tbuckley/cabot-search huggingface dataset:
Abstract 4141748: Association of Cumulative Cardiovascular Health Score Through Young Adulthood With Cardiovascular-Kidney Outcomes in Midlife
Authors: Hokyou Lee, Hyeok-Hee Lee, Eun Jin Kim, Jong Hyun Jhee, Hyeon Chang Kim
Journal: Circulation (2024)

Introduction: Little is known about cumulative cardiovascular health (CVH) measures and associated health outcomes. This gap, together with the AHA’s recent focus on cardiovascular-kidney-metabolic interactions, led to the hypothesis that greater cumulative CVH (cumCVH), through young adulthood, is associated with a lower combined risk of cardiovascular and kidney events in midlife. Methods: This study included 241,924 participants from the 2012-2014 Korean National Health Insurance general health screening without prior cardiovascular disease (CVD) or chronic kidney disease (CKD) at index age 40. Each participant had ≥3 examination visits: Y0 (age 30), Y10 (age 40), and ≥1 in between (median, 8 visits total). We calculated a 10-year cumCVH score as the area under the CVH score curve from age 30 to 40, using the AHA’s “Life’s Essential 8” construct (0 to 100 points per visit; cumCVH 0 to 1000 point-years; Fig A). The primary outcome was a composite of CVD events (myocardial infarction, ischemic stroke, heart failure, or death from CVD) or kidney events (high-risk CKD, kidney replacement therapy, or death from kidney disease). Results: Over a median follow-up of 9.2 years, 3560 cardiovascular-kidney events occurred. Participants with a higher cumCVH score by age 40 had a lower cumulative incidence of cardiovascular-kidney events in the following decade (Fig B). After adjustment, every 10 point-years of cumCVH score (i.e., 1 year lived with 10-point greater CVH) was associated with a 5.1% lower risk of cardiovascular-kidney events after age 40 (Fig C). Every 100 point-years of cumCVH score (i.e., 10 years lived with 10-point greater CVH) was associated with a 41% lower risk of cardiovascular-kidney events. The associations were similar for secondary cardiovascular-kidney outcomes (Fig D) and remained significant when adjusted for the slope of CVH change or the midlife CVH score, both of which were independently associated with the outcomes. Conclusions: Greater cumulative CVH through young adulthood was associated with a lower combined risk of cardiovascular-kidney events in midlife. The results underscore the importance of maintaining better early-life CVH for the prevention of cardiovascular and kidney diseases.
Abstract 4141714: Curcumol as a novel STlNG inhibitor suppresses type I interferon release to improve myocardial infarction
Authors: NA YANG
Journal: Circulation (2024)

Background: Myocardial infarction is a leading cause of morbidity and mortality worldwide, often resulting in extensive myocardial cell death and the release of damage-associated molecular patterns. These DAMPs activate the Stimulator of Interferon Genes pathway, which subsequently induces the release of type I interferon and other pro-inflammatory cytokines, contributing to the inflammatory microenvironment and exacerbating cardiac dysfunction. Curcumol, a compound isolated from the traditional Chinese medicine zedoary turmeric, has demonstrated anti-inflammatory and anti-tumor properties. This study investigates the potential of Curcumol as a novel STING inhibitor to suppress type I interferon release and improve outcomes following MI. Methods: A mouse model of myocardial infarction was established by ligating the left anterior descending coronary artery in vivo. Mice were treated with curcumin, and cardiac function was assessed by echocardiography. Post-myocardial infarction, macrophages were isolated and subjected to RNA-Seq analysis, which revealed that IFNβ1 was the most significantly downregulated transcription factor. Surface plasmon resonance assays were conducted to detect the direct binding of curcumol to the STING protein and validated in vivo using STING knockout mice. In vitro experiments were performed to assess the effect of curcumol on STING oligomerization and transport, utilizing co-immunoprecipitation and immunofluorescence staining. Result: Curcumol treatment improved cardiac function in post-infarction mice, as evidenced by increased ejection fraction and reduced infarct size. In vitro, curcumol significantly reduced the release of type I interferons and the production of pro-inflammatory cytokines. Mechanistically, curcumol inhibited STING ER-to-Golgi translocation by suppressing STING oligomerization, thereby inhibiting STING-dependent pathway activation. Compared to H-151, curcumol demonstrated favorable inhibitory effects and may be a potential novel STING inhibitor. Conclusion: Our study demonstrates that Curcumol, a compound isolated from the traditional Chinese medicine zedoary turmeric, shows significant potential as a novel STING inhibitor. These findings suggest that Curcumol is a promising STING inhibitor for improving outcomes following myocardial infarction by targeting and modulating the STING pathway. Keywords: Curcumol, STING, Type I Interferon, Inflammation, myocardial infarction
Abstract 4141705: Volume of Physical Activity and Coronary Artery Calcium - ELSA-Brasil Cohort Analysis
Authors: Ronaldo Correa Fabiano, Giuliano Generoso, Henrique Staniak, Murilo Foppa, Paulo Lotufo, Isabela Bensenor, Marcio Bittencourt
Journal: Circulation (2024)

Introduction: Current guidelines recommend 500-1000 metabolic equivalent minutes per week (METs-min/wk) of physical activity (PA) to reduce cardiovascular (CVD) risk. Interestingly, studies (DeFina 2019, Aengevaeren 2017) have found an association between high PA and subclinical coronary artery atherosclerosis (CAD) cross-sectionally by coronary artery calcium score (CAC). However, Shuval et al (2024) did not find this association. We aim to investigate the association between PA and CAC in the ELSA-Brasil cohort. Methods: We analyzed cross-sectionally data of 2711 asymptomatic statin-free individuals without prior CVD or inflammatory disease from the ELSA-Brasil cohort. PA and CAC were examined by unadjusted and adjusted (age, sex, race) regression. PA and CAC were used as both continuous (log-transformation) and categorical variables to evaluate the results' robustness. For visual illustration, raw data, unadjusted, and adjusted regressions were plotted. Results: The mean age was 50±8, 53% (1433/2711) were female, 15% (387/2577) and 61% (1573/2577) were black and white, respectively. CAC = 0, CAC 1 – 100, and greater than 100 in 2001/2711 (73.8%), 485/2711 (17.9%), and 225/2711 (8.3%), respectively. PA (METs-min/wk) 0 – 500, 500 – 1000, and higher than 1000 in 66.3% (1797/2711), 13.8% (367/2711), and 16.2% (441/2711), respectively. In unadjusted regression (similar using categorical or continuous both CAC and PD), PA was associated with CAC (OR = 1.06, 95% CI: 1.02-1.10, p=0.005) but this association was not found when adjusted to age, sex, and race (table, graphic). Conclusions: A high volume of physical activity was not associated with CAC after adjustment for age, sex, and race in relatively young asymptomatic statin-free individuals from the ELSA-Brasil cohort without prior CVD.
Abstract 4141733: Impact of Achilles Tendon Thickening on the Long-Term Clinical Outcomes of Acute Coronary Syndrome Patients with Intensive Lipid-lowering Therapy Following Percutaneous Coronary Intervention
Authors: Subaru Fujii, SHO NAKAO, Takayuki Ishihara, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Takuya Tsujimura, Yasuhiro Matsuda, Yosuke Hata, Hiroyuki Uematsu, Masaya Kusuda, Wataru Ariyasu, Hirotaka Ooka, Satoshi Kudo, HAYA MATSUBARA, Ryo Muroya, Toshiaki Mano
Journal: Circulation (2024)

Background: Lipid-lowering therapy (LLT) is a primary means of secondary prevention in patients with acute coronary syndrome (ACS) and the current guidelines recommend maximum tolerated statin and ezetimibe as LLT. Achilles tendon thickening (ATT) is one of the criteria for the diagnosis of familial hypercholesterolemia, which can sometimes be accompanied by ACS. However, the impact of ATT on the prognosis after ACS under the intensive LLT remains unclear. Hypothesis: ACS patients with ATT would have worse prognosis even with receiving intensive LLT. Aims: The aim of the current study was to compare the long-term prognosis of ACS patients with and without ATT. Methods: We retrospectively analyzed 218 patients who underwent successful percutaneous coronary intervention for ACS and received the intensive LLT with maximum tolerated doses of statins and ezetimibe at our hospital from September 2017 to May 2023. Thickness of Achilles tendon was measured on radiography, and ATT was defined as Achilles tendon ≥8.0 mm in males and ≥7.5 mm in females. The cumulative incidence of 5-year major adverse cardiovascular events (MACE), defined as a composite of cardiac death, spontaneous myocardial infarction, target vessel revascularization, and stent thrombosis, was estimated by the log-rank test and was compared between the patients with and without ATT. Hazard ratio (HR) and 95% confidence interval (CI) of ATT for MACE were estimated through a multivariable Cox model. Results: ATT was found in 58 patients (26.6%). The proportion of low-density lipoprotein cholesterol (LDL-C) &lt; 70 mg/dL was significantly lower in patients with ATT (45% vs. 77%, p&lt;0.001). The 5-year cumulative incidence of MACE was significantly higher in patients with ATT than those without ATT (22.2% vs. 7.6%, p=0.021, Figure). Multivariate analysis showed ATT significantly impacted on the incidence of MACE (HR 3.13, 95% CI 1.18-8.31, p=0.022). Conclusions: ATT was associated with lower achievement rate of target LDL-C level and worse long-term clinical outcomes in patients with ACS receiving intensive LLT, which suggests more intensive lipid management including the introduction for proprotein convertase subtilisin/kexin type 9 inhibitor in patients with ATT.
Abstract 4141725: Abnormal day-night blood pressure and systemic hemodynamics in heart failure compared to normotension and controlled hypertension
Authors: Sambasiva Rao Srungavarapu, Chander Khatri, Peter Osmond, Joseph Izzo
Journal: Circulation (2024)

Background: High night-time BP and heart rate (HR) and insufficient decreases (“non-dipping”) in night-time BP and HR are markers of high morbidity and mortality. Non-dipping has been reported in some patients with hypertension (HT) or history of acute heart failure (HF) but the underlying derangements in ambulatory systemic hemodynamics have not been described. Aims: Present studies were undertaken to confirm whether patients with history of HF have abnormal dipping of BP and HR and to identify potential differences between day and night ambulatory hemodynamics in HF, normotensives (N), and controlled HT (C-HT, 24-hr systolic BP&lt;135 mHg). Methods: Ambulatory BP-pulse wave readings (PWA, ARCSolver/Mobil-O-Graph) were taken every 20 minutes for 24 hrs, with day and night values averaged. Variables of interest included systolic and diastolic BP (SBP and DBP), HR, cardiac index (CI), stroke volume index (SVI), and total vascular resistance index (TVRI). Groups were compared by ANOVA/Bonferroni. HF patients were further characterized by echo ejection fraction (EF) as preserved (HFpEF) or reduced (&lt;40%, HrEF). Results: Data were obtained from 138 individuals (N 39, C-HT 63, and HF 36); main results are summarized in the Table. Night SBP was higher in HFpEF than HFrEF but both had persistently low SVI and high HR and TVRI. In those with echo and ambulatory PWA studies within 6 months, SVI did not correlate with EF. Conclusions: HF patients, irrespective of EF, often have nocturnal hypertension (night-time SBP &gt; 120) and high HR compared to N and C-HT; they also have blunted nocturnal dipping of BP and HR. These findings suggest that 24-hr ambulatory BP-PWA monitoring may be of value in routine HF management. Our study also shows that ambulatory PWA is feasible in HF patients and that everyday hemodynamic patterns in HF differ from N and C-HT; HF patients, irrespective of EF, are characterized by persistently low SVI and persistently high HR and TVRI throughout the day and night, a pattern consistent with excessive sympathetic nervous overactivity. Further studies are necessary before recommending routine systemic hemodynamic assessment in HF.
Abstract 4141747: The OurHealth Study: A Decentralized Biobank of South Asian Americans
Authors: Shriienidhie Ganesh, Romit Bhattacharya, Aarushi Bhatnagar, Rishi Madnani, Bhaavana Oruganty, Satoshi Koyama, Aniruddh Patel, Kaavya Paruchuri, Sanchita Parulkar, Shilpa Bhupathiraju, Namrata Sengupta, Amit Khera, Whitney Hornsby, Martha Gulati, Rohan Khera, Latha Palaniappan, Pradeep Natarajan
Journal: Circulation (2024)

Introduction: South Asians living in the United States (SAUS) experience greater cardiovascular disease (CVD) events compared to most other racial and ethnic groups. Limited representation and collection of relevant community-specific identity, health, lifestyle, and exposure factors in studies to date have impeded understanding of this elevated risk. To address these scientific gaps, the OurHealth study was devised as a scalable national biobank of SAUS populated with demographic, health, and genetic data. Aims: The primary objectives of OurHealth are to discover South Asian-specific genomic and non-genomic risk factors for CVD and serve as a reliable resource of culturally appropriate information for cardiovascular health. Methods: OurHealth is enabled by the study platform website (https://ourhealthstudy.org), recruiting adult individuals who (1) identify with South Asian ancestry, (2) are comfortable reading or speaking English, and (3) live in the US. Recruitment efforts include social media outreach, community-based events, clinic recruitment, and health webinars, amongst others. OurHealth integrates the data donation and genomics platforms, allowing participants to remotely consent, complete surveys collecting demographic and health information, and return biospecimens for genetic sequencing. Results: Of the 664 participants who have completed the Baseline Survey, OurHealth currently includes 288 (43.4%) females and 19 (2.9%) additionally identifying with non-Asian ethnicity. Study participants’ mean (SD) age is 46 (13.8) years. Participants represent 362 unique South Asian region-language-religion groups with varied representation across the US and several identifying with multiple groups (Fig 1). Of the 615 participants who have completed the cardiometabolic history survey, 39 (6.3%) report a prior diagnosis of coronary artery disease, 237 (38.5%) hypercholesterolemia, 115 (18.7%) hypertension, 11 (1.8%) prior myocardial infarction, and 72 (11.7%) type 2 diabetes. Conclusions: OurHealth is an ongoing diverse national biobank building on prior efforts. The study provides a unique opportunity to better discover and understand the drivers of CVD risk across a diverse South Asian population in the US.
Abstract 4141603: Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases as Biomarkers in Duchenne Muscular Dystrophy Cardiomyopathy
Authors: Joseph Starnes, Michael Campbell, Katheryn Gambetta, Kan Hor, Nazia Husain, Jennifer Li, Frank Raucci, Brian Soriano, Christopher Spurney, Jonathan Dayan, Larry Markham, Jonathan Soslow
Journal: Circulation (2024)

Introduction/Background: Cardiomyopathy is the leading cause of death in patients with Duchenne muscular dystrophy (DMD), but existing biomarkers are poor indicators of cardiomyopathy onset and progression. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) regulate collagen turnover and have previously been associated with DMD cardiomyopathy through their role in fibrosis. Hypothesis: We hypothesized that MMPs/TIMPs would correlate with cardiac magnetic resonance (CMR) measures of cardiomyopathy. Aims: We aimed to assess the relationship between circulating MMPs/TIMPs and CMR measures of cardiomyopathy. Methods: Patients with DMD were prospectively enrolled in a multi-center observational study with CMR, quantitative muscle testing (QMT), and bloodwork. CMR included measurement of left ventricular ejection fraction (LVEF), late gadolinium enhancement (LGE) global severity score (GSS), LGE using full-width half-maximum (FWHM), and global circumferential strain (Ecc) using tagged images. Spearman’s rank test was used to assess correlation between CMR measurements and MMPs. Wilcoxon rank-sum tests were used to compare MMPs by binary categories. Results: A total of 166 patients were included (mean age 14.4 years, 83% white/11.9% Black/10.8% Hispanic). MMP1 and the MMP1/TIMP1 ratio correlated negatively with LVEF and positively LGE GSS (Table 1). MMP7 correlated positively with LGE GSS and Ecc. Patients with LGE had higher MMP1, MMP7, and MMP1/TIMP1 (Figure 1). Similarly, patients with reduced LVEF had higher MMP1 and MMP1/TIMP1, although not MMP7. MMP7 and MMP1/TIMP1 were also negatively correlated with total QMT. Conclusions: Multiple MMPs and TIMPs associate with DMD cardiomyopathy severity and may serve as biomarkers of DMD cardiac disease progression.
Abstract 4141033: Acute clinical outcomes following virtual reality implementation in the electrophysiology laboratory
Authors: Letizia Romano, Pierangelo Calvelli, Gianluca Quirino, Caterina Tomaselli, Antonello Talarico, Pino Pasqua, Antonio Curcio
Journal: Circulation (2024)

Introduction: Pain discomfort increases procedural time in electrophysiology laboratory and prolongs surgical length. Virtual reality-based analgesia (VR-A) improves patient’s acceptance of the procedural steps, mostly in the emergency context. To date, routine adoption of VR-A is limited in cardiology since it is recommended for other surgeries. Hypothesis: we postulated that administration of VR-A would facilitate patient’s compliance, allowing to increasing number of electrophysiology procedures, to reducing burden of complications, and to accelerating discharge. Methods: from April 2024 to May 2024 patients admitted to our academic hospital for cardiac rhythm disorders requiring pacemaker (PM) or implantable cardioverter/defibrillator (ICD) were enrolled. They were randomized in two groups (allocation ratio 1:1) by including either standard sedation protocol, or VR-A for cardiac device implants. Numeric rating scale score was used to assess pain. Variation of vital parameters was measured at baseline, 15, 30 and 60 min after procedural start, as well as at 30 min after procedural ending for an objective evaluation of pain. Statistical analysis was performed with SPSS. Results: Baseline clinical characteristics did not differ between groups. Patients underwent PM (N=12) and ICD (N=8) implantations, showing similar allocation and mean procedural durations (69.5±23.4 min vs 69.5±10.9 min, p =0.3), but significant difference in numeric rating scale score (4.5±0.8 vs.5.9±1.7, p =0.02) in VR-A vs standard group. Standard protocol registered significant differences in blood pressure [F(4, 45)=6.95; p &lt;0.001] and in heart rate [F(4, 45)=12.55; p &lt;0.001] during interventions, with greater variation between the baseline and 60-min determinations at post-hoc analysis ( p &lt;0.001). No significant differences were found in VR-A group for blood pressure [F(4, 45)=1.61; p =0.19] and heart rate [F(4, 45)=0.47; p =0.78]. Leadless PM (2/12, 17%) and subcutaneous ICD (2/8, 25%) while less invasive and well tolerated procedures allowed discharge during the same day of the intervention, by simply combining VR-A and remote patient monitoring provided at that time. Conclusions: VR-A has shown to be an effective tool for pain management during electrophysiology procedures. Participants immersed in VR-A experienced lower pain, less distressed and unpleasant feelings, without psychological impairment, until declaring to prefer VR-A for potential future medical procedures.
Abstract 4141524: Patient education in cardiovascular disease in Sub-Saharan Africa: the “Heart School” pilot project at IPMS/Cheikh Anta Diop University of Dakar, Senegal
Authors: Aliou Alassane Ngaide, Ngone GAYE, Abdoul Kane
Journal: Circulation (2024)

Background: Patient education is a core component of cardiac rehabilitation program and a part of the consensus statement for Cardiac rehabilitation delivery model for low resource settings. To our knowledge, there is little to no evidence regarding cardiac patient education implementation in sub–Saharan Africa, despite all the benefits and the urgent need for prevention in our settings. Purpose: To describe a patient education (PE) pilot project named “the Heart School” at Cheikh Anta Diop University of Dakar. Methods: In this cross sectional study were included 45 patients addressed for a patient education program. Patient education was delivered on weekly one-on-one sessions. Content of the educational program is shown in figure 1. Progression was assessed through self-evaluation scales with scores ranging from 0 to 10 administered before and after the program. Data analysis was performed with SPSS version 18 with a level of significance set at p&lt;0.05. Results:: Coronary artery disease was the primary indication in 87% of cases. At the end of the program, there was a significant improvement in knowledge of the disease (4.5 vs. 7.4; p &lt;0.001) and its treatment (4.7 vs. 6.8; p &lt;0.001), as well as good practices of physical activity (4.5 vs. 7; p &lt;0.001), cardioprotective diet (4.2 vs. 7; p &lt;0.001) and motivation to change lifestyle (5.6 vs. 7.8; p &lt;0.001). Conclusion: Results from this pilot project were promising. However long-term follow up is necessary to better assess the sustainability of these results.
Abstract 4141704: An Innovative, Non-invasive, Credit-Card Sized Device for Ambulatory 12 Lead ECG Recording: First-In-Human Experience Compared to Standard 12 Lead ECG
Authors: Thomas Deering, Dejan Vukajlovic, Milos Babic, Branko Djurdjevic, Vladimir Atanasoski, Marjan Miletic, Suneet Mittal, Prashanthan Sanders
Journal: Circulation (2024)

Background: The multiple electrodes needed to generate a 12-lead electrocardiogram (12L ECG) limits its use to traditional health care settings. An innovative credit-card sized unit (HeartBeam, Santa Clara, CA, USA) when placed on the chest without cables captures a vectorcardiogram (VCG). A personalized transformation matrix (PTM) then converts the signals into a 12L ECG. Objective: This is the first quantitative (standard intervals and amplitudes) and qualitative (rhythm diagnosis) accuracy assessment of a synthesized 12L ECG (Syn 12L) compared to a simultaneously recorded standard 12L ECG (Std 12L) on patients in sinus rhythm (SR) or in a non-life-threatening arrhythmia. Methods: The 80 patients, who were enrolled at a single center (Dedinje Cardiovascular Research Institute, Belgrade, Serbia), first underwent recording of a Std 12L and VCG to create a unique PTM, which was used to create the Syn 12L from the VCG. Then a simultaneous Std 12L and VCG were recorded. The quantitative endpoint was the calculated difference (mean and standard deviation [SD]) between the Syn 12L and Std 12L in a series of intervals (RR, PQ, QJ, and QT) and amplitudes (P wave, R wave, and T wave). For the qualitative endpoint, 2 blinded electrophysiology physicians (EP) classified the Syn 12L and Std 12L arrhythmia status. Results: Of the 80 patients, 41 were in SR and 39 in another rhythm (3:SR with PACs, 5:SR with PVCs, 1:SR with pre-excitation, 16:atrial fibrillation, 3:atrial flutter, 2:atrial pacing, and 9:ventricular pacing). The interval and amplitude differences are listed in the table. Rhythm classification by the blinded EPs demonstrated a sensitivity of 94.9% (95% CI: 82.7-99.4%) and specificity of 100% (95% CI: 91.4-100%) compared to Std 12L. Conclusion: In this first study comparing the performance of a 12L ECG created from a credit card sized VCG recorder, the 12L Syn demonstrated clinically equivalent interval and amplitude accuracy and excellent agreement in arrhythmia classification when compared to a simultaneously recorded 12L Std. This approach holds significant promise, potentially permitting patients to obtain a 12L ECG outside of a health care setting with a compact, easy to use device.