tbuckley/cabot-search huggingface dataset:
Abstract P055: Diabetes, Early Heart Failures Stages (A &amp; B), And Progression To Overt Heart Failure In Older Adults: The Atherosclerosis Risk In Communities Study
Authors: Justin B Echouffo Tcheugui, Chiadi E Ndumele, Sui Zhang, Roberta Florido, Kunihiro Matsushita, Josef Coresh, Hicham Skali, Amil M Shah, Elizabeth Selvin
Journal: Circulation (2021)

Introduction: Diabetes confers a high risk of heart failure (HF). However, the influence of diabetes in preclinical HF (stages A or B) on the progression to overt HF is not well understood. Hypothesis: Diabetes accelerates progression to clinically overt HF, but significantly more so in stage A than B. Methods: We included older adults (aged 66-90 years) without clinical HF (n= 4782) who attended ARIC study visit 5 (2011-2013). We categorized participants into stage A (n=3067) or B (n=1715) HF. Within each stage A or B, we used Cox regression to quantify the associations of diagnosed diabetes and glycemic control (HbA 1C &lt;7% vs. ≥ 7%) with progression to HF. We also evaluated the relative and absolute risk associations of cross-categories of HF stages (A vs. B) and diabetes and glycemic control with incident HF. Results: There were 401 HF events during a median 6.3 years follow-up (mean age 75, 59% female, 21% Black, 28% with diabetes). The 7.6-year cumulative HF risk among individuals with diabetes and HbA 1C ≥ 7% vs. those without diabetes was 11.9% vs. 4.5% in stage A, and 18.1% vs. 13.6% in stage B. In stages A and B, individuals with uncontrolled diabetes had significantly higher risks of HF compared to those without diabetes (all P &lt;0.05; Table ). Uncontrolled diabetes was more strongly associated with HF in stage A than stage B ( P =0.02). In cross-categories of HF stage, diabetes, and glycemic control, individuals with stage B HF and uncontrolled diabetes had greater than 4-fold risk of HF than those with stage A HF without diabetes. Conclusions: Among older adults with preclinical HF stages (A and B), uncontrolled diabetes is associated with substantial short-term (~8 year) risk of HF and should be a focus of aggressive preventive therapies. Newer anti-diabetes therapies such as SGLT2 inhibitors are currently recommended in adults with diabetes and clinical HF, but not stages A and B. Our results suggest that among older adults, such therapies may yield clinical benefits in early HF stages.
2020 American Heart Association and American College of Cardiology Consensus Conference on Professionalism and Ethics: A Consensus Conference Report
Authors: Ivor J. Benjamin, C. Michael Valentine, William J. Oetgen, Katherine A. Sheehan, Ralph G. Brindis, William H. Roach, Robert A. Harrington, Glenn N. Levine, Rita F. Redberg, Bernadette M. Broccolo, Adrian F. Hernandez, Pamela S. Douglas, Ileana L. Piña, Emelia J. Benjamin, Megan J. Coylewright, Jorge F. Saucedo, Keith C. Ferdinand, Sharonne N. Hayes, Athena Poppas, Karen L. Furie, Laxmi S. Mehta, John P. Erwin, Jennifer H. Mieres, Daniel J. Murphy, Gaby Weissman, Colin P. West, Willie E. Lawrence, Frederick A. Masoudi, Camara P. Jones, Daniel D. Matlock, Jennifer E. Miller, John A. Spertus, Lynn Todman, Cathleen Biga, Richard A. Chazal, Mark A. Creager, Edward T. Fry, Michael J. Mack, Clyde W. Yancy, Richard E. Anderson
Journal: Circulation (2021)

4. Oversight of the process by completely independent organizational personnel to ensure compliance.This section discusses this process as it applies to associational and intellectual interests and in the context of educational activities, publications, peer review, research data, technology, and expert testimony.The many other contexts in which an interest can create COIs are beyond the scope of this section.The task force supports the existing relevant policies and guidelines of the ACC and AHA, National Academy of Medicine (NAM), ACGME, AMA, and National Institutes of Health, all of which have been carefully created and vetted, 32 and makes recommendations that merit further consideration in the implementation of this process. Recommendations Related to Disclosure of RWIs in Educational Activities and Scientific Publications 1.Disclosure of RWIs should be mandatory for educational activities and scientific publications. 2.Comprehensive current RWI disclosures should be collected and assessed by organizations for individuals involved in educational activities and scientific publications. 3.The ACC and AHA should educate their members and promote compliance with the applicable policies 33,34 and other organizational publications on RWIs as they relate to educational activities and publications. 4.The ACC and AHA should have oversight bodies and personnel in place to independently and objectively assess, manage, and oversee the integrity of any endeavor in accordance with applicable laws, industry standards, and best practices.
Abstract 16572: Single-Cell Transcriptomics Revealed Distinct B Cell Activation and Repression States in Obese Adipose Tissue
Authors: Alyssa J Matz, Lili Qu, Chuan Li, Anthony Vella, Beiyan Zhou
Journal: Circulation (2020)

Obesity increases risk of several disease states including type-2 diabetes, arthritis, and cardiovascular disease. B cell dysfunction within visceral adipose tissue (AT) has been demonstrated to be a driving force towards insulin resistance, but the AT B cells (ATBs) responsible have not been well identified or characterized. We sought to elucidate the cellular changes occurring in ATBs during obesity that will confer obesity’s comorbidities using the single cell RNA sequencing technique. Consistent with previous studies, we observed a significant change in the B cell compartment composition in obese AT compared to the control lean ATBs. As expected, the majority of lean ATBs were naïve cells, characterized by several factors including moderate expression of transcription factor Pax5 and low BCR activation. Further cell function annotation identified two distinct states with increased proportions of obese ATBs, which were revealed by differential gene expression analysis to be either activated towards antibody producing or in a state of repression. The first state was characterized by an upregulation of several genes in B cell receptor (BCR) signaling and subsequent transcription factors such as Blk, Cd19, Pax5, Slamf7, and Cr2, suggesting activation. Such activation status is concomitant with high Ighm and increasing Ighd levels in the same cell population. Interestingly, we also observed a distinct B subtype that was also enriched in obese ATBs. These ATBs displayed low immunoglobulin production, low BCR associated proteins, low transcription factors, and high Pdcd1lg2, mouse homolog to human PD-L2, the programmed cell death ligand used in B cell repression. Further characterization of these newly identified ATB states under healthy or obese conditions suggested a significant change in B cell polarized action in obesity. The impact of these diversified ATB on other immune cells and the adipocyte actions and their cell-cell interaction will be further analyzed using our original bioinformatic programs. A high resolution of ATBs action in obesity will provide critical information to develop new therapeutic/prevention strategies against obesity induced health risk.
Pathogenic ATM Variant-Harbouring Well-Differentiated Aggressive Type 1 Gastric Neuroendocrine Tumour with High-grade Features (G3 NET): a New Addition to the Clinical and Pathological Spectrum of Gastric Neuroendocrine Neoplasms
Authors: Hussein Nassereddine, Matthieu Chicaud, Khedidja Rebah, Nathalie Théou-Anton, Anne Sautet, Jacques Dermer, Anne Couvelard
Journal: Endocrine Pathology (2021)
Abstract 17052: Cardiothoracic Surgeons With a PhD Degree Exhibit Greater Research Productivity
Authors: Simar Bajaj, Hanjay Wang, Kiah M Williams, Joseph Heiler, Joshua Pickering, Keerthi Manjunatha, Mark Sanchez, Christian O'Donnell, Jack Boyd
Journal: Circulation (2020)

Introduction: A PhD degree can offer significant research experience for academic surgeons. Here, we evaluated the impact of a PhD on research productivity and career advancement in cardiothoracic (CT) surgeons. Methods: All CT surgeons practicing at an accredited United States CT surgery training program in 2018 who earned a PhD or completed a research fellowship during training (RF) were included (n=583). To ensure a more consistent training pathway, we performed a sub-analysis of U.S. medical school graduates (n=456). Surgeon-specific data were obtained from publicly available sources (eg. institutional webpages, Scopus). Results: 92 (15.8%) surgeons obtained a PhD while 491 (84.2%) did not but did a RF (Table 1A). Importantly, attending start year was similar (2005 vs 2005, p=0.5202). As of 2018, PhD surgeons published greater first-author (17.0 vs 12.0, p=0.0079), last-author (12.0 vs 6.0, p=0.0462), and total papers (68.5 vs 52.0, p=0.0148), as well as total papers per year as an attending (4.6 vs 3.0, p=0.0148). However, PhD surgeons took a similar amount of time as non-PhD surgeons who did a RF to become a full professor from the start of their first job (12.0 vs 11.0, p=0.6620). No difference was observed in current academic rank neither (p=0.8047). For U.S. medical school graduates, there were 40 PhD surgeons and 416 non-PhD surgeons who did a RF (Table 1B). Both groups published a similar number of first-author (13.0 vs 13.0, p=0.5379), last-author (12.5 vs 6.0, p=0.0981), total papers (64.5 vs 54.0, p=0.3453), and total papers per year as an attending (3.2 vs 3.0, p=0.7546). Years to full professor were also similar between these two groups (12.0 vs 11.0, p=0.6007) as was current academic rank (p=0.3114). Conclusions: A PhD degree is not associated with faster career advancement but may be associated with enhanced research productivity for some surgeons due to the impact of their medical school training environment.
Glycated Hemoglobin and Risk of Cardiovascular Events in Patients without Diabetes in the Heart Institute of Japan Acute Myocardial Infarction
Authors: Higashitani Michiaki, Murasaki Kagari, Ogawa Hiroshi, Uchida Yoshie, Kameyama Kinichi, Nagashima Michitaka, Mori Fumiaki, Takagi Atsushi, Tsurumi Yukio, Hagiwara Nobuhisa, Kasanuki Hiroshi
Journal: Circulation (2008)
Abstract 15072: Thirty Day Episode of Care Spending Following Heart Failure Hospitalization Among Medicare Beneficiaries With Heart Failure
Authors: Nihar R Desai, Craig Parzynski, Ralph J Riello, Phil Sarocco, Tariq Ahmad
Journal: Circulation (2020)

Background: Heart failure (HF) is one of the costliest conditions in the US with immense public health interest to examine and improve the value of care. We sought to characterize current payments spanning the index hospitalization through 30-days post-discharge for Medicare beneficiaries with HF. Methods: Using Medicare fee-for-service administrative claims data, we identified patients hospitalized with HF from 2016-2018 with the following primary discharge diagnoses (ICD-10 codes): systolic HF (50.2 and 50.4), diastolic HF (50.3), hypertensive heart disease (HHD) with HF (I11), and HHD with HF and chronic kidney disease (CKD) (I13). Coding patterns over time across these four groups, mean 30-day episode of care spending overall, and proportion of total costs allocated to the index hospitalization and post-acute care were analyzed. Results: The study sample included 174,539 patients hospitalized with systolic HF; 163,071 diastolic HF; 221,820 HHD with HF; and 359,950 HHD with HF and CKD. Over time, there was a substantial increase in the use of the HHD with HF +/- CKD codes, accounting for 52% of HF hospitalizations in 2018 (Figure). We found substantial spending on 30-day episode for HF with nearly 2-fold variation across mean spending. Overall, 30-day episode spending was significantly higher for HHD with HF and CKD as compared to other diagnoses. Across all codes, the index hospitalization accounts for 70% of total episode spending while 30% is accounted for by post-acute care spending (Table). Conclusions: This patient episode-level analysis of contemporary Medicare beneficiaries suggests several areas to improve the value of HF care. The 30-day episode of care spending for heart failure hospitalizations is substantial with more than 2-fold variation. The impact of alternative payment models on HF outcomes and spending remains an important area for ongoing investigation.
Abstract 13180: Ultrasound Jugular Venous Pressure Collapse Point Predicts Elevated Right Atrial Pressure on Right Heart Catheterization in Obese and Nonobese Patients
Authors: Libo Wang, Jonathan Harrison, Elizabeth Dranow, Lillian Khor
Journal: Circulation (2020)

Introduction: Accurate intravascular volume status assessment is central to heart failure management, but current non-invasive bedside techniques remain a challenge. Visual inspection of jugular venous pulsation (JVP) is used as a surrogate for central venous pressure (CVP). Studies have shown variability and inaccuracy of the JVP exam in estimating CVP or right atrial pressure (RAP). Published methods of RAP estimation through internal jugular vein (IJV) ultrasonography are either complex or require offline analysis. We validated a simplified approach to ultrasonography of the JVP (uJVP) as a method to predict RAP. Methods: Adult patients undergoing right heart catheterization (RHC) were enrolled prior for IJV imaging with point of care ultrasound (POCUS) device, Butterfly iQ™. The IJV was identified on ultrasound with the patient reclined (head of bed between 30-45°) and followed cranially until tapering smaller than the adjacent carotid artery throughout the entirety of the respiratory cycle. The height of this collapse point from the sternal angle added to 5 centimeters was defined as ultrasound JVP (uJVP). Results: 77 participants underwent uJVP assessment on the same day prior to RHC. Average BMI was 33 kg/m 2 . The area under the curve (AUC) of uJVP and RAP greater than 10mmHg on RHC was 0.879 (95% CI 0.759-0.931, p&lt;0.001), with AUC of 0.972 and 0.818 for non-obese and obese subgroups respectively, and AUC of 0.876 for elevated RAP and pulmonary capillary wedge pressure (PCWP). A uJVP cutoff of 9 or higher was 85% sensitive and 72% specific at identifying RAP greater than 10mmHg. Conclusion: We developed and validated a novel technique identifying the uJVP using POCUS which correlates with invasive RAP regardless of obesity. This technique predicted combined elevated left and right sided intracardiac pressures. The uJVP’s potential to enhance the diagnostic value of the bed-side examination in an increasingly obese heart failure population warrants further research.
Abstract MP18: Association Of Longitudinal Social Determinants Through Young Adulthood With Mid-life Cardiovascular Health: The Coronary Artery Risk Development In Young Adults (CARDIA) Study
Authors: Lindsay P Zimmerman, Kiarri N Kershaw, David H Rehkopf, Yuan Luo, Donald M Lloyd-Jones
Journal: Circulation (2021)

Introduction: Deeper understanding of the longitudinal associations of social determinants of health (SDOH) at younger ages with cardiovascular health (CVH) in middle age is needed to address persistent health disparities. Methods: We used repeated measures of individual and neighborhood-level SDOH data from CARDIA participants (ppts) to understand how SDOH change from ages 18-44 years. There were 48 diverse SDOH exposures measured. Using a novel, machine learning, sequential pattern mining method (Subgraph Augmented Non-negative Matrix Factorization), we identified clusters of time-dependent SDOH variables occurring in 5% or more of ppts. Clusters were then used as independent variables in logistic regression models to assess associations with CVH at age ≥45 years. CVH status was defined using the AHA’s Simple 7 metrics on diet, physical activity, smoking, BMI, cholesterol, blood pressure, and blood glucose, and summarized by a 14-point score (poor 0-7, moderate 8-11, high 12-14 points). We tested associations of clusters with the outcome of poor CVH at age ≥45 years, and identified the characteristics of significant SDOH clusters. Results: There were 3,522 ppts included (46.3% Black, 55.9% women; mean age 25.3 years at baseline). Mean CVH score (out of 14) was 10.4 ± 1.8 points at baseline and 8.9 ± 2.3 points at age ≥45 years; 483 ppts (13.7%) had high, 2026 (57.5%) had moderate, and 1013 (28.8%) had poor CVH in middle age. The best performing logistic model included 4 SDOH trend clusters (Table). SDOH Clusters 1, 2, and 3 were each associated with significant 50-80% lower odds of having poor CVH in middle age, whereas Cluster 4 was associated with 2.5-fold higher odds of poor CVH. The most informative variables over time comprising each SDOH cluster are also shown in the Table. Conclusions: Specific SDOH clusters through young adulthood are significantly associated with reaching mid-life with poor CVH status. Components of these SDOH clusters may be potential targets for social interventions and policies to improve CVH.
Abstract 15554: Mendelian Randomization of 436 Circulating Proteins Identifies Putatively Causal Proteins for Cardiovascular Disease and Its Risk Factors
Authors: Chen Yao, Shih-jen Hwang, Tianxiao Huan, Roby Joehanes, Daniel Levy
Journal: Circulation (2020)

Introduction: Despite numerous efforts to understand the molecular mechanisms underlying cardiovascular disease, it remains the leading cause of death worldwide. Circulating proteins are frequently used as clinical biomarkers and may serve as effective drug targets. Hypothesis: Identifying genetic variants associated with circulating protein concentrations (pQTLs) and combining them with genome-wide association study (GWAS) results may bridge a knowledge gap of unexplained heritability, identify potentially causal proteins, and highlight promising therapeutic targets. Methods: We measured concentrations of 436 plasma proteins among 484 Framingham participants using OLINK cardiovascular disease and inflammation panels. For each protein, we conducted a GWAS using 1000G imputed genotypes (imputation quality &gt;20%). Then we performed two sample Mendelian randomization using cis-pQTLs (SNPs within 1Mb of transcriptional start site of the protein coding gene) as instrumental variables and 11 public cardiovascular trait GWAS (coronary artery disease (CAD), HDL cholesterol, LDL cholesterol, triglycerides (TG), body mass index (BMI), obesity, fasting blood glucose, type 2 diabetes, systolic blood pressure, diastolic blood pressure, and Hypertension) as outcomes. Results: At Bonferroni-corrected P&lt;0.05, we identified 5281 cis-pQTLs for 76 proteins. Mendelian randomization identified 13 putatively causal proteins for seven cardiovascular traits: FGF-5, IL-6RA, LPL , and TFPI for CAD; CAPG, IGG_FCrrec, LPL, and TFPI for HDL; KIM1, LPL, and TNFB for TG, ENTPD6 for BMI; FGF-5, TFPI, UMOD, IGFBP3, PXN, and NUCB2 for blood pressure traits. Conclusions: At Bonferroni-corrected P&lt;0.05, we identified 5281 cis-pQTLs for 76 proteins. Mendelian randomization identified 13 putatively causal proteins for seven cardiovascular traits: FGF-5, IL-6RA, LPL , and TFPI for CAD; CAPG, IGG_FCrrec, LPL, and TFPI for HDL; KIM1, LPL, and TNFB for TG, ENTPD6 for BMI; FGF-5, TFPI, UMOD, IGFBP3, PXN, and NUCB2 for blood pressure traits.
Evaluation of Myocardial Infarction by Cardiovascular Magnetic Resonance at 0.55-T Compared to 1.5-T
Authors: W. Patricia Bandettini, Sujata M. Shanbhag, Christine Mancini, Jennifer L. Henry, Margaret Lowery, Marcus Y. Chen, Hui Xue, Peter Kellman, Adrienne E. Campbell-Washburn
Journal: JACC. Cardiovascular imaging (2021)
Metformin Affects Gut Microbiome Composition and Function and Circulating Short-Chain Fatty Acids: A Randomized Trial
Authors: Noel T. Mueller, Moira K. Differding, Mingyu Zhang, Nisa M. Maruthur, Stephen P. Juraschek, Edgar R. Miller, Lawrence J. Appel, Hsin-Chieh Yeh
Journal: Diabetes Care (2021)

To determine the longer-term effects of metformin treatment and behavioral weight loss on gut microbiota and short-chain fatty acids (SCFAs).We conducted a 3-parallel-arm, randomized trial. We enrolled overweight/obese adults who had been treated for solid tumors but had no ongoing cancer treatment and randomized them (n = 121) to either 1) metformin (up to 2,000 mg), 2) coach-directed behavioral weight loss, or 3) self-directed care (control) for 12 months. We collected stool and serum at baseline (n = 114), 6 months (n = 109), and 12 months (n = 105). From stool, we extracted microbial DNA and conducted amplicon and metagenomic sequencing. We measured SCFAs and other biochemical parameters from fasting serum.Of the 121 participants, 79% were female and 46% were Black, and the mean age was 60 years. Only metformin treatment significantly altered microbiota composition. Compared with control, metformin treatment increased amplicon sequence variants for Escherichia (confirmed as Escherichia coli by metagenomic sequencing) and Ruminococcus torques and decreased Intestinibacter bartlettii at both 6 and 12 months and decreased the genus Roseburia, including R. faecis and R. intestinalis, at 12 months. Effects were similar in comparison of the metformin group with the behavioral weight loss group. Metformin versus control also increased butyrate, acetate, and valerate at 6 months (but not at 12 months). Behavioral weight loss versus control did not significantly alter microbiota composition but did increase acetate at 6 months (but not at 12 months). Increases in acetate were associated with decreases in fasting insulin. Additional whole-genome metagenomic sequencing of a subset of the metformin group showed that metformin altered 62 metagenomic functional pathways, including an acetate-producing pathway and three pathways in glucose metabolism.Metformin, but not behavioral weight loss, impacted gut microbiota composition at 6 months and 12 months. Both metformin and behavioral weight loss altered circulating SCFAs at 6 months, including increasing acetate, which correlated with lower fasting insulin. Future research is needed to elucidate whether the gut microboime mediates or modifies metformin's health effects.