tbuckley/cabot-search huggingface dataset:
Abstract 058: Accelerometer-Measured Physical Activity and Sedentary Behavior and Risks of All-Cause and Cardiovascular Disease Mortality Among Postmenopausal Cancer Survivors: The Women’s Health Accelerometry Collaboration
Authors: Eric Hyde, Gretchen Bandoli, Jingjing Zou, Noe Crespo, Humberto Parada, Kelly Evenson, Michael LaMonte, Steve Nguyen, Annie Green Howard, Marcia Stefanick, Meghan Skiba, Tracy Crane, I-Min Lee, Andrea LaCroix
Journal: Circulation (2025)

Introduction: The relationship between physical activity (PA) and sedentary behavior (SB) with mortality among women after a cancer diagnosis is understudied. We examined accelerometer-measured daily PA and SB in relation to all-cause and cardiovascular disease (CVD) mortality among postmenopausal cancer survivors in the Women’s Health Accelerometry Collaboration (WHAC). Methods: This study included 2,616 WHAC participants who reported a cancer diagnosis prior to baseline. From 2011–2015, WHAC participants wore an ActiGraph GT3X+ on the hip for ≥10 hours per day for ≥4 of 7 days. Daily accelerometer PA measures included light PA, moderate-to-vigorous PA (MVPA), total PA, and steps. SB measures were total sitting time and mean sitting bout duration. Mortality outcomes were ascertained through 2022. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable stratified Cox regression for each PA and SB measure in association with all-cause and CVD mortality. Models were adjusted for age, race/ethnicity, education, smoking status, alcohol use, general health, postmenopausal hormone use, diabetes, CVD, BMI, physical function, cancer type, and years since cancer diagnosis. Evidence of non-linearity was explored using restricted cubic splines. Results: Overall, the 2,616 cancer survivors (mean [Standard Deviation, SD] age, 74.3 [6.7] years) were followed for a mean of 8.2 years. For all-cause mortality (n=646 cases), 1-SD increments in light PA (78.3 min/day), total PA (96.7 min/day) sitting time (102.3 min/day) and sitting bout duration (4.7 min/bout) were associated with adjusted HRs (95% CIs) of 0.92 (0.84, 1.00), 0.89 (0.80, 0.98), 1.12 (1.02, 1.23), and 1.05 (0.97, 1.13), respectively. Statistically significant nonlinear associations were observed for MVPA and steps ( Figure ). The dose-response curve for steps shows the maximal benefit occurs around 5,000 steps/day before leveling off. The maximal mortality benefit for MVPA was near 50 min/day. For CVD mortality (n=119 cases), 1-SD increments in MVPA (32.9 min/day) and steps (2470 steps/day) were associated with adjusted HRs (95% CIs) of 0.59 (0.41, 0.84) and 0.64 (0.45, 0.93), respectively, while associations for light PA, total PA, and SBs were not significant. Conclusions: Among postmenopausal cancer survivors, higher PA and lower sitting time are associated with reduced risk of all-cause mortality, while more MVPA and steps were associated with reduced CVD mortality risk.
Abstract P1123: Longitudinal Associations of 24-hour Movement Behaviors with Heart Failure: The Jackson Heart Study
Authors: Robert Booker, Mercedes Carnethon, Dorothea Dumuid, Raymond Jones, Sadiya Khan, Chiadi Ndumele, Robert Newton, Shaina Alexandria
Journal: Circulation (2025)

Introduction: Heart failure (HF) morbidity and mortality are disparately greater among Black individuals compared with their peers from other racial and ethnic backgrounds. Sleep, physical activity (PA), and sedentary behavior (SB) are each associated with incident HF, but these are interdependent behaviors, and integration of these exposures is needed to best understand the holistic risk for HF. Therefore, we examined the association between 24-hour compositional distribution of these behaviors and incident HF, including HF subtypes (i.e., HF with preserved ejection fraction [HFpEF] and HF with reduced ejection fraction [HFrEF]). Methods: Black adults ( N =5,306) aged 21-84 years old residing in the Jackson, MS metropolitan area were recruited to join the Jackson Heart Study (JHS) between 2000-2004 (baseline), with additional examinations 2005-2008 and 2009-2013. At baseline, usual nightly hours of sleep were self-reported using the JHS Sleep History Form, PA was collected via the JHS Physical Activity Cohort survey, and SB was calculated as the remainder of the 24 hours. Individuals with HF or a history of HF before 2005, the start of HF surveillance, were excluded. Events of incident HF, and HF subtypes, were assessed annually through 2016. Cox proportional hazard regression was used to estimate the association between the composition of 24-hour movement behavior and the risk of each outcome. Models were adjusted for baseline age, sex, education, body mass index, smoking status, diabetes, hypertension, chronic obstructive pulmonary disease, coronary heart disease, and chronic kidney disease. Results: Participants ( n =4,102) included 64% females and had a mean (SD) age of 54.5 (12.5) years. The cumulative incidence of HF was 8.1% (311 events) over a mean follow-up of 10.5 years. Most of the 24-hour day was SB (71.7%), followed by sleep (26.6%) and PA (1.7%). The proportion of time spent in PA, relative to the remaining movement behaviors, was associated with a lower risk of incident HF (0.88 [0.81, 0.95]) and HFpEF (0.86 [0.77, 0.96]). There was no association between PA and the risk of incident HFrEF. Neither the proportion of sleep nor SB, relative to the remaining movement behaviors, was associated with the risk of HF or HF subtypes. Conclusions: Among Black adults in the JHS, higher PA, relative to SB and sleep, was associated with a lower risk of incident HF and HFpEF. Promotion of habitual PA over the 24-hour cycle may reduce the risk of HF.
Abstract P1006: Trajectories of Cardiometabolic Diseases and Cancer: Transition Patterns, Multiomics Signatures, and Prediction Model
Authors: Xuanwei Jiang, Guangrui Yang, Meng Chen, Nannan FENG, Lan Xu, Xihao Du, Victor Zhong
Journal: Circulation (2025)

Objective Multimorbidity is a growing but understudied global challenge in an aging world. Cardiometabolic disease (CMD) and cancer are the 2 most common chronic diseases, yet their transition patterns remain unclear, and reliable tools for early prediction of disease trajectories across the lifespan are scarce. Methods: This study was conducted on 429,909 UK Biobank participants without baseline CMD and cancer. CMD included type 2 diabetes, coronary disease, heart failure, and stroke. A multistate analysis was used to investigate transition patterns and identify multiomics signatures for transitions from baseline to single morbidity and to multimorbidity. Machine learning prediction models for disease trajectories were constructed using genomics, metabolomics, and proteomics data, and predictive performance was assessed. Results: During a median follow-up of 15 years, 105,855 participants developed morbidity and 15,044 developed multimorbidity of CMD and cancer. Participants with multimorbidity had a 9%-30% higher mortality risk and 2.4-5.3 years of shorter survival time than those healthy or with single morbidity. Development of CMD before cancer presented a poorer prognosis than the reverse order. Distinct and shared multiomics signatures underlying disease trajectories were identified. Top 10 multiomics signatures presented a dose-response characteristic from health to single morbidity and to multimorbidity of CMD and cancer. Proteomics scores showed superior prediction performance than metabolomics and genomics scores. For 10-year outcome prediction, proteomics scores showed varying performance across disease trajectories, with area under receiver-operating characteristic curves ranging from 0.64 for health-to-only cancer trajectory to 0.90 for health-to-CMD-to-death trajectory, significantly better than the base model and traditional clinical model. Conclusions This study revealed disease trajectories of CMD and cancer with varying prognostic implications that were predicted with differing accuracy through multiomics approaches.
Abstract P2028: Air Pollution Induces Atrial Fibrosis via CARD9-Mediated Immune Response
Authors: Yuqi Cui, Xiaochun Ma, Sheevang Patel, Mohamed Mraiyan, Zhenguo Liu
Journal: Circulation (2025)

Background: Exposure to ambient fine particulate matter (PM) triggers systemic inflammation and is associated with atrial fibrosis (AF) and cardiac arrhythmia. The cytosolic adaptor caspase recruitment domain 9 (CARD9) is crucial for macrophage function and innate immune response. This study aimed to investigate the role of CARD9-dependent immune response in PM-induced macrophage-mediated inflammation and the detrimental effects of PM on the heart atrium, exploring the underlying mechanisms. Methods: Male C57BL/6 wild type (WT) mice (4-6 months old, n=8-12) and age- and sex-matched CARD9 knockout (CARD9 -/- ) mice (n=8-12) were intranasally exposed to PM for 1, 2, 7, 14, and 28 days. Serum levels of TNF-α, IL-1β, IL-6, and IL-10 were measured using ELISA. Total macrophage populations and M1/M2 subpopulations in bone marrow (BM) and blood were analyzed in mice with and without PM exposure. BM macrophages were cultured for 48 hours in M0, M1, or M2 medium to analyze their populations and cytokine production with or without PM exposure. Phosphorylated Akt (p-Akt), p-Erk, and Ankyrin-B levels were determined in atrial cardiomyocytes using immunoblotting. AF area was measured with Masson’s trichrome staining. Results: PM exposure significantly elevated serum levels of TNF-α, IL-1β, and IL-6 in WT mice within 24 hours, but not in CARD9-/- mice （Fig. 1). In CARD9-/- mice, PM exposure increased the M2 macrophage population and IL-10 levels compared to WT mice (Fig. 2), with similar findings observed in vitro using BM cells cultured in M0, M1, and M2 media. PM-induced AF was linked to reduced atrial p-Akt and Ankyrin-B levels, effects that were mitigated in CARD9-/- mice compared to WT mice (Fig.3). Conclusion: PM exposure-induced AF may be linked to an enhanced macrophage inflammatory response through CARD9-mediated reduction in IL-10 secretion, resulting in a decreased M2 macrophage polarization from M0 macrophage. This study outlines the underlying mechanism of air pollution-induced atrial arrhythmia and explores potential prevention strategies and treatments.
Abstract P2121: Associations of Physical Activity and Sedentary Behavior with CVD Risk: Mediation by Cardiac Autonomic Function (Pooled Analysis of Six NHLBI Cohorts)
Authors: Zachary Pope, Francis Ryan Avenido, Christine Prissel, Nathan Mitchell, Mahesh Mathew, Pamela Schreiner, David Jacobs, Lin Yee Chen, Susan Heckbert, Elsayed Soliman, Donald Lloyd-Jones, Kelley Gabriel, David Siscovick, Bruce Psaty, Phyllis Stein, Mercedes Carnethon, Daniel Levy, Mark Pereira
Journal: Circulation (2025)

Objective: High sedentary behavior (SB) and low physical activity (PA) can worsen glycemic control, impairing cardiac autonomic function (CAF) and increasing cardiovascular disease (CVD) risk. We examined 1) associations of PA and SB with CVD risk and 2) whether CAF, assessed by heart rate variability (HRV), mediated these associations overall and in those with and without type 2 diabetes (T2D). Methods: We analyzed data from 28,897 participants from six NHLBI cohorts: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Heart Study, Jackson Heart Study, and the Multi-Ethnic Study of Atherosclerosis. We harmonized self-reported PA and SB data as the cumulative average of PA and SB percentiles over all timepoints prior to a fatal/non-fatal CVD event or end of follow-up. HRV was expressed as the SD of normal-to-normal RR intervals (SDNN)—a time-domain measure of HRV and our proxy for CAF. Covariates included harmonized data on age, race/ethnicity, sex, study center, education, smoking, alcohol, diet, and lipid, blood pressure, and T2D medications. We used Cox regression to examine associations of PA and SB with CVD risk, reporting standardized betas for PA and SB. Estimate pooling was performed with a random effects model. HRV mediation was the % difference in pooled PA and SB betas when HRV was in vs. out of the model, with ≥10% beta attenuation defined as mediation. Results: Across cohorts, mean age was 30-71 years, with 8,780 CVD events observed and a mean follow-up of 7,090 days until a CVD event. PA was strongly inversely associated with CVD risk, while SB had a marginal positive association with CVD risk. There was no evidence of CAF mediation for PA. For SB, we observed no evidence of CAF mediation overall but, for those with and without T2D, we observed 16.1% and 7.7% mediation, respectively (Table). Conclusion: Additional research is needed with more robust HRV and SB measures to discern whether the relationship between SB and CVD risk is truly mediated by CAF and whether this mediation varies by T2D status.
Abstract P2026: Association Between Air Pollutants Exposure and Cardiovascular Hospital Admissions: A Systematic Review
Authors: Vibhu Amrutiya, Yamunesh Patel, Gareema Naik, Kashish Parmar, Dhaval Patel
Journal: Circulation (2025)

Background: The air we breathe, along with the pollution it carries, has become an inseparable part of daily life for millions of people worldwide. Exposure to air pollutants has been linked to harmful effects on cardiovascular health. Objective: We aim to evaluate and present the data on cause-specific cardiovascular hospitalizations due to various air pollutants. Methods: We searched through PubMed and Google Scholar databases for literature from January 2019 to September 2024 using the keywords “air pollution and cardiovascular hospital admissions”. Studies of relevant design were included where cardiovascular hospital admission was the specific outcome, and one or more of the following exposures were investigated: PM 2.5 , PM 10 , NO 2 , SO 2 , O 3 and CO. Only studies available in full text and in English language were included. Results: A total of 248 studies were identified, out of which 37 studies met our inclusion criteria. There were 16 time-series studies, 9 case-crossover, 7 cohorts, 4 regression analyses and 1 cross-sectional study. Across all studies (n=37), exposure to PM 2.5 (n=23) showed the most consistent association with hospital admissions for cardiovascular diseases (CVD), with Ischemic Heart Disease (IHD) (n=18) being the most common outcome. Sixteen studies reported that an increase in the concentration of PM 2.5 , PM 10 and NO 2 was associated with a significant rise in the hospital admissions for overall CVD including IHD, Heart failure, Heart rhythm disturbances, Stroke and Hypertension. Hospital admissions for cerebrovascular events, particularly ischemic stroke, were more strongly associated with exposure to SO 2 , CO and PM 10 , among other pollutants. Similarly, hospital admissions for hypertension were more strongly associated with PM 10 exposure. O 3 and NO 2 exposure were closely linked to hospitalizations for IHD, among other CVD. Elderly populations were more susceptible to effects of air pollutant exposure. Hospital admissions also showed seasonal variations due to changing air pollutant levels throughout the year. Conclusion: Our study highlights the importance of air pollution as a major contributor to hospital admissions due to CVD. These findings amplify the need for public health interventions to reduce air pollutant levels, essential to mitigate the burden of cardiovascular diseases and improve overall health and quality of life. Additional studies are needed to better understand the impact of various air pollutants on cardiovascular outcomes.
Abstract P1109: Yogurt consumption is associated with poorer sleep outcomes cross-sectionally, but not long-term
Authors: Emma Guyonnet, Pauline Duquenne, Mathilde Touvier, Valentina Andreeva, Marie-Pierre St-Onge
Journal: Circulation (2025)

Introduction: Emerging evidence suggests that diet also influences sleep health. Dairy intake may impact sleep but few studies have evaluated the association between dairy consumption and sleep health. We evaluated the association between dairy consumption (total and subtypes) and sleep outcomes cross-sectionally and longitudinally in a French population. Hypothesis: Participants with higher dairy intakes will have better sleep outcomes compared to those with lower intakes. Methods: We studied 37,396 adults from the NutriNet-Santé e-cohort (mean age 49.9±14.8 y). Dairy product intake was estimated at baseline (2014) from at least two 24-h dietary recalls and stratified as low, moderate, or high based on average intake. Trouble sleeping, chronic insomnia, and acute insomnia were assessed at baseline and follow-up (2023). Total sleep time (TST) was estimated from sleep logs at baseline. We fit multivariate logistic regression models adjusted for sociodemographics, anthropometrics, lifestyle behaviors, sugar and saturated fat intakes, and diet quality to estimate the odds ratio (OR) of sleep health associated with dairy consumption. Results: In cross-sectional analyses, participants with high total dairy intake had 6% higher odds of acute insomnia, compared to those with low intake (OR high vs low =1.06; 95% CI 1.00-1.12; P-trend=0.042). High intake of yogurt-like products (e.g. yogurts, curd cheese and petit-suisses) was associated with higher odds of trouble sleeping (OR high vs low =1.07; 95% CI 1.02-1.13; P-trend=0.013), chronic insomnia (OR high vs low =1.08; 95% CI 1.01-1.15; P-trend=0.027), and acute insomnia (OR high vs low =1.13; 95% CI 1.08-1.19; P-trend&lt;0.0001), but lower odds of long TST (OR high vs low =0.79; 95%CI 0.70-0.88; P-trend&lt;0.0001). Similar associations for TST were observed for high fermented dairy (e.g., cheese and yogurt) (P-trend=0.0006) and high-fat dairy (P-trend=0.0072) intakes. In longitudinal analyses, trends in the opposite direction were noted for chronic insomnia (P-trend range: 0.064–0.994). Conclusions: Our findings suggest that certain dairy products may be associated with poorer sleep outcomes in cross-sectional analyses; however, these associations did not predict sleep quality long-term. It is possible that individuals with sleep difficulties increased their dairy intake to improve sleep. Clinical interventions are warranted to confirm findings, address causality, and accurately inform dietary guidelines for sleep health.
Abstract P1175: Endometriosis diagnosis, staging, and typology in relation to dyslipidemia
Authors: Karen Schliep, Anna Pollack, Kathryn Rexrode, Rachael Hemmert, Madeline Paulsen, Jessica Chan, Hediyeh Baradaran, Jennifer Majersik, Michael Varner, Matt Peterson, Joseph Stanford, Jenna Krall, Jessica Page, Leslie Farland
Journal: Circulation (2025)

Background: Individuals with endometriosis, a gynecologic condition affecting approximately 11% of people with a uterus, may have an elevated risk for developing cardiovascular disease (CVD) later in life. However, the mechanisms underlying this association are not well understood. Methods: We investigated the association between incident endometriosis diagnosis, staging, and typology and lipid biomarkers measured at time of diagnostic surgery among women participating in the NICHD ENDO study (n=395). Endometriosis was categorized using the American Society for Reproductive Medicine staging (I−IV). Endometriosis typology was defined by lesion depth and location and categorized as superficial endometriosis (SE), ovarian endometrioma (OE), and deep infiltrating endometriosis (DE). With no endometriosis as our reference, we evaluated the associations between endometriosis diagnosis, stage (I/II vs III/IV), and typology (SE, OE, DE, OE+DE) and dyslipidemia using standard clinical thresholds (total cholesterol ≥200 mg/dL, high-density lipoprotein (HDL) &lt;50 mg/dL, low-density lipoprotein (LDL) ≥100 mg/dL, triglycerides ≥175 mg/dL, non-HDL ≥130 mg/dL, VLDL ≥30 mg/dL, Apolipoprotein A-1 (APO-A1) &lt;125 mg/dL, Apolipoprotein B (APOB) ≥120 mg/dL; APOB/APO-A1 ratio &gt;0.78). We calculated adjusted prevalence ratios (aPR) and 95% CIs via generalized linear models, controlling for age, race/ethnicity, marital status, BMI, income (poverty level), and serum cotinine as a marker of smoking. Results: At the time of gynecologic surgery, individuals were mean 32 years (SD: 7 years), non-Hispanic white (79%), married (71%), and mean BMI 28 (SD=8). While we found no differences in endometriosis diagnosis or endometriosis staging and dyslipidemia ( Figure 1; Table 1 ), a pattern emerged regarding endometriosis typology ( Table 2 ). Women with OE+DE, compared to no endometriosis, had increased prevalence of dyslipidemia: total cholesterol &gt;200 mg/dL: 1.87 (0.99, 3.57); triglycerides &gt; 175 mg/dL: 2.48 (1.34, 4.57); VLDL ≥30 mg/dL: 2.08 (1.28, 3.38); and APOB mg/dL ≥120: 2.86 (1.22, 6.66). OE appeared to be driving this association. SE was not associated with dyslipidemia. Conclusions: The association between endometriosis, especially of more severe typology, and subsequent CVD may be through dyslipidemia, which may be detectable at the time of endometriosis diagnosis. Further research in larger, more representative samples is needed before definitive conclusions can be made.
Abstract P2035: All The Common Cardiovascular Diseases Are Aggravated By Climate Hazards: Current Evidence And Mechanisms
Authors: zaiyong zheng, Xue Zhang, Qiuting Li, Yaling Qie, Xin Zhang, Chan Yang, Keran Jia, Liangchuan Zhang, Yuchang Liu, Yanyan Dai, Yingla Li, Yuan Kong, Xueting Yu, Famei Wang, Yating Peng, Min Fu, Hong Jia, Zhang Zhang
Journal: Circulation (2025)

Climate change is widely recognized as a significant factor impacting cardiovascular diseases , yet a detailed and comprehensive understanding of this relationship remains underdeveloped. Aim: This study aims to provide a thorough review of the current epidemiological evidence regarding how climate change affects cardiovascular diseases. Method: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, population-based epidemiological studies focused on climate change and cardiovascular diseases were collected from Google Scholar up to January 2023. A Bibliometric analysis was conducted to describe the basic bibliographic information of the included studies. Due to methodological reasons, a meta-analysis was not performed. Results: A total of 308 relevant studies were identified from 46,200 search records that met the specified criteria, with the USA, China, and Australia being the leading contributors in this field. These studies identified 208 unique pathways through which climate change influences the morbidity and mortality of cardiovascular diseases. Key climate factors such as heatwaves, cold spells, dust storms, air pollution, wildfires, and hurricanes were found to significantly increase the risk of cardiovascular diseases. Among these, temperature change emerged as the most extensively studied topic. Conclusion: Cardiovascular disease can be exacerbated by various climate hazards, underscoring the need for more controlled and high-quality research to further explore these hazardous effects and interventions. Moreover, further measures are needed to mitigate extreme climate changes and reduce their impact on cardiovascular health.