bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 1186: Asymmetric Dimethylarginine and HDL-cholesterol Independently Affect Arterial Wall Thickness in the First Decade of Life
Authors: Ayer Julian G , Marks Guy , Harmer Jason A , Raitakari Olli T , Celermajer David S 
Published: July 2021

Introduction The pathological changes of early atherosclerosis (fatty streaks and fibrous plaques) may be observed in the young and can be reflected
in vivo
by the carotid intima-media thickness (CIMT), measured by ultrasound. CIMT is a reliable marker of subclincal atherosclerosis in adults and traditional cardiovascular risk factors present in childhood predict CIMT in adulthood. However, the determinants of CIMT in childhood are largely unknown. We assessed the influence of traditional cardiovascular risk factors and also asymmetric dimethylarginine (ADMA, an endogenous inhibitor of nitric oxide synthesis) on CIMT, in healthy 8-year old children.

Methods 406 community-based children (age 8.0±0.1, 49% girls) had anthropometry, systolic and diastolic blood pressure (SBP, DBP) and mean left and right CIMT measured. A non-fasting blood sample was collected for HDL, non-HDL cholesterol, apolipoprotein B (apo B), high sensitivity CRP (hs-CRP) and ADMA (measured by ELISA). Correlates of CIMT were evaluated.
Results Mean (± sd) values were CIMT 0.59±0.06 mm, HDL 1.46±0.37 mmol/L, non-HDL cholesterol 2.96±0.70 mmol/L, apo B 0.64±0.15 mmol/L, and ADMA 0.91±0.22 μmol/L; median hs-CRP was 0.3 mg/L (interquartile range 0.21 to 1.09 mg/L). On univariate analysis, CIMT was associated significantly with SBP (r=0.164, p<0.001), DBP (r=0.105, p<0.017), HDL (r= −0.142, p<0.006) and ADMA (r=0.182, p<0.001). Measures of body size, apo B and hs-CRP were not significantly related to CIMT. On multivariable analysis, HDL (β coefficient = −0.118, p<0.035) and ADMA (β coefficient = 0.175, p<0.002) were significant independent determinants of CIMT in a model adjusted for all measured risk factors and sex.
Conclusions Lower HDL-cholesterol and higher levels of ADMA, an endogenous inhibitor of nitric oxide synthesis, are significantly associated with CIMT in childhood. These data may permit earlier cardiovascular risk stratification and suggest novel mechanisms whereby HDL and ADMA might be modulating atherogenesis at an earlier stage than previously envisaged.
Abstract 3199: Diastolic Dysfunction in Chronic Heart Failure and Aging - Effects of Exercise Training
Authors: Sandri Marcus , Gielen Stephan , Mangner Norman , Höllriegel Robert , Erbs Sandra , Linke Axel , Möbius-Winkler Sven , Hambrecht Rainer , Schuler Gerhard 
Published: July 2021

BACKGROUND: Diastolic left ventricular dysfunction may occur in both physiologic aging and chronic heart failure (CHF). It has, however, never been assessed, whether the degree of diastolic impairment in CHF is influenced by age and if the previously observed beneficial effects of exercise (ET) on left ventricular filling are diminished in old age.

METHODS: In this study we randomised 53 pts. with stable CHF(LVEF 27.3±2.1%) and 51 healthy subjects (HS) (LVEF 61.5±2.7%) to a training (T) or a control group (C). To detect possible aging effects we included subjects <55 (young) and >65 years (old). Subjects in the T-group exercised 4 times daily at 60 to 70% of VO
2
max for 4 weeks under supervision. At baseline and after the intervention E/A ratio and lateral E/E′ ratio were determined by echocardiography and with tissue Doppler imaging.

RESULTS: As compared to young HS, old HS showed at baseline a reduced E/A ratio and an increased E/È ratio (young: E/A 1.2±0.2; E/È 7.3±0.1 old: E/A 0.7±0.1; E/È 13.5±0.3; p<0.05). In CHF pts., diastolic function was impaired (young E/A 0.8±0.2; E/È 12.9±0.5 old: E/A 0.8±0.1; E/È 13.7±0.4). No difference of these baseline parameters between the age groups was observed (p=0.72). As a result of ET, E/A ratio improved from 0.7±0.1 to 1.2±0.2 and E/È ratio improved from 13.7±0.3 to 9.3±0.4 in old HS (p<0.05), while it remained unchanged in young training HS and C. In young and old pts. with CHF four weeks of ET resulted in a significant change in E/A ratio (young: from 0.8±0.1 to 1.2±0.1; p<0.05; old: from 0.7±0.1 to 1.1±0.2 p<0.05) and E/È ratio (young: from 13.1±0.3 to 10.1±0.2; p<0,05; old: from 14.1±0.3 to 11.2±0.3; p<0.05). In C no effect was detectable.
CONCLUSIONS: The present trial provides new insight into chronobiology of cardiovascular training effects: Among HS aging is associated with the development of significant left ventricular diastolic dysfunction. In CHF both young and old pts. exhibit a similar degree of LV-dysfunction. Four weeks of ET are effective in improving diastolic function in old HS and in young and old CHF pts. The lusitropic training effects were not significantly diminished among older pts. underlining the potentials of rehabilitation interventions in this patient group.
Abstract 3262: Impact of the MESA Arterial Age Calculator Incorporating Coronary Calcium on CHD Risk Estimation
Authors: Munir Jamalah , Bindeman Jody , Bauer Kelly , Byrd Carole , Wu Holly , O’Malley Patrick , Taylor Allen 
Published: July 2021

Background: The MESA study recently published a web-based calculator for the computation of arterial age incorporating Framingham risk factors and coronary calcium to integrate the incremental predictive value of coronary calcium within the Framingham risk score, a reference-standard clinical coronary heart disease (CHD) risk calculator. We examined the impact of arterial age on the distribution of CHD risk estimation.
Methods: We applied CHD risk factor data from the Prospective Army Coronary Calcium Project, a screening cohort of 2000 men and women between the ages of 40 and 50, to the MESA Arterial Age calculator (available at www.mesa-nhlbi.org). Subjects were studied with measured CHD risk factors and electron beam CT for the identification of coronary artery calcium. Framingham risk scores (FRS), using the 10 year CHD risk model with and without arterial age, were calculated using the MESA arterial age calculator. An estimate CHD risk between 6 and 20% was categorized as intermediate risk, and compared for the calculations using chronological age, and arterial age.
Results: Demographics of the cohort included mean age 42.9 ± 2.7 yrs, male gender 82%, hypertension 8.0%, systolic blood pressure 123 ± 13 mm Hg, current smoking 7.7%, total cholesterol 203 ± 36 mg/dL, and HDL-C 53 ± 14 mg/dL. Mean FRS was 4.5 ± 3.6%. Coronary calcium was present in 394 subjects (19.7%). Application of the arterial age calculator increased mean age from 42.9 ± 2.7 to 43.6 ± 10.4 years (P < .001), and the mean FRS increased from 4.5 ± 3.6 to 7.3 ± 8.1% (P < .001). Reclassification was seen primarily among male subjects, in whom the mean age (chronological vs. arterial age) increased from 42.9 ± 2.7 to 44.2 ± 11.0 (P < .001) and the prevalence of intermediate CHD risk increased from 26.2% (429 of 1639) to 37.4% (613/1639; P < .001). Among women, mean age (chronological vs. arterial age) was reduced by calcium scoring (42.7 ± 2.6 vs. 40.7 ± 6.3%; P < .001) and a shift to intermediate risk was seen in only 0.6% of subjects (from 10 to 18 out of 349).
Conclusions: Among healthy middle-aged individuals, the MESA arterial age calculator modestly shifts predicted CHD risk estimation, and reclassifies 1 in 9 men from low to intermediate risk. Arterial age was lower than chronological age in women.
Abstract 3268: Ethnic Differences in the 12 Lead -EKG - Relevance to the Cardiovascular Evaluation for Hypertrophic Cardiomyopathy in Athletes
Authors: Rawlins John , Papadakis Michael , Edwards Carey , Basavarajaiah Sandeep , Sharma Sanjay 
Published: July 2021

Introduction Cardiac adaptation to intense physical exercise is associated with physiological increases in cardiac dimensions that are reflected on the EKG. The EKG changes in Caucasian athletes (WA) are established, however, there is a paucity of data in black athletes (BA) who constitute an increasing proportion of elite athletes in Western countries. We sought to identify differences (if any) in EKG characteristics between BA and WA participating in similar sporting disciplines.
Methods Between 2007– 8, 222 nationally ranked male BA aged 14 –35 and 496 WA of similar age, size and range of sporting disciplines underwent a EKG and standard 2-D echocardiography. All athletes with a left ventricular wall thickness > 12mm and deep T wave inversion (> −0.2 mV) underwent Holter monitor, exercise stress test, and cardiac MRI to exclude phenotypic features of hypertrophic cardiomyopathy (HCM).
Results Black athletes had a greater prevalence of voltage criteria for left ventricular hypertrophy (LVH) (57% vs 42%; p < 0.005), ST segment elevation (76% vs 33%; p < 0.001) and T wave inversions (25% vs 4%; p < 0.001) compared with WA. ST segment elevation in all athletes was confined to the anterior precordial leads but 50% BA exhibited a unique convex ST segment elevation pattern that was absent in WA. There was no correlation between T wave inversions and LVH at echocardiography or cardiac MRI. Indeed none of the BA with T wave inversions displayed any phenotypic features of HCM.
Conclusion Black athletes exhibit different adaptive responses to exercise than WA. Deep T wave inversions and convex ST segment elevation are common in BA, with or without LVH and may overlap with HCM. These results have significant implications during pre-participation screening. There is the potential risk of generating a false positive diagnosis of HCM and lead to unnecessary exclusion from competitive sport, if data derived from WA, used to identify an abnormal EKG, is incorrectly extrapolated to BA.
Abstract 4990: Multi-Marker Approach Using Novel Biomarkers Improves Prediction of Subclinical Atherosclerosis: Observations from the Dallas Heart Study
Authors: Rohatgi Anand , Matulevicius Susan , Das Sandeep R , Khera Amit , McGuire Darren K , Ayers Colby R , de Lemos James A 
Published: July 2021

Background: Although many novel markers are independently associated with cardiovascular risk, few significantly improve predictive performance. We hypothesized that combining multiple novel biomarkers would improve prediction of subclinical atherosclerosis over standard methods.
Methods: We measured coronary calcium (CAC) by electron beam CT (n=2440), as well as hsCRP, NT-proBNP, and four novel biomarkers including soluble receptor for advanced glycation end products (sRAGE), peptidoglycan recognition protein-1 (PGLYRP-1), soluble endothelial cell-selective adhesion molecule (sESAM), and osteoprotegerin (OPG) in the Dallas Heart Study, a multi-ethnic probability-based population sample age 30 – 65. An integer score was created based on the number of biomarkers that were elevated >= 95th percentile for sex and race. The incremental value of the biomarker score over a model including Framingham risk categories in predicting CAC was analyzed.

Results: Increasing biomarker score was associated with increased CAC prevalence (59% for score >= 3 vs. 17% for score = 0, figure

). Compared with the Framingham risk model alone, the addition of the biomarker score significantly increased the C index (0.705 vs. 0.749, p<0.0001), lowered the Bayesian Information Criterion (2232 vs. 2195), and also improved reclassification into higher and lower risk categories (Net Reclassification Index = 14.2%, p<0.0001; Integrated Discrimination Index =2.4%, p<0.0001).

Conclusion: Use of a multi-marker score including established and novel biomarkers improves prediction of CAC beyond the Framingham risk categories using multiple different statistical metrics.

Figure.

Prevalence of CAC by Biomarker Score*
Abstract 5063: Cardiovascular Effects of Transdermal Testosterone in Postmenopausal Women
Authors: Vitale C , Collins P , Marazzi G , Caminiti G , Lodhi I , Rodenberg C A , Rosano G M 
Published: July 2021

Testosterone Transdermal Patch (TTP) has been developed for the treatment of postmeno-pausal women (PMW) with hypoactive sexual desire disorder (HSDD). Since the cardiovascular (CV) effects of testosterone in women are still unclear we conducted a pooled analysis of the large phase III clinical program to evaluate the efficacy and safety of 300 μg/day TTP, alone or in association with hormone replacement therapy (HRT), versus placebo in surgical or natural PMW.
Design & Methods: A total of 2795 women aged between 26 –70 years (mean age 52(SD=6.8) years) were included in 5 phase III randomized, double-blind, placebo-controlled clinical trials (treatment duration range 24 – 52 weeks) as part of the TTP Clinical program. 4 studies included PMW (natural and surgical, two each respectively) receiving HRT while 1 study was conducted without HRT, in either surgical or natural PMW. Women with known CV disorders were excluded from the studies. Changes from baseline in standard metabolic and CV risk factors were compared. The incidence of stroke, myocardial infarction (MI) and venous thromboembolism (VTE) alone or as a composite CV endpoint was assessed.
Results: The 2795 PMW were randomized to receive either placebo (n=1297) or TTP (n=1498). Baseline mean BMI was 27 kg/m2 (SD=5.3 kg/m2) and 56% were naturally menopausal. The demographic and baseline parameters were similar among the treatment groups. No significant changes in CV risk factors (Total Cholesterol, Triglycerides, Insulin, Glucose, Systolic and Diastolic Blood Pressure) were detected during the study period, apart from a blunting of the increases in HDL-C by TTP at 24 and 52 weeks (Placebo 52-week mean change 2.59 mg/dl vs. TTP 52-week mean change 1.20 mg/dl, p<0.005) and of the decrease in LDL-C by TTP at 24 (p<0.05), but not at 52 weeks. During the double-blind (24 weeks), placebo-controlled period of the combined studies, 4 major CV events (2 MIs and 2 strokes) were reported in placebo patients and 3 (2 MIs and 1 stroke) in those receiving TTP. One VTE occurred in a patient receiving TTP and HRT.
Conclusion: TTP therapy in these clinical trials did not adversely affect CV risk profile and did not change the risk of major CV events in these surgical and naturally PMW with or without concomitant HRT.
Abstract 5133: Does Public Smoking Ban Reduce the Incidence of Myocardial Infarction in Michigan? A Systematic Review and Attributable Risk Analysis
Authors: Al-Mallah Mouaz , Alqaisi Fadi , Nerenz David , Boedeker Stephanie , Weaver W. Douglas 
Published: July 2021

Background: Smoking is a well-established risk factor for cardiovascular disease. The Michigan legislature is currently considering a proposal for a comprehensive smoking ban (CSB) in Michigan. The potential impact of such a law on the incidence AMI is not known. We conducted a meta-analysis to study the impact of CSB on the incidence of AMI and calculated the impact of potential CSB on the incidence of AMI in Michigan.
Methods: We searched MEDLINE, EMBASE, and Cochrane databases from inception till May 2008 for studies comparing the rates of AMI hospital admissions before and in the year after the implementation of CSB legislation. Of 135 potentially relevant articles screened initially, 5 studies met the inclusion criteria. A random-effects model meta-analysis was done and between-studies heterogeneity was compared with I2. The attributable risk (AR) of CSB on AMI incidence was calculated and multiplied with the number of AMI admissions in Michigan.
Results: In the published studies, a CSB was associated with a decrease in the incidence of AMI (RR 96%, 95% CI 93%–100%, p=0.05). There was no heterogeneity between the included studies (I2<50%). The AR of CSB on the incidence of AMI is −4.2%. The average number of hospital admissions for AMI as first-listed diagnosis in Michigan between 1999 and 2006 was 27,007 per year. Thus, if a CSB legislation is implemented in Michigan in 2008, the calculated reduction of hospital admissions for AMI is 1130 admissions per year as of 2009..
Conclusion: CSB is associated with a significant reduction of annual hospital admissions for AMI. The financial impact of this reduction on health care cost is yet to be determined.
Abstract 6215: Childhood Obesity In Two Communities - Relation to Health Habits and Resources
Authors: Eagle Taylor , Jackson Elizabeth A , Aaronson Susan , Fitzgerald Catherine , Mitchell Lindsey , Gurm Roopa , DuRussel-Weston Jean , Goldberg Caren S , Eagle Kim 
Published: July 2021

Background. Middle school children residing in a community with fewer resources may have less opportunity to be physically active or consume a healthy diet which may lead to an increased risk for obesity, and poorer baseline cardiovascular health.
Methods. We compared health status of middle school students (average age 12 years) in two Michigan communities; Ann Arbor (AA) and an adjacent town, Ypsilanti (YPSI) (median household income 77,000 and 28,610, respectively). Blood pressure (BP), cholesterol, blood glucose, body mass index (BMI), and self-reported diet and physical activity habits were collected at baseline in students (n=733) from 5 AA and 2 YPSI middle schools.

Results. The percentage of children receiving free lunch was higher among the YPSI children compared to the AA children (60% vs. 26%, p =0.01). More YPSI children were in the 95
th
percentile for weight compared to the AA children (22.2% vs. 12.6%) and on average had a greater BMI (21.2 ± 4.8 vs. 19.9 ± 4.1, p =0.004) and LDL-cholesterol (99.9 ± 27.5 vs. 91.7 ± 26.9, p =0.005). Compared to AA children, the YPSI children were less likely to consume one or more servings of vegetables/day (67.7% vs. 80.6%, p =0.004) while no difference was observed in fruit consumption. Non-diet soft drink consumption was higher among the YPSI children compared to those from AA (45.9% vs. 30.8%, p =0.002). YPSI children were less likely to report attending a school-based physical education class in the past week (41.4% vs. 9.9%, p<0.001) or to participate on a school-based sports team (65.4% vs. 38.3%, p<0.001). The majority of children in both communities reported watching one or more hours of TV/day; however YPSI children were more likely to watch six or more hours/day compared to AA children (12.8% vs. 4.0%, p<0.001). A similar pattern was observed for video games, with 11.3% of YPSI children reporting six or more hours/day of playing video games compared to 1.9% AA children (p<0.001).

Conclusions. We observed a marked difference in diet, physical activity habits and cardiovascular parameters among children from two neighboring communities with varying resources. The local and national response to childhood obesity must focus on these community resources in order to improve childhood health.
Abstract 6253: Increased Expression of Thioredoxin Interacting Protein Promotes Oxidative Stress and Contributes to the Pathogenesis Of Diabetic Cardiomyopathy
Authors: Connelly Kim A , Kelly Darren J , Zhang Michael , Thai Kerri , Advani Andrew , Krum Henry , Gilbert Richard E 
Published: July 2021

Background: Alterations in the thioredoxin (TRX) antioxidant system have been implicated in the pathogenesis of cardiac injury, particularly in the diabetic setting. While constitutively present, TRX activity is reduced by the presence of its endogenous inhibitor, thioredoxin interacting protein (TxnIP). We hypothesized that by increasing TxnIP, diabetes may reduce TRX activity and contribute to oxidative stress.
Methods: Cell culture studies were performed using the H9C2 rat cardiomyoblast cell line and neonatal cardiomyocytes isolated from 1 day old Sprague Dawley rat neonates. In-vivo studies were performed using a hemodynamically-validated rodent model of diabetic diastolic heart failure, the diabetic (mRen-2)27 transgenic rat (Ren-2). Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) was used as a measure of oxidative stress.
Results: In- vitro, high glucose (25mmol/l) resulted in increased TxnIP mRNA expression in both neonatal cardiomyocytes as well as H92C cells (2.21 ± 0.6 v 1.00 ± 0.19, p<0.05 compared to normoglycaemic conditions) with a 45% reduction in TRX activity (0.11 ± 0.01 v 0.061± 0.003, p<0.01). In-vivo, diabetes led to a 250% rise in TxnIP mRNA expression compared to control (2.54 ± 0.5 v 1.00 ± 0.11, p<0.001) that was accompanied by a three fold rise in urinary 8-OHdG (680 ± 280 v 1395 ± 391 ng/ml, p<0.001).
Conclusion: In both the in vitro and in vivo settings, high glucose leads to TxnIP over-expression associated with reduced TRX activity thereby increasing oxidative stress and implicating this system in the pathogenesis of the cardiac dysfunction that characterizes the diabetic state. Pharmacological manipulation of the TRX-TxnIP system may represent a novel target to reduce diabetic complications.
Abstract 6278: Burden of Chronic Renal Insufficiency in the General Population and Added Predictive Power of GFR to BNP and NT-proBNP in Detection of Altered Ventricular Structure and Function
Authors: Cataliotti Alessandro , Rodeheffer Richard J , Mahoney Douglas W , Lam Carolyn S , Redfield Margaret M , Martin Fernando L , Burnett John C 
Published: July 2021

Background: Chronic renal insufficiency (CRI) is a strong predictor of increased mortality in the presence of heart failure (HF) and its prevalence has been increasing in the US. In addition, CRI is a major contributing factor to the progression of HF as it is associated with chronic volume overload, accelerated atherosclerosis and hypertension (HTN). The first aim of the current study was to evaluate the prevalence of CRI in an adult general population. The second aim was to address whether calculated glomerular filtration rate (cGFR) adds value to the cardiac biomarkers BNP and NT-proBNP in detecting early cardiac structural and functional impairments in the general population.
Methods: From 1997 to 1999 medical history, physical examination, echocardiography, BNP (Biosite) and NT-proBNP (Roche) and serum creatinine (SCr) were obtained in 1,982 randomly selected residents of Olmsted County, MN >= 45 years (range 45 – 96 years). GFR was calculated using the Cockroft Gault equation. CRI was defined as a GFR < 60 ml/min. Cardiac structure and function were evaluated by in-depth echocardiographic examination.
Results: The prevalence of cardiovascular co-morbidities was coronary atherosclerosis 12%, HTN 29.5% and diabetes mellitus 7.5%. The prevalence of CRI was 22.8% when cGFR was used for its detection. Importantly, by Chi-Square model, cGFR significantly increased the ability of BNP in detecting left ventricular hypertrophy (LVH) (p=0.004), increased relative wall thickness (p=0.0036), diastolic dysfunction (DDF) (p=0.0001) and HTN (p=0.0002). Similarly, when combined with NT-proBNP, cGFR increased the predictive power of detecting DDF (p=0.0001) and HTN (p=0.0366).
Conclusion: This study reports a higher than predicted prevalence of CRI in this general US population equal to 23% and closely associated with the prevalence of HTN (29.5%). Importantly, this study also demonstrates that cGFR has additive predictive power when used in combination with two cardiac biomarkers of cardiac dysfunction and remodeling, BNP and NT-proBNP. These studies underscore the increasing burden of CRI in the general population and the utility of assessing cardiorenal function by combining renal and cardiac biomarkers in assessment of cardiac structure and function.