Hasil untuk "cs.HC"

Elena Ghotbi, David A. Bluemke, Quincy A. Hathaway et al.

Daniel S Nuyujukian, Jin J Zhou, Juraj Koska et al.

Abstract Background It is not well established whether blood pressure variability (BPV) is associated with risk of incident heart failure (HF) as well as with subclinical markers of HF and myocardial injury. We investigated these relationships in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods We examined the association between visit-to-visit BPV (estimated by variability independent of the mean—VIM) and HF in MESA (2000-2012), a community-based cohort study of 6814 individuals free of clinical cardiovascular disease (including HF) at baseline, using Cox models and joint longitudinal-survival models. VIM was calculated from Exams 1 to 5. Serial measurements (Exams 1 and 5) of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin-T (hs-cTnT) were used to test the early onset and directionality of the relationships by logistic regression. Results Over a median of 9.4 years of follow-up, VIM-SBP was associated with HF in adjusted Cox models including CVD risk factors (HR = 1.33 [95% CI, 1.03-1.69]), as well as in joint longitudinal-survival models. BPV was associated with elevated Exam 5 NT-proBNP (>125 pg/mL) after multivariable adjustment (VIM-SBP: OR = 1.26 [95% CI, 1.17-1.37]; VIM-DBP: OR = 1.23 [95% CI, 1.14-1.33]) and Exam 5 elevation in hs-cTnT (for VIM-SBP, OR = 1.27). Conclusions BPV was associated with incident HF and longitudinal increases of subclinical markers of HF and myocardial injury in a multi-ethnic community-based cohort. These data indicate that visit-to-visit BPV may contribute to the development of HF.

Juraj Koska, Yueming Hu, Jeremy Furtado et al.

OBJECTIVE Higher truncated-to-native apolipoprotein (apo) C-I proteoform ratios (C-I′/C-I) are associated with favorable cardiometabolic risk profiles, but their relationship with longitudinal changes in insulin resistance (IR) and incident diabetes is unknown. RESEARCH DESIGN AND METHODS Plasma apoC-I proteoforms were measured by mass spectrometry immunoassay at baseline in 4,742 nondiabetic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) and 524 participants with prediabetes in the Actos Now for Prevention of Diabetes (ACT NOW) study. The primary outcome was incident diabetes (fasting glucose [FG] ≥7.0 mmol/L or hypoglycemic medication use in MESA; FG ≥7.0 mmol/L or 2-h glucose ≥11.1 mmol/L in an oral glucose tolerance test [OGTT] in ACT NOW). Secondary outcomes were changes in FG and HOMA-IR in MESA, and OGTT-glucose area under the curve (AUCglucose) and Matsuda insulin sensitivity index (ISI) in ACT NOW. RESULTS In MESA, a higher C-I′/C-I was associated with lower risk of diabetes (n = 564 events; HR 0.87 [95% CI 0.79, 0.95] per SD; P = 0.0036; median follow-up, 9 years), and smaller increases (follow-up adjusted for baseline) in FG (−0.5%; P < 0.0001) and HOMA-IR (−2.9%; P = 0.011) after adjusting for baseline clinical and demographic covariates, including plasma triglycerides and HDL cholesterol. Total apoC-I concentrations were not associated with changes in FG, HOMA-IR, or incident diabetes. In ACT NOW, higher C-I′/C-I was associated with smaller increases in AUCglucose (−1.8%; P = 0.0052), greater increases in ISI (7.2%; P = 0.0095), and lower risk of diabetes (n = 59 events; 0.66 [95% CI 0.48, 0.91]; P = 0.004; median follow-up, 2.5 years) after adjusting for treatment group and diabetes risk factors, including plasma lipids. CONCLUSIONS Our results indicate that apoC-I truncation may contribute to changes in glucose levels, IR, and risk of diabetes.

Maurice Pradella, Justin J. Baraboo, Shyam Prabhakaran et al.

BackgroundLeft atrial (LA) myopathy is thought to be associated with silent brain infarctions (SBI) through changes in blood flow hemodynamics leading to thrombogenesis. 4D‐flow MRI enables in‐vivo hemodynamic quantification in the left atrium (LA) and LA appendage (LAA).PurposeTo determine whether LA and LAA hemodynamic and volumetric parameters are associated with SBI.Study TypeProspective observational study.PopulationA single‐site cohort of 125 Participants of the multiethnic study of atherosclerosis (MESA), mean age: 72.3 ± 7.2 years, 56 men.Field Strength/Sequence1.5T. Cardiac MRI: Cine balanced steady state free precession (bSSFP) and 4D‐flow sequences. Brain MRI: T1‐ and T2‐weighted SE and FLAIR.AssessmentPresence of SBI was determined from brain MRI by neuroradiologists according to routine diagnostic criteria in all participants without a history of stroke based on the MESA database. Minimum and maximum LA volumes and ejection fraction were calculated from bSSFP data. Blood stasis (% of voxels <10 cm/sec) and peak velocity (cm/sec) in the LA and LAA were assessed by a radiologist using an established 4D‐flow workflow.Statistical TestsStudent's t test, Mann–Whitney U test, one‐way ANOVA, chi‐square test. Multivariable stepwise logistic regression with automatic forward and backward selection. Significance level P < 0.05.Results26 (20.8%) had at least one SBI. After Bonferroni correction, participants with SBI were significantly older and had significantly lower peak velocities in the LAA. In multivariable analyses, age (per 10‐years) (odds ratio (OR) = 1.99 (95% confidence interval (CI): 1.30–3.04)) and LAA peak velocity (per cm/sec) (OR = 0.87 (95% CI: 0.81–0.93)) were significantly associated with SBI.ConclusionOlder age and lower LAA peak velocity were associated with SBI in multivariable analyses whereas volumetric‐based measures from cardiac MRI or cardiovascular risk factors were not. Cardiac 4D‐flow MRI showed potential to serve as a novel imaging marker for SBI.Level of Evidence3Technical EfficacyStage 2

Maíra Tristão Parra, Isaac Sada, Rebecca Gold et al.

Frank Cranmer

In April 2023, the House of Bishops of the Province of the Church of Uganda elected Canon Godfrey Kasana as Bishop of Luwero. Before his consecration could take place, however, a member of the church submitted a petition alleging that he was unsuitable for consecration on grounds of adultery – and in June the House of Bishops revoked his nomination. The respondents, in effect, sought judicial review of that decision, while the Archbishop argued that the claim was brought against the wrong party and was frivolous, vexatious and an abuse of process.

Mahsima Shabani, Diptavo Dutta, Bharath Ambale-Venkatesh et al.

BackgroundRare pathogenic variants in cardiomyopathy (CM) genes can predispose to cardiac remodeling or fibrosis. We studied the carrier status for such variants in adults without clinical cardiovascular disease (CVD) in whom cardiac MRI (CMR)-derived measures of myocardial fibrosis were obtained in the Multi-Ethnic Study of Atherosclerosis (MESA).ObjectivesTo identify CM-associated pathogenic variants and assess their relative prevalence in participants with extensive myocardial fibrosis by CMR.MethodsMESA whole-genome sequencing data was evaluated to capture variants in CM-associated genes (n = 82). Coding variants with a frequency of <0.1% in gnomAD and 1,000 Genomes Project databases and damaging/deleterious effects based on in-silico scoring tools were assessed by ClinVar database and ACMG curation guidelines for evidence of pathogenicity. Cases were participants with high myocardial fibrosis defined as highest quartile of extracellular volume (ECV) or native T1 time in T1-mapping CMR and controls were the remainder of participants.ResultsA total of 1,135 MESA participants had available genetic data and phenotypic measures and were free of clinical CVD at the time of CMR. We identified 6,349 rare variants in CM-associated genes in the overall MESA population, of which six pathogenic/likely pathogenic (P/LP) variants were present in the phenotyped subpopulation. The genes harboring P/LP variants in the case group were MYH7, CRYAB, and SCN5A. The prevalence of P/LP rare variants in cases was higher than controls (5 in 420 [1.1%] vs. 1 in 715 [0.1%], p = 0.03). We identified two MYBPC3 Variants of Unknown Significance (VUS)s with borderline pathogenicity in the case group. The left ventricle (LV) volume, mass, ejection fraction (EF), and longitudinal and circumferential strain in participants with the variants were not different compared to the overall cohort.ConclusionsWe observed a higher prevalence of rare potentially pathogenic CM associated genetic variants in participants with significant myocardial fibrosis quantified in CMR as compared to controls without significant fibrosis. No cardiac structural or functional differences were found between participants with or without P/LP variants.

Claire F. McGroder, Carrie P. Aaron, Suzette J. Bielinski et al.

Adhesion molecules may contribute to the development of interstitial lung disease (ILD) and have been proposed as prognostic biomarkers in idiopathic pulmonary fibrosis. Our objective was to determine whether the circulating adhesion molecules soluble intracellular adhesion molecule (sICAM)-1, soluble vascular cell adhesion molecule (sVCAM)-1 and P-selectin are associated with subclinical ILD in community-dwelling adults.The Multi-Ethnic Study of Atherosclerosis enrolled males and females aged 45–84 years from six communities in the United States in 2000–2002. High attenuation areas were defined as the percentage of imaged lung volume with attenuation −600–−250 HU on cardiac computed tomography (CT). Interstitial lung abnormalities were visually assessed on full-lung CT. Spirometry was performed on a subset of individuals. ILD hospitalisations and deaths were adjudicated.In fully adjusted analyses, higher levels of sICAM-1, sVCAM-1 and P-selectin were associated with greater high attenuation areas (2.94%, 95% CI 1.80–4.07%; 1.24%, 95% CI 0.14–2.35%; and 1.58%, 95% CI 0.92–2.23%, respectively), and greater rate of ILD hospitalisations (HR 1.36, 95% CI 1.03–1.80; 1.40, 95% CI 1.07–1.85; and 2.03, 95% CI 1.16–3.5, respectively). sICAM-1 was associated with greater prevalence of interstitial lung abnormalities (OR 1.39, 95% CI 1.13–1.71). sICAM-1 and P-selectin were associated with lower forced vital capacity (44 mL, 95% CI 12–76 mL and 29 mL, 95% CI 8–49 mL, respectively). sVCAM-1 and P-selectin were associated with increased risk of ILD death (HR 2.15, 95% CI 1.26–3.64 and 3.61, 95% CI 1.54–8.46, respectively).Higher levels of circulating sICAM-1, sVCAM-1 and P-selectin are independently associated with CT and spirometric measures of subclinical ILD, and increased rate of adjudicated ILD events among community-dwelling adults.

Laura D Carbone, Petra Bůžková, Howard A Fink et al.

ABSTRACT   Interest in niacin has increased in the setting of reports suggesting that niacin plays a role in diseases of aging. No study to date has examined the association of dietary niacin intake with multiple skeletal health parameters including bone mineral density (BMD), hip fractures, and body composition, and none have included both African American and white men and women. Participants included 5187 men and women ≥65 years from the Cardiovascular Health Study (CHS). Mean daily dietary niacin intake was 32.6 mg, with quartiles 1 through 4 defined as 3.6 to 21.8 mg/day, 21.9 to 30.2 mg/day, 30.3 to 40.9 mg/day, and 41.0 to 102.4 mg/day, respectively. Risk of incident hip fracture per 10 mg increment of daily dietary niacin intake was estimated using proportional hazards models. During a median follow-up of 13 years, 725 participants had an incident hip fracture. In models adjusted for demographic and clinical characteristics and diet, dietary niacin intake was significantly associated with an increased risk of hip fractures (hazard ratio [HR] 1.12; 95% CI, 1.01 to 1.24) with spline models suggesting a U-shaped association. In post hoc analyses, both the lowest (HR 1.31; 95% CI, 1.04 to 1.66) and highest (HR 1.53; 95% CI, 1.20 to 1.95) quartiles of niacin intake were associated with an increased risk of incident hip fracture versus quartiles 2 and 3. There was a trend for a significant inverse association of dietary niacin intake with hip BMD (p = 0.06), but no significant association with total body BMD or any body composition measures. In this cohort of elderly, community-dwelling African American and white men and women, both high and low dietary niacin intakes were associated with a significantly increased risk of subsequent hip fracture, suggesting a possible U-shaped association. By comparison, dietary niacin may have an inverse linear association with hip BMD. © 2018 American Society for Bone and Mineral Research.

Emily W. Gower, James F. Lovato, Walter T. Ambrosius et al.

David M. Kern, Amy H. Auchincloss, Mark F. Stehr et al.

Lauren N. Strand, Rebekah L. Young, Alain G. Bertoni et al.

AbstractPurposeOnly small and short‐term studies have evaluated statins in relation to changes in heart structure. We estimated the association between new statin use and 10‐year remodeling of the left ventricle.MethodsThe Multi‐Ethnic Study of Atherosclerosis collected data on statin use over approximately 10 years, conducting cardiac magnetic resonance (CMR) imaging at baseline and the 10‐year exam. Participants were free of baseline cardiovascular disease, and we excluded users of statins at baseline. Statin initiation was defined as a report of current use at any of the 4 subsequent exams. Primary outcomes were the change in left ventricular mass index (LVMI; % predicted by height, weight, and sex) and mass‐to‐volume ratio. Associations were estimated in a propensity score‐matched analysis.ResultsA total of 3113 participants (53% female; 40% European‐American, 25% African‐American, 22% Hispanic‐American, and 13% Chinese‐American) were eligible; 2431 returned for follow‐up CMR imaging after a median of 9.4 years. Statin therapy (moderate dose, 76%) was started by 36% of participants (N = 872). We excluded 42 participants with incident myocardial infarction. Compared with nonuse, statin use was associated with less 10‐year progression in LVMI (−2.35 percentage points; 95% CI, −4.24 to −0.47; P = .01) and mass‐to‐volume ratio (−0.03 absolute difference; 95% CI, −0.07 to −0.00; P = .02); effects were small in magnitude. A dose response was observed: Higher statin dose was associated with less LVMI progression.ConclusionsIn contrast to previous small studies, we found very modest associations between statin use and indices of left ventricular remodeling over 10 years in this prospective study of a diverse cohort.

Jason L Sanders, Wensheng Guo, Ellen S O’Meara et al.

Weihong Tang, Mary Cushman, David Green et al.

Coagulation factor VIII and von Willebrand factor (VWF) are key proteins in procoagulant activation. Higher FVIII coagulant activity (FVIII:C) and VWF antigen (VWF:Ag) are risk factors for cardiovascular disease and venous thromboembolism. Beyond associations with ABO blood group, genetic determinants of FVIII and VWF are not well understood, especially in non European‐American populations. We performed a genetic association study of FVIII:C and VWF:Ag that assessed 50,000 gene‐centric single nucleotide polymorphisms (SNPs) in 18,556 European Americans (EAs) and 5,047 African Americans (AAs) from five population‐based cohorts. Previously unreported associations for FVIII:C were identified in both AAs and EAs with KNG1 (most significantly associated SNP rs710446, Ile581Thr, P  = 5.10 × 10 −7 in EAs and P  = 3.88 × 10 −3 in AAs) and VWF rs7962217 (Gly2705Arg, P  = 6.30 × 10 −9 in EAs and P  = 2.98 × 10 −2 in AAs). Significant associations for FVIII:C were also observed with F8 / TMLHE region SNP rs12557310 in EAs ( P  = 8.02 × 10 −10 ), with VWF rs1800380 in AAs ( P  = 5.62 × 10 −11 ), and with MAT1A rs2236568 in AAs ( P  = 1.69 × 10 −6 ). We replicated previously reported associations of FVIII:C and VWF:Ag with the ABO blood group, VWF rs1063856 (Thr789Ala), rs216321 (Ala852Gln), and VWF rs2229446 (Arg2185Gln). Findings from this study expand our understanding of genetic influences for FVIII:C and VWF:Ag in both EAs and AAs. Am. J. Hematol. 90:534–540, 2015. © 2015 Wiley Periodicals, Inc.

Gina S. Lovasi, John M. Richardson, Carlos J. Rodriguez et al.

Objective. We use a case-crossover analysis to explore the association between incident cardiovascular events and residential relocation to a new home address.Methods. We conducted an ambidirectional case-crossover analysis to explore the association between incident cardiovascular events and residential relocation to a new address using data from the Cardiovascular Health Study (CHS), a community-based prospective cohort study of 5,888 older adults from four U.S. sites beginning in 1989. Relocation was assessed twice a year during follow-up. Event occurrences were classified as present or absent for the period preceding the first reported move, as compared with an equal length of time immediately prior to and following this period.Results. Older adults (65+) that experience incident cardiovascular disease had an increased probability of reporting a change of residence during the following year (OR 1.6, 95% confidence interval (CI) = 1.2–2.1). Clinical conditions associated with relocation included stroke (OR: 2.0, 95% CI: 1.2–3.3), angina (OR: 1.6, 95% CI: 1.0–2.6), and congestive heart failure (OR: 1.5, 95% CI: 1.0–2.1).Conclusions. Major incident cardiovascular disease may increase the probability of residential relocation in older adults. Case-crossover analyses represent an opportunity to investigate triggering events, but finer temporal resolution would be crucial for future research on residential relocations.

Logan Dumitrescu, Cara L. Carty, Nora Franceschini et al.

Atsushi Hozawa, Aaron R. Folsom, Hassan Ibrahim et al.

Maurice Pradella, Justin J. Baraboo, Anthony Maroun et al.

R. Shi

CS Hatton, AO Wilkie, HC Drysdale et al.

Abstract We describe a family in which alpha-thalassemia occurs in association with a deletion of 62 kilobases from a region upstream of the alpha globin genes. DNA sequence analysis has shown that the transcription units of both alpha genes downstream of this deletion are normal. Nevertheless, they fail to direct alpha globin synthesis in an interspecific hybrid containing the abnormal (alpha alpha)RA chromosome. It seems probable that previously unidentified positive regulatory sequences analogous to those detected in a corresponding position of the human beta globin cluster are removed by this deletion.