bluuebunny/crossref_metadata_2025 huggingface dataset:
ДОСЛІДЖЕННЯ ГЕПАТОПРОТЕКТОРНИХ ВЛАСТИВОСТЕЙ ГУСТОГО ЕКСТРАКТУ ГРИБІВ ШИЇТАКЕ
Authors: Herasymets I. I. , Fira L. S. , Medvid I. I.
Published: March 2020

Вступ. У статті розглянуто питання щодо визначення динаміки лабораторних показників у сироват­ці крові та гомогенаті печінки щурів, уражених парацетамолом, і після корекції густим екстрактом грибів шиїтаке.

Мета дослідження – вивчити гепатопротекторні властивості густого екстракту грибів шиїтаке в експерименті на щурах з модельованим парацетамоловим гепатитом.

Методи дослідження. Дослідження проводили на білих щурах-самцях. Тварин поділили на 10 груп, кожна з яких включала 6 щурів. Гострий гепатит моделювали шляхом введення парацетамолу інтра­гастрально в дозі 1250 мг/кг 1 раз на добу (протягом 2-х діб) у вигляді суспензії в 2 % розчині крохмального гелю. Для корекції токсичного ураження застосовували густий екстракт грибів шиїтаке, який вводили інтрагастрально за 2 год до введення парацетамолу та щоденно після ураження в дозі 150 мг/кг маси тіла. Препарат порівняння “Силібор” вводили за тією ж схемою, що й екстракт грибів шиїтаке, в дозі 20мг/кг маси тіла тварини. На 3-тю, 7-му і 10-ту доби від початку ураження проводили евтаназію щурів з використанням барбамілу натрію. Дослідженням піддавали гомогенат печінки та сироватку крові. Ступінь цитолізу гепатоцитів після введення коригувальних чинників оцінювали за активністю аланін- та аспартатамінотрансфераз, гамма-глутамілтранспептидази, лужної фосфатази і величиною тимолової проби.

Результати й обговорення. Виявлено виражений цитоліз гепатоцитів після введення щурам токсиканта на основі дослідження активності амінотрансфераз, гамма-глутамілтранспептидази, лужної фосфатази та величини тимолової проби. Застосування густого екстракту грибів шиїтаке сприяло нормалізації досліджуваних показників, що свідчило про гепато- та цитопротекторні властивості цього фармакологічного препарату.

Висновки. Отримані результати підтверджують порушення структурно-функціональної цілісності печінки, формування явищ цитолізу і холестазу в печінці після ураження щурів токсичними дозами парацетамолу. Виявлено позитивний вплив густого екстракту грибів шиїтаке на динаміку лабораторних показників у сироватці крові та гомогенаті печінки тварин за умов змодельованого парацетамолового гепатиту.
ДOCЛIДЖЕННЯ ВПЛИВУ ФІТОКОМПОЗИЦІЙ НA ПPOЦECИ НEФEPМEНТAТИВНOГO ГЛIКOЗИЛЮВAННЯ, АКТИВНІСТЬ ЦИТОЛІТИЧНИХ ПРОЦЕСІВ, ПОКАЗНИКИ ЛІПІДНОГО ОБМІНУ ТA БАЛАНС ПЕРОКСИДНОГО ОКИСНЕННЯ ЛІПІДІВ В ОРГАНІЗМІ ТВАРИН ПРИ ЕКСПЕРИМЕНТАЛЬНОМУ ЦУКРОВОМУ ДІАБЕТІ
Authors: Kurylo Kh. I. , Klishch I. M. , Volska A. S. , Rozhkovskyi Ya. V.
Published: March 2020

Вступ. Цукровий діабет – одна з глобальних медико-соціальних і економічних проблем сьогодення. Його лікування потребує комплексного підходу і ґрунтується на застосуванні пероральних гіпоглікемічних засобів, проведенні дієтотерапії, інсулінотерапії та фітотерапії. Ризик виникнення негативних побічних ефектів зростає при комбінованій фармакотерапії цукрового діабету. Актуальним є пошук принципово нових за механізмом дії засобів, здатних знижувати рівень глікемії та інсулінорезистентність, сприяти відновленню інсуліноутворювальної функції підшлункової залози і нівелювати шкідливі для організму прояви оксидативного стресу, що розвивається при цукровому діабеті. У цьому відношенні перспективним є дослідження гіпоглікемічної дії лікарських рослин. Встановлення особливостей впливу фітокомпозиції, яка містить екстракти козлятника лікарського, чорниці звичайної і таурин, на патогенетичні ланки експериментальних патологічних процесів та механізмів її гіпоглікемічної активності є пріоритетним і актуальним, а отримані результати сприятимуть розробці нових фітопрепаратів з гіпоглікемічною дією.

Мета дослідження – з’ясувати метаболітотропні ефекти та обґрунтувати доцільність застосування ліпосомальної форми фітокомпозиції на основі козлятника лікарського, чорниці звичайної і таурину для підвищення ефективності корекції метаболічних зрушень при експериментальному цукровому діабеті.

Методи дослідження. Експерименти проводили на статевозрілих щурах-самцях, яким моделювали стрептозотоциновий цукровий діабет, а для корекції застосовували галевіт та арфа-комбі.

Результати й обговорення. Фітокомпозиція на основі козлятника лікарського, чорниці звичайної і таурину та галевіт за умов лікувально-профілактичного застосування при експериментальному цукровому діабеті 2 типу сприяли відновленню показників вуглеводного обміну, покращували стан ліпідного обміну, оксидантно-антиоксидантний баланс організму шляхом корекції в печінці тварин активності супероксиддисмутази, каталази і збереження природних резервів відновленого глутатіону, поліпшували процеси енергозабезпечення клітин шляхом стабілізації в крові активності сукцинатдегідрогенази, спричиняли антицитолітичний та детоксикаційний вплив, зменшуючи тим самим рівень ендогенної інтоксикації.

Висновок. Отримані результати – підґрунтя для подальшого вивчення можливостей комбінованого застосування фітокомпозиції на основі козлятника лікарського, чорниці звичайної і таурину з метою зменшення побічних ефектів.
ІНФОРМАЦІЙНА СИСТЕМА ПІДСУМКОВОГО ОЦІНЮВАННЯ ЗНАНЬ ІНОЗЕМНИХ ГРОМАДЯН НА ДОДИПЛОМНОМУ ЕТАПІ ПІДГОТОВКИ ЛІКАРІВ
Authors: Selskyy P. R. , Volska A. S. , Klishch I. M. , Selskyy B. P. , Buryachkivskyy E. S. , Kurylo Kh. I.
Published: March 2020

Підвищення ефективності викладання та об’єктивності оцінювання дисциплін можливе за допомогою інноваційних освітніх та комп’ютерних технологій. Підготовка фахівців із числа іноземних громадян з високим рівнем практичної компетентності – один із важливих чинників подальшого розвитку навчального закладу в напрямку інтеграції у міжнародний освітній простір.

У статті висвітлено досвід впровадження інформаційної системи комплексного семестрового тестового іспиту для підсумкового оцінювання знань іноземних студентів-медиків з метою підвищення якості підготовки лікарів із числа іноземних громадян на додипломному етапі.

Число іноземних студентів зростає щорічно. Додипломна підготовка лікарів-іноземців здійснюється упродовж шести років. Рівень практичної та професійної компетентностей іноземних студентів дозволив покращити низку впроваджених новітніх технологій навчання, які продовжують удосконалюватись.

Застосування інноваційних технологій оцінювання іноземних студентів на додипломному етапі підготовки лікарів дозволяє об’єктивно визначати рівень знань.

Комплексний багаторівневий підхід з відповідним програмним забезпеченням дає можливість досягти об’єктивності оцінювання дисципліни, обробки даних та інтерпретації результатів. Комплексне застосування новітніх інформаційних та педагогічних технологій дозволяє суттєво підвищити рівень підготовки фахівців із числа іноземних громадян.

Покращення успішності іноземних студентів у процесі навчання свідчить про ефективність навчальних методик та технологій, а також про появу з часом об’єктивної мотивації до здобуття ґрунтовних знань та вмінь.

Досвід упровадження незалежної системи підсумкового оцінювання з достатнім рівнем об’єктивності може бути використаний у подальших дослідженнях щодо розробки інформаційних освітніх систем для підвищення якості додипломної підготовки лікарів із числа іноземних громадян з ефективним управлінням навчальним процесом.
Abstract 47: Changes in Gut-microbial Metabolite L-carnitine and Improvements in Atherogenic Lipoprotein Metabolism in Overweight and Obese Individuals: The POUNDS Lost Trial
Authors: Heianza Yoriko , Zhou Tao , DiDonato Joseph A , Bray George A , Sacks Frank M , Qi Lu
Published: March 2020

Introduction:
Atherogenic lipoproteins, apolipoproteins (apo), and lipoprotein subspecies with apo CIII are risk factors for cardiovascular disease (CVD). A gut-microbiota related metabolite L-carnitine has been found to promote atherosclerosis and may be related to an increased risk of CVD. Associations of L-carnitine with atherogenic lipid metabolism have not been clarified.

Hypothesis:
We tested a hypothesis that diet-induced changes in L-carnitine might contribute to improving atherogenic lipid profiles among overweight and obese adults.

Methods:
A total of 510 participants had data on blood levels of L-carnitine and lipid markers in a 2-year weight-loss dietary intervention trial. We measured 35 specialized lipid profiles including apo B and cholesterol concentrations in lipoprotein fractions (defined by the presence or absence of apo C-III) in 279 participants.

Results:
Higher baseline L-carnitine levels were significantly associated with elevated concentrations of triglycerides (p=0.0048) and lower HDL cholesterol (p=0.01) levels. Higher L-carnitine levels were also associated with elevated concentrations of cholesterol and apo B in lipoprotein fractions with apo CIII, such as cholesterol in VLDL with apo CIII (p=0.02), cholesterol in LDL with apo CIII (p=0.0056), apo B in HDL with apo CIII (p=0.01), apo B in VLDL with apo CIII (p=0.0008), and apo B in LDL with apo CIII (p=0.0038). We found that people with 6-month decreases in L-carnitine after the dietary intervention (median change: -3.4 μM) had significantly reduced LDL cholesterol levels over 2 years (p < 0.05; Fig, A). Also, people with greater increases in L-carnitine (median change: 3.2 μM) showed 2-year increases in cholesterol in VLDL with apo CIII or in LDL with apo CIII (p < 0.05 for both) (Fig, B).

Conclusions:
Diet-induced decreases in gut-microbiota-related metabolite L-carnitine may have significant influences on long-term improvements in atherogenic lipid profiles among obese patients in a dietary intervention.
Abstract MP33: Association of Cardiac Troponin T and Troponin I With Peripheral Neuropathy in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Hicks Caitlin W , Wang Dan , Tang Olive , Matsushita Kunihiro , Hoogeveen Ron , Ballantyne Christie M , Jia Xiaoming , Selvin Elizabeth
Published: March 2020

Introduction:
There is growing evidence that high sensitivity troponin I (hs-cTnI) and high sensitivity troponin T (hs-cTnT) are associated with distinct clinical characteristics and perform differently for cardiovascular risk stratification. The comparative associations of hs-cTnI and hs-cTnT with microvascular complications, such as peripheral neuropathy (PN), have not been quantified.

Methods:
We conducted a cross-sectional analysis of 2,974 black and white participants in the ARIC study who underwent monofilament PN testing at visit 6 (2016-2017, age 71-94 years). Hs-cTnI and hs-cTnT were measured in serum and categorized according to population tertiles. We used logistic regression to assess the associations of hs-cTnI and hs-cTnT with PN among adults with and without diabetes after adjusting for traditional risk factors.

Results:
Overall, 38% of participants had evidence of PN. Median hs-cTnI and hs-cTnT levels were 3.3ng/L (IQR 2.2-5.2) and 11.0ng/L (8.0-16.0) for participants with PN and 2.6ng/L (1.8-4.0) and 8.0ng/L (6.0-12.0) for participants without PN, respectively. Only hs-cTnT was significantly associated with PN after adjusting for traditional risk factors (
Figure, panel A
) and after mutually adjusting for both troponin measurements (
Figure, panel B
). The association of hs-cTnT with PN was similar for adults with and without diabetes (P=0.62 for interaction).

Conclusions:
PN was common among older adults with and without diabetes. Hs-cTnI and hs-cTnT had distinct associations with PN, with a more robust association for hs-cTnT. These findings add to the growing body of knowledge regarding differences in the use of high sensitivity troponin assays for monitoring risk in the general population.
Abstract MP47: Genome-wide Gene-leptin Interaction Study Identifies Loci Contributing to Leptin Resistance
Authors: Shen Luqi , Zhang Ruiyuan , Cordero José , Wang Jia-Sheng , Shen Ye , Lou Lei , Xie Zhong-Ru , Yin Hang , Qi Yanling , Liang Lirong , Li Changwei
Published: March 2020

Background:
In a preliminary candidate genes study, we robustly identified that the nicotinic acetylcholine receptor genes modified obesity’s sensitivity to leptin. However, the finding only explained a small proportion of the heritability of leptin resistance. Therefore, the current study expanded our preliminary work to the entire human genome to identify additional novel mechanisms of leptin resistance in humans.

Methods:
Discovery stage analyses were conducted among 3,838 White participants of the Framingham Heart Study (FHS) 3
rd
generation. SNPs contributing to leptin resistance were identified by examining interactions between the SNPs and leptin on body mass index (BMI) and waist circumference (WC), controlling for age, gender, and the first 3 genetic principal components. Gene-based analyses were conducted by combining SNP-based p values using the GATES method. Promising SNPs (
P
<1х10
-6
) and genes (
P
<1х10
-4
) of the FHS were further evaluated for replication among 667 White participants of the Multi-Ethnic Study of Atherosclerosis (MESA) study. Analysis results of the FHS and MESA were combined using inverse-variance-weighted meta-analysis method for SNPs and Fisher’s method for genes. Genomic control was applied before meta-analysis.

Results:
Single SNP-based analyses identified that
PCTP
rs78580870, 17:53899497 (FHS
P
=1.90х10
-8
, MESA
P
=0.01, Meta
P
=8.23х10
-10
) interacted with leptin on BMI. Gene-based analyses robustly identified 4 genes interacting with leptin on WC, including
MED9
(FHS
P
=5.60х10
-6
, MESA
P
=1.79х10
-3
, Meta
P
=1.95х10
-7
) at 17p11.2,
RASD1
(FHS
P
=3.92х10
-6
, FHS
P
=1.33х10
-3
, Meta
P
=1.05х10
-7
) at 17p11.2,
DTX3
(FHS
P
=5.27х10
-7
, MESA
P
=3.57х10
-2
, Meta
P
=3.53х10
-7
) at 12q13.3, and
ARHGEF25
(FHS
P
=7.55х10
-7
, MESA
P
=4.96х10
-2
, Meta
P
=6.79х10
-7
) at 12q13.3. These 4 genes have related biological functions of leptin or obesity.

Conclusion:
We identified 1 novel genomic locus and 4 novel genes explaining leptin resistance among White. Future large scale genomic studies of leptin resistance among multiple ethnic groups are warranted.
Abstract P121: Multidimensional Allostatic Load Score Directly Associates With Coronary Artery Disease Burden in Psoriasis
Authors: Lateef Sundus S , Batool Mariyam , Prakash Nina , Uceda Domingo E , Dey Amit K , Abdelrahman Khaled M , Elnabawi Youssef , Reddy Aarthi S , Svirydava Maryia D , Nanda Navya , Rodante Justin A , Keel Andrew , Teague Heather L , Al Najafi Mina , Zhou Wunan , Playford Martin P , Chen Marcus Y , Powell-Wiley Tiffany M , Mehta Nehal N
Published: March 2020

Introduction:
Psoriasis is a chronic inflammatory skin disease associated with accelerated development of asymptomatic coronary artery disease (CAD) by coronary computed tomography angiography (CCTA). Allostatic load score is a multidimensional measure related to chronic stress which incorporates cardiovascular, metabolic and inflammatory indices. To better understand the physiologic impact of chronic stress in psoriasis, we studied the association between allostatic load score and subclinical CAD.

Hypothesis:
We hypothesized that allostatic load score would associate with coronary artery disease burden beyond traditional risk factors in an ongoing psoriasis cohort study.

Methods:
Consecutive psoriasis patients (n=275) underwent CCTA for assessment of coronary artery disease burden (QAngio, Medis). Allostatic load score was determined using established methods (see Table 1 footnote). The association between coronary artery disease burden and allostatic load score was characterized by multivariable regression (STATA 12).

Results:
Psoriasis patients were middle-aged, predominantly male and white, with low cardiovascular risk by Framingham risk score and moderate-severe psoriasis severity
(Table 1)
. Allostatic load score associated with total coronary burden (β=0.39; p<0.001) and non-calcified coronary burden (β=0.40; p<0.001) in unadjusted analyses. In multivariable models, allostatic load score was still associated with total coronary burden (β=0.30; p<0.001) and non-calcified coronary burden (β=0.31; p<0.001) independent of race, Framingham risk score and waist-hip ratio.

Conclusions:
Allostatic load score positively associated with both total and non-calcified coronary artery burden beyond traditional risk factors, suggesting multisystem physiologic dysregulation related to chronic stress may drive subclinical atherosclerosis in psoriasis. Efforts to understand stress effects and its reduction are critical in this population at high-risk for cardiovascular disease.
Abstract P202: Prevalence, Factors, And Long-Term Outcomes Associated With Myocardial Infarction With Non-Obstructive Coronary Artery (MINOCA) Diagnosis In A Large Rural Health Care System Cohort
Authors: Schmitz Katlin , Benziger Catherine P
Published: March 2020

Hypothesis:
Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a common cause of false positive (FP) ST-segment elevation myocardial infarction (STEMI) with associated high morbidity and mortality.

Background:
MINOCA is an important clinical problem found in patients presenting with acute coronary syndrome. Various clinical disorders lead to a working MINOCA diagnosis and make treatment and diagnosis a challenge for clinicians. MINOCA was recently defined by the American Heart Association (AHA) as those presenting with myocardial infarction with nonobstructive coronary arteries on angiography and no alternative diagnoses for presentation.

Methods:
Between 5/01/2009 -6/24/2019, all consecutive STEMI patients were prospectively examined and categorized into true positive STEMI activations or false positive STEMI activations (FP-STEMI). FP- STEMI were further categorized into groups based on the presence or absence of obstructive coronary arteries by angiography.

Results:
We had 472 FP-STEMI patients (42.3% female, median age of 58.9±16.9 years, 53.4% lived rurally) with 152 (31.4%) having evidence of coronary artery stenosis >50%. A secondary cause was identified for an additional 162 (34.3%) patients. Of the remaining FP-STEMI, 82 (2.9%) met criteria for MINOCA and 76 (2.6%) were borderline MINOCA due to not meeting the troponin criteria. Within the MINOCA group, the three most common presentations were: unknown etiology (42.7%), supply-demand mismatch (26.8%), and spontaneous coronary artery dissection (17.1%). The MINOCA group had a higher baseline incidence of dyslipidemia (p=0.037) compared to FP-STEMI and borderline MINOCA and lower smoking compared to borderline MINOCA (p=0.029). At discharge, referral to cardiac rehabilitation was lower (p=0.015) with only 69.7% of MINOCA patients having prescriptions for aspirin, 50% angiotensin converting enzyme inhibitors or angiotensin receptor blockers, 64.5% beta blockers, and 65.8% statins. MINOCA had the highest statin prescription rate compared to borderline MINOCA and secondary (65.8% vs 51% vs 42.1%; respectively p=0.012). There was no significant difference between the mortality of MINCOA patient compared to the FP-STEMI patients. Only 10 (3.5%) had cardiac magnetic imaging studies obtained within 6 months (MINOCA 3.9%, borderline MINCOA 3.9%, and FP-STEMI 2.7% respectively). MINOCA patients had similar 30-day and 1-year mortality to FP-STEMI patients (9.0% vs 12.4% and 12.5% vs 15.2 % 30-day and 1-year respectively; p=0.064 and p=0.107).

Conclusion:
MINOCA represents a challenging group of patients with high mortality and low rates of medication prescription and cardiac rehabilitation referral.
Abstract P227: Psychosocial Predictors of Physical Capacity in Cardiac Rehabilitation
Authors: Koirala Binu , Everett Bronwyn , Salamonson Yenna , Zecchin Robert , Davidson Patricia
Published: March 2020

Introduction:
Despite the impressive gains achieved by those who attend cardiac rehabilitation, many patients fail to maintain the gains in physical capacity in the longer term. There are likely psychosocial characteristics that can be leveraged to sustain behavior change.

Hypothesis:
Patients with higher perceived cardiac control, social support, and exercise self-efficacy, without depression, and those who received motivational interviewing (MI) sessions, adjunctive to cardiac rehabilitation, will have a significantly higher physical capacity.

Methods:
This is a secondary analysis of the data from a randomized controlled trial of MI as a tool to enhance secondary prevention strategies in cardiovascular disease (MICIS study) conducted at three hospitals in Sydney, Australia who attended 6-week phase II cardiac rehabilitation. Two, 1-hour sessions of a nurse-delivered motivational interview focused on increasing physical capacity was implemented and the participants were followed at 6-weeks and 12-months. The outcome for the study was physical capacity measured by distance walked on the six-minute walk test (6MWT). Multiple imputations were used to handle missing data. Descriptive statistics, t-tests, chi-square tests and linear regression for cluster data were used for data analysis.

Results:
The mean (SD) age of participants (n=110) at baseline was 60.1 (10.57) years and the majority were male (71.8%). (Table). In the adjusted analysis, motivational interviewing (p =0.57), perceived cardiac control (p=0.30), self-efficacy for exercise (p = 0.06) and level of depressive symptoms were not related to 6MWT. With every unit increase in perceived social support score, there was a decrease in distance walked in 6MWT by 1.30 meters (b = -1.30; p= 0.007).

Conclusion:
In this sample, psychosocial predictors, except social support, were not likely to influence physical capacity. Investigating barriers and facilitators to sustaining the effects of cardiac rehabilitation are needed.
Abstract P234: Associations of Clinical Characteristics and Health-related Behaviors With Physical Activity Levels in Stage B Heart Failure Patients
Authors: Tristao Parra Maira , Pung Meredith A , Wilson Kathleen , Pruitt Christopher , Greenberg Barry H , Mills Paul
Published: March 2020

Hypothesis:
insufficiently active heart failure patients will report poorer QoL, more fatigue and depressive mood compared to active patients.

Aims:
To characterize clinical characteristics and health-related behaviors according to physical activity (PA). Also, to explore predicting factors of quality of life (QoL).

Methods:
Cross-sectional analysis of a cohort of Stage B HF patients. PA classification was set as active, moderately active or insufficiently active, according to the LTEQ questionnaire. For QoL, the SF-36 questionnaire was used. ANOVAS, Chi-Square tests or likelihood ratios and unadjusted multiple regression models were calculated. Significance was set at p ≤ 0.05.

Results:
In this cohort, 277 HF patients completed the PA questionnaire. The prevalence of active patients was higher than moderately active and insufficiently active (53.3% vs 15.2% and 29.6%), respectively. Younger age (p = 0.044), lower waist circumference (WC) (p = 0.002), and lower waist-to-hip ratio (p = 0.046) were associated with being active. The prevalence of Type II diabetes mellitus (T2DM) in the active groups was significantly lower (p = 0.001). Physically active groups had cases of mild LV enlargement (1.4% and 7.5%, respectively), while no cases were observed among insufficiently active patients (p = 0.017). PA was positively associated with less fatigue (p= 0.002), more vigor (p = 0.001), more self-efficacy (p < 0.001), and better quality of life (p = 0.002). Patients who were less physically active had more inflammation (CRP, p = 0.015; IL-6, p <0.001; TNF-α: p = 0.033, and IL-1ra, p = 0.001). WC (β =-0.16, p = 0.008), glucose (β =-0.12, p < 0.001) and fatigue (β = - 0.39, p < 0.001) predicted general health perception (R
2
= 0.449). For physical functioning (high scores reflects performing PA without limitations due to health), WC (β = - 0.28, p = 0.001), sleep (β = - 1.50, p = 0.003) and fatigue (β = - 0.32, p = 0.018) were significant predictors (R
2
= 0.422); while age (β = 0.36, p <0.001) physical activity (β = 0.051, p = 0.055), sleep (β = 0.50, p =0.046), fatigue (β = -0.37, p <0.001) and depression (β = -1.12, p <0.001) predicted emotional well-being (R
2
= 0.696).

Conclusion:
Physically active heart failure patients had a better anthropometric profile and lower prevalence of T2DM. In this cohort, PA was not a significant predictor for general and physical functioning, but it remained relevant for predicting emotional well-being.
Abstract P244: Association Between Early Life Trauma and Change in HRV During Mental Stress Among Patients With Recent Myocardial Infarction
Authors: Kim Ye Ji , Levantsevych Oleksiy , Alkhalaf MhmtJamil , Soudan Majd , Bremner J Douglas , Quyyumi Arshed A , Pearce Brad , Elon Lisa , Lewis Tene T , Raggi Paolo , Vaccarino Viola , Shah Amit J
Published: March 2020

Background:
Early-life traumatic experiences have been associated with increased cardiovascular disease risk. Little is known about how early-life traumatic experiences may affect changes in autonomic function during mental stress among young subjects post-MI.

Objective:
We hypothesized that those with high exposure to early-life trauma, compared to those with low exposure to early-life trauma, would have increased autonomic dysfunction at baseline, worse stress reactivity, and slower autonomic recovery.

Methods:
We evaluated 321 subjects with a history of recent myocardial infarction who underwent a laboratory-based mental stress speech task. HRV was measured at rest (T0), during mental stress (T1), and during recovery (T2) with ambulatory electrocardiographic monitoring. We evaluated low frequency (LF) HRV as the primary outcome because of its relationship with baroreflex sensitivity, psychological stress, and cardiovascular disease outcomes. Early life trauma was assessed using the Early Trauma Inventory Self Report - Short Form (ETI-SF) and a binary variable was calculated using one SD above the mean of the ETI-SF score, a previously validated cutpoint, to indicate high early-life trauma exposure and low otherwise. Sociodemographic factors, including race, highest education attained, age, and gender, were considered as potential confounders in multiple linear regression models. Differences amongst stress, rest, and recovery metrics were evaluated as outcomes in separate models.

Results:
Of 321 subjects with HRV data, 284 were included in the final analytic sample after excluding those with missing covariates. The mean age was 50.7 ± 6.7, 49% were female (139), and 64% were African-American (182); 260 (88.4%) reported experiencing high levels of early-life trauma. There were no associations between early-life trauma during baseline HRV (T0), reactivity to stress (T1 - T0), and prolonged reactivity (T2 - T0). However, those with high early-life trauma had reduced HRV during recovery from stress compared to those with low early-life trauma (T2 - T1; Beta (95% CI) = -0.37 (-0.73, -0.01)). Results were similar after adjustment for sociodemographic factors and did not vary by race/ethnicity or gender.

Conclusion:
Among subjects with recent MI, high exposure to early-life trauma is associated with prolonged stress-induced autonomic dysfunction during stress and recovery, while the low exposure subjects revert to baseline HRV levels during recovery. This may indicate greater stress-induced cardiotoxicity in those exposed to early life trauma.
Abstract P252: Passive Smoking in Childhood and Mortality From Coronary Heart Disease in Adulthood Among Japanese Men and Women: The Jacc Study
Authors: Teramoto Masayuki , Iso Hiroyasu , Muraki Isao , Shirai Kokoro , Tamakoshi Akiko
Published: March 2020

Background:
Secondhand smoke exposure among adults is an established risk factor for cardiovascular disease, but little is known about the impact of passive smoking in childhood on risk of adverse cardiovascular outcome in adulthood. We examined whether childhood exposure to secondhand smoke is associated with mortality from coronary heart disease(CHD) in adulthood among Japanese men and women.

Methods:
We analyzed the data for 71,459 participants ( 31,027 men and 40,432 women) aged 40-79 years, with no history of CHD, stroke, or cancer at the baseline (1988-1990) and who completed a lifestyle questionnaire including the number of family members who smoked at home in childhood(0,1,2 and 3+ members) under the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study).

Results:
The sex-specific proportions of current smokers were 49.0% for 0 member, 54.3% for 1 member, 56.8% for 2 members and 59.3% for 3+members among men, and the respective proportions among women were 3.3%, 5.2%, 7.2%, and 11.2%.During the median follow-up of 18.9 years, a total of 955 (589 men and 366 women) deaths from CHD were reported. There was a dose-response relationship between the number of smoking family members at home and CHD mortality at adulthood among the middle aged (40-59 years); the multivariable HRs, adjusting for age, sex, history of hypertension and diabetes, body mass index, smoking status, alcohol consumption, hours of exercise and walking, perceived mental stress, educational level and employment status, were 1.05 (95% CI: 0.74, 1.48) for 1 family member, 1.27(0.83, 1.94) for 2 family members and 2.34(1.17, 4.68) for 3+ family members compared with no family member(p for trend=0.04). Such an association was not observed for the older persons aged 60-79 years.The excess CHD mortality associated with 3+ family members among the middle-aged was more evident among never or ex-smokers than among current smokers: the respective multivariable HRs were 3.74(1.40, 10.01) and 1.90(0.72, 5.06).

Conclusions:
Passive smoking exposure in childhood was associated with increased risk of mortality from CHD in adulthood, primarily for the middle aged men and non-current smokers.
Abstract P268: Greater Cognitive Impairment Among Older Adults With Type 1 Diabetes as Compared to Non-diabetic Controls: Results From the Study of Longevity in Diabetes (SOLID)
Authors: Lacy Mary E , Gilsanz Paola , Eng Chloe , Beeri Michal S , Karter Andrew J , Whitmer Rachel A
Published: March 2020

Introduction:
Studies have shown poorer cognitive function in children and adolescents with type 1 diabetes (T1D) as compared to non-diabetic peers. However, little is known about cognitive function in older adults with T1D.

Hypothesis:
We hypothesized that older adults with T1D and type 2 diabetes (T2D) would have greater cognitive impairment than age, sex, race/ethnicity, and education-matched controls without diabetes.

Methods:
We compared baseline cognitive impairment among older adults (aged ≥60) from the Study of Longevity in Diabetes (SOLID) with T1D (n=771), T2D (=234) and no diabetes (n=253). Cognitive tests assessed three cognitive domains identified via factor analysis (language, executive function, episodic memory). All cognitive test scores were standardized and cognitive impairment was defined as 1.5 SD below the mean. In logistic regression models adjusted for age, sex, education, and race/ethnicity, we examined the association between diabetes status (T1D, T2D or no diabetes) and cognition on each cognitive domain and on global cognition (average of scores on the 3 domains).

Results:
In adjusted regression models, compared to older adults without diabetes, those with T1D were more likely to have impaired cognitive function on the language (OR=2.13, 95% CI: 1.08, 4.17) and executive function domains (OR=2.66, 95% CI: 1.36, 5.22). No significant differences in global cognitive impairment or impairment on the episodic memory domain were observed for T1D and no significant differences on any domain were observed for T2D.

Conclusions:
Our findings suggest that older adults with T1D have greater cognitive impairment than their peers without diabetes; findings were specific to the language and executive function domains, with episodic memory being unaffected. No increase in cognitive impairment was observed for older adults with T2D. Additional research is needed to understand the causes and potentially modifiable factors associated with impaired cognition among older adults with T1D.
Abstract P312: Association Between Religious Attendance And Obesity In African American And Afro-Caribbean Men
Authors: Barrington Debbie
Published: March 2020

Introduction:
The increasing prevalence of obesity continues to be a public health concern in the United States (US). Religiosity, commonly characterized as the frequency of ritualistic practice and attendance at places of worship has been found to provide favorable cardiovascular health impacts including lower blood pressure and cholesterol levels; however, studies on the effect of religiosity on obesity have been mixed. Furthermore, national surveys have shown obesity prevalence to differ by ethnicity; foreign-born blacks have lower rates of obesity compared to US-born blacks. Research on a potential ethnic interaction on the impact of religious attendance on obesity has also been limited.

Hypothesis:
It is hypothesized that the association between religious attendance and obesity in black Americans may differ by ethnicity.

Methods:
Multiple logistic regression models were used to examine the association between religious attendance and obesity for African American (N = 1208) and Afro-Caribbean men (N = 628), 18 years and older, in the National Survey of American Life (2001-2003). Odds ratios (OR) of the association between religious attendance and adult obesity were estimated after adjusting for age, socioeconomic measures, health and lifestyle measures within regression models stratified by ethnicity.

Results:
The overall prevalence of obesity was 29.15% among African American men and 19.74% among Afro-Caribbean men. The prevalence of obesity among those who attended church weekly or more than weekly was 33.48% for African American men and 13.36% for Afro-Caribbean men. Afro-Caribbean men who attended church weekly or more than weekly had 48% lower odds of obesity than men who attended church less than weekly; age-adjusted OR = 0.52; 95%CI: (0.28, 0.98). The protective association of church attendance remained for Afro-Caribbean men after additionally adjusting for socioeconomic, health and lifestyle factors; adjusted OR = 0.40; 95%CI: (0.23, 0.67). No significant association between religious attendance and obesity was found for African American men.

Conclusions:
These findings suggest that religious attendance may be a protective factor for obesity among Afro-Caribbean men in the US. Since the prevalence of obesity among the foreign-born increases with length of US residency, religiosity may curb cardiovascular risk by lowering their body mass index trajectories across the life course.
Abstract P323: HIV- and Subclinical Cardiovascular Disease-specific Transcriptomes in Nonclassical Monocytes: The Women’s Interagency HIV Study
Authors: Lin Juan , Hanna David B , Qi Qibin , wang tao , Mueller Karin A , Ghosheh Yanal , Anastos Kathryn , LAZAR Jason M , MacK Wendy , Tien Phyllis , COHEN MARDGE , igho ofotokun , Gange Stephen , HEATH SONIA , Tracy Russell P , Hodis Howard N , LANDAY ALAN , Kaplan Robert , Ley Klaus F
Published: March 2020

Objectives:
Nonclassical monocytes (NCM) have patrolling functions relevant to atherosclerosis. While NCM have low surface CXCR4 expression in people with concurrent HIV and CVD (Mueller
Cardiovasc Res
2019), the extent of CVD-related gene expression and the pathways involved are unknown. We described the gene transcription signature of NCM to provide insight into potential mechanisms of HIV-associated CVD.

Methods:
We identified transcriptomic changes in circulating NCM among women with and without chronic HIV infection. CVD was defined by plaques found on B-mode carotid artery ultrasound. The study included 23 HIV
-
CVD
-
, 21 HIV
+
CVD
-
, 20 HIV
-
CVD
+
, and 21 HIV
+
CVD
+
women, with these four groups matched by age (median = 45), race (95% minority) and smoking (86% ever-smokers). Using cryopreserved cells, we flow-sorted NCM (CD14
dim
CD16+) and deep-sequenced their mRNA (average depth >40 million reads) to identify differentially expressed genes (DEG) contrasting HIV alone, CVD alone, and concurrent HIV
+
CVD
+
groups, versus HIV
-
CVD
-
, based on FDR-adjusted P<0.05.

Results:
After filtering to genes with raw counts >10 in >60% of participants, 11,343 protein coding genes were analyzed. HIV alone was associated with 10 DEGs on NCM (Figure). Women affected by both HIV and CVD had 93 DEGs, only six of which were shared by the HIV alone DEG signal. CVD alone was associated only with upregulated CDK18, which was also identified as a DEG in the HIV
+
CVD
+
group.

Conclusion:
Concurrent HIV and CVD (HIV
+
CVD
+
) is associated with altered gene expression in NCMs relative to HIV
-
CVD
-
, generating responses that involve interleukins (IL32, IL4R), immune checkpoint inhibition (LAG3), chemokines (CCL4, CCL5) and lipid homeostasis (ABCD2).
Abstract P341: Development of Predictive Models for Cardiovascular Health to Support Its Use in Real-world Data
Authors: Hu Hui , Bian Jiang , Pearson Thomas A , Lipkind Heather S , Zheng Yi , Zhao Jinying
Published: March 2020

Life’s Simple 7 (LS7) developed by the American Heart Association (AHA) is a new index of cardiovascular health (CVH). LS7 is comprised of 7 metrics, including 3 health factors (blood pressure [BP], total cholesterol, and glucose) and 4 health behaviors (body mass index [BMI], cigarette smoking, diet, and physical activity). To date, CVH estimates are mainly obtained from national surveys, clinical trials, and cohort studies. Real-world data (RWD) such as electronic health records (EHRs) and claims data and real-world evidence generated from these data are playing an increasing role. However, the lack of information on all 7 CVH metrics in RWD limits the use of the CVH concept in research and preventions based on RWD. Using data from the 1999-2016 National Health and Nutrition Examination Survey (NHANES), we developed predictive models for CVH among adults using 3 metrics (i.e. BP, BMI, and smoking) and sociodemographic factors (i.e. age, gender, race/ethnicity, education, and marital status) which are widely available in RWD. Each CVH metric was categorized into ideal (2 points), intermediate (1 point), or poor (0 point), and then weighted accordingly following LS7 to generate an overall CVH score (0-14 points) with a higher score indicating better CVH. Individuals with more than 4 ideal CVH metrics were determined as having ideal CVH. In addition, we also developed models using 4 CVH metrics (i.e. BP, BMI, and smoking + one of the other 4 metrics). The data were randomly divided into training (80%) and testing (20%) sets. Gradient boosting decision trees models were trained using the CatBoost library with hyper-parameters tuned by a grid search based on 5-fold cross validations. A total of 45,614 individuals aged 18 years and older in 1999-2016 NHANES were included. The models with 3 CVH metrics (i.e. BP, BMI, and smoking) as predictors achieved a test-AUC of 0.95 and a test-RMSE of 1.39. Including one of the other 4 CVH metrics (i.e. total cholesterol, glucose, diet, or physical activity) as a predictor in the models along with the previous 3 metrics (i.e. BP, BMI, and smoking) further improved the predictive performance (test-AUC>0.96 and test-RMSE<1.38). These findings suggested that the 3 CVH metrics (i.e. BP, BMI, and smoking) that are widely available in RWD can be used to accurately estimate CVH among adults in the United States.
Abstract P376: Associations Between Moderate To Vigorous Physical Activity And Sedentary Time On Cognitive Function In Older Adults With Cardiovascular Disease
Authors: Hoffmann Nicole M , Petrov Megan E
Published: March 2020

Cardiovascular disease (CVD) is associated with increased risk for cognitive decline. Lifestyle behaviors such as moderate to vigorous physical activity (MVPA) and reduced sedentary time (ST) may mitigate this decline, but limited research exists. The aim of the study was to examine the joint association of MVPA and ST on cognitive function by CVD status. Adults (n=2844, ≥60yrs) from the 2011-2014 National Health and Nutrition Examination Survey underwent cognitive testing (Digit Symbol Substitution Test [DSST]; Animal Fluency [AF]). Participants reported minutes of MVPA per week (categorized by U.S. PA Guidelines:
≥
150min MPA and/or
≥
75min VPA PA vs <150min MPA and <75min VPA), and typical ST per day (≤7hrs vs >7hrs
)
, and reported physician-diagnosed CVD (i.e., myocardial infarction, stroke, coronary heart disease, or heart failure). Weighted linear regression analyses assessed the joint association of MVPA and ST on cognitive function, and tested the modifying effect of CVD status (alpha level for interaction terms set at 0.1) after adjustment for demographics, hypertension, diabetes, body mass index, and depression symptomatology. See Table. There were significant main effects for combined MVPA-ST groups on DSST (Wald
F
(3,30)=4.92,
p
=.007) and AF (Wald
F
(3,30)=5.01,
p
=.006). Individuals who did not engage in MVPA regardless of ST had significantly worse scores on DSST compared to the reference group. There was a significant main effect for CVD on DSST (Wald
F
(1,32)=8.82,
p
=.006). There was a significant interaction between MVPA-ST groups and CVD status on DSST (Wald
F
(3,30)=3.691,
p
=.023). Stratified analyses indicated among individuals with CVD, the buffering effect of MVPA was maintained, but the interaction was not significant for those without CVD. In a sample of adults with a history of CVD, meeting recommendations for MVPA appeared to preserve executive functioning regardless of ST. This research highlights the added importance for people with a history of CVD to participate in the recommended amount of MVPA.
Abstract P387: Risk Factors for Neonatal Intensive Care Unit Admission; Project Watch, 2012-2017
Authors: Sriram Ksheeraja , Umer Amna , Hamilton Candice , John Collin C , LILLY Christa
Published: March 2020

Background:
Neonatal intensive care unit (NICU) admission is often due to specific cardiovascular conditions. Low birthweight, another common reason for NICU admission, is also linked to later cardiovascular risk. Within the past decade, the rate of NICU admissions in the United States has significantly increased. Identification of emerging risk factors for NICU admission will help inform efforts to reduce the number of newborns requiring intensive care.

Methods:
The objective of this study was to identify risk factors for NICU admission in all infants born in West Virginia (WV), 2012-2017, via Project WATCH. Fifteen exposure variables including demographics, maternal and infant characteristics, were included in multivariable logistic regression analyses, stratified by preterm and term births.

Results:
Of 120,894 neonates, 6,393 (5.3%) were admitted to NICU. Among preterm infants (Table 1), predictors included male sex (OR: 1.11), insurance status (OR: 1.29), APGAR scores less than or equal to 3 (OR: 2.57), maternal diabetes (OR: 1.68 and 2.01), residence outside WV (OR: 1.27), intrauterine substance exposure (OR: 1.94), congenital abnormalities (OR: 2.58), and low birthweight (OR: 1.73 and 6.64). Risk factors in term infants included all factors identified for preterm infants, as well as maternal smoking, maternal age, and number of previous pregnancies.

Conclusions:
In addition to infant characteristics predictive of NICU admission (e.g., birthweight and APGAR score), socioeconomic factors (e.g., insurance status and rurality) and preventable risk factors (e.g., maternal smoking and substance use) provide an opportunity for intervention during pregnancy, with the goal to decrease the number of newborns requiring intensive care.
Abstract P389: Sleep Behavior Risk Score and BMI in a Sample of Adolescents Undergoing Bariatric Surgery
Authors: KAAR Jill L , Talker Ishaah , Russell Samuel , Inge Thomas , Hawkins Stephen M , Aloia Mark , Simon Stacey , Moore Jaime
Published: March 2020

Objective:
To examine sleep behaviors and their associations with health characteristics in a cohort of adolescents with severe obesity undergoing bariatric surgery at Children’s Hospital Colorado.

Methods:
A retrospective chart review of electronic medical records was performed. All patients receiving care at the Children’s Hospital Colorado (CHCO) Bariatric Surgery Center between 06/17-08/19 were included. Demographic, medical and family history, self-reported sleep behaviors, and laboratory measures were abstracted, including medical problem list (e.g., type 2 diabetes (T2D), hypertension) and body mass index (BMI). A sleep behavior risk score (SBRS) was developed using five criteria (short sleep defined as <8 hrs/night, variability of sleep timing greater than 60 minutes, daytime naps, bedtime past midnight, and mobile devices in bed). Participants were classified as having a high SBRS if they met three or more of the criteria. T-tests were used to examine the differences between baseline health characteristics by SBRS score.

Results:
Data from 78 patients, aged 16.82.1, were reviewed. The majority of patients were female (71%), Hispanic (52%) and in 10-12
th
grade in school (64%). Prior to surgery, 24% of the patients were diagnosed with hypertension and 20% with type 2 diabetes. The majority of patients (60%) had a high SBRS at baseline. High SBRS was significantly associated with higher baseline BMI (49.2 vs 45.0; p=0.03). SBRS score was not significantly associated with diagnosis of hypertension, type 2 diabetes, hyperlipidemia, or obstructive sleep apnea.

Conclusions:
In a population of adolescents seen in the Bariatric Surgery Center at CHCO, a majority of patients met criteria for high risk sleep behaviors, and worse sleep behaviors preoperatively were related to higher baseline BMI. A high SBRS may adversely impact adolescents’ overall health prior to surgery, which may have implications for weight loss success post-surgery. The evaluation for sleep health should be more rigorously evaluated and standardized as part of efforts to improve health outcomes in patients undergoing bariatric surgery.
Abstract P441: Oral Glucose Tolerance Test Detects Diabetes at Early Stages
Authors: Mosslemi Mitra , Wong Nathan D
Published: March 2020

Introduction:
Diabetes is a significant risk factor for cardiovascular disease (CVD) and one of the leading causes of death in the USA. The progression to type 2 diabetes, as the major type, is known to be gradual and remissible by intervention at early stages. However, despite the diabetes epidemic over the past few decades in the US, diabetes detection at the early stages has received insufficient attention. Assessing which diabetes diagnostic test can detect progression to diabetes at early stages may help to improve diagnostic recommendations for the at-risk population.

Hypothesis:
We hypothesize that the Oral Glucose Tolerance Test (OGTT) can detect diabetes at earlier stages compared with Hemoglobin A1c (HbA1c) and Fasting Plasma Glucose (FPG) tests. Therefore, the diabetes cases which are diagnosable only by OGTT have a better CVD risk profile.

Methods:
We extracted diabetes cases with laboratory evidence of diabetes OGTT ≥ 200 or FPG ≥ 126 or HbA1c ≥ 6.5% who reported themselves as undiagnosed by a doctor from the National Health and Nutrition Survey (NHANES) 2005-2014. We compared the CVD risk factors in the undiagnosed diabetes group between the subgroup, which was diagnosable only by OGTT and the subgroup, which was diagnosable by HbA1c or FPG.

Results:
Among the total of 953 undiagnosed diabetes cases (projected to 26.4 million) from NHANES 2005-2014, 207 (6.1 million, 23%) had a normal HbA1c and FPG, but OGTT ≥ 200. After adjustment for gender and race, the subgroup who were only diagnosable by OGTT had a better glycemic profile and considerably milder insulin resistance compared with the subgroup who were diagnosable by other diagnostic tests (table).

Conclusions:
The results indicate that OGTT can assess diabetes at earlier stages compared with HbA1c and FPG, providing opportunities for earlier preventive strategies.