tbuckley/cabot-search huggingface dataset:
Abstract P353: Effect of Exergaming-Based Dance Training Paradigm in Improving Cardiovascular Function and Functional Mobility Among People With Chronic Stroke
Authors: Savitha Subramaniam, Jun Ma
Journal: Circulation (2024)

Background: Dance-based exergaming (DBExG) , could potentially facilitate cardiovascular conditioning and functional mobility while enhancing physical activity behavior among people with chronic stroke (PwCS). Albeit, PwCS exhibits limitations (e.g., health care, and travel) in laboratory/outpatient rehabilitation programs, making them inaccessible. The DBExG from the laboratory (phase 1) to a safe and feasible home-based exercise program (phase 2) could effectively improve cardiovascular and functional mobility and address the accessibility limitations. Aim: To evaluate the feasibility, effect, and adherence of DBExG in promoting heart rate variability (HRV) and functional mobility in a laboratory and home-based rehabilitation approach. Design: Pre-post interventional study. Setting: Laboratory (phase 1) and home-based (phase 2) settings. Methods: Community-dwelling PwCS (n=10) participated in the study and received DBExG training using the commercially available Kinect dance gaming “Just Dance 3”. The first 6 weeks of training were provided in the laboratory setting and were delivered in a high-intensity tapering method with the first two weeks consisting of 5 sessions/week, the next two weeks of 3 sessions/week, and the last two weeks of 2 sessions/week, with a total of 20 sessions. Followed by 4 more weeks of DBExG training in the participant’s house (3 days/week), with a total of 12 sessions. Feasibility was addressed by acceptability and retention. Data obtained for HRV analysis pre- and post-intervention consists of HRV for ten minutes in (1) supine resting position; and (2) quiet standing. High-frequency (HF) power measures as indicators of cardiac parasympathetic activity, low-frequency (LF) power of parasympathetic-sympathetic balance, and LF/HF of sympatho-vagal balance were calculated. Six-minute walk test (6-MWT) was used to assess functional mobility. Changes in physical activity during pre- and post-intervention for one week and also during dance training were assessed using Fibit. Results: All participants completed the laboratory and home-based DBExG. All participants reported enjoying the sessions and most felt they were beneficial. Study retention and session adherence was 90% and 96%, in phase 1, and 2 respectively. There were no falls, or adverse safety events reported in either phase of the study. The results showed improvements in HRV HF, LF, and LF/HF. The result findings indicated significant improvement in the 6-MWT. The number of steps during dance intervention increased significantly from 1 st to the 32 nd session. Conclusions: A combination of laboratory, transitioned to home-based maintenance therapy approach appears feasible, safe, and effective thus promising for post-stroke rehabilitation. A larger randomized controlled trial is recommended to further investigate efficacy.
Abstract P231: Are Resiliency and Religiosity/Spirituality Associated With Better Sleep Outcomes in Midlife Latinas?
Authors: Latesha K Harris, Krista M Perreira, Andrea Cazales, Christian Long, Yamnia I Cortés
Journal: Circulation (2024)

Background: The disproportionate cardiovascular disease (CVD) burden among Latinas is not completely explained. An important health behavior in CVD prevention is sleep. In the United States (U.S.), Latinas experience unique sociocultural stressors that may impact sleep, particularly in midlife. Yet, little is known about protective factors such as resiliency and religiosity/spirituality among midlife Latinas. Aims: To assess the relation of resiliency and religiosity/spirituality with sleep disturbances in midlife Latinas. Methods: We conducted a cross-sectional analysis using baseline data from 49 participants in a pilot study to reduce CVD risk in midlife Latinas. Participants were Latinas aged 40-60 years who were perimenopausal or early postmenopausal, free of CVD, with no menopause hormone therapy use in the prior three months. Women were recruited from community settings. The frequency of sleep disturbances (trouble falling asleep, waking early, or nocturnal awakenings) over the past two weeks was assessed, and a sum score was created (0-16). The 6-item Brief Resilience Scale was used to assess the perceived ability to “bounce back” or recover from hardship. Religiosity/spirituality was determined by self-report (how important is religion/spirituality to you). Multivariable linear regression models were performed at p&lt;0.15, adjusting for sociodemographic. Results: Participants were on average aged 47.1±4.5 years, 47% had less than a high school education, and 98% were born outside of the continental U.S. Sixty-nine percent of women experienced trouble falling asleep. The mean sleep score was 6.9±4.6. In adjusted models, we found an inverse relationship between resiliency and sleep (ß[SE]= -0.33[0.13],p=0.01). Religiosity/spirituality was not related to sleep disturbances (ß[SE]= 1.15[1.60],p=0.48). Conclusions: In this analysis of midlife Latinas, higher resiliency was associated with poorer sleep. Findings suggest that the ability to “bounce back” after hardship and religiosity/spirituality may not buffer the negative impact of stress on sleep. Further research is necessary with objective sleep measures to identify protective factors for sleep disturbances that may subsequently improve CVD risk in midlife Latinas.
Abstract MP71: Novel Association Between Parity and Skeletal Muscle Adiposity in Middle-Aged and Older African Caribbean Women
Authors: Zhongjie Zhang, Samar R El Khoudary, Ryan Cvejkus, Caterina Rosano, Victor Wheeler, Allison L Kuipers, Iva Miljkovic
Journal: Circulation (2024)

Objective: Pregnancy and parity (number of children born to a women) are associated with alterations in metabolism and lifestyle, which may affect women’s short- and long-term cardiometabolic health. Greater skeletal muscle adiposity (myosteatosis) is recognized as a major risk factor for cardiometabolic diseases, especially in African ancestry individuals. While lifetime parity has been previously associated with greater central obesity years after childbearing ceased, it remains unclear whether parity is associated with myosteatosis. Methods: We examined the association of parity (0, 1, 2, 3, 4+) with myosteatosis and general and central obesity among 1,119 African Caribbean women, aged 40-84 years, recruited from 2019 to 2023 without regard to health status. Calf myosteatosis area was measured by CT-derived intermuscular adipose tissue (IMAT, mm 2 ) and skeletal muscle density (mg/cm 3 , with a lower density indicating more adiposity). Multivariable linear regression models were used to estimate the adjusted means of IMAT, muscle density, BMI, and waist circumference for each parity group. Results: The mean age of women who reported ever being pregnant (N=969) was 55.8 (SD=9.0) years. They were obese on average (BMI=32.1 (SD=6.8) kg/m 2 ), and had given birth to an average of 3 (SD=2.3) children. In multivariable models, higher parity was significantly associated with higher IMAT and lower muscle density, after accounting for age, BMI, physical activity, and comorbidities (see Table). Parity showed no associations with BMI or waist circumference. Conclusions: Parity may be associated with greater accumulation of adiposity in skeletal muscle, despite no link with general or central adiposity among African Caribbean women. Our novel findings, if confirmed in prospective studies, might highlight the need for tailored strategies for maintaining healthy muscles in multiparous women of African ancestry. Table. Adjusted population marginal means (95% CI) for myosteatosis by parity groups in African Caribbean women a
Abstract P162: Projected Reduction in Incident Non-Ischemic Heart Failure by Controlling Risk Factors in Individuals With Diabetes
Authors: Susan Hennessy, Joanne Penko, Pamela G Coxson, Ross Boylan, Brandon K Bellows, Yiyi Zhang, Kendra D Sims, Andrew E Moran, Kirsten Bibbins-Domingo, Dhruv S Kazi
Journal: Circulation (2024)

Background: Individuals with diabetes have an elevated risk of non-ischemic heart failure (NIHF), and comorbidities such as hypertension, obesity, and smoking exacerbate this risk. Compared with the status quo in US adults with diabetes, we projected the decrease in NIHF incidence and prevalence that could occur if hypertension, overweight/obesity, and smoking status were treated to evidence-based thresholds. Methods: The Cardiovascular Disease (CVD) Policy Model is a computer simulation that provides nationally representative estimates of CVD burden for the US population aged 35-94 years. We used National Health and Nutrition Examination Survey (2015-2018) data to determine diabetes prevalence (i.e., “ever been told you have diabetes”, HbA1c ≥6.5%, fasting glucose ≥126mg/dl, or non-fasting glucose ≥200mg/dl) in individuals without prior CVD. Incident NIHF rates were estimated from pooled epidemiologic cohorts. We modeled the impact of treating hypertension (SBP ≥130mmHg), overweight or obesity (BMI ≥25Kg/m 2 ), and current smoking to evidence-based thresholds (SBP &lt;130mmHg, BMI &lt;25Kg/m 2 , and smoking cessation) on incident and prevalent NIHF over ten years (2023-2032). Results: An estimated 28.4 million US adults aged 35-94 years have diabetes and no prior CVD. Of these, 50% have hypertension, 89% are overweight or obese, and 13% are current smokers. In ten years under the status quo, the projected incidence of NIHF would be 604,000 cases per year and the prevalence of NIHF would be 4.7 million individuals. Treating risk factors to evidence-based thresholds across the whole population would reduce NIHF incidence to 528,000 cases per year, a 13% decline, and prevalence to 4.4 million individuals, an 8% decline. Achieving a BMI ≤25Kg/m 2 among those with overweight/obesity would have the greatest independent effect on projected HF incidence and prevalence ( Table ). Conclusions: Weight loss, blood pressure control, and smoking cessation in patients with diabetes could substantially reduce the US burden of incident NIHF.
Abstract P167: Association Between Obesity and New-Onset Heart Failure Among People With Hypertension in Thailand
Authors: Boonsub Sakboonyarat, Jaturon Poovieng, Ram Rangsin
Journal: Circulation (2024)

Obesity establishes cardiovascular risk factors, including high blood pressure, hyperlipidemia, and high blood glucose, and also results in cardiovascular events. In Thailand, the epidemiological data on the relationship between obesity and heart failure (HF) among high-risk populations was limited. We assessed the hypothesis that increased body mass index (BMI) was associated with the new-onset HF among people with hypertension (HTN); we also assessed the effect modifier of uncontrolled HTN on this association. We conducted a retrospective cohort study in 2018. Thai people with HTN aged 20 years and older receiving continuous care at out patient clinic in the hospitals nationwide were included. While those with a history of HF before 12 months from the data collection date were excluded. The new-onset HF was defined regarding the ICD-10 as I50 in the medical records within 12 months. The information on the characteristics and BMI of participants was extracted from the medical records by well-trained registered nurses. Obesity was defined as BMI ≥25 kg/m 2 . We performed multivariable log-binomial regression analysis to determine the association between BMI and new-onset HF and presented as the adjusted risk ratio (aRR) and 95%CI. A total of 35,756 participants were included in the analysis. The mean age of participants was 64.5±0.1 years. In all, 61.4% were women, and 50.0% had controlled HTN (SBP&lt;140 mmHg and DBP &lt;90 mmHg) two visits consecutively. The mean BMI was 25.1±0.02 kg/m 2 . New-onset HF occurred in 75 participants (0.21%). Adjusting for age, sex, health schemes, geographic regions, hospital types, type 2 diabetes, dyslipidemia, renal insufficiency, history of ischemic heart disease, smoking status, alcohol use, uncontrolled HTN, and ACEI/ARB use, increased BMI per 1 kg/m 2 was significantly associated with new-onset HF (aRR 1.09 [95%CI: 1.05-1.14]). In comparison with participants with BMI of 18.5-22.9 kg/m 2 , the aRR for new-onset HF was 1.57 (95% CI:0.80-3.08), 3.69 (95%CI: 1.73-7.87), and 5.18 (95% CI: 1.81-14.81) in those with BMI 25.0-29.9, 30.0-34.9, and ≥35.0 kg/m 2 , respectively. For participants with obesity, aRR for new-onset HF was 2.05 (95% CI: 1.24-3.39) compared to non-obese participants. The effect modification of uncontrolled HTN on the association between obesity and new-onset HF was not observed ( p -value = 0.641). In conclusion, an increased BMI had a higher risk for new-onset HF among Thai people with HTN. Obesity was independently associated with new-onset HF among people with HT, regardless of uncontrolled HTN.
Abstract P277: Adherence to Time-Restricted Eating, Plasma Metabolomic Signatures, and Risk of Coronary Heart Disease
Authors: Yoriko Heianza, Qi Sun, Emily M Drotz, Oona J DiMatteo, Kathryn M Rexrode, Mona Alotaibi, Mohit Jain, JoAnn E Manson, Lu Qi
Journal: Circulation (2024)

Introduction: Early time-restricted eating (TRE) has been recently suggested as an effective dietary intervention strategy to improve risk factors of coronary heart disease (CHD), whereas late TRE may be related to poor cardiometabolic health. Metabolomic pathways linking the adherence to habitual TREs depending on the time of the day and CHD risk are unknown. Hypothesis: We tested whether adherence to early or late TRE was related to distinct metabolomic signatures (including those in pathways of energy/purine pyrimidine metabolism, lipids, carbohydrates, and acylcarnitines). We then tested whether TRE-related plasma metabolites were associated with the risk of incident CHD among women without prior CHD. Methods: This study included 674 women without cardiovascular disease who completed 7-day food records and measurements of untargeted plasma metabolomics in a sub-study of the Nurses’ Health Studies (NHS/NHSII). TRE was indicated by 4-12 hours of daily eating window. The adherence to TRE was assessed by summing up the TRE days in a week (0-7 days). We analyzed two TRE habits: early TRE (starting before 9 a.m./ending no later than 9 p.m.) and late TRE (beginning after 9 a.m.). Separately, plasma metabolites were measured in a prospective nested case-control of 762 incident cases of CHD and 762 matched controls identified over 10-14 years of follow-up in the NHS. A metabolomic risk score for predicting adherence to late TRE (MRS-TRE late ) was created based on metabolites selected through the elastic net procedure with a 10-fold cross-validation. Results: Adherence to late TRE was positively associated with greater adiposity, insulin/proinsulin, uric acid, and medium-chain fatty acids/acylcarnitines; the late TRE habit was inversely related to metabolites in the TCA cycle/pyruvate metabolism and specific PC species ( P FDR &lt;0.05). On the other hand, metabolites in lipid pathways (including diglyceride DG 38:5) and glucose were inversely related to the adherence to early TRE. Individual levels of late-TRE-related metabolites in energy/phosphatidylcholine /acylcarnitine pathways were significantly associated with an increased risk of CHD. Every 1 SD increment of MRS-TRE late , based on 21 metabolites in various metabolic pathways, was associated with a relative risk (RR) of 1.24 (95% CI: 1.11, 1.38) for CHD in a model adjusted for matching factors, and a RR of 1.15 (1.02, 1.29) after adjusting for covariates, such as demographic factors, diet quality, alcohol, lifestyle factors, and BMI. Women in the top tertile of MRS-TRE late had a 1.44-fold (1.10, 1.89) increased risk of CHD as compared to those in the lowest tertile after adjusting for the covariates. Conclusions: TRE habit, depending on the timing, was related to distinct metabolomic pathways, and adherence to late TRE may be associated with metabolic reliance linked to the risk of incident CHD among women.
Abstract P466: A Culturally Tailored mHealth Lifestyle Intervention Improves Diet and Physical Activity Self-Regulation Among African Americans
Authors: Mathias Lalika, Sarah Jenkins, Sharonne N Hayes, Clarence Jones, Lora E Burke, Lisa A Cooper, Christi A Patten, LaPrincess C Brewer
Journal: Circulation (2024)

Background: Physical inactivity and poor adherence to healthy eating guidelines impact cardiovascular health (CVH) outcomes in African American (AAs). Our randomized controlled trial (RCT) testing the FAITH! App, an mHealth lifestyle intervention, showed efficacy in promoting ideal CVH, particularly diet and physical activity (PA) among AAs, warranting exploration of underlying factors. Psychosocial factors (e.g., self-regulation, self-efficacy, social support) are key to healthy behavior adoption. Hypothesis: The intervention group would have greater improvements in diet and PA-related psychosocial factors than the control group after using the FAITH! App. Methods: A 2-arm cluster RCT was conducted among AAs from 16 churches in Minnesota comparing the FAITH! App intervention to a delayed intervention control group. The FAITH! App included culturally relevant, CVH-focused education modules, diet/PA self-monitoring and a sharing board. The outcomes were change in diet and PA self-regulation and self-efficacy (primary) and social support and barriers (secondary) at 6 months post-intervention. The intervention effect was assessed using linear regression. Results: Sixty-eight participants were included (71% female; mean age [SD]: 54.7 [12.6] years) ( Table 1 ). The intervention group showed a significantly greater increase in diet self-regulation [planning/tracking nutrition] (+0.66, p&lt;.03) and PA self-regulation [step count strategies] (+0.47, p=.003) than the control group. Within groups, the intervention group demonstrated significant improvements across diet and PA self-regulation measures, while the control group showed an improvement only in fruit/vegetable and grain intake. No effect was observed in self-efficacy, social support, or barriers. Conclusions: Our culturally tailored mHealth lifestyle intervention was associated with notable increases in diet and PA self-regulation, suggesting a potential mechanism by which the FAITH! App improves healthy eating and PA among AAs.
Abstract P169: Cardiovascular Disease Incidence Among Male Veterans by Sexual Orientation and Race
Authors: Meredith S Duncan, Carl Streed, Kory Heier, John O'Leary, Melissa Skanderson, Joseph Goulet
Journal: Circulation (2024)

Introduction: Studies of cardiovascular disease (CVD) in sexual minority (SM) men (i.e., gay, bisexual) vs. heterosexual men are limited by small sample sizes and lack of objective CVD ascertainment. Small samples also hinder study at the intersection of race and sexual orientation on CVD events. We used the Veterans Healthcare Administration Lesbian, Gay, Bisexual, Transgender Electronic Health Record cohort to fill these knowledge gaps. Methods: We studied 919,404 male cisgender veterans who were free of prevalent CVD and classified as SM or non-SM by a natural language processing tool. We defined incident CVD as first instance of AMI, ischemic stroke, cardiac revascularization, or CVD death between baseline and date of death or 8/31/22. We stratified sample statistics by SM status and race. We used Cox proportional hazards regression to assess the intersection of sexual orientation and race with incident CVD; we adjusted for Hispanic ethnicity and age. Based on the minority stress model, non-SM White men were the referent. Results: Within races, traditional CVD risk factors were similarly distributed by SM status but SM men had greater prevalence of stress-associated characteristics like substance use, depression, and anxiety. Heterosexual, gay, and bisexual Asian men had lower CVD risk than non-SM White men, while Black/African American and Multiracial men had persistently increased CVD risk ( Table ). White and American Native gay men had increased CVD risk vs. non-SM White men. With the exception of Asians, all unclassified SM men had increased CVD incidence vs. non-SM White men. Risk was highest in among Black or Multiracial SM men. Conclusion: This is one of the first studies to examine the intersection of sexual orientation and race on CVD risk in male veterans. CVD risk appears increased or decreased in certain racial groups regardless of sexual orientation but this is not always true and invites further study into the mechanisms by which stress results in inequitable CVD events across groups.
Abstract P110: Biomarkers of Atrial Fibrillation-Related Pathways and Left Atrial Structure and Function in an Overweight and Obese Population
Authors: Linzi Li, Dora Romaguera, Angel M M Alonso-Gomez, Estefania A Toledo, Alvaro Alonso
Journal: Circulation (2024)

Background: Blood biomarkers of atrial fibrillation (AF)-related pathways can characterize the atrial substrate promoting the development of AF. Exploring associations of blood biomarkers with left atrial (LA) structure and function could enhance our understanding of AF etiopathogenesis and inform AF prevention strategies. Methods: We studied 532 participants of the PREDIMED-Plus trial, a multicenter randomized trial in overweight and obese adults (55-75 years) with the metabolic syndrome in Spain. The trial objective was to test a lifestyle intervention for primary prevention of cardiovascular disease. At baseline, 3 and 5 years after randomization, these participants underwent transthoracic echocardiography and provided blood for serum biomarker measurements [propeptide of procollagen type I (PICP), high-sensitivity (hs) troponin T (hsTnT), hs C-reactive protein (CRP), 3-nitrotyrosine (3-NT), and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP)]. Outcomes of interest included LA peak systolic longitudinal strain (LA PSLS), LA volume index (LAVi), LA function index (LAFi), and LA stiffness index (LASi). We performed cross-sectional and longitudinal analyses to evaluate relationships between log-transformed biomarkers and echocardiographic measurements using multiple linear regression and mixed models: 1) baseline biomarkers and LA outcomes; 2) baseline biomarkers and change in LA outcomes from baseline through year 5; 3) concomitant changes in biomarkers and LA outcomes from baseline to year 5. Results: The participants in this analysis had a mean age of 65 (SD 4.8) years, 40% females, and BMI of 32.2 (SD 3.3) kg/m 2 . At baseline, increased NT-proBNP was associated with worse LAVi (0.78 mL/m 2 , 95% CI 0.04, 1.52), LAFi (-3.61, 95% CI -6.75, -0.46), and LASi (0.02, 95% CI 0.00, 0.04). Higher baseline NT-proBNP was associated with a greater decrease in LA PSLS at year 3 (-0.82%, 95% CI -1.57, -0.06) but not year 5 (-0.01%, 95% CI -0.77, 0.75), and an increase in LASi at years 3 (0.04, 95% CI 0.01, 0.06) and 5 (0.02, 95% CI 0.00, 0.04). Over 5 years, larger elevation in NT-proBNP was associated with more decline in LA PSLS (-0.19%, 95% CI -0.35, -0.02) and more elevation in LAVi (0.28 mL/m 2 , 95% CI 0.10, 0.45) each year. PICP, hsTnT, CRP and 3-NT did not show consistently significant associations with LA outcomes at baseline and through 5 years. Conclusion: In an overweight and obese population, higher NT-proBNP was associated with LA volume enlargement and worsening LA function over 5 years. The implications of these findings for prevention and prediction of AF warrant further investigation.