tbuckley/cabot-search huggingface dataset:
Abstract P1022: Interatrial Septal Thickening as a Predictor of Atrial Fibrillation and Structural Heart Remodeling
Authors: Dallin Swanson, Ramy Abdelmaseih, THIERRY KOCHKARIAN, Zahir Amin, Bisma Khwaja, Maha Yaqub, Ritika Saxena, Wissam Khalife
Journal: Circulation (2025)

Introduction: Lipomatous hypertrophy of the interatrial septum is characterized by adipose deposition in the interatrial septum (IAS). Although generally considered benign, its associations with arrhythmias and remodeling are not well understood and require further investigation. Understanding the role of IAS thickening in arrhythmogenesis and remodeling could improve detection and management. Hypothesis: We hypothesized that increased IAS thickness is associated with a higher prevalence of atrial fibrillation (AF), larger body surface area (BSA), interventricular septal thickness (IVS), coronary artery disease (CAD), and valvular disease. Methods: We conducted a retrospective analysis of 208 consecutive patients who underwent transesophageal echocardiography. IAS thickness was manually measured in the bicaval view by a trained physician at our academic center. IAS thickness was stratified into the groups &lt;6 mm, 6-12 mm, and &gt;12 mm. We analyzed variables including IVS thickness, valvular defects, electrocardiogram abnormalities, medications, and morbidities such as diabetes and hypertension. BMI and BSA were calculated. Chi-square and ANOVA were used to assess statistical significance (p &lt; 0.05). Results: Among the 208 patients (mean age 60.5 years; 56% male), IAS thickening was significantly associated with increased BSA (p &lt; 0.05), suggesting that body size and metabolic factors contribute to septal hypertrophy and structural heart changes. Patients with thicker IAS also had increased IVS thickness (p &lt; 0.05), indicating that hypertrophic changes extend beyond the atrial septum to affect broader myocardial structures. IAS thickening was linked to CAD (p &lt; 0.05) and mitral regurgitation (p &lt; 0.05), suggesting that septal hypertrophy may serve as a marker for valvular pathology and atherosclerotic burden. AF was strongly correlated with increased IAS thickness (p &lt; 0.05), reinforcing its link to electrical and structural heart remodeling. Conclusions: Increased IAS thickness may be associated with atrial arrhythmias, BSA, IVS thickness, CAD, and valvular dysfunction. Particularly in patients with cardiovascular risk factors, IAS thickening is linked to arrhythmias and structural heart changes. It may serve as a valuable marker for identifying at-risk patients and enabling earlier intervention to prevent adverse cardiac events. Larger studies are necessary to further explore these associations and deepen our understanding of IAS thickening’s clinical significance.
Abstract P2137: Depressive symptoms during late pregnancy are associated with higher cardiovascular disease risk 2-7 years after delivery.
Authors: Shannon Donofry, William Grobman, C Noel Bairey Merz, George Saade, Matthew Hoffman, Victoria Pemberton, Lisa Levine, Sadiya Khan, Uma Reddy, Lynn Yee, Janet Catov
Journal: Circulation (2025)

Background: Adverse pregnancy outcomes (APOs) are risk factors for future cardiovascular disease (CVD). APOs are more common among individuals who experience depression during pregnancy, and depression is a well-established CVD risk factor in non-pregnant populations. The purpose of the present study was to evaluate the relationship between depressive symptoms in pregnancy and future CVD risk, and to determine whether this relationship was mediated by APOs. Methods: This secondary analysis of the multisite prospective nuMoM2b-Heart Health Study included 4,050 participants (M age =27.6±5.6 years), with complete longitudinal data for variables from early pregnancy to 2-7 years post-delivery. Participants self-reported depressive symptoms on the Edinburgh Postnatal Depression Scale (EPDS) at 6-13 (early pregnancy) and 22-29 (mid-pregnancy) weeks of gestation. APOs were collected prospectively and adjudicated and included small-for-gestational-age birth, hypertensive disorders of pregnancy, gestational diabetes mellitus, placental abruption, and preterm birth. CVD risk factors, assessed at 2-7 years after delivery (follow-up interval M =3.2±0.9 years), were modeled as a higher order latent factor indicated by intermediate latent factors: insulin resistance (glucose and insulin), adiposity (waist circumference and BMI), blood pressure (SBP and DBP), and dyslipidemia (triglycerides and HDL cholesterol). Structural equation modeling was used to test whether APOs (present or absent) mediated the relationship between mid-pregnancy EPDS scores and latent CVD risk 2-7 years post-delivery, covarying for EPDS scores in early pregnancy (approximating pre-pregnancy), length of follow-up interval, smoking history, age, education, and income. Results: The model adequately fit the data (CFI=.96; RMSEA=.058; SRMR=.04). The direct effects of APOs ( β =.26, p &lt;.01) and late pregnancy EPDS scores ( β =.13, p &lt;.01) on latent CVD risk were significant. BMI ( r =.16), waist circumference ( r =.15), and HDL cholesterol ( r =-.13) were the CVD risk factors most strongly associated with late pregnancy EPDS scores ( r range=|.04-.16|). The indirect effect of EPDS scores on CVD risk through APOs was not significant ( p &gt;.6). Discussion: Depressive symptoms in mid-pregnancy were associated with higher CVD risk 2-7 years after delivery, but this effect was not mediated by experiencing APOs. Future studies should evaluate whether pregnancy interventions to improve mood reduces subsequent risk of CVD.
Abstract P1049: Screen Time and Social-Emotional Skills in Michigan Middle School Students Participating in Project Healthy Schools
Authors: Whitney Gallagher, Rachel Krallman, Chih Wen Pai, Brad Newman, Kim Eagle, Elizabeth Jackson
Journal: Circulation (2025)

Introduction: Time spent on electronic devices, specifically mobile devices and computers, amongst adolescents has increased in the past decade. While there is agreement that too much recreational screen time (ST) can have negative effects on physiological and behavioral health, studies examining the impact on social-emotional (SE) skills are sparse. This study aims to assess the relationship between ST and SE skills among adolescents. We hypothesized that students with higher daily recreational ST will experience more difficulty across SE skills. Methods: We examined baseline self-reported survey responses (N = 362) from 6 th grade students attending a Project Healthy Schools-participating middle school from 2022-2024. SE skills (self-awareness, self-management, responsible decision making, relationship skills, social awareness) were compared among tertiles of total daily ST (low [0-5 hours], medium [&gt;5-10], and high [&gt;10]) based on chi-squared tests. Students’ total daily ST was calculated by summing the 4 ST modalities (TV/movie, computer, video games, mobile device). SE skills were also examined separately for computer and mobile device ST (low [0-2 hours], medium [3-4], and high [5+]). Results: Total ST was positively associated with students reporting greater difficulty with responsible decision making (p=0.001). High mobile device ST was positively associated with increased indicated difficulty with self-awareness (p=0.001) and responsible decision making (p=0.004). High computer ST was positively associated with more difficulty for self-awareness (p=0.002), responsible decision making (p=0.003), relationship skills (p=0.028), and social awareness (p=0.02). Conclusions Higher ST, including total, computer, and mobile device ST were associated with increased difficulty with several SE skills, in particular responsible decision making. These results suggest that limiting ST may assist middle-school students in SE competencies.
Abstract P2011: Recruitment and Baseline Characteristics of Caribbean and South America Team-based Strategy to Control Hypertension (CATCH) Trial
Authors: Farah Allouch, Katherine Mills, Paola Lanza, Trevor Ferguson, Jacqueline Duncan, Carene Lindsay, Jose P Lopez-Lopez, Mabel Reyes, Patricio Lopez-Jaramillo, Marshall Tulloch-Reid, Jiang He
Journal: Circulation (2025)

Background: Uncontrolled hypertension is a major global public health challenge, especially in low- and middle-income countries. In the Caribbean and South America Team-based Strategy to Control Hypertension (CATCH) trial, we are testing the effectiveness and implementation of a team-based care strategy for blood pressure control among patients with uncontrolled hypertension in Colombia and Jamaica. Objectives: To describe the baseline characteristics of participants in the CATCH trial. Methods: The CATCH is a cluster randomized-effectiveness implementation trial conducted in 40 primary care clinics in Colombia and Jamaica. We randomly assigned 20 clinics to the team-based care intervention and 20 to provider training intervention stratified by county and urbanization. A care team consisting of physicians-nurses-community health workers collaborated to deliver the intervention. The intervention and data collection will last for 18 months. Results: We screened 2,339 individuals and successfully recruited 1,710 hypertensive patients (1,050 in Colombia and 660 in Jamaica) who met the eligibility criteria. A total of 692 individuals were excluded from the trial: 563 (81.4%) due to BP &lt;130/80mmHg with standardized measurement, 63 (9.1%) due to kidney disease or heart failure, and 58 (8.4%) due to other reasons. Approximately 1% refused to consent for the trial. Participants were, on average, 62 years old, 70% were women, and 51% has less than high school education. Overall, 50% of participants identified as Mixed race and 36% identified as Black. Almost all (98%) of participants were taking antihypertensive medications at recruitment. In addition, 29% participants had diabetes, 46% had hypercholesterolemia, and 7% had grade 3 or 4 chronic kidney disease. Compared to Jamaicans, participants from Colombia were older (63 vs. 60 years) and more likely to be male (37% vs. 18%), and to identify as Mixed race (76% vs. 10%). Education status was similar between the two countries. Participants in Jamaica had a higher cardiovascular disease risk burden - diabetes (35% vs. 24%), hypercholesterolemia (51% vs. 43%), and chronic kidney disease (11% vs. 5%). Conclusion: We successfully recruited primary care patients with hypertension into the CATCH trial representative of primary care patients in Jamaica and Colombia. In future work we will assess reach by comparing our participants’ demographic characteristics to those of the overall hypertensive populations in both countries.
Abstract P1135: Evidence Lacking for Association Between two Variants of the <i>CRP</i> Gene and Pre-eclampsia: Strong Heart Study
Authors: Lyle Best, Jessica Reese, Saroja Voruganti, Quan Sun, Nora Franceschini, Shelley Cole, Jason Umans, Emily Harville
Journal: Circulation (2025)

Introduction: Pre-eclampsia (PE) and other hypertensive disorders of pregnancy (HDP) constitute serious threats to maternal and fetal well-being. While the definitive cause (or causes) of PE has been sought since the time of Hippocrates, maternal immune dysfunction is one of many hypotheses that remain popular. A key component of the innate immune system, C-reactive protein (CRP), is elevated during pregnancies complicated by PE, but it is typically considered a secondary marker of inflammation initiated by other factors. None the less, genetic variants increasing the expression of CRP have been found associated with PE in multiple populations, suggesting a more primary role. Methods: Through a combination of self-report, medical record review and birth certificate information, the Strong Heart Study was able to assemble a dataset of 59 cases and 1080 women without similar indications of PE or gestational hypertension. Genotypes related to two CRP variants (rs1341665 and rs1205) were available and additive/dominant models evaluated using Chi-square and logistic regression methods for association with HDP. A p-value of 0.05 was considered statistically significant. Results: Neither variant, nor any of the genetic models showed significant association with HDP using either statistical test. Further analysis adjusting for body mass index or a more stringently defined outcome excluding gestational hypertension was similarly uninformative. Conclusion: Although previous investigation has demonstrated association between one of these variants (and other CRP variants unable to be tested in this cohort) in an American Indian population, this analysis was unable to replicate this finding. Possible reasons include difficulty comprehensively ascertaining cases and inclusion of other American Indian populations.
Abstract 012: Pilot Testing of Hypertension Management Support with EHR-Integrated Telemonitoring and Automated Patient Messaging for Patients at High Risk from Hypertension
Authors: Stephen Persell, Yaw Peprah, Ji Young Lee, Lucia Petito, Hironori Sato
Journal: Circulation (2025)

Introduction: Remote patient monitoring (RPM) of blood pressure (BP) can help support hypertension management. To improve the timely interpretation and action based on home BP values, automated messages providing clinical guidance could be delivered to patients based on the results of their home BP monitoring and used to encourage monitoring when additional information is needed for decision making. We hypothesized that among patients with elevated office BP at increased risk from hypertension due to coexisting cardiovascular disease, renal disease or diabetes mellitus, RPM with automated patient messages delivered through an EHR portal would lead to antihypertensive medication adjustments and improved home BP values. Methods: This was a pilot test of RPM with automated messages to patients sent in response to home BP values. Seven clinicians (5 primary care physicians and two nephrologists) reviewed lists of their patients with qualifying comorbidities whose most recent two office BP were ≥140/90 mm Hg (n = 285). Standardized home BP readings supervised by study staff were taken at baseline and 3 months, with follow up at 9 months planned. Antihypertensive medication changes, number of messages sent, and number read by the patient were assessed from EHR data. Results: Clinicians gave approval for 82% (n = 234) of eligible patients to be contacted, of whom 30% (n=70) enrolled. Of enrollees, 31% were non-Hispanic White and 60% were non-Hispanic Black, 69% were female. Baseline mean (SD) office BP was 143 (16) / 79 (11) mm Hg and their baseline mean home BP was 141 (17) / 83 (14) mm Hg. At the 3-month follow up, mean home BP had declined to 130 (15) / 78 (12) mm Hg; p&lt;0.001/&lt;0.001. After a median follow up of 5 months, patients had received a median (IQR) of 6 (5 to 8) messages, and 75% were read. Blood pressure medication changes were common with 50 (71%) having at least one medication change (36% had antihypertensive therapy increased, 9% decreased, and 27% had both types of changes); median (IQR) number of medication changes was 1 (0-3). Conclusions: Among high-risk patients with uncontrolled office BP who received RPM and automated patient portal messaging, medication adjustments were common and home BP was lower at 3 months. Patient and clinician feedback will be used to inform improvements. Future work should consider whether RPM with automated messaging is an effective solution to maintain and improve BP while not over-burdening the health system.
Abstract MP24: Socioeconomic Disparities in Cardiac Rehabilitation Perceptions and Delivery Mode Preferences: A Nationally Representative Survey Among Diverse Cardiac Patients.
Authors: Grace Patrice Anyetei-Anum, Helayna Abraham, Natalie Averkamp, Matthew Johnson, Ashton Krogman, Donald Clark, Melvin Echols, Michael and Jo Alice Hall, karen hodgman, Brian Kaihoi, Stephen Kopecky, Shawn Leth, Shaista Malik, Jill Marsteller, Lena Mathews, Robert Scales, Adam Shultz, Bryan Taylor, Phillip Schulte, Randal Thomas, Nathan Wong, Thomas Olson, LaPrincess Brewer
Journal: Circulation (2025)

Background: Cardiac rehabilitation (CR) is essential to secondary cardiovascular disease prevention and management of cardiac patients. Despite its proven benefits, CR remains underutilized with enrollment and completion rates ranging from 10-30% in the US. Yet, there is a scarcity of nationally representative data among diverse populations on socioeconomic differences in barriers and beliefs of CR participation and delivery mode preferences. Hypothesis: The perceptions (barriers, beliefs), CR delivery mode preferences, and CR utilization (prior enrollment) varies by socioeconomic status (SES) among CR-eligible individuals. Methods: We conducted an anonymous national electronic survey from March 2023 to January 2024 of individuals self-reporting a prior CR-eligible diagnosis. The 22-item CR Barriers Scale assessed perceived barriers to CR enrollment and participation using a 5-point Likert scale (strongly disagree to strongly agree). A 13-item, validated questionnaire assessed 4 subscales pertaining to patients’ beliefs about CR, each rated on a 5-point Likert scale (strongly disagree to strongly agree): perceived necessity, concerns about exercise, practical barriers and perceived suitability. CR delivery mode preferences were ascertained (eg, virtual, at-home, etc.). Mean barriers and belief scores as well as delivery mode preferences were stratified by SES. Low SES was defined as ≤ high school education, Medicaid insurance, or uninsured. High SES was defined as &gt; high school education and non-Medicaid health insurance. Responses were analyzed using descriptive statistics with R software. Results: A total of 466 participants completed the survey (38.1% women, 30.6% minoritized racial/ethnic group, 29.6% low SES, 95% response rate) ( Table 1 ). The majority indicated prior enrollment in CR (81.5%) with no difference by SES. CR barrier scores did not differ significantly by SES (p=0.331) ( Table 2 ). Beliefs about CR perceived necessity and perceived suitability differed by SES (p&lt;0.001 and p=0.025), but beliefs regarding concerns about exercise and practical barriers did not. The low SES group reported a higher preference for completely at-home CR compared to the high SES group (33.6% vs 7.4%, p&lt;0.001). Conclusion: Our findings suggest that CR beliefs varied by SES while utilization did not. For CR-eligible patients experiencing socioeconomic disadvantage, at-home CR may be a preferred alternative to center-based CR to increase CR participation and adherence.
Abstract P1143: Not So Invincible: Young Adults with Prediabetes Report Fear of Future Diabetes Motivates Behavior Change
Authors: Abigail Arons, Mai Baalbaki, Amy Beck
Journal: Circulation (2025)

Introduction: Young adulthood is an unmet opportunity for cardiovascular prevention. While prediabetes is often assessed in young adult primary care visits, the “young invincibles” assumption presumes youth are unmotivated by long term health. No qualitative study has garnered young adults’ perspectives on what prediabetes means to them. Methods: Semi-structured interviews in English and Spanish with outpatients ages 18-26 with prediabetes (HgbA1c or chart diagnosis) January to September 2024, at one safety net hospital and one academic medical center. We excluded patients with diabetes, or who were unaware of their diabetes risk. Interviewees were asked about diabetes risk perceptions and experiences discussing prediabetes with providers. We used thematic analysis to determine themes. Results: We interviewed 24 participants (63% female, 71% Latino/a/x, 29% Black, 61% food insecure, 39% any college). Several key themes emerged (Table 1). Participants understood prediabetes accurately and had mixed perceptions of whether diabetes was avoidable for themselves. Learning of prediabetes had a strong emotional impact, often grounded in family experiences with diabetes. Fear of diabetes prompted behavior changes, which youth largely made on their own, with short duration. Youth preferred honest, encouraging communication from providers. Conclusions Fear of future diabetes motivates behavior change for young adults. Health care providers’ conversations with young adults about prediabetes have lasting emotional impact. Providers should use honest, clear language that emphasizes the possibility of change. Strengthening connections to supportive programs could continue momentum after these conversations to facilitate lasting behavior change.
Abstract 047: Plasma metabolic signatures of healthy diets and healthspan: an integrative analysis of metabolomics and genetics among 12,478 US adults with 32 years of follow-up
Authors: Huan Yun, Jie Hu, Xingyan Wang, Magdalena Sevilla-Gonzalez, Zhendong Mei, Anne-Julie Tessier, Deirdre Tobias, Oana Zeleznik, A Eliassen, Clary Clish, Walter Willett, JoAnn Manson, Frank Hu, Liming Liang, Jun Li
Journal: Circulation (2025)

Background: Extending the healthspan – years of lived without disease – is a public health priority. Healthy diets have been linked to lower chronic disease risk, but the underlying mechanisms are largely unknown. We have previously identified plasma multi-metabolite signatures that measure intakes and metabolic responses to different dietary patterns. Hypothesis: Plasma metabolic signatures of heathy diets are associated with longer healthspan. Methods: We studied 12,478 participants from Nurses’ Health Studies and Health Professional Follow-up Study who were free of baseline chronic diseases. Diet was assessed by a food frequency questionnaire and indices for 3 recommendation-based, 3 plant-based, and 2 mechanism-based diets, were calculated. Plasma metabolome was profiled by liquid chromatography-mass spectrometry. Metabolic signatures for 8 dietary patterns, each based on 38-66 metabolites, were derived using elastic net model from our prior study. A polygenetic risk score (PRS) of shortened healthspan was calculated based on a published genome-wide association study using LDpred2. Cox regression was used to test associations with healthspan, which ended at the time of first onset of any of 11 major chronic diseases including cardiovascular disease. Results: During up to 32.4 years of follow-up, 6,021 individuals developed at least one chronic disease within an average of 23.8 years. In multivariable analyses, per standard deviation (SD) increase in metabolic signatures of all 5 examined healthful diets (e.g., Mediterranean diet) were associated with a lower risk of shortened healthspan (hazard ratio [HR]: 0.83-0.88; P &lt; 6e-8), whereas signatures of 3 unhealthful diets (e.g., proinflammatory diet) were associated with a higher risk of shortened healthspan (HR: 1.08-1.26; P &lt; 1e-3) ( Fig. A ). These associations persisted after adjusting for their corresponding dietary indices. While the derived PRS significantly predicted the genetic risk for any chronic diseases ( Fig. B ), the associations between metabolic signatures of diets and healthspan were not modified by such a genetic burden ( P-interaction &gt;0.05; Fig. C ). Conclusions Plasma metabolic signatures that reflect intakes and metabolic responses to heathy diets are associated with longer healthspan, regardless of genetic burden for chronic diseases.