tbuckley/cabot-search huggingface dataset:
Abstract P2115: Spatiotemporal Transcriptomics Analysis Of Central Venous Stenosis Suggests TNF-alpha As A Potential Therapeutic Target In Chronic Kidney Disease Rats
Authors: Saran Lotfollahzadeh
Journal: Circulation (2025)

Introduction: In the United States, 50-80% of chronic kidney disease (CKD) patients use a central venous catheter (CVC) for hemodialysis. Protracted exposure of CVCs against fragile venous walls results in central venous stenosis (CVS), which has devastating complications. Despite its higher prevalence of up to 40% in CKD patients, little is known about its pathogenesis and the means to target it. Hypothesis: We posit that a venous guide-wire injury will induce specific perturbation in the target cells (endothelial and vascular smooth muscle cells) in the CKD milieu. Methods: Twenty-two 8-12-week-old Sprague Dawley rats on 0.75 % Adenine diet (CKD rats) for two weeks and N=18 normal chaw (control ) were subjected to guide wire injury on their right internal jugular veins. After the injury, animals were harvested on days 0, 5, and 14. GeoMax Whole transcriptome analysis, validation, and molecular studies were performed after validation studies. Results: Compared to non-CKD rats, injured veins of CKD rats showed higher thrombus, deposition of extracellular matrix, and perivascular fibrosis, all consistent with CVS. Spatial transcriptomics analysis revealed significant (P &lt; 0.05) and at least more than 50% upregulation of genes of matrix modifying enzymes (MMP 10 and 19), collagen, and others. OF these changes, a consistent 1.6 to 2-fold upregulation was noted in the Tumor Necrosis Factor (TNF) family members (Tnfrsf1b, Traf3, ifnb1, Tradd) in endothelial and vascular smooth muscle cells. This finding was validated using IHC, which demonstrated TNF-alpha upregulation in the endothelial cells of the injured veins of CKD rats (P= 0.002, P &lt;0.0001 at days 5 and 14) compared to controls. Mechanistic probing revealed that endothelial cells exposed to the serum from CKD patients suppressed survival and migration (P &lt;0.05), both of which were reversed by anti-TNF neutralizing antibodies (P =0.05) through the JNK and Phospho p-38 pathway. At the same time, no effect was noted in primary human vascular smooth muscle cells. Conclusion: Leveraging a rodent model of CVS, this study generates and validates the first central venous stenosis model in rats, demonstrating higher perivascular fibrosis in the CKD milieu. The spatiotemporal genetic perturbation in the injured vein of CKD rats, showing the multitude of pathways perturbed by the injury in the CKD milieu of TNF, can be therapeutically targeted with FDA-approved TNF agents.
Abstract P3099: Greater Adherence to the 2020-2025 Dietary Guidelines for Americans on Consumption of Dark Green Vegetables and Legumes is Associated with Lower Carotid Femoral Pulse Wave Velocity in a Cohort of Community-Dwelling Older Adults without Dementia
Authors: Mengyi Li, Jiatong Li, Yuefang Chang, Emma Barinas-Mitchell, Cristina Murray-Krezan, Whitney Wharton, Timothy Hughes, Akira Sekikawa
Journal: Circulation (2025)

Introduction: Carotid-femoral pulse wave velocity (cfPWV) is the gold standard measure of arterial stiffness and is a well-established predictor of cardiovascular mortality and morbidity. Adherence to Dietary Guidelines for Americans, assessed by the Healthy Eating Index (HEI), has been associated with reduced cardiovascular mortality and morbidity and favorable blood pressure effects, potentially reducing arterial stiffness. Hypothesis: We hypothesize that greater adherence to the 2020-2025 Dietary Guidelines for Americans and its components is associated with lower cfPWV in a cohort of community-dwelling older adults aged 65-85 without dementia. Methods: We used the baseline data from the Arterial stiffness, Cognition, and Equol (ACE) trial, a multicenter RCT designed to test the effect of a 24-month intervention of equol supplementation on brain health among 400 self-reported White and Black/African Americans from Pittsburgh, PA, Winston-Salem, NC, and Atlanta, GA. Total cfPWV was measured supine after a 10-minute rest using the SphygmoCor XCEL system. Systolic blood pressure was assessed at the same visit without hypertension medication. Self-reported dietary intake from one weekday and one weekend interviewer-administered 24-hour dietary recalls was analyzed using the Nutrition Data System for Research software version 2022. The overall HEI-2020 and 13 component scores were determined. Multiple linear regression models were used to assess the associations of the HEI-2020 or individual components with cfPWV adjusting for demographic and cardiometabolic risk factors. Results: Our analytical cohort included 196 participants recruited at the Pittsburgh site. The cohort was 48.5% female and 8.7% Black/African American, with an average age of 71.9 years (SD: 4.6). Participants had a mean HEI-2020 score of 58.4 (SD: 13.8) and a mean cfPWV of 8.90 m/s (SD: 1.54). The participants were mostly in good health. Total HEI was not associated with cfPWV (p=0.78). On average, consuming adequate dark green vegetables and legumes (≥0.2 cup equiv. per 1,000 kcal) was associated with 0.6 m/s lower cfPWV than eating no dark green vegetables or legumes (p=0.03). Greater consumption of protein-dense food groups was positively associated with cfPWV (p=0.04); yet, total protein intake was not. Conclusion: Greater adherence to the 2020-2025 Dietary Guidelines for Americans on consumption of dark green vegetables and legumes is associated with lower cfPWV.
Abstract P2100: Longitudinal association between MIND diet adherence, inflammatory mechanism, and cognitive health
Authors: Vivian Hsing-Chun Wang, YIAN GU, Alice Gelman, Jasmin Divers, Donglan Zhang
Journal: Circulation (2025)

Introduction: Evidence is limited on the cognitive benefits of the Mediterranean-DASH Intervention for Neurodegenerative Delay(MIND) diet and biological mechanism for middle-age adults. We examined the longitudinal association of MIND diet with cognitive change over time and whether the association was mediated by reduced inflammation. Hypothesis: A higher MIND diet score, indicating better adherence to the dietary pattern, was associated with slower cognitive decline, and inflammation—measured by circulating inflammatory biomarkers—mediated the association. Methods: This study included data from 3,515 participants of the 2013 Health Care and Nutrition Survey (HCNS), a subsample of the Health and Retirement Study, who were over 50 years of age, were without probable dementia at the baseline in 2012, and had self-reported cognitive measures between 2012 and 2020, MIND diet score, and key demographics. Inflammatory biomarkers included C-reactive protein (CRP), tumor necrosis factor receptor (TNFR1), and Insulin-like growth factor 1 (IGF-1). Change in cognition were estimated using linear mixed effects models. All models were adjusted for age, sex, race/ethnicity, educational attainment, household income, and presence of APOE e4 allele. Results: Over half of the respondents were aged 65 years and older (51.7%) and female (54.7%). At baseline, compared to the low tertile, higher adherence to MIND diet was associated with better cognitive score [middle tertile: β(SE)=0.41(0.12); high tertile: β(SE)=0.66 (0.16), p &lt;0.001], lower levels of CRP ( p &lt;0.001) and TNFR1 ( p &lt;0.001), and higher level of IGF1 ( p &lt;0.001); higher TNFR1 was associated with worse cognitive scores [β(SE)=-0.038(.17), p &lt;0.029]. TNFR1 mediated 16.02% of the total effect of the MIND diet on cognitive function (indirect β = 0.11, 95% CI [0.08, 0.15]). During the 8-year follow-up, participants in the higher tertile of MIND diet had a slower rate of cognitive decline over time compared to those in the low tertile [low: β(SE)=-0.24(0.023); middle: β(SE)=-0.19(0.023); high: β(SE)=-0.11 (0.028)], p &lt;0.001. The association between MIND diet and cognitive change was attenuated—7.90% for the high tertile—after including TNFR1. Conclusions: Following a healthy MIND dietary pattern at middle-age can help slow down cognitive decline, which occurs at least partially through mitigating the TNFR1-related inflammation pathway.
Abstract P2117: Associations of cardiac biomarkers with physical activity and sedentary behavior in postmenopausal women
Authors: Connor Miller, Andrea LaCroix, Charles Eaton, Eric Hyde, Alexi Vasbinder, Steve Nguyen, Chongzhi Di, Michael LaMonte
Journal: Circulation (2025)

Background: Associations of physical activity (PA) and sedentary behavior (SB) with biomarkers of cardiac stress could have implications for cardiovascular resiliency in aging women but are understudied. Methods: Postmenopausal women (50-79 years old at Women’s Health Initiative enrollment) (a) without known CHD, (b) with available self-reported usual PA and SB information, and (c) with available blood biomarkers for high-sensitivity C-reactive protein (hsCRP mg/L; inflammation), tissue plasminogen activator (tPA ng/mL; fibrinolysis), N-terminal pro-brain natriuretic protein (NT-proBNP pg/mL; volume overload), and plasminogen activator inhibitor-1 (PAI-1 pg/mL; thrombosis/endothelial dysfunction) were included in this cross-sectional analysis (n=3,537 for hsCRP, tPA, NT-proBNP; n = 2,460 PAI-1). Adjusted means were estimated from linear regression models. All data was ascertained at study enrollment. Results: Controlling for age, race-ethnicity, history of stroke, heart failure, treated diabetes or hypertension, smoking, and postmenopausal hormone use, adjusted mean biomarker concentrations across incremental walking categories (0, &gt;0-3.5, &gt;3.5-8.33, &gt;8.33 MET-hr/wk) were: hsCRP 4.1, 3.7, 3.2, 2.5, trend P&lt;.001; NT-proBNP 162.9, 155.1, 148.2, 151.3, trend P=.05; tPA 8.9, 9.2, 8.3, 8.0, trend P=.01; PAI-1 16691, 16896, 15717, 14672, trend P&lt;.001 ( Figures 1&amp;2 ). Similar patterns were observed across strenuous activity categories, aside from NT-proBNP. Across incremental categories of SB (&lt;4.6, 4.6-8.5, &gt;8.5 hr/day) positive associations were seen for adjusted mean hsCRP 3.4, 3.6, 3.9, trend P&lt;.01; tPA 8.2, 8.9, 9.9, trend P=.03; PAI-1 15552, 16407, 16639, trend P=.05. In stratified analysis, inverse associations were observed regardless of comorbid status (prevalent diabetes, hypertension, heart failure, or cancer). Associations were attenuated but significant among older women, and associations of PA measures with hsCRP were stronger in those with high BMI (30+ kg/m 2 ). Conclusion: In this cross-sectional study of postmenopausal women, higher levels of walking and strenuous PA were associated with lower concentrations of biomarkers related to inflammation (hsCRP), fibrinolysis (tPA), and thrombosis/endothelial dysfunction (PAI-1), while higher SB was positively associated with elevated levels. The findings highlight the role of PA in promoting cardiovascular resiliency during aging, and underscore the adverse impact of prolonged SB.
Abstract 013: Exploring Facilitators and Barriers for Personalized Dietary Incentives among Online Shoppers at Cardiovascular Risk and Key Informants to Inform an Automated Shopping Platform
Authors: Maya Vadiveloo, Emily Elenio, Alison Tovar, Anne Thorndike
Journal: Circulation (2025)

The Smart Cart trial found that a personalized healthy food incentive platform (grocery incentives, education, &amp;recipes) improved grocery purchase quality, especially among adults at cardiovascular risk. To maximize reach, it will be essential to automate the platform (Smart Cart 2.0) and to integrate stakeholder feedback before testing. This convergent, parallel mixed methods study identified facilitators and barriers to healthy eating and app acceptability and sustainability for online grocery shopping among adults at cardiovascular risk. Shoppers (age 18+, grocery shop online,&amp;with obesity/hypertension, n=19) and key informants (health professionals, n=11) in the northeast were recruited. Shoppers completed a 20-min survey in Qualtrics and 45-min in-depth interview. Key informants completed 30-min in-depth interviews. Surveys queried sociodemographics, diet habits, and app acceptability; interview guides were developed with validated implementation science frameworks. Mock-up app images were sent before conducting Zoom-recorded interviews and participants shared experiences for themselves or their clients. Descriptive statistics were calculated with Stata; interviews were transcribed and dual-coded for thematic analysis with Atlas.ti. Shoppers were female (89%), White (63%), had a mean age of 38y; 32% were nutrition insecure. Primary barriers to healthy eating were money and time (26%), and most (55%) said health was their primary driver when shopping. There was high acceptability (&gt;60%) for 4/5 app elements, and most wanted healthy recipes (90%). Four themes emerged from interviews:1) buying and consuming healthy foods consistently is hard- barriers related to food cost, meal planning, and tech and cultural literacy were common; 2) a one-stop shop for healthy meal planning would help -the benefits of personalized healthy recipes and ability to shop those recipes were often noted; 3) the app addresses shoppers’ short-term needs and the app’s functionality was a facilitator, and 4) some changes to the app would promote long-term sustainability. Key informants found ways the app could integrate within existing programs and how health outcome data would support app sustainability; both groups suggested new features like gamification. Smart Cart 2.0 addressed many barriers to healthy eating and app use, and participants were optimistic that it would support their diet goals. Feedback will be integrated into the app and tested in a mock shopping trial.
Abstract P3078: Long-Term Sustainability of a Hypertension Control Initiative
Authors: Alison Smith, Ashley Wagner, Andrew Mills, Gary Harmon, Eduardo Sanchez
Journal: Circulation (2025)

Sustainability, the continuation of a new program, is an ongoing challenge and a barrier to “sustaining” success. The American Heart Association (AHA) has completed the National Hypertension Control Initiative (NHCI), a 3-year demonstration project jointly funded by the United States Department of Health and Human Services’ Office of Minority Health and the Health Resources Services Administration (HRSA) to improve blood pressure (BP) control in 350 low-performing HRSA-funded community health centers (CHCs) with about 1.5 million persons with hypertension (HTN). Implementation strategies to improve BP control included accurate BP measurement, team-based care, standardized treatment protocols, culturally and linguistically appropriate services, and use of self-measured BP (SMBP) monitoring. Sustainability strategies for NHCI include the standardization and protocolization of care processes; adoption of data-informed performance improvement; and continuation and reinforcement of BP control efforts through Target: BP™, a BP control initiative jointly developed and delivered by AHA and the American Medical Association, serving about 9 million persons with HTN. Eligibility for NHCI included BP control &lt; 60%. In 2023, year 3, 55.5% of NHCI CHCs reported BP control ≥60%. They experienced a 9.6% improvement (18.8% relative change) in BP control from 2020-2023, compared to a 7.7% improvement (13.2% relative change) for all HRSA CHCs. In 2023, 89% of NHCI CHCs reported using a BP measurement protocol, 93% reported an SMBP protocol, and 77% reported a BP treatment algorithm. Implementation of protocols and BP improvement will be sustained by pursuing participation in Target: BP. In the 1st and 2nd years of NHCI, 33% and 35%, respectively, of 346 NHCI CHCs concurrently participated in Target: BP. Of those submitting data in 2023, 25% reported control rates ≥70% and 67% reported adoption of evidence-based practices. In 2024, 55% of all CHCs participated in Target: BP. AHA’s NHCI work can be sustained by 1) enrollment of all NHCI CHCs in Target: BP through efforts of AHA staff that supported NHCI activities, 2) leveraging Target: BP tools, resources, and quality improvement support, and 3) seeking extramural funding to support AHA BP control efforts. Sustainability of NHCI through Target: BP could be extended from 346 NHCI CHCs to all 1487 CHCs with over 31 million patients. AHA can ensure sustainability of NHCI efforts beyond the 3-year NHCI period through Target: BP.
Abstract P3081: Evaluation of Blood Pressure Management Practices Among Non-Cardiovascular Physicians in Zhejiang Province, China
Authors: Yue Wu, Cheng Tong, Renzhao Wu, Shuwei Huang
Journal: Circulation (2025)

Introduction: In clinical practice, we observed suboptimal blood pressure (BP) control prior to admission. Due to the need for treatment of other conditions, many patients are managed by non-cardiovascular specialists, resulting in discrepancies in BP control levels during hospitalization between specialist and non-specialist care. Hypothesis: By reviewing clinical data, we analyzed BP management before and after treatment by cardiovascular specialists versus non-specialists, validating the hypothesis that non-specialist physicians demonstrate inadequate BP management during hospitalization. Methods: We employed simple random sampling to select 500 adults with essential hypertension (EH) admitted to Zhejiang Provincial People's Hospital in January 2022. Clinical records were collected; comparisons were made regarding antihypertensive medication usage and BP control status before and after admission, along with an evaluation of management practices by non-specialist physicians. Results: A total of 500 adults with EH participated in this study. Compared to pre-admission BP control, there was a significant increase in treatment rates, BP control, and combination therapy following admission (100.0% vs 83.0%, 67.0% vs 36.2%, 63.5% vs 40.6%, P&lt;0.05). Approximately 62.4% of patients were admitted under non-specialty care, with only 37.5% achieving adequate BP control at admission time. The discharge BP control rate (63.0 % vs 72.9%), long-term monitoring adherence and discharge monitoring rates (81.1% vs 100.0%, 90.1% vs 100.0%), medication adjustment rate (20.2% vs 72.9%), and combined treatment rate (49.8% vs 84.0%) were all significantly lower than those seen in specialty care settings (all P &lt;0 .05). Conclusions: The treatment rate and control rate of patients prior to admission in Zhejiang Province were higher than those in other regions of China. However, over 60% of patients had inadequate BP control and require referral to hospitals with cardiovascular departments for further management. The core principles governing medication use before and after admission remained consistent, suggesting that differences in BP control may be linked to the use of combination medications. Over 60% of patients received care from non-cardiovascular departments, where rates of BP control, monitoring adherence, and medication adjustment were notably low—indicating a persistent gap in hypertension management knowledge among non-cardiovascular physicians.
Abstract P1168: The Association Between Self-Perceived Risk of Heart Disease and Barriers and Motivators to Research Participation
Authors: Ivree DATCHER, Olivia Affuso, ALEXANDRA KRALLMAN, Bertha Hidalgo
Journal: Circulation (2025)

Purpose: Prior studies have investigated how barriers and motivators (B&amp;M) impact women’s participation in heart health-related research, but there is limited understanding of how women’s perceptions of their own heart health risk impact such B&amp;M. This study aimed to investigate the association between self-perceived risk of heart disease and B&amp;M to heart health-related research participation. We hypothesize that self-perceived risk of heart disease will be associated with encountering increased barriers or motivators to research participation on average. Methods: Data from the Barriers and Motivators to Research survey from the American Heart Association’s Millennial Women’s Health Study (MWHS) were used to conduct this analysis. B&amp;M were measured using the established B&amp;M research scale employed in prior health research. B&amp;M were tallied among each participant and the number of total B&amp;M were counted. We performed descriptive statistics and the association between B&amp;M and perceived risk of heart disease was assessed by performing one-way ANOVA Kruskal-Wallis tests for nonparametric data. Results: A total of 200 women participated in the study. Of these, 39% were Black and 21% were Hispanic, with an average age of 44 (10.9). Sixty-five percent of women within the study population perceived themselves to be at risk of heart disease and 60% of the population reported that they did not experience barriers, instead reporting that they felt motivated to participate in research. We found that there was no significant difference in average total amount of barriers or motivators between any groups that perceived themselves to be at risk of heart disease ( = 8.5, = 4, p = 0.07, = 7.6, = 4, p = 0.11). Additionally, women who reported a single barrier to participation in research were more likely to report encountering at least 3 motivators to research participation. Conclusion: Women who perceived themselves to be at risk for heart disease reported strong motivation to participate in heart-related research. Although most women in our sample did not report encountering barriers to participation, those who did identified barriers such as difficulty finding time to participate and lack of interest in learning about the information research may provide about their health. Further research is necessary to gain a deeper understanding of the specific motivators and barriers experienced by women from minoritized backgrounds when invited to participate in heart research.