tbuckley/cabot-search huggingface dataset:
Abstract P184: Association of Plasma Lipid Species With Lipoprotein Insulin Resistance Score Before and After Exercise Training
Authors: Eric Leszczynski, Prasun K Dev, Jacob Barber, Prashant Rao, Michael Mi, Sujoy Ghosh, Margery Connelly, Clary Clish, Claude Bouchard, Jeremy Robbins, Robert E Gerszten, Mark A Sarzynski
Journal: Circulation (2024)

Background: The lipoprotein insulin resistance (LP-IR) score has been shown to assess insulin resistance, predict future type 2 diabetes, and improve with regular exercise. The lipidomic profile is known to differ with insulin resistance and type 2 diabetes, but few studies have examined lipidome associations with LP-IR, particularly in response to an exercise intervention. Methods: Plasma lipids were measured using the C8-positive LC-MS method in 671 participants from the HERITAGE Family Study (56% Female, 35% Black, 35.2 yrs) before and after a 20-week exercise intervention. LP-IR, a weighted index of six lipoprotein parameters, was measured before and after training through nuclear magnetic resonance spectroscopy (Labcorp, NC). Linear mixed models were used to test the associations of 193 known plasma lipids with LP-IR before and after exercise training. All models were adjusted for age, sex, and race, while post-training models also adjusted for baseline lipid and baseline LP-IR. Results: A total of 162 lipids (84%) were associated (FDR&lt;0.05) with LP-IR at baseline ( Figure 1 ). The top positive associations were found for TG species, while cholesterol ester species showed the top inverse associations. Following training, the change in 143 (74%) lipids were associated (FDR&lt;0.05) with change in LP-IR. There were 129 lipid species associated with both baseline and changes in LP-IR, while 33 were only associated with baseline measures and 14 only associated with changes in LP-IR following exercise ( Figure 1 ). Conclusions: We found that most lipids were associated with LP-IR regardless of exercise training status. Importantly, we identified a subset of lipids that were only associated with changes in LP-IR, which may represent exercise responsive biomarkers of exercise induced changes in LP-IR. However, further research is needed to identify the biological mechanisms connecting the changes in these lipid species and metabolic changes following exercise training.
Abstract P189: Optimal Measures of Carbohydrate Quality to Reduce the Risk of Type 2 Diabetes
Authors: Hala B Alessa, Caleigh M Sawicki, Walter Willett, Shilpa Bhupathiraju, Frank B Hu
Journal: Circulation (2024)

Introduction: A plethora of indices have been investigated as optimal measures of carbohydrate quality in relation to risk of type 2 diabetes (T2D), but a systematic comparison has not been conducted. Hypothesis: We hypothesized that not all carbohydrate quality indices are equally associated with the risk of T2D. Methods: We investigated associations between twenty-two carbohydrate quality variables and T2D risk among 212,883 US adults with up to 32y of follow-up in the ongoing Nurses’ Health Study (NHS), NHS II, and the Health Professionals Follow-up Study. We used multivariable and BMI-adjusted Cox proportional hazards regression models. Results: Cereal fiber (comparing extreme quintiles of intake, RR:0.82, 95% CI:0.78, 0.87), whole fruit carbohydrates (RR:0.82, 95% CI:0.78, 0.87), glycemic index (RR:1.18, 95% CI:1.12, 1.24), and sugar-sweetened beverage (SSB) sugar (RR:1.23, 95% CI:1.17, 1.29) had the largest observed risk estimates of T2D (all P-trend&lt;0.001). In addition, dietary glycemic load, starch, starchy vegetables, and potato and legume carbohydrates were positively associated (RR’s= 1.07 - 1.14), while whole grain carbohydrate intake was inversely associated with risk of T2D (RR= 0.94). Total and refined grain carbohydrates, added sugar, and non-starchy vegetables were not associated with risk of T2D. Ratios of carbohydrate or starch to total fiber or cereal fiber were all positively associated with risk of T2D (RR’s=1.11 - 1.33). The alternate Carbohydrate Quality Index (aCQI) (RR:0.73, 95% CI:0.69, 0.77) was more strongly associated with risk of T2D than the original CQI (RR:0.90, 95% CI:0.85, 0.95; both P-trend&lt;0.001). Conclusion: Although many indices were associated with risk of T2D, higher intakes of cereal fiber and whole fruit carbohydrates, and lower intakes of glycemic index and sugar-sweetened beverage sugar had the lowest risk of T2D. The aCQI, comprising these four dietary variables and whole-grain carbohydrates, was strongly associated with risk of T2D and warrants further investigation.
Abstract P280: Understanding the Association Between Resilience Factors and Lifestyle-Based CVD Prevention Among Young Adults in Puerto Rico
Authors: Andrea Lopez-Cepero, Milagros C Rosal, Cynthia Perez
Journal: Circulation (2024)

Background: Recent research has identified associations between optimism and cardiovascular disease endpoints. However, other resilience factors like shift-and-persist (SP; adapting the self to stress while finding purpose in tough times), spirituality, social support, and life satisfaction have been understudied. We assessed associations among these factors and a lifestyle-based CVD metric (the Fuster BEWAT score (FBS)) and identified the strongest predictor among young adults in Puerto Rico (PR), a population with a high burden of CVD risk factors. Methods: This cross-sectional analysis used data from young adults (18-29y) who underwent survey and clinical assessments (September 2020-September 2023 ) as part of the PR-OUTLOOK study. Those with complete data were included (n=1,721; 61% female). SP was measured with the Chen scale, optimism with the Life Orientation Test-Revised-6 items scale, spirituality with the Daily Spiritual Experiences Scales, social support (from friends, family, and partner) with the Whalen scale, and life satisfaction with one item from the International Social Survey Program. Higher scores in all scales represent greater resilience and all were converted to z-scores. The FBS included blood pressure, exercise, weight, diet, and tobacco. All metrics were dichotomized as ideal (1) or non-ideal (0) and a total FBS was calculated and categorized according to the number of ideal metrics: poor (0-1), intermediate (2-3), and ideal (≥4). The intermediate and ideal groups were grouped for analysis due to small cell size. Logistic regression models assessed the association between each resilience factor and intermediate/ideal FBS (vs. poor) adjusting for socio-demographics, health insurance, and depression symptoms (Model 1), and for all other resilience factors (Model 2). Results: In the sample, 46% had a poor FBS score, 53% had an intermediate score, and 1% achieved an ideal score. In Model 1, a one standard deviation increase in SP was associated with a 21% higher odds of intermediate/ideal FBS (OR=1.21; 95% CI=1.08-1.36), while optimism, life satisfaction, and social support were associated with 17% (OR=1.17; 95% CI=1.05-1.32), 15% (OR=1.15; 95% CI=1.03-1.29), and 12% (OR=1.12; 95% CI=1.01-1.25) higher odds, respectively. Upon adjusting for all resilience factors (Model 2), only SP remained significantly associated with intermediate/ideal FBS (OR=1.17, 95% CI=1.01-1.35). Conclusion: While optimism, life satisfaction, and social support demonstrated initial associations with better FBS scores, SP emerged as the most significant resilience factor predicting FBS. If confirmed with longitudinal studies, SP could be an important target for future studies of CVD prevention interventions.
Abstract P164: Patient-Reported Awareness and Understanding of the Diagnosis of Heart Failure With Preserved Ejection Fraction
Authors: Yulia Khodneva, Pankaj Arora, Larry Hearld, Megan Nordberg, Andrea Cherrington
Journal: Circulation (2024)

Background: Heart failure with preserved ejection fraction (HFpEF) accounts for half of all HF cases, is difficult to diagnose and manage, and represents the fastest growing subtype of HF in the US. Lack of awareness about the HFpEF diagnosis among patients contributes to delays in seeking care, reduced participation in self-management, and worse health outcomes. Methods: This study explored HFpEF-related knowledge among patients using semi-structured interviews guided by the “Integrated Health Literacy Model”. Patients were asked to describe 1) their heart condition, as they understand it; 2) where they currently learn about their heart condition; 3) what they want to learn more about; and 4) who can help them learn more. Results: In this study, 10 patients with HFpEF were recruited from a local health care system ( Table ). All patients were unaware of having HFpEF; 8 out of 10 thought they had "congestive HF." Patients learned about their condition from cardiologists, primary care physicians and clinic staff. All reported using the Internet to seek information, though in some cases information was confusing or contradictory to what they were told before. Patients noted that they had symptoms for a long time before learning the symptoms were HF-related. Patients wish to know more about the prognosis, factors that can help or make their condition worse, signs and symptoms to monitor, use of wearable devices to monitor, how to live longer and non-pharmacological treatment options. Most patients wanted to learn more about their condition from cardiologists, however, some faced challenges in their current cardiology care, citing lack of time during the clinic visit, difficulty with medical terminology and inability to ask follow-up questions. Patients emphasized a need for more emotional support at the time of diagnosis and help addressing mental health. Conclusion: Patients were not aware they had HFpEF, expressed multiple needs for education and support, and identified cardiologists as the most credible source of education.
Abstract P233: Leveraging Community-Engaged Research Methods to Improve Recruitment and Retention of Midlife Black Women in Cardiovascular Research
Authors: Holly J Jones, Tamilyn Bakas, Melinda Butsch Kovacic
Journal: Circulation (2024)

Introduction: Midlife Black women (ages 45-64) are more likely to die of a cardiovascular disease (CVD)-related cause compared to White women of the same age and less likely to be optimally controlled for upstream chronic conditions like hypertension or dyslipidemia. Black women are also 58% less likely than White women to identify heart disease as their greatest health risk. Recruitment and retention of Black women in research trials has been historically difficult, contributing to the paucity of interventions designed to address the unique sociocultural factors that contribute to the existing health disparities. The Midlife Black Women’s Stress Reduction and Wellness intervention (B-SWELL) was created to lower stress and increase CVD awareness and adoption of healthy lifestyle behaviors to lower CVD risk in midlife Black women. Hypothesis We hypothesized that a theoretically based intervention co-developed with midlife Black women from the community would yield a culturally appropriate and appealing intervention, resulting in high retention, low attrition, and high satisfaction. Methods: Mixed methods and community-engaged methods were used in the preliminary research that supported the B-SWELL feasibility trial. Each step (i.e., conceptualization, development, intervention design and delivery) was viewed through a Black Feminist lens, giving voice to midlife Black women. The B-SWELL materials and content were co-developed with an existing community research advisory board (C-RAB) and midlife Black women from the community to produce a culturally tailored and targeted product that was rated highly by experts. A randomized feasibility study was conducted. Recruitment was led by the C-RAB and other community partners. Satisfaction was measured using a 9-item tool ranging from 1 (strongly disagree) to 5 (strongly agree) and a maximum score of 45. Narrative feedback responses were also obtained. Results: Recruitment (N=52) was completed within 30 days and attrition was low (8%). Four participants withdrew prior to the start of the feasibility trial. The remaining 48 participants completed the trial, and none were lost to follow up. Participant satisfaction ratings were high with a mean of 41. Narrative feedback responses were positive. Participant responses indicated an increase in CVD awareness and motivation to adopt healthier behaviors: “Sisterhood is very important to Black women's health." “Never too late in your life to make changes and better choices.” “I need to be a cheerleader and I need to be checked on as well". Conclusions: Theoretically based interventions that employ community-engaged methods have potential to increase recruitment and retention of midlife Black women in research studies. We recommend integration of community-engaged methods at each level of development and for delivery of interventions targeted to at-risk subpopulations like midlife Black women.
Abstract P185: Plasma Lipidome Signature of Visceral Fat Reveals Heterogenous Cardiometabolic Risk Profiles
Authors: Eric Leszczynski, Prasun K Dev, Jacob Barber, Prashant Rao, Michael Mi, Sujoy Ghosh, Clary Clish, Claude Bouchard, Jeremy Robbins, Robert E Gerszten, Mark A Sarzynski
Journal: Circulation (2024)

Background: Excessive visceral fat is associated with metabolic alterations and is a causal risk factor for CVD. The plasma lipidome is altered in obesity and lipidome signatures of BMI and obesity have been identified. However, few studies have examined the plasma lipidome in relation to visceral fat. Methods: Plasma lipids were measured using the C8-positive LC-MS method in 671 participants from the HERITAGE Family Study (56% Female, 35% Black, 35 yrs). Visceral fat was measured using CT scans. Linear mixed models were used to test the associations of 193 known plasma lipids with visceral fat adjusting for age, sex, race, and BMI. A FDR&lt;5% was used to determine significance. Results: In individual models, 156 lipid species were significantly associated with visceral fat, with 109 species associated after additional adjustment for BMI ( Fig 1 ). The top positively associated lipids were triglycerides, while cholesterol esters showed the strongest inverse associations with visceral fat. A LASSO regression model retained 73 lipids and explained 78.5% of the variance in visceral fat. Delta visceral fat was calculated as the difference between predicted (from LASSO) and measured visceral fat. Examining quartiles of delta visceral fat showed that discordance between predicted and actual visceral fat was associated with differing cardiometabolic profiles independent of age, sex, race, visceral fat, and BMI. Individuals with higher delta visceral fat (Q4, overpredicted) had significantly (p&lt;1.0x10 -04 ) higher levels of TG, apoB, total cholesterol, LDL-C, and fasting insulin and lower levels of large HDL particles and LPL activity compared to those with lower delta visceral fat (Q1, underpredicted). Conclusions: The plasma lipidome is widely associated with visceral fat levels. A lipidome-based visceral fat score may provide additional information over measured visceral fat for assessment of cardiometabolic health. Further studies are needed to test and validate the clinical utility of such lipidome-based scores.
Abstract P203: Healthy Diet Perception, Cardiovascular Disease, and Risk Factors in Americans
Authors: Jenny Jia
Journal: Circulation (2024)

Introduction: Healthy diet perception may influence cardiovascular (CV) outcomes. Misperceptions on the healthfulness of one’s diet can interfere with the precontemplative and contemplative stages of behavioral change if individuals overestimate their diet quality. Using a nationally-representative sample, we explored the prevalence of healthy diet misperception in the general population and in those with CV diseases, as well as whether misperceptions are associated with clinical CV risk factors. Methods: We included adults≥20 years old from the National Health and Nutrition Examination Survey 2017-2020. Using survey data on participants’ perception of their own diet and diet recall data to calculate Healthy Eating Index-2015 (HEI), we divided participants into dietary quantiles. We categorized healthy diet perception (HDP) as overestimated (perceived&gt;HEI quantile), accurate (perceived=HEI quantile), or underestimated (perceived&lt;HEI quantile). We categorized those who self-reported hypertension, coronary heart disease, myocardial infarction, congestive heart failure, and stroke as having CV disease. Clinical CV risk factor measures were body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin A1c, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). We used multiple logistic regression to measure the association between CV disease and HDP and multiple linear regression for HDP and CV risk factors, stratified by presence of CV disease. Results: Of 7,710 adults, 4,470 (57.5 weighted %) overestimated HDP; 1,924 (25.6 weighted %) underestimated HDP; and 1,316 (16.9 weighted %) correctly estimated HDP. After adjusting for age, sex, and education level, having CV disease was not associated with incorrectly estimating HDP (adjusted OR 1.08; 95% CI 0.93, 1.26) or overestimating HDP (adjusted OR 1.21; 95% CI 1.00, 1.48), compared to correctly estimating HDP. Among those with CV disease, overestimating HDP was associated with higher BMI (adjusted difference 1.9 m/kg 2 ; 95% CI 0.8, 2.9) and lower HDL (adjusted difference -2.8 mg/dL; 95% CI -5.1, -0.5). Among those without CV disease, overestimating HDP was only associated with higher BMI (adjusted difference 1.9; 95% CI 0.8, 2.9) Conclusions: More than half of Americans overestimate their diet quality, and adults with CV disease do not estimate diet quality more accuracy than those without CV disease. Among adults with CV disease, misperceptions in diet quality were associated with worse CV risk factor profiles, highlighting the need to assess and educate patients with CV disease on personal diet quality as part of healthy lifestyle promotion. Among those without CV disease, dietary misperceptions were associated with higher BMI, suggesting that increasing awareness of one's diet is also important in CV disease prevention.
Abstract P122: A Semi-Automated Tool Can Increase Stroke Clinical Trial Recruitment
Authors: Murat Sari, Marcelo Rocha
Journal: Circulation (2024)

Introduction: Stroke is a major public health problem, and stroke-related research is crucial. However, enrollment in randomized controlled stroke trials of acute therapies is challenging, leading to missed patients during the screening phase. The current screening process is person-dependent and can be highly variable across stroke team members, time of the day, and hospitals. High-volume stroke centers participate in more than 15 simultaneous NIH and industry-sponsored stroke trials. We hypothesize that a HIPAA-compliant screening tool can optimize screening and increase trial enrollment. Methods: This tool is a HIPAA-compliant application, developed by the Power Team at the University of Pittsburgh Medical Center, using Microsoft Power Apps. It has three purposes: screening, maintaining the database, and reporting. The screening process begins with patient demographics, and basic stroke-related data, followed by acute ischemic, subacute ischemic, and hemorrhagic stroke trial groups. Users can select their preferred subgroup of studies and continue filling in the rest of the form by answering pertinent questions. Upon form submission, the tool calculates the patient’s eligibility status for each trial in that group. The database is immediately available on the opening page or on the cloud. After submission, this can be edited, e.g., refusal for enrollment, or change in the patient’s condition. Reporting can be automated by using Power tools or it can be done manually. For manual reporting, the database gives filtering options based on time frames, patients, trials, and more. Results: The tool is in the testing phase, and we expect to have enrollment data by the time of the meeting. Conclusions: This tool has several advantages over manual screening. First, it reduces the orientation time for new research team members. Second, it mitigates the risk of overlooking potentially eligible patients in time-sensitive scenarios. Third, it is highly customizable by editing the codebook and can be adjusted per research site. This can be particularly helpful for smaller hospitals surrounded by underserved areas and can decrease health disparities by extending the chance of clinical trial participation. Fourth, it automatically maintains an up-to-date data log, which can be extracted at various intervals, such as monthly or per study. This not only streamlines the data recording but also simplifies reporting to study sponsors. Lastly, it expedites trial completion by accelerating the enrollment process. In conclusion, this tool can have significant benefits for research teams and for the broader public.
Abstract P363: The Influence of Social Support on Heart Disease Risk Factor Knowledge in Texas African American Women
Authors: Brittny Bratcher-Rasmus, Marilyn Massey-Stokes
Journal: Circulation (2024)

Introduction: Heart disease disproportionately impacts African American (AA) women nationwide and in Texas. Heart disease disparities stem from risk factors related to limited heart disease risk factor knowledge and socioeconomic resources. Social support mitigates chronic disease risk, yet this is the first study to examine the relationship between perceived social support and heart disease risk within this population. The study aimed to (1) examine how perceived social support impacts heart disease risk factor knowledge among AA women and (2) examine whether demographic characteristics moderate a relationship between perceived social support and heart disease knowledge. Hypothesis: We hypothesize that social support moderates heart disease risk factor knowledge in AA women in Texas based on demographic variables. Methods: This was a quantitative study with purposeful, snowball sampling representative of AA women aged 30-55 in Texas (n = 121). The participants completed a survey comprised of demographic questions, the Heart Disease Knowledge Questionnaire, and the Multidimensional Scale for Perceived Social Support. Results: Approximately half the participants displayed heart disease knowledge deficiencies. Multiple regression analysis revealed that when demographic variables were controlled, age (standardized β= .28, p = .002) and income (standardized β= .19, p = .037) were the only predictor variables indicating that social support impacts heart disease knowledge, with nonsignificant differences in the regression model (standardized β = -.023, p = .80). Hierarchical multiple regression revealed that age (F change = 1.056, R square change = .008, and p = .306), education (F (3, 115) = .583, p = .627), family history (F (2, 116) = 1.51, p = .225), and income (F change = 1.006, R2 change = .008, and p = .318) as individual predictors yielded nonsignificant differences in the overall predictive model, indicating that demographic variables did not moderate a relationship between social support and heart disease knowledge. Conclusion: Overall, the study revealed a need to implement public health education programs to increase heart health knowledge through interventions that combine education and social support among AA women to influence health behavior change and reduce heart health disparities.