المؤلفون: Jiang, Xuan, Shao, Yanqiu, Araj, Faris G, Amin, Alpesh A, Greenberg, Benjamin M, Drazner, Mark H, Xing, Chao, Mammen, Pradeep PA

المصدر: Journal of the American Heart Association. 9(19)

مصطلحات موضوعية: Muscular Dystrophy, Brain Disorders, Pediatric, Clinical Research, Human Genome, Genetics, Cardiovascular, Heart Disease, Duchenne/ Becker Muscular Dystrophy, Orphan Drug, Rare Diseases, Intellectual and Developmental Disabilities (IDD), Aetiology, 2.1 Biological and endogenous factors, Musculoskeletal, Adult, Cardiomyopathies, Cystic Fibrosis, Cystic Fibrosis Transmembrane Conductance Regulator, Dystrophin, Female, Genetic Predisposition to Disease, Heart Function Tests, Humans, Magnetic Resonance Imaging, Cine, Male, Muscular Dystrophy, Duchenne, Mutation, Missense, Natriuretic Peptide, Brain, Peptide Fragments, Stroke Volume, Ventricular Dysfunction, Left, Whole Exome Sequencing, Duchene muscular dystrophy-associated cardiomyopathy, genetic modifier, whole exome sequencing, Exome Sequencing, Duchene muscular dystrophy–associated cardiomyopathy, Cardiorespiratory Medicine and Haematology

الوصف: Background Duchenne muscular dystrophy (DMD) is a neuromuscular disorder caused by mutations within the dystrophin gene. DMD is characterized by progressive skeletal muscle degeneration and atrophy and progressive cardiomyopathy. It has been observed the severity of cardiomyopathy varies in patients with DMD. Methods and Results A cohort of male patients with DMD and female DMD carriers underwent whole exome sequencing. Potential risk factor variants were identified according to their functional annotations and frequencies. Cardiac function of 15 male patients with DMD was assessed by cardiac magnetic resonance imaging, and various cardiac magnetic resonance imaging parameters and circulating biomarkers were compared between genotype groups. Five subjects carrying potential risk factor variants in the cystic fibrosis transmembrane regulator gene demonstrated lower left ventricular ejection fraction, larger left ventricular end-diastolic volume, and higher NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels compared with 10 subjects who did not carry the potential risk factor variants (P=0.023, 0.019 and 0.028, respectively). Conclusions This study revealed heterozygous cystic fibrosis transmembrane regulator gene missense variants were associated with worse cardiac function in patients with DMD. The cystic fibrosis transmembrane regulator gene may serve as a genetic modifier that accounts for more severe cardiomyopathy in patients with DMD, who would require more aggressive management of the cardiomyopathy.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/22w8q3tdTest

المؤلفون: Gore, Maria Odette, Ayers, Colby R, Khera, Amit, deFilippi, Christopher R, Wang, Thomas J, Seliger, Stephen L, Nambi, Vijay, Selvin, Elizabeth, Berry, Jarett D, Hundley, W Gregory, Budoff, Matthew, Greenland, Philip, Drazner, Mark H, Ballantyne, Christie M, Levine, Benjamin D, de Lemos, James A

المصدر: Journal of the American Heart Association. 9(15)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Aging, Heart Disease - Coronary Heart Disease, Prevention, Cardiovascular, Heart Disease, Atherosclerosis, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Aged, Aged, 80 and over, Biomarkers, C-Reactive Protein, Cardiovascular Diseases, Carotid Intima-Media Thickness, Electrocardiography, Female, Humans, Male, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Risk Assessment, Risk Factors, Troponin T, carotid intima-media thickness, coronary artery calcium, high-sensitivity cardiac troponin T, high-sensitivity C-reactive protein, N-terminal pro B-type natriuretic peptide, plaque, N‐terminal pro B‐type natriuretic peptide, carotid intima‐media thickness, high‐sensitivity C‐reactive protein, high‐sensitivity cardiac troponin T, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology

الوصف: Background Current strategies for cardiovascular disease (CVD) risk assessment focus on 10-year or longer timeframes. Shorter-term CVD risk is also clinically relevant, particularly for high-risk occupations, but is under-investigated. Methods and Results We pooled data from participants in the ARIC (Atherosclerosis Risk in Communities study), MESA (Multi-Ethnic Study of Atherosclerosis), and DHS (Dallas Heart Study), free from CVD at baseline (N=16 581). Measurements included N-terminal pro-B-type natriuretic peptide (>100 pg/mL prospectively defined as abnormal); high-sensitivity cardiac troponin T (abnormal >5 ng/L); high-sensitivity C-reactive protein (abnormal >3 mg/L); left ventricular hypertrophy by ECG (abnormal if present); carotid intima-media thickness, and plaque (abnormal >75th percentile for age and sex or presence of plaque); and coronary artery calcium (abnormal >10 Agatston U). Each abnormal test result except left ventricular hypertrophy by ECG was independently associated with increased 3-year risk of global CVD (myocardial infarction, stroke, coronary revascularization, incident heart failure, or atrial fibrillation), even after adjustment for traditional CVD risk factors and the other test results. When a simple integer score counting the number of abnormal tests was used, 3-year multivariable-adjusted global CVD risk was increased among participants with integer scores of 1, 2, 3, and 4, by ≈2-, 3-, 4.5- and 8-fold, respectively, when compared with those with a score of 0. Qualitatively similar results were obtained for atherosclerotic CVD (fatal or non-fatal myocardial infarction or stroke). Conclusions A strategy incorporating multiple biomarkers and atherosclerosis imaging improved assessment of 3-year global and atherosclerotic CVD risk compared with a standard approach using traditional risk factors.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/27x9k00zTest

المؤلفون: de Lemos, James A, Ayers, Colby R, Levine, Benjamin D, deFilippi, Christopher R, Wang, Thomas J, Hundley, W Gregory, Berry, Jarett D, Seliger, Stephen L, McGuire, Darren K, Ouyang, Pamela, Drazner, Mark H, Budoff, Matthew, Greenland, Philip, Ballantyne, Christie M, Khera, Amit

المصدر: Circulation. 135(22)

مصطلحات موضوعية: Epidemiology, Biomedical and Clinical Sciences, Health Sciences, Heart Disease - Coronary Heart Disease, Cardiovascular, Patient Safety, Aging, Prevention, Heart Disease, Atherosclerosis, Clinical Research, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Adult, Aged, Biomarkers, Cardiovascular Diseases, Cohort Studies, Combined Modality Therapy, Electrocardiography, Ethnicity, Female, Follow-Up Studies, Humans, Male, Middle Aged, Population Surveillance, Prospective Studies, Risk Assessment, Texas, biomarker, C-reactive protein, coronary calcium, NT-proBNP, risk prediction, troponin T, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Sports science and exercise

الوصف: BackgroundCurrent strategies for cardiovascular disease (CVD) risk assessment among adults without known CVD are limited by suboptimal performance and a narrow focus on only atherosclerotic CVD (ASCVD). We hypothesized that a strategy combining promising biomarkers across multiple different testing modalities would improve global and atherosclerotic CVD risk assessment among individuals without known CVD.MethodsWe included participants from MESA (Multi-Ethnic Study of Atherosclerosis) (n=6621) and the Dallas Heart Study (n=2202) who were free from CVD and underwent measurement of left ventricular hypertrophy by ECG, coronary artery calcium, N-terminal pro B-type natriuretic peptide, high-sensitivity cardiac troponin T, and high-sensitivity C-reactive protein. Associations of test results with the global composite CVD outcome (CVD death, myocardial infarction, stroke, coronary or peripheral revascularization, incident heart failure, or atrial fibrillation) and ASCVD (fatal or nonfatal myocardial infarction or stroke) were assessed over >10 years of follow-up. Multivariable analyses for the primary global CVD end point adjusted for traditional risk factors plus statin use and creatinine (base model).ResultsEach test result was independently associated with global composite CVD events in MESA after adjustment for the components of the base model and the other test results (P

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3804j934Test

المؤلفون: Jessup, Mariell, Drazner, Mark H, Book, Wendy, Cleveland, Joseph C, Dauber, Ira, Farkas, Susan, Ginwalla, Mahazarin, Katz, Jason N, Kirkwood, Peggy, Kittleson, Michelle M, Marine, Joseph E, Mather, Paul, Morris, Alanna A, Polk, Donna M, Sakr, Antoine, Schlendorf, Kelly H, Vorovich, Esther E

المصدر: Maine Medical Center

مصطلحات موضوعية: American Heart Association, Cardiology, Cardiomyopathies, Clinical Competence, Fellowships and Scholarships, Heart Failure, Heart Transplantation, Heart-Assist Devices, Humans, Patient Care Management, Postoperative Complications, Preceptorship, United States, Medical Education

العلاقة: https://knowledgeconnection.mainehealth.org/mmc/1964Test; https://pubmed.ncbi.nlm.nih.gov/28284970Test/

الإتاحة: https://knowledgeconnection.mainehealth.org/mmc/1964Test
https://pubmed.ncbi.nlm.nih.gov/28284970Test/

المؤلفون: de Lemos, James A., Ayers, Colby R., Levine, Benjamin, deFilippi, Christopher R., Wang, Thomas J., Hundley, W. Gregory, Berry, Jarett D., Seliger, Stephen L., McGuire, Darren K., Ouyang, Pamela, Drazner, Mark H., Budoff, Matthew, Greenland, Philip, Ballantyne, Christie M., Khera, Amit

مصطلحات موضوعية: Adult, Male, Middle Aged, Combined Modality Therapy, Risk Assessment, Texas, Article, Cohort Studies, Electrocardiography, Cardiovascular Diseases, Population Surveillance, Ethnicity, Humans, Female, Prospective Studies, Biomarkers, Aged, Follow-Up Studies

الوصف: Current strategies for cardiovascular disease (CVD) risk assessment among adults without known CVD are limited by suboptimal performance and a narrow focus on only atherosclerotic CVD (ASCVD). We hypothesized that a strategy combining promising biomarkers across multiple different testing modalities would improve global and atherosclerotic CVD risk assessment among individuals without known CVD.We included participants from MESA (Multi-Ethnic Study of Atherosclerosis) (n=6621) and the Dallas Heart Study (n=2202) who were free from CVD and underwent measurement of left ventricular hypertrophy by ECG, coronary artery calcium, N-terminal pro B-type natriuretic peptide, high-sensitivity cardiac troponin T, and high-sensitivity C-reactive protein. Associations of test results with the global composite CVD outcome (CVD death, myocardial infarction, stroke, coronary or peripheral revascularization, incident heart failure, or atrial fibrillation) and ASCVD (fatal or nonfatal myocardial infarction or stroke) were assessed over10 years of follow-up. Multivariable analyses for the primary global CVD end point adjusted for traditional risk factors plus statin use and creatinine (base model).Each test result was independently associated with global composite CVD events in MESA after adjustment for the components of the base model and the other test results (Among adults without known CVD, a novel multimodality testing strategy using left ventricular hypertrophy by ECG, coronary artery calcium, N-terminal pro B-type natriuretic peptide, high-sensitivity cardiac troponin T, and high-sensitivity C-reactive protein significantly improved global CVD and ASCVD risk assessment.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::3d1197858f81a6c8dda49c066767664fTest
https://europepmc.org/articles/PMC5486874Test/

المؤلفون: Pandey, Ambarish, Garg, Sushil, Matulevicius, Susan A, Shah, Amil M, Garg, Jalaj, Drazner, Mark H, Amin, Alpesh, Berry, Jarett D, Marwick, Thomas H, Marso, Steven P, de Lemos, James A, Kumbhani, Dharam J

المصدر: Department of Medicine

مصطلحات موضوعية: Chi-Square Distribution, Diastole, Fibrosis, Heart Failure, Humans, Mineralocorticoid Receptor Antagonists, Randomized Controlled Trials as Topic, Recovery of Function, Stroke Volume, Treatment Outcome, Ventricular Dysfunction, Left, Ventricular Function, Ventricular Remodeling, Department of Medicine, Fellows and Residents, Medicine and Health Sciences

الوصف: BACKGROUND: There has been an increasing interest in use of mineralocorticoid receptor antagonists (MRAs) in patients with heart failure with preserved ejection fraction (HFPEF). However, a comprehensive evaluation of MRA effects on left ventricular (LV) structure and function in these patients is lacking. In this meta-analysis, we evaluated the effects of MRAs on LV structure and function among patients with diastolic dysfunction or HFPEF. METHODS & RESULTS: Randomized, controlled clinical trials evaluating the efficacy of MRAs in patients with diastolic dysfunction or HFPEF were included. The primary outcome was change in E/e', a specific measure of diastolic function. Secondary outcomes included changes in other measures of diastolic function, LV structure, surrogate markers for myocardial fibrosis (carboxy-terminal peptide of procollagen type I [PICP] and amino-terminal peptide of pro-collagen type-II [PIIINP]), blood pressure, and exercise tolerance. In the pooled analysis, MRA use was associated with significant reduction in E/e' (weighted mean difference [WMD] [95% confidence interval {CI}]: -1.68 [-2.03 to -1.33]; P CONCLUSION: MRA therapy in patients with asymptomatic diastolic dysfunction or HFPEF is associated with significant improvement in diastolic function and markers of cardiac fibrosis without a significant change in LV mass or dimensions.

العلاقة: https://scholarlyworks.lvhn.org/medicine/5058Test; https://pubmed.ncbi.nlm.nih.gov/26459931Test/

الإتاحة: https://scholarlyworks.lvhn.org/medicine/5058Test
https://pubmed.ncbi.nlm.nih.gov/26459931Test/

المؤلفون: Stewart, Ralph, Szalewska, Dominika, She, Lilin, Lee, Kerry L., Drazner, Mark H., Lubiszewska, Barbara, Kosevic, Dragana, Ruengsakulrach, Permyos, Nicolau, José C., Coutu, Benoit, Choudhary, Shiv K., Mark, Daniel B., Cleland, John G.F., Piña, Ileana L., Velazquez, Eric J., Rynkiewicz, Andrzej, White, Harvey

المصدر: JACC. Heart failure. 2(4)

مصطلحات موضوعية: Heart Failure, Male, Exercise Tolerance, Myocardial Ischemia, Kaplan-Meier Estimate, Middle Aged, Article, Ventricular Dysfunction, Left, Treatment Outcome, Risk Factors, Exercise Test, Humans, Female, Coronary Artery Bypass, Exercise

الوصف: The objective of this study was to assess the prognostic significance of exercise capacity in patients with ischemic left ventricular (LV) dysfunction eligible for coronary artery bypass graft surgery (CABG).Poor exercise capacity is associated with mortality, but it is not known how this influences the benefits and risks of CABG compared with medical therapy.In an exploratory analysis, physical activity was assessed by questionnaire and 6-min walk test in 1,212 patients before randomization to CABG (n = 610) or medical management (n = 602) in the STICH (Surgical Treatment for Ischemic Heart Failure) trial. Mortality (n = 462) was compared by treatment allocation during 56 months (interquartile range: 48 to 68 months) of follow-up for subjects able (n = 682) and unable (n = 530) to walk 300 m in 6 min and with less (Physical Ability Score [PAS]55, n = 749) and more (PAS ≤55, n = 433) limitation by dyspnea or fatigue.Compared with medical therapy, mortality was lower for patients randomized to CABG who walked ≥300 m (hazard ratio [HR]: 0.77; 95% confidence interval [CI]: 0.59 to 0.99; p = 0.038) and those with a PAS55 (HR: 0.79; 95% CI: 0.62 to 1.01; p = 0.061). Patients unable to walk 300 m or with a PAS ≤55 had higher mortality during the first 60 days with CABG (HR: 3.24; 95% CI: 1.64 to 6.83; p = 0.002) and no significant benefit from CABG during total follow-up (HR: 0.95; 95% CI: 0.75 to 1.19; p = 0.626; interaction p = 0.167).These observations suggest that patients with ischemic left ventricular dysfunction and poor exercise capacity have increased early risk and similar 5-year mortality with CABG compared with medical therapy, whereas those with better exercise capacity have improved survival with CABG. (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease [STICH]; NCT00023595).

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::56e60611debbb275642dc796dc648ce9Test
https://pubmed.ncbi.nlm.nih.gov/25023814Test

المؤلفون: Brinker, Stephanie K, Pandey, Ambarish, Ayers, Colby R, Barlow, Carolyn E, DeFina, Laura F, Willis, Benjamin L, Radford, Nina B, Farzaneh-Far, Ramin, de Lemos, James A, Drazner, Mark H, Berry, Jarett D

المصدر: JACC. Heart failure. 2(3)

مصطلحات موضوعية: Male, Heart Failure, Diastolic, Ventricular Remodeling, Cardiac Volume, Myocardium, Stroke Volume, Organ Size, Middle Aged, Article, Ventricular Dysfunction, Left, Cross-Sectional Studies, Echocardiography, Physical Fitness, Exercise Test, Humans, Female, Heart Atria, Longitudinal Studies

الوصف: This study sought to compare the cross-sectional associations between fitness and echocardiographic measures of cardiac structure and function.Cardiorespiratory fitness is inversely associated with heart failure risk. However, the mechanism through which fitness lowers heart failure risk is not fully understood.We included 1,678 men and 1,247 women from the Cooper Center Longitudinal Study who received an echocardiogram from 1999 to 2011. Fitness was estimated by Balke protocol (in metabolic equivalents) and also categorized into age-specific quartiles, with quartile 1 representing low fitness. Cross-sectional associations between fitness (in metabolic equivalents) and relative wall thickness, left ventricular end-diastolic diameter indexed to body surface area, left atrial volume indexed to body surface area, left ventricular systolic function, and E/e' ratio were determined using multivariable linear regression analysis.Higher levels of mid-life fitness (metabolic equivalents) were associated with larger indexed left atrial volume (men: beta = 0.769, p0.0001; women: beta = 0.879, p value ≤0.0001) and indexed left ventricular end-diastolic diameter (men: beta = 0.231, p0.001; women: beta = 0.264, p0.0001). Similarly, a higher level of fitness was associated with a smaller relative wall thickness (men: beta = -0.002, p = 0.04; women: beta = -0.005, p0.0001) and E/e' ratio (men: beta = -0.11, p = 0.003; women: beta = -0.13, p = 0.01). However, there was no association between low fitness and left ventricular systolic function (p = NS).Low fitness is associated with a higher prevalence of concentric remodeling and diastolic dysfunction, suggesting that exercise may lower heart failure risk through its effect on favorable cardiac remodeling and improved diastolic function.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::6eb246ffdebf64a67fb714f69b44a338Test
https://pubmed.ncbi.nlm.nih.gov/24952691Test

المؤلفون: Patel, Parag C.¹ parag.patel@utsouthwestern.edu, Reimold, Sharon C.¹, Araj, Faris G.¹, Ayers, Colby R.¹, Kaiser, Patricia A.¹, Peshock, Ronald M.¹, Yancy, Clyde W.², Ring, W. Steves³, Gupta, Sachin¹, Mishkin, Joseph D.¹, Mammen, Pradeep P.A.¹, Markham, David W.¹, Drazner, Mark H.¹

المصدر: Journal of Heart & Lung Transplantation. Dec2010, Vol. 29 Issue 12, p1369-1379. 11p.

مصطلحات موضوعية: *CARDIAC hypertrophy, *HEART transplantation, *MAGNETIC resonance imaging, *LEFT heart ventricle, *MULTIVARIATE analysis, *HEART disease related mortality, *HEART disease prognosis

مستخلص: Background: Although risk factors for left ventricular (LV) hypertrophy in the native heart are well known, as is its association with increased risk of adverse outcomes, such information is poorly defined in heart transplant (HTx) recipients. We determined whether increased LV mass and concentricity (mass/volume) were associated with death in patients after HTx. Methods: Between May 2003 and May 2006, 140 HTx recipients underwent cardiac magnetic resonance imaging (MRI). Clinical characteristics associated with increased LV mass were determined. Cox proportional hazard models were constructed to assess the relationship of LV mass and concentricity with death. Results: MRIs were acquired a median of 6.0 years after transplant. The top quartile of indexed LV mass and concentricity were 35.8 g/m2.7 or higher and 1.5 g/ml or higher, respectively. History of rejection (odds ratio [OR], 5.9; 95% confidence interval [CI], 2.1–16.4; p < 0.01), diabetes (OR, 3.3; 95% CI, 1.3–8.2; p = 0.01), and post-transplant year of MRI acquisition (OR, 1.2; 95% CI, 1.1–1.4; p < 0.01) were associated with the top quartile of LV mass in multivariable models. LV mass and concentricity were independently associated with cardiovascular death (hazard risk [HR], 1.11 per g/m;2.7 HR, 10.1 per g/ml, p ≤ 0.01, respectively). LV concentricity was independently associated with all-cause mortality (HR, 4.4 per g/ml, p < 0.01). Conclusion: A history of rejection and diabetes are associated with increased LV mass. Increased LV mass, particularly of a concentric phenotype, is an independent risk factor for cardiovascular and all-cause mortality after HTx. [ABSTRACT FROM AUTHOR]