without a prior diagnosis of cardiovascular disease or heart failure, 1.8 years [0.4–3.6] post-radiotherapy involving at least 5 Gray (Gy) to at least 10% of the heart. High-sensitivity C-reactive protein (CRP) was abnormal (≥2 mg/L) in 16 (64%) subjects. Cardiac function and reserve was measured with Doppler echocardiography before and after exercise and defined as left-ventricular ejection fraction (LVEF), early diastolic mitral annulus velocity (e’), and increase in LV outflow tract velocity time integral cardiac output (cardiac reserve) with exercise. Subjects with abnormal CRP had significantly lower LVEF (51 [44–59] % vs 61 [52–64] %, P = 0.039), lower e’ (7.4 [6.6–7.9] cm/sec vs 9.9 [8.3–12.0] cm/sec, P = 0.010), and smaller cardiac reserve (+ 1.5 [1.2–1.7] L/min vs + 1.9 [1.7–2.2] L/min, P = 0.024). Conclusion Elevated systemic inflammation is associated with impaired left-ventricular systolic and diastolic function both at rest and during exercise in subjects who have received radiotherapy with significant incidental heart dose for the treatment of cancer.
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- 2020
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11. Physical activity, sedentary behaviors and all-cause mortality in patients with heart failure: Findings from the NHANES 2007-2014.
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Youngdeok Kim, Justin M Canada, Jonathan Kenyon, Hayley Billingsley, Ross Arena, Carl J Lavie, and Salvatore Carbone
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Medicine ,Science - Abstract
BackgroundLimited data are available examining the effects of both moderate- and vigorous-intensity physical activity (MVPA) and sedentary behavior (SB) on longevity among patients with heart failure (HF). This study examined the associations of MVPA and SB with all-cause mortality in HF patients using a nationally representative survey data.MethodsNational Health and Nutrition Examination Survey data (2007-2014) were used. 711 adults with self-reported congestive HF, linked to 2015 mortality data were analyzed. Self-reported MVPA and SB minutes were used to create the three MVPA [No-MVPA, insufficient (I-MVPA; Results119 deaths occurred over an average of 4.9 years of follow-up. Lower MVPA and higher SB were independently associated with poor survival (P < .001). Joint and stratified analyses showed that the protective effect of MVPA was most pronounced among patients with SBConclusionIn this HF cohort, MVPA and SB were independently and jointly associated with all-cause mortality. The beneficial effect of MVPA is attenuated by excessive SB; however, engaging in some amount of MVPA may provide a protective effect and attenuates the detrimental effects associated with excessive SB.
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- 2022
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12. Sedentary Behaviors, Physical Inactivity, and Cardiovascular Health: We Better Start Moving!
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Salvatore Carbone, PhD, MS, Cemal Ozemek, PhD, and Carl J. Lavie, MD
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Medicine (General) ,R5-920 - Published
- 2020
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13. The CANVAS Program: implications of canagliflozin on reducing cardiovascular risk in patients with type 2 diabetes mellitus
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Salvatore Carbone and Dave L. Dixon
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Diabetes mellitus ,Major adverse cardiovascular event ,Sodium glucose co-transporter 2 inhibitor ,Canagliflozin ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Canagliflozin is a sodium glucose co-transporter 2 (SGLT2) inhibitor that reduces blood glucose, as well as blood pressure, body weight, and albuminuria in patients with type 2 diabetes mellitus (T2DM). In the CANagliflozin cardioVascular Assessment Study (CANVAS) Program, patients with T2DM and high cardiovascular risk treated with canagliflozin had a significantly lower risk of the composite outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke; hospitalization for heart failure; and renal outcomes, but also a greater risk of lower-limb amputation. Cardiovascular outcomes trials of some other T2DM agents (i.e., empagliflozin, dapagliflozin, liraglutide, semaglutide, albiglutide) have also shown potential cardiovascular and renal benefits. As a result, diabetes treatment guidelines have begun to incorporate consideration of cardiovascular and renal benefits into their treatment recommendations. Antihyperglycemic agents with proven beneficial cardiovascular effects represent a new opportunity for the diabetologist and cardiologist, in the setting of a multidisciplinary approach, to concomitantly improve glycemic control and reduce the risk of cardiovascular events in patients with T2DM. This review briefly discusses the pharmacology of canagliflozin, including clinical and preclinical data; it also describes the effects of canagliflozin on cardiovascular outcomes and side-effects, and compares these effects with other glucose-lowering agents with proven cardiovascular benefits.
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- 2019
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14. Edema Index Predicts Cardiorespiratory Fitness in Patients With Heart Failure With Reduced Ejection Fraction and Type 2 Diabetes Mellitus
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Amr Marawan, Georgia K. Thomas, Justin M. Canada, Hayley E. Billingsley, Dave L. Dixon, Benjamin W. Van Tassell, Dinesh Kadariya, Roshanak Markley, Brando Rotelli, Keyur B. Shah, Le Kang, Francesco S. Celi, Antonio Abbate, and Salvatore Carbone
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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15. A phase 1 clinical trial of SP16, a first-in-class anti-inflammatory LRP1 agonist, in healthy volunteers.
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George F Wohlford, Leo F Buckley, Dinesh Kadariya, Taeshik Park, Juan Guido Chiabrando, Salvatore Carbone, Virginia Mihalick, Matthew S Halquist, Adam Pearcy, Dana Austin, Cohava Gelber, Antonio Abbate, and Benjamin Van Tassell
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Medicine ,Science - Abstract
BackgroundEndogenous serine protease inhibitors are associated with anti-inflammatory and pro-survival signaling mediated via Low-density lipoprotein receptor-related protein 1 (LRP1) signaling. SP16 is a short polypeptide that mimics the LRP1 binding portion of alpha-1 antitrypsin.MethodsA pilot phase I, first-in-man, randomized, double blind, placebo-controlled safety study was conducted to evaluate a subcutaneous injection at three dose levels of SP16 (0.0125, 0.05, and 0.2 mg/kg [up to 12 mg]) or matching placebo in 3:1 ratio in healthy individuals. Safety monitoring included vital signs, laboratory examinations (including hematology, coagulation, platelet function, chemistry, myocardial toxicity) and electrocardiography (to measure effect on PR, QRS, and QTc).ResultsTreatment with SP16 was not associated with treatment related serious adverse events. SP16 was associated with mild-moderate pain at the time of injection that was significantly higher than placebo on a 0-10 pain scale (6.0+/-1.4 [0.2 mg/kg] versus 1.5+/-2.1 [placebo], P = 0.0088). No differences in vital signs, laboratory examinations and electrocardiography were found in those treated with SP16 versus placebo.ConclusionA one-time treatment with SP16 for doses up to 0.2 mg/kg or 12 mg was safe in healthy volunteers.
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- 2021
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16. Sarcopenic Obesity in Heart Failure With Preserved Ejection Fraction
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Danielle L. Kirkman, Natalie Bohmke, Hayley E. Billingsley, and Salvatore Carbone
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sarcopenia ,obesity ,heart failure ,diastolic ,exercise tolerance ,quality of life ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Heart failure with preserved ejection fraction (HFpEF) is a public health epidemic that is projected to double over the next two decades. Despite the high prevalence of HFpEF, there are currently no FDA approved therapies for health-related outcomes in this clinical syndrome making it one the greatest unmet needs in cardiovascular medicine. Aging and obesity are hallmarks of HFpEF and therefore there is a high incidence of sarcopenic obesity (SO) associated with this syndrome. The presence of SO in HFpEF patients is noteworthy as it is associated with co-morbidities, worsened cardiovascular health, hospitalizations, quality of life, and mortality. Furthermore, SO plays a central role in exercise intolerance, the most commonly reported clinical symptom of this condition. The aim of this review is to provide insights into the current knowledge pertaining to the contributing pathophysiological mechanisms and clinical outcomes associated with HFpEF-related SO. Current and prospective therapies to address SO in HFpEF, including lifestyle and pharmaceutical approaches, are discussed. The urgent need for future research aimed at better understanding the multifaceted physiological contributions to SO in HFpEF and implementing interventional strategies to specifically target SO is highlighted.
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- 2020
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17. Interleukin‐1 Blockade Inhibits the Acute Inflammatory Response in Patients With ST‐Segment–Elevation Myocardial Infarction
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Antonio Abbate, Cory R. Trankle, Leo F. Buckley, Michael J. Lipinski, Darryn Appleton, Dinesh Kadariya, Justin M. Canada, Salvatore Carbone, Charlotte S. Roberts, Nayef Abouzaki, Ryan Melchior, Sanah Christopher, Jeremy Turlington, George Mueller, James Garnett, Christopher Thomas, Roshanak Markley, George F. Wohlford, Laura Puckett, Horacio Medina de Chazal, Juan G. Chiabrando, Edoardo Bressi, Marco Giuseppe Del Buono, Aaron Schatz, Chau Vo, Dave L. Dixon, Giuseppe G. Biondi‐Zoccai, Michael C. Kontos, and Benjamin W. Van Tassell
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acute myocardial infarction ,interleukin‐1 ,heart failure ,ST‐segment–elevation myocardial infarction ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background ST‐segment–elevation myocardial infarction is associated with an intense acute inflammatory response and risk of heart failure. We tested whether interleukin‐1 blockade with anakinra significantly reduced the area under the curve for hsCRP (high sensitivity C‐reactive protein) levels during the first 14 days in patients with ST‐segment–elevation myocardial infarction (VCUART3 [Virginia Commonwealth University Anakinra Remodeling Trial 3]). Methods and Results We conducted a randomized, placebo‐controlled, double‐blind, clinical trial in 99 patients with ST‐segment–elevation myocardial infarction in which patients were assigned to 2 weeks treatment with anakinra once daily (N=33), anakinra twice daily (N=31), or placebo (N=35). hsCRP area under the curve was significantly lower in patients receiving anakinra versus placebo (median, 67 [interquartile range, 39–120] versus 214 [interquartile range, 131–394] mg·day/L; P
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- 2020
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18. Low-Density Lipoprotein Receptor–Related Protein-1 Is a Therapeutic Target in Acute Myocardial Infarction
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Stefano Toldo, PhD, Dana Austin, MS, Adolfo G. Mauro, MS, Eleonora Mezzaroma, PhD, Benjamin W. Van Tassell, PharmD, Carlo Marchetti, PhD, Salvatore Carbone, MS, Soren Mogelsvang, PhD, Cohava Gelber, PhD, and Antonio Abbate, MD, PhD
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ischemia reperfusion ,low-density lipoprotein receptor-related protein-1 ,serine protease inhibitor ,SERPINs ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Low-density lipoprotein receptor–related protein-1 (LRP1) is a ubiquitous membrane receptor functioning as a scavenger and regulatory receptor, inducing anti-inflammatory and prosurvival signals. Based on the known structure–activity of the LRP1 receptor binding site, the authors synthesized a small peptide (SP16). SP16 induced a >50% reduction in infarct size (p < 0.001) and preservation of left ventricular systolic function (p < 0.001), and treatment with an LRP1 blocking antibody eliminated the protective effects of SP16. In conclusion, LRP1 activation with SP16 given within 30 min of reperfusion during experimental acute myocardial infarction leads to a cardioprotective signal reducing infarct size and preservation of cardiac systolic function.
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- 2017
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19. Dietary Fat, Sugar Consumption, and Cardiorespiratory Fitness in Patients With Heart Failure With Preserved Ejection Fraction
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Salvatore Carbone, MS, Justin M. Canada, MS, RCEP, Leo F. Buckley, PharmD, Cory R. Trankle, MD, Hayley E. Billingsley, RD, Dave L. Dixon, PharmD, Adolfo G. Mauro, MS, Sofanit Dessie, MD, Dinesh Kadariya, MD, Eleonora Mezzaroma, PhD, Raffaella Buzzetti, MD, Ross Arena, PhD, Benjamin W. Van Tassell, PharmD, Stefano Toldo, PhD, and Antonio Abbate, MD, PhD
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body composition ,diet ,heart failure with preserved ejection fraction ,obesity ,unsaturated fatty acids ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Heart failure with preserved ejection fraction (HFpEF) is associated with obesity and, indirectly, with unhealthy diet. The role of dietary components in HFpEF is, however, largely unknown. In this study, the authors showed that in obese HFpEF patients, consumption of unsaturated fatty acids (UFA), was associated with better cardiorespiratory fitness, and UFA consumption correlated with better diastolic function and with greater fat-free mass. Similarly, mice fed with a high-fat diet rich in UFA and low in sugars had preserved myocardial function and reduced weight gain. Randomized clinical trials increasing dietary UFA consumption and reducing sugar consumption are warranted to confirm and expand our findings.
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- 2017
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20. Metabolic modulation predicts heart failure tests performance.
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Daniel Contaifer, Leo F Buckley, George Wohlford, Naren G Kumar, Joshua M Morriss, Asanga D Ranasinghe, Salvatore Carbone, Justin M Canada, Cory Trankle, Antonio Abbate, Benjamin W Van Tassell, and Dayanjan S Wijesinghe
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Medicine ,Science - Abstract
The metabolic changes that accompany changes in Cardiopulmonary testing (CPET) and heart failure biomarkers (HFbio) are not well known. We undertook metabolomic and lipidomic phenotyping of a cohort of heart failure (HF) patients and utilized Multiple Regression Analysis (MRA) to identify associations to CPET and HFBio test performance (peak oxygen consumption (Peak VO2), oxygen uptake efficiency slope (OUES), exercise duration, and minute ventilation-carbon dioxide production slope (VE/VCO2 slope), as well as the established HF biomarkers of inflammation C-reactive protein (CRP), beta-galactoside-binding protein (galectin-3), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP)). A cohort of 49 patients with a left ventricular ejection fraction < 50%, predominantly males African American, presenting a high frequency of diabetes, hyperlipidemia, and hypertension were used in the study. MRA revealed that metabolic models for VE/VCO2 and Peak VO2 were the most fitted models, and the highest predictors' coefficients were from Acylcarnitine C18:2, palmitic acid, citric acid, asparagine, and 3-hydroxybutiric acid. Metabolic Pathway Analysis (MetPA) used predictors to identify the most relevant metabolic pathways associated to the study, aminoacyl-tRNA and amino acid biosynthesis, amino acid metabolism, nitrogen metabolism, pantothenate and CoA biosynthesis, sphingolipid and glycerolipid metabolism, fatty acid biosynthesis, glutathione metabolism, and pentose phosphate pathway (PPP). Metabolite Set Enrichment Analysis (MSEA) found associations of our findings with pre-existing biological knowledge from studies of human plasma metabolism as brain dysfunction and enzyme deficiencies associated with lactic acidosis. Our results indicate a profile of oxidative stress, lactic acidosis, and metabolic syndrome coupled with mitochondria dysfunction in patients with HF tests poor performance. The insights resulting from this study coincides with what has previously been discussed in existing literature thereby supporting the validity of our findings while at the same time characterizing the metabolic underpinning of CPET and HFBio.
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- 2019
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21. C-Reactive Protein and N-Terminal Pro-brain Natriuretic Peptide Levels Correlate With Impaired Cardiorespiratory Fitness in Patients With Heart Failure Across a Wide Range of Ejection Fraction
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Jessie van Wezenbeek, Justin M. Canada, Krishna Ravindra, Salvatore Carbone, Cory R. Trankle, Dinesh Kadariya, Leo F. Buckley, Marco Del Buono, Hayley Billingsley, Michele Viscusi, George F. Wohlford, Ross Arena, Benjamin Van Tassell, and Antonio Abbate
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heart failure ,biomarker ,systemic inflammation ,myocardial strain ,cardiorespiratory fitness ,cardiopulmonary exercise testing ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Impaired cardiorespiratory fitness (CRF) is a hallmark of heart failure (HF). Serum levels of C-reactive protein (CRP), a systemic inflammatory marker, and of N-terminal pro-brain natriuretic peptide (NT-proBNP), a biomarker of myocardial strain, independently predict adverse outcomes in HF patients. Whether CRP and/or NT-proBNP also predict the degree of CRF impairment in HF patients across a wide range of ejection fraction is not yet established.Methods: Using retrospective analysis, 200 patients with symptomatic HF who completed one or more treadmill cardiopulmonary exercise tests (CPX) using a symptom-limited ramp protocol and had paired measurements of serum high-sensitivity CRP and NT-proBNP on the same day were evaluated. Univariate and multivariate correlations were evaluated with linear regression after logarithmic transformation of CRP (log10) and NT-proBNP (logN).Results: Mean age of patients was 57 ± 10 years and 55% were male. Median CRP levels were 3.7 [1.5–9.0] mg/L, and NT-proBNP levels were 377 [106–1,464] pg/ml, respectively. Mean peak oxygen consumption (peak VO2) was 16 ± 4 mlO2•kg−1•min−1. CRP levels significantly correlated with peakVO2 in all patients (R = −0.350, p < 0.001) and also separately in the subgroup of patients with reduced left ventricular ejection fraction (LVEF) (HFrEF, N = 109) (R = −0.282, p < 0.001) and in those with preserved EF (HFpEF, N = 57) (R = −0.459, p < 0.001). NT-proBNP levels also significantly correlated with peak VO2 in all patients (R = −0.330, p < 0.001) and separately in patients with HFrEF (R = −0.342, p < 0.001) and HFpEF (R = −0.275, p = 0.032). CRP and NT-proBNP did not correlate with each other (R = 0.05, p = 0.426), but independently predicted peak VO2 (R = 0.421, p < 0.001 and p < 0.001, respectively).Conclusions: Biomarkers of inflammation and myocardial strain independently predict peak VO2 in HF patients. Anti-inflammatory therapies and therapies alleviating myocardial strain may independently improve CRF in HF patients across a large spectrum of LVEF.
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- 2018
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22. Lifestyle Interventions with a Focus on Nutritional Strategies to Increase Cardiorespiratory Fitness in Chronic Obstructive Pulmonary Disease, Heart Failure, Obesity, Sarcopenia, and Frailty
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Hayley Billingsley, Paula Rodriguez-Miguelez, Marco Giuseppe Del Buono, Antonio Abbate, Carl J Lavie, and Salvatore Carbone
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cardiorespiratory fitness ,peak oxygen consumption ,cardiopulmonary exercise testing ,chronic obstructive pulmonary disease ,heart failure ,obesity ,sarcopenia ,frailty ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Cardiorespiratory fitness (CRF) is an independent predictor for all-cause and disease-specific morbidity and mortality. CRF is a modifiable risk factor, and exercise training and increased physical activity, as well as targeted medical therapies, can improve CRF. Although nutrition is a modifiable risk factor for chronic noncommunicable diseases, little is known about the effect of dietary patterns and specific nutrients on modifying CRF. This review focuses specifically on trials that implemented dietary supplementation, modified dietary pattern, or enacted caloric restriction, with and without exercise training interventions, and subsequently measured the effect on peak oxygen consumption (VO2) or surrogate measures of CRF and functional capacity. Populations selected for this review are those recognized to have a reduced CRF, such as chronic obstructive pulmonary disease, heart failure, obesity, sarcopenia, and frailty. We then summarize the state of existing knowledge and explore future directions of study in disease states recently recognized to have an abnormal CRF.
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- 2019
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23. Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis
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William L. Baker, Leo F. Buckley, Michael S. Kelly, John D. Bucheit, Eric D. Parod, Roy Brown, Salvatore Carbone, Antonio Abbate, and Dave L. Dixon
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ambulatory blood pressure monitoring ,diabetes mellitus ,diabetic therapy/glitazones ,high blood pressure ,hypertension ,metformin ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundSodium‐glucose cotransporter 2 (SGLT2) inhibitors are a novel class of antihyperglycemic agents that improve glycemic control by increasing glycosuria. Additional benefits beyond glucose lowering include significant improvements in seated clinic blood pressure (BP), partly attributed to their diuretic‐like actions. Less known are the effects of this class on 24‐hour ambulatory BP, which is a better predictor of cardiovascular risk than seated clinic BP. Methods and ResultsWe performed a meta‐analysis of randomized, double‐blind, placebo‐controlled trials to investigate the effects of SGLT2 inhibitors on 24‐hour ambulatory BP. We searched all studies published before August 17, 2016, which reported 24‐hour ambulatory BP data. Mean differences in 24‐hour BP, daytime BP, and nighttime BP were calculated by a random‐effects model. SGLT2 inhibitors significantly reduce 24‐hour ambulatory systolic and diastolic BP by −3.76 mm Hg (95% CI, −4.23 to −2.34; I2=0.99) and −1.83 mm Hg (95% CI, −2.35 to −1.31; I2=0.76), respectively. Significant reductions in daytime and nighttime systolic and diastolic BP were also found. No association between baseline BP or change in body weight were observed. ConclusionsThis meta‐analysis shows that the reduction in 24‐hour ambulatory BP observed with SGLT2 inhibitors is a class effect. The diurnal effect of SGLT2 inhibitors on 24‐hour ambulatory BP may contribute to their favorable effects on cardiovascular outcomes.
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- 2017
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24. 3415 Percent Predicted Peak Exercise Oxygen Pulse Is a Marker of Cardiac Reserve Following Thoracic Radiotherapy
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Justin McNair Canada, Elisabeth Weiss, John Grizzard, Ronald Evans, Ryan Garten, Benjamin Van Tassell, Salvatore Carbone, Cory R. Trankle, Hayley Billingsley, Dinesh Kadariya, and Antonio Abbate
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Medicine - Abstract
OBJECTIVES/SPECIFIC AIMS: Cardiac radiation exposure following anti-cancer (CA) thoracic radiotherapy (RT) treatment increases risk of heart failure in a dose-dependent manner with a predominantly restrictive cardiomyopathy phenotype and is characterized by a diffuse fibrosis within the myocardium. The peak oxygen pulse (O2Pulse) determined at cardiopulmonary exercise testing (CPET) is the quotient of oxygen consumption (VO2) divided by the heart rate (HR) at peak exercise. Through deduction of the Fick equation (VO2 = cardiac output (CO) x arteriovenous oxygen difference) it provides a noninvasive estimate of the stroke volume response to exercise. Knowledge of the relationship between cardiac radiation dose and O2Pulse may provide mechanistic insight into the cardiac reserve of the CA survivor following thoracic RT. METHODS/STUDY POPULATION: Patients without a history of cardiovascular disease with a history of thoracic RT for CA treatment with significant incidental heart exposure (≥5 Gray (Gy) to ≥10% of the heart volume) underwent treadmill CPET to determine cardiorespiratory fitness and cardiac magnetic resonance (CMR) imaging to quantify central hemodynamics and for myocardial tissue characterization. The mean cardiac radiation dose (MCRD) and %volume of heart dose was determined from dose-volume histograms reflective of the dose contributions from all RT treatments for each patient. The oxygen pulse (milliliters (mL) of O2 per heart beat) was determined by dividing the absolute VO2 by the HR (beats per minute, bpm) at peak exercise and reported as %-predicted values to account for age and gender differences. Data are reported as number (%) or median (interquartile range). A stepwise multivariate linear regression model was created from significant univariate RT and CMR variables to determine independent predictors of %O2Pulse. RESULTS/ANTICIPATED RESULTS: Thirty patients (age = 63 [57-67] years, 18 [60%] female, 2.0 [0.1-28.7] years since completion of RT) underwent study procedures. The peak VO2=1376 mL·min-1 (62% of predicted) and peak HR = 150 (122-164) bpm resulted in a peak O2Pulse of 9.2 mL/beat (82% of predicted). The MCRD = 5.6 [3.7-17.8] Gy was inversely associated with %O2Pulse at univariate analysis (R = −0.514, p < .01), but was not retained at multivariate analysis. The CMR-derived CO ([4.9 (4.09-5.90) Liters/minute], β = +.374, p < .01), CMR-extracellular volume ([ECV, 26.9 (24.8-29.2)%], β = −.536, p < .01), and volume of the heart exposed to ≥30 Gy ([2.5 (0-15.0)Gy], (β = −.345, p = .01) were retained in the model (R2 = .709, F(3,19) = 15.438, p < .001) and were independent predictors of the %O2Pulse. DISCUSSION/SIGNIFICANCE OF IMPACT: In patients with significant heart exposure following RT, %O2Pulse (a surrogate of stroke volume response to exercise) is inversely associated with cardiac radiation dose and is related to central hemodynamics (CO) and markers of diffuse fibrosis (ECV).
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- 2019
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25. 3426 Increased Monounsaturated Fat Consumption is Associated with Improved Body Composition in Subjects with Obesity and Heart Failure with Preserved Ejection Fraction
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Hayley Billingsley, Salvatore Carbone, Brando Rotelli, Dinesh Kadariya, Justin M. Canada, Roshanak Markley, and Antonio Abbate
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Medicine - Abstract
OBJECTIVES/SPECIFIC AIMS: We hypothesized that increasing percent calories from MUFA (%MUFA) would be associated an increased FFM/FM index. METHODS/STUDY POPULATION: Nine consecutive HFpEF patients with obesity participated in a 12-week pilot feasibility trial of UFA supplementation (NCT03310099). Subjects were educated at baseline by a dietitian on UFA rich foods including high MUFA choices such as extra-virgin olive oil, canola oil and avocados. Participants were given a list of items, corresponding serving sizes and asked to eat at least one serving of these UFA rich foods per day for 12 weeks. Adherence was encouraged through weekly phone calls by the dietitian. Standardized 5-pass 24-hour dietary recall was performed by a dietitian at baseline and 12 weeks. The recalls were analyzed to establish intake of MUFA in percent calories (%kcals) with Nutrition Data Systems for Research software (NDSR). Body composition including FM%, fat free mass percent of body weight (FFM%) and ratio of FFM to FM (FFM/FM Index) was measured with bioelectrical impedance analysis (RJL systems) at baseline and 12 weeks. Statistical analysis was performed with SPSS (24.0). Spearman rank test was used for correlations. Values are expressed as numbers and percentages or as median and interquartile range (IQR). RESULTS/ANTICIPATED RESULTS: Subjects were mostly female (56%) with a median age 56 (IQR 50-59). Baseline median body mass index (kg/m2) was 36.7 (36.2-48.0), median FM% was 44.5 (IQR 32.5-53.4), median FFM% was 55.5 (IQR 46.7-67.5) and median FFM/FM Index was 1.25 (IQR 0.88-2.1).The only significant change was an increase in %MUFA from baseline 12.4% (IQR 6.9-14.3) to 12 weeks 21.8% (17.6-36.9) (p = 0.008). Increased %MUFA was highly associated with increased FFM% (r = 0.783, p = 0.013) (Figure 1A), decreased FM%(r = −0.783, p = 0.013)(Figure 1B) and increased FFM/FM index (r = 0.800, p = 0.010) (Figure 1C). All correlations remained statistically significant after adjustment for changes in energy intake. DISCUSSION/SIGNIFICANCE OF IMPACT: Increasing dietary %MUFA is protective against negative changes in body composition in patients with obesity and HFpEF, independent of changes in caloric intake. Future work should focus on whether the correlation found in this pilot study translate in improved body composition and finally, exercise tolerance and clinical outcomes.
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- 2019
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26. 2438
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Salvatore Carbone, Benjamin Van Tassell, Antonio Abbate, Justin Canada, Leo F. Buckley, Sade Johns, Dinesh Kadariya, and F. Gerard Moeller
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Medicine - Abstract
OBJECTIVES/SPECIFIC AIMS: Cocaine use is a significant health problem in the United States and associated with increased risk of adverse cardiovascular outcomes. Our goal was to evaluate the effects of rapid cocaine infusions on cardiovascular hemodynamics among patients with cocaine abuse disorder. METHODS/STUDY POPULATION: Patients with a history of cocaine abuse but no overt cardiovascular disease received 4 consecutive intravenous infusions of cocaine (0, 10, 20, 40 mg) given in randomized, double-blinded order. The infusion procedure was repeated on 2 consecutive days (4 infusions each day). Following each dose, patients underwent continuous monitoring via fingertip plethysmography for 30 minutes, followed by an additional 30 minutes washout procedure. Patients were surveyed throughout this timeline to record symptoms of cocaine response. Finger tracings were then used to calculate arterial pressure curves and parameters of heart rate, blood pressure, cardiac output, stroke volume, and systemic vascular resistance according to device-specific algorithms. Mean values were calculated over the entire 30 minutes follow-up and peak values were defined as the maximum value sustained over any 60-second interval during the follow-up period. RESULTS/ANTICIPATED RESULTS: Seven patients were enrolled and received cocaine infusions of 2 consecutive days. Cocaine dose was positively associated with mean cardiac output (R=0.489, p
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- 2017
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27. 2390
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Justin M. Canada, Hayley Billingsly, Leo Buckley, Salvatore Carbone, Dinesh Kadariya, Benjamin Van Tassell, Antonio Abbate, and Mohammad Siddiqui
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Medicine - Abstract
OBJECTIVES/SPECIFIC AIMS: Nonalcoholic fatty liver disease (NAFLD) affects 1 in 3 Americans and can exist in 2 histological subtypes: simple hepatic steatosis (SHS) and nonalcoholic steatohepatitis (NASH), a clinically aggressive variant. Fatigue is the most common complaint in patients with NAFLD but the etiology of fatigue is unknown. Thus, the goal of this study was to objectively evaluate fatigue via maximal cardiopulmonary exercise testing and identify determinants of exercise intolerance in NAFLD. METHODS/STUDY POPULATION: In total, 14 subjects with histologically confirmed NAFLD were prospectively enrolled. Subjects with cirrhosis or those with known history of heart failure (systolic or diastolic) were excluded. Fatigue was quantified via the Duke Activity Status Index (DASI) questionnaire. A symptom-limited treadmill cardiopulmonary exercise test was performed in all subjects to measure exercise time (ET) and peak oxygen consumption (peak VO2). Doppler-echocardiography was performed to measure systolic and diastolic function. RESULTS/ANTICIPATED RESULTS: The DASI score and ET was significantly reduced in patients with NASH (n=10) when compared to those with SHS [40.2 (IQR=24.2–50.7) vs. 58.2 (IQR=50.7–58.2), p=0.04]; [9.1 (IQR=6.4–12.2) vs. 13.1 (IQR=12.5–13.1) min, p=0.02, respectively] reflecting moderate fatigue and impaired overall exercise capacity. The ET was directly linked to peak VO2 (R=+0.79, p
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- 2017
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28. Dietary Fats and Chronic Noncommunicable Diseases
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Hayley E. Billingsley, Salvatore Carbone, and Carl J. Lavie
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cardiometabolic disease ,unsaturated fat ,Mediterranean diet ,low-fat diet ,Nutrition. Foods and food supply ,TX341-641 - Abstract
The role of dietary fat has been long studied as a modifiable variable in the prevention and treatment of noncommunicable cardiometabolic disease. Once heavily promoted to the public, the low-fat diet has been demonstrated to be non-effective in preventing cardiometabolic disease, and an increasing body of literature has focused on the effects of a relatively higher-fat diet. More recent evidence suggests that a diet high in healthy fat, rich in unsaturated fatty acids, such as the Mediterranean dietary pattern, may, in fact, prevent the development of metabolic diseases such as type 2 diabetes mellitus, but also reduce cardiovascular events. This review will specifically focus on clinical trials which collected data on dietary fatty acid intake, and the association of these fatty acids over time with measured cardiometabolic health outcomes, specifically focusing on morbidity and mortality outcomes. We will also describe mechanistic studies investigating the role of dietary fatty acids on cardiovascular risk factors to describe the potential mechanisms of action through which unsaturated fatty acids may exert their beneficial effects. The state of current knowledge on the associations between dietary fatty acids and cardiometabolic morbidity and mortality outcomes will be summarized and directions for future work will be discussed.
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- 2018
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29. Diet-Induced Obesity HFpEF Murine Models
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Salvatore Carbone, PhD, MS, Adolfo G. Mauro, MS, Stefano Toldo, PhD, and Antonio Abbate, MD, PhD
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2018
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30. 2363
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Leo Buckley, Justin Canada, Salvatore Carbone, Cory Trankle, Michele Mattia Viscusi, Jessica Regan, Dave Dixon, Nayef Abouzaki, Sanah Christopher, Hayley Billingsley, Dinesh Kadariya, Ross Arena, Antonio Abbate, and Benjamin Van Tassell
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Medicine - Abstract
OBJECTIVES/SPECIFIC AIMS: Our goal was to compare the ventriculo-arterial coupling and left ventricular mechanical work of patients with systolic and diastolic heart failure (SHF and DHF). METHODS/STUDY POPULATION: Patients with New York Heart Association Functional Class II-III HF symptoms were included. SHF was defined as left ventricular (LV) ejection fraction50%. Analysis of the fingertip arterial blood pressure tracing captured with a finger plethysmography cuff according to device-specific algorithms provided brachial artery blood pressure and stroke volume. LV end-systolic volume was measured separately via transthoracic echocardiography. Arterial elastance (Ea), a measure of pulsatile and nonpulsatile LV afterload, was calculated as LV end-systolic pressure (ESP)/end-diastolic volume. End-systolic elastance (Ees), a measure of load-independent LV contractility, was calculated as LV ESP/end-systolic volume. Ventriculo-arterial coupling (VAC) ratio was defined as Ea/Ees. Stroke work (SWI) was calculated as stroke volume index×LV end-systolic pressure×0.0136 and potential energy index (PEI) as 1/2×(LV end-systolic volume×LV end-systolic pressure×0.0136). Total work index (TWI) was the sum of SWI+PEI. RESULTS/ANTICIPATED RESULTS: Patients with SHF (n=52) and DHF (n=29) were evaluated. Median (IQR) age was 57 (51–64) years. There were 48 (58%) and 59 (71%) patients were male and African American, respectively. Cardiac index was 2.8 (2.2–3.2) L/minute and 3.0 (2.8–3.3) L/minute in SHF and DHF, respectively (p=0.12). Self-reported activity levels (Duke Activity Status Index, p=0.48) and heart failure symptoms (Minnesota Living with Heart Failure Questionnaire, p=0.55) were not different between SHF and DHF. Ea was significantly lower in DHF compared with SHF patients [1.3 (1.2–1.6) vs. 1.7 (1.4–2.0) mmHg; p
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- 2017
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31. 2544
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Hayley Billingsley, Salvatore Carbone, Justin M. Canada, Leo Buckley, Dave L. Dixon, Dinesh Kadariya, Sofanit Dessie, Benjamin W. Van Tassell, Antonio Abbate, and Mohammad Siddiqui
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Medicine - Abstract
OBJECTIVES/SPECIFIC AIMS: Nonalcoholic steatohepatitis (NASH) is a common cause of chronic liver disease in the United States characterized by fat accumulation, inflammation, and fibrosis. Higher amounts of fat-free mass (FFM) and lower amounts of fat mass (FM) have been associated with better outcomes in several chronic diseases, recently also in NASH. Body composition is highly influenced by diet. However, the role of diet on body composition in patients with NASH is largely unknown. We hypothesized that consumption of polyunsaturated fatty acids (PUFA), healthy fatty acids mainly found in fish, nuts, and some vegetable oils, is associated with improved body composition, specifically greater FFM and lower FM, in NASH patients. METHODS/STUDY POPULATION: In total, 13 patients with histologically confirmed NASH underwent body composition testing via bioelectrical impedance analysis to estimate FFM% (% of body weight), FM% (% of body weight), and FFM/FM ratio. PUFA and saturated fat consumption was determined by standardized 5-pass 24-hour dietary recall. Correlations were computed using the Spearman rank test. RESULTS/ANTICIPATED RESULTS: Median body mass index (BMI) was 35.7 kg/m2 (32.8–42.7), median age of the sample was 50 years (46.3–57.3), and 73% were female. Median percent of calories from polyunsaturated fat was 6.8% (5.4–9.6). Percent of calories from PUFA was positively and significantly associated with greater FFM% (R=0.56, p=0.049), lower FM% (R=−0.59, p=0.035), and greater FFM/FM ratio (R=0.58, p=0.037). Additionally, a higher PUFA to saturated fatty acids ratio was also significantly correlated with greater FFM% (R=0.58, p=0.039), lower FM% (R=−0.64, p=0.020), and greater FFM/FM ratio (R=0.57, p=0.043). DISCUSSION/SIGNIFICANCE OF IMPACT: In patients with NASH, the consumption of PUFA is associated with higher FFM and lower FM, which suggests a protective role of these nutrients on body composition. A larger study on patients with NASH is warranted to confirm our findings on PUFA consumption and body composition, as well as to determine whether these effects will improve clinical outcomes.
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- 2017
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32. Abnormal left ventricular subendocardial perfusion and diastolic function in women with obesity and heart failure and preserved ejection fraction
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Roshanak Markley, Marco Giuseppe Del Buono, Virginia Mihalick, Alexander Pandelidis, Cory Trankle, Jennifer H. Jordan, Kevin Decamp, Chris Winston, Salvatore Carbone, Hayley Billingsley, Andrew Barron, Georgia Thomas, Benjamin Van Tassell, W. Gregory Hundley, Peter Kellman, and Antonio Abbate
- Abstract
Purpose – Coronary microvascular dysfunction (CMD) is common in patients with heart failure with preserved ejection fraction (HFpEF) and obesity. Stress cardiovascular magnetic resonance (CMR) has been proposed as a non-invasive tool for detection of CMD. The aim of this study was to determine relationship between CMD and diastolic function in patients with HFpEF using a novel CMR technique. Methods – Patients with obesity and HFpEF without epicardial coronary artery disease (CAD) underwent Doppler echocardiography to measure diastolic function, followed by vasodilator stress CMR, using a single bolus, dual sequence, quantitative myocardial perfusion mapping to measure myocardial blood flow (MBF) at rest and at peak hyperemia. With this, myocardial perfusion reserve (MPR), global stress endocardial-to-epicardial (endo:epi) perfusion ratio, and total ischemic burden (IB, defined as myocardial segments with MBF Results – Nineteen subjects were enrolled (100% female, 42% Black). Median age was 64 [56–72] years. Global stress MBF was 2.43 ml/min/g [2.16–2.78] and global myocardial perfusion reserve (MPR) was 2.34 [2.07–2.88]. All had an abnormal subendocardial perfusion with an endo:epi of less than 1 (0.87 [0.81–0.90]). Regional myocardial hypoperfusion was detected in 14 (74%) patients with an IB of 6% [0-34.4]. Endo:epi ratio significantly correlated with IB (R=-0.510, p = 0.026) and measures of diastolic function (R = 0.531, p = 0.019 and R=-0.544, p = 0.014 for e’ and E/e’ respectively). Conclusion – Using a novel quantitative stress CMR myocardial perfusion mapping technique, women with obesity and HFpEF were found to have patterns of abnormal subendocardial perfusion which significantly correlated with measures of diastolic dysfunction.
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- 2023
33. Recognizing risk factors associated with poor outcomes among patients with COVID-19
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Paula Rodriguez-Miguelez, Allison Heefner, and Salvatore Carbone
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Cardiology and Cardiovascular Medicine - Published
- 2023
34. Chronic Electronic Cigarette Users Exhibit Reduced Cardiorespiratory Fitness and Associated Increased Cardiovascular Disease Risk
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Tijana Simovic, Chloe Matheson, Kolton Cobb, Allison Heefner, Christopher Thode, Hayley Billingsley, Hannah Salmons, Syed Imran Ahmed, Salvatore Carbone, Ryan Garten, Alison Breland, Caroline Cobb, Patrick Nana-Sinkam, and Paula Rodriguez-Miguelez
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Physiology - Abstract
BACKGROUND: Electronic cigarettes (e-cigs) are popular tobacco products that are currently advertised as a safer alternative to traditional cigarettes. Preliminary data, primarily from animal studies, suggests that e-cigs are associated with an increased cardiovascular disease (CVD) risk. Cardiorespiratory fitness is a marker of cardiovascular (CV) health and a predictor of CV mortality, which is diminished in traditional tobacco users. However, the effect of chronic e-cigs usage on cardiorespiratory fitness and associated CVD risk in otherwise healthy individuals without established CVD or CVD risk factor, is currently unknown. PURPOSE: The purpose of this study was to investigate the impact of chronic e-cig use on cardiorespiratory fitness and CVD risk in healthy young adults. METHODS: Ten chronic e-cig users (ECU, 4 males and 6 females; age: 24±3 yr; e-cigs usage 3±1.5 yr.) and ten demographical matched, never users (NU, 4 males and 6 females; age: 22.7±2 yr.) participated in this study. Cardiorespiratory fitness was measured by peak oxygen consumption (VO2peak) via a respiratory gas exchange analyzer during a cardiopulmonary exercise test. CVD risk was calculated using Framingham’s 30-year CVD risk score accounting for 8 risk factors (age, sex, systolic blood pressure, total cholesterol, high-density lipoprotein, presence of diabetes mellitus, hypertension treatment, and smoking status). RESULTS: Chronic e-cig users exhibited significantly lower VO2peak (ECU vs. NU; 30.9±4.9 vs. 37.8±6.4 ml/kg/min; p=0.015) and percent predicted (ECU vs. NU; 85.9±16 vs. 105.4±14 % predicted; p=0.001) when compared to never users. Framingham’s 30-year CVD risk score was significantly higher in ECU than in NU (7.7± 4.8, vs. 2.7±0.8 %; p=0.017). Furthermore, an inverse association was identified between VO2peak and 30-year CVD risk ( r=-0.720; p= 0.030). CONCLUSIONS: For the first time, we have identified significantly reduced cardiorespiratory fitness, a marker of CV health and mortality risk, in chronic e-cig users when compared to never users. In addition, chronic e-cig users exhibit higher CVD risk scores. Results from our study imply a negative effect of chronic e-cig use on CV health in otherwise young, apparently healthy adults. Future studies are warranted to investigate the long-term effects of e-cig use on CV health. Supported in part by a Rapid Response Project NIDA/FDA (PRM). Supported in part by a Rapid Response Project NIDA/FDA (PRM). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
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- 2023
35. Weighing in on weight loss in heart failure with reduced ejection fraction
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Salvatore, Carbone, Adrian, daSilva-deAbreu, and Carl J, Lavie
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Cardiology and Cardiovascular Medicine - Published
- 2023
36. Intramuscular and Intermuscular Adipose Tissue in Older Adults
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Salvatore Carbone
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Cardiology and Cardiovascular Medicine - Published
- 2022
37. Combined Use of Voltage Mapping and Speckle-tracking Analysis for the Characterization of Arrhythmogenic Right Ventricular Cardiomyopathy: A Case Report
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AMATO SANTORO, NICOLò SISTI, CLAUDIA BAIOCCHI, GIULIA MANDOLI, ANTONIO BIANCOFIORE, SIMONE PISTORESI, VALERIO ZACà, SALVATORE CARBONE, MARTA FOCARDI, FLAVIO D’ASCENZI, and MATTEO CAMELI
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- 2022
38. Change in Eosinophil Count in Patients with Heart Failure Treated with Anakinra
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Golino, M, Moroni, F, Giuseppe Del Buono, M, Canada, J, Talasaz, A, Piñel, S, Mbualungu, J, Vecchiè, A, (Jane) Ho, A, Thomas, G, Carbone, S, Billingsley, H, Turlington, J, Markley, R, Trankle, C, De Ponti, R, Van Tassell, B, Abbate, A, Michele Golino, Francesco Moroni, Marco Giuseppe Del Buono, Justin M. Canada, Azita H. Talasaz, Sebastian Piñel, James Mbualungu, Alessandra Vecchiè, Ai-Chen (Jane) Ho, Georgia K. Thomas, Salvatore Carbone, Hayley E. Billingsley, Jeremy Turlington, Roshanak Markley, Cory Trankle, Roberto De Ponti, Benjamin Van Tassell, Antonio Abbate, Golino, M, Moroni, F, Giuseppe Del Buono, M, Canada, J, Talasaz, A, Piñel, S, Mbualungu, J, Vecchiè, A, (Jane) Ho, A, Thomas, G, Carbone, S, Billingsley, H, Turlington, J, Markley, R, Trankle, C, De Ponti, R, Van Tassell, B, Abbate, A, Michele Golino, Francesco Moroni, Marco Giuseppe Del Buono, Justin M. Canada, Azita H. Talasaz, Sebastian Piñel, James Mbualungu, Alessandra Vecchiè, Ai-Chen (Jane) Ho, Georgia K. Thomas, Salvatore Carbone, Hayley E. Billingsley, Jeremy Turlington, Roshanak Markley, Cory Trankle, Roberto De Ponti, Benjamin Van Tassell, and Antonio Abbate
- Abstract
Background: Interleukin-1 blockade with anakinra leads to a transient increase in eosinophil blood count (eosinophils) in patients with acute myocardial infarction. We aimed to investigate the effect of anakinra on changes in eosinophils in patients with heart failure (HF) and their correlation with cardiorespiratory fitness (CRF). Methods: We measured eosinophils in 64 patients with HF (50% females), 55 (51–63) years of age, before and after treatment, and, in a subset of 41 patients, also after treatment cessation. We also evaluated CRF, measuring peak oxygen consumption (VO2) with a treadmill test. Results: Treatment with anakinra significantly and transiently increased eosinophils, from 0.2 [0.1–0.3] to 0.3 [0.1–0.4] × 103 cells/µL (p < 0.001) and from 0.3 [0.2–0.5] to 0.2 [0.1–0.3] × 103 cells/µL, with suspension (p < 0.001). Changes in eosinophils correlated with the changes in peak VO2 (Spearman’s Rho = +0.228, p = 0.020). Eosinophils were higher in patients with injection site reactions (ISR) (n = 8, 13%; 0.5 [0.4–0.6] vs. 0.2 [0.1–0.4] × 103 cells/µL, p = 0.023), who also showed a greater increase in peak VO2 (3.0 [0.9–4.3] vs. 0.3 [−0.6–1.8] mLO2·kg−1·min−1, p = 0.015). Conclusion: Patients with HF treated with anakinra experience a transient increase in eosinophils, which is associated with ISR and a greater improvement in peak VO2.
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- 2023
39. Better pharmacotherapy in heart failure with reduced ejection fraction may partly explain the obesity paradox
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Salvatore Carbone, Andrew Elagizi, and Carl J. Lavie
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Cardiology and Cardiovascular Medicine - Published
- 2023
40. Review for 'Pleiotropic effects of GLP‐1RAs on peripheral artery disease: Is there any hope?'
- Author
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Salvatore Carbone
- Published
- 2023
41. Nutrition Assessment and Dietary Interventions in Heart Failure
- Author
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Elissa Driggin, Laura P. Cohen, Dympna Gallagher, Wahida Karmally, Thomas Maddox, Scott L. Hummel, Salvatore Carbone, and Mathew S. Maurer
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
42. Diabetes Status Modifies the Association Between Different Measures of Obesity and Heart Failure Risk Among Older Adults: A Pooled Analysis of Community-Based NHLBI Cohorts
- Author
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Matthew W Segar, Jaime P. Almandoz, Salvatore Carbone, Corby K. Martin, Nitin Kondamudi, Ambarish Pandey, Ian J. Neeland, Javed Butler, Tiffany M. Powell-Wiley, Kershaw V. Patel, and Carl J. Lavie
- Subjects
Male ,medicine.medical_specialty ,Waist ,Article ,Cohort Studies ,Risk Factors ,Physiology (medical) ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,Obesity ,Prediabetes ,Abdominal obesity ,Aged ,Heart Failure ,business.industry ,medicine.disease ,United States ,Cohort ,Attributable risk ,Female ,medicine.symptom ,National Heart, Lung, and Blood Institute (U.S.) ,Cardiology and Cardiovascular Medicine ,business ,Body mass index - Abstract
Background: Obesity and diabetes are associated with a higher risk of heart failure (HF). The interrelationships between different measures of adiposity—overall obesity, central obesity, fat mass (FM)—and diabetes status for HF risk are not well-established. Methods: Participant-level data from the ARIC study (Atherosclerosis Risk in Communities; visit 5) and the CHS (Cardiovascular Health Study; visit 1) cohorts were obtained from the National Heart, Lung, and Blood Institute Biologic Specimen and Data Repository Information Coordinating Center, harmonized, and pooled for the present analysis, excluding individuals with prevalent HF. FM was estimated in all participants using established anthropometric prediction equations additionally validated using the bioelectrical impedance-based FM in the ARIC subgroup. Incident HF events on follow-up were captured across both cohorts using similar adjudication methods. Multivariable-adjusted Fine-Gray models were created to evaluate the associations of body mass index (BMI), waist circumference (WC), and FM with risk of HF in the overall cohort as well as among those with versus without diabetes at baseline. The population attributable risk of overall obesity (BMI≥30 kg/m 2 ), abdominal obesity (WC>88 and 102 cm in women and men, respectively), and high FM (above sex-specific median) for incident HF was evaluated among participants with and without diabetes. Results: The study included 10 387 participants (52.9% ARIC; 25.1% diabetes; median age, 74 years). The correlation between predicted and bioelectrical impedance-based FM was high ( R 2 =0.90; n=5038). During a 5-year follow-up, 447 participants developed HF (4.3%). Higher levels of each adiposity measure were significantly associated with higher HF risk (hazard ratio [95% CI] per 1 SD higher BMI=1.15 [1.05, 1.27], WC=1.22 [1.10, 1.36]; FM=1.13 [1.02, 1.25]). A significant interaction was noted between diabetes status and measures of BMI ( P interaction=0.04) and WC ( P interaction=0.004) for the risk of HF. In stratified analysis, higher measures of each adiposity parameter were significantly associated with higher HF risk in individuals with diabetes (hazard ratio [95% CI] per 1 SD higher BMI=1.29 [1.14–1.47]; WC=1.48 [1.29–1.70]; FM=1.25 [1.09–1.43]) but not those without diabetes, including participants with prediabetes and euglycemia. The population attributable risk percentage of overall obesity, abdominal obesity, and high FM for incident HF was higher among participants with diabetes (12.8%, 29.9%, and 13.7%, respectively) versus those without diabetes (≤1% for each). Conclusions: Higher BMI, WC, and FM are strongly associated with greater risk of HF among older adults, particularly among those with prevalent diabetes.
- Published
- 2022
43. Resistance exercise for cardiac rehabilitation
- Author
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Danielle L. Kirkman, Duck-chul Lee, and Salvatore Carbone
- Subjects
Cardiac Rehabilitation ,Cardiovascular Diseases ,Quality of Life ,Humans ,Resistance Training ,Cardiology and Cardiovascular Medicine ,Exercise ,Article ,Exercise Therapy - Abstract
Lean mass abnormalities are highly prevalent in patients referred for cardiac rehabilitation (CR). As such, current guidelines recommend incorporating resistance exercise (RE) into the exercise prescription of Phase II-IV CR. The effects of RE on health-related outcomes in patients with cardiovascular (CV) disease (CVD) have not been extensively investigated in comparison to aerobic exercise, the traditional modality of exercise implemented in CR. The purpose of this review is to highlight the growing prevalence of lean mass abnormalities such as dynapenia and sarcopenia in CVD and briefly outline the contributing pathophysiology of these impairments as potential targets for RE training. An update on the current evidence pertaining to the effects of RE on exercise capacity, skeletal muscle strength, body composition, CV health, and quality of life in CR patient populations is provided. The current recommendations for RE training in CR are discussed. Future directions for research and clinical practice in this field are highlighted, and included the need to identify the most efficacious principles of resistance training for different health related outcomes in CVD, as well as the suggested drive towards a 'personalized medicine' approach to exercise prescription in CR.
- Published
- 2022
44. Preservation of Cardiac Reserve and Cardiorespiratory Fitness in Patients With Acute De Novo Versus Acute on Chronic Heart Failure With Reduced Ejection Fraction
- Author
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Ross Arena, Juan Ignacio Damonte, Roshanak Markley, Hayley Billingsley, Azita Hajhossein Talasaz, Emily Federmann, Antonio Abbate, Benjamin W. Van Tassell, Salvatore Carbone, Justin M. Canada, Cory R. Trankle, Juan Lu, Ai-Chen Ho, Alessandra Vecchié, Virginia L. Mihalick, Jeremy Turlington, Marco Giuseppe Del Buono, George F. Wohlford, and Dinesh Kadayira
- Subjects
Male ,medicine.medical_specialty ,Ventricular Function, Left ,Article ,Oxygen Consumption ,Interquartile range ,Internal medicine ,Humans ,Medicine ,In patient ,Retrospective Studies ,Heart Failure ,Ejection fraction ,business.industry ,Cardiac reserve ,Stroke Volume ,Cardiorespiratory fitness ,Cardiopulmonary exercise testing ,Middle Aged ,medicine.disease ,Pathophysiology ,Cardiorespiratory Fitness ,Heart failure ,Acute Disease ,Chronic Disease ,Exercise Test ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
There is limited understanding on the potential differences in the pathophysiology between de novo heart failure with reduced ejection fraction (HFrEF) and acute on chronic HFrEF. The aim of this study was to assess differences in cardiorespiratory fitness (CRF) parameters between de novo heart failure and acute on chronic HFrEF using cardiopulmonary exercise testing (CPX). We retrospectively analyzed CPX data measured within 2 weeks of discharge following acute hospitalization for HFrEF. Data are reported as median and interquartile range or frequency and percentage (%). We included 102 patients: 32 (31%) women, 81 (79%) black, 57 [51–64] years of age, BMI of 34 [29–39] Kg/m(2). Of these, 26 (25%) had de novo HFrEF and 76 (75%) had acute on chronic HFrEF. When compared with acute on chronic, patients with de novo HFrEF had a significantly higher peak oxygen consumption (VO(2)) (16.5 [12.2–19.4] vs 12.8 [10.1 15.3] mL·kg(−1) min (−1), p
- Published
- 2021
45. Dietary Fiber Is Associated With Greater Quality Of Life In Patients With Recently Decompensated Heart Failure With Reduced Ejection Fraction: A Post-hoc Analysis Of The Gourmet-HF Randomized Study
- Author
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Hayley E Billingsley, Scott Hummel, and Salvatore Carbone
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2023
46. Effect of Canagliflozin Compared With Sitagliptin on Serum Lipids in Patients with Type 2 Diabetes Mellitus and Heart Failure with Reduced Ejection Fraction: A Post-Hoc Analysis of the CANA-HF Study
- Author
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Dinesh Kadariya, Salvatore Carbone, Hayley Billingsley, Richard H. Cooke, Antonio Abbate, Benjamin W. Van Tassell, Cory R. Trankle, Dave L. Dixon, Justin M. Canada, and Linda Hart
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Urology ,Blood lipids ,Article ,chemistry.chemical_compound ,Double-Blind Method ,Post-hoc analysis ,medicine ,Humans ,Prospective Studies ,Canagliflozin ,Sodium-Glucose Transporter 2 Inhibitors ,Pharmacology ,Dipeptidyl-Peptidase IV Inhibitors ,Ejection fraction ,Triglyceride ,business.industry ,Cholesterol, HDL ,Sitagliptin Phosphate ,Type 2 Diabetes Mellitus ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Cholesterol ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,chemistry ,Sitagliptin ,Heart failure ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Heart Failure, Systolic ,medicine.drug - Abstract
The sodium glucose co-transporter 2 inhibitors have demonstrated favorable effects on cardiovascular and renal disease; however, they may also increase low-density lipoprotein cholesterol (LDL-C). There are limited data directly comparing the effects of sodium glucose co-transporter 2inhibitors on serum lipids to other antihyperglycemic therapies. In this post-hoc analysis of the CANA-HF trial, we sought to compare the effects of canagliflozin to sitagliptin in patients with type 2 diabetes mellitus (T2DM) and heart failure and reduced ejection fraction (HFrEF). The CANA-HF trial was a prospective, randomized controlled study that compared the effects of canagliflozin 100 mg daily to sitagliptin 100 mg daily on cardiorespiratory fitness in patients with HFrEF and T2DM. Of the 36 patients enrolled in CANA-HF, 35 patients had both baseline and 12-weeks serum lipids obtained via venipuncture. The change in LDL-C from baseline to 12 weeks was 5 (-12.5 to 19.5) mg/dL versus -8 (-19 to -1) mg/dL (P = 0.82) and triglyceride levels was -4 (-26 to 9) mg/dL and -10.5 (-50 to 29.3) mg/dL (P = 0.52) for canagliflozin and sitagliptin, respectively. No significant differences were found between canagliflozin and sitagliptin for total cholesterol, high-density lipoprotein cholesterol or non-HDL-C (P > 0.5 for all). These data suggest that compared with sitagliptin, canagliflozin may not increase LDL-C in patients with T2DM and HFrEF.
- Published
- 2021
47. Nonpharmacological Strategies in Heart Failure with Preserved Ejection Fraction
- Author
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Natalie J. Bohmke, Hayley E. Billingsley, Danielle L. Kirkman, and Salvatore Carbone
- Subjects
Heart Failure ,Exercise Tolerance ,Humans ,Stroke Volume ,General Medicine ,Cardiology and Cardiovascular Medicine ,Ventricular Function, Left - Abstract
Patients with heart failure with preserved ejection fraction (HFpEF) suffer from a high rate of cardiometabolic comorbidities with limited pharmaceutical therapies proven to improve clinical outcomes and cardiorespiratory fitness (CRF). Nonpharmacologic therapies, such as exercise training and dietary interventions, are promising strategies for this population. The aim of this narrative review is to present a summary of the literature published to date and future directions related to the efficacy of nonpharmacologic, lifestyle-related therapies in HFpEF, with a focus on exercise training and dietary interventions.
- Published
- 2022
48. Sarcopenic Obesity Is Associated With Reduced Cardiorespiratory Fitness Compared With Nonsarcopenic Obesity in Patients With Heart Failure With Reduced Ejection Fraction
- Author
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Hayley E. Billingsley, Marco Giuseppe Del Buono, Justin M. Canada, Youngdeok Kim, Juan Ignacio Damonte, Cory R. Trankle, Geza Halasz, Virginia Mihalick, Alessandra Vecchié, Roshanak R. Markley, Dinesh Kadariya, Edoardo Bressi, Horacio Medina de Chazal, Juan Guido Chiabrando, James Mbualungu, Jeremy Turlington, Ross Arena, Benjamin W. Van Tassell, Antonio Abbate, and Salvatore Carbone
- Subjects
Heart Failure ,Oxygen ,Sarcopenia ,Oxygen Consumption ,Cardiorespiratory Fitness ,Exercise Test ,Humans ,Stroke Volume ,Obesity ,Cardiology and Cardiovascular Medicine - Abstract
Background: Sarcopenia impairs cardiorespiratory fitness (CRF) in patients with heart failure with reduced ejection fraction (HFrEF). Obesity has also been shown to impair CRF; however, the effects of sarcopenia on CRF in patients with obesity and HFrEF are unknown. The aim of this analysis was to examine differences in CRF between patients with sarcopenic obesity (SO) and non-SO (NSO) with HFrEF. We also assessed associations between skeletal muscle mass index (SMMI) and CRF. Methods: Forty patients with HFrEF and obesity underwent cardiopulmonary exercise testing to collect measures of CRF including peak oxygen consumption (VO 2 ), circulatory power, oxygen uptake efficiency slope, O 2 pulse, and exercise time. Body composition was performed in all patients using bioelectrical impedance analysis to quantify fat mass index and divide patients into SO and NSO based on SMMI cutoffs. Results are presented as mean (SD) or median [interquartile range] as appropriate. Results: Nearly half (43% [n=17]) of patients had SO. Patients with SO had a lower SMMI than those with NSO, and no differences in fat mass index were observed between groups. Those with SO achieved a lower absolute peak VO 2 (NSO, 1.62±0.53 L·min -1 versus SO, 1.27±0.44 L·min -1 , P =0.035), oxygen uptake efficiency slope (NSO, 1.92±0.59 versus SO, 1.54±0.48, P =0.036), and exercise time (NSO, 549±198 seconds versus SO, 413±140 seconds, P =0.021) compared to those with NSO. On multivariate analysis, SMMI remained a significant predictor of absolute peak VO 2 when adjusted for age, sex, adiposity, and HF severity. Conclusions: In patients with HFrEF and obesity, sarcopenia, defined as low SMMI, is associated with a clinically significant reduction in CRF, independent of adiposity.
- Published
- 2022
49. Associations of total and aerobic steps with the prevalence and incidence of frailty in older adults with hypertension
- Author
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Salvatore Carbone, Elizabeth C. Lefferts, Esmée A. Bakker, Duck-chul Lee, and Carl J. Lavie
- Subjects
Male ,medicine.medical_specialty ,Weakness ,Frail Elderly ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Physical activity ,Blood Pressure ,Fitness Trackers ,030204 cardiovascular system & hematology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Prevalence ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Geriatric Assessment ,Aged ,Aged, 80 and over ,Exercise Tolerance ,Frailty ,business.industry ,Incidence ,Incidence (epidemiology) ,Actigraphy ,Iowa ,Lower incidence ,Cross-Sectional Studies ,Hypertension ,Pedometer ,Lower prevalence ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Item does not contain fulltext PURPOSE: To examine the associations of total steps/day and faster aerobic steps/day (≥60 steps/min) with the development of frailty in older adults with hypertension (HTN) using a two-phased cross-sectional and prospective approach. METHODS: The sample consisted of 427 older adults with HTN from the Physical Activity and Aging Study (PAAS), aged ≥65 years, with valid step data from an accelerometer-based pedometer. Participants were classified into tertiles of total steps/day (low, mid, high) and three categories of aerobic steps/day (none, low, high). Frailty was defined using a modified Fried score with 5 subdomains including shrinking, weakness, slowness, low physical activity (PA), and exhaustion. RESULTS: We observed a negative dose-response relationship across categories of total steps/day and aerobic steps/day for the prevalence of frailty and the subdomains of slowness, low PA, and exhaustion (all p for trends
- Published
- 2021
50. Differences in Immune Cell Mitochondrial Function in Black and White Patients with Heart Failure with Preserved Ejection Fraction
- Author
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Natalie J. Bohmke, Domenico A. Chavez, Hayley E. Billingsley, Juan I. Damonte, Marco G. Del Buono, Austin T. Robinson, Roshanak Markley, Salvatore Carbone, Antonio Abbate, and Danielle L. Kirkman
- Subjects
Genetics ,Molecular Biology ,Biochemistry ,Biotechnology - Published
- 2022
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