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Randal J Thomas, Alexis L Beatty, Theresa M Beckie, LaPrincess C Brewer, Todd M Brown, Daniel E Forman, Barry A Franklin, Steven J Keteyian, Dalane W Kitzman, Judith G Regensteiner, Bonnie K Sanderson, Mary A Whooley
Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible patients participating in CR in the United States. New delivery strategies are urgently needed to improve participation...
May 13, 2019: Circulation
Anne R Cappola, Akshay S Desai, Marco Medici, Lawton S Cooper, Debra Egan, George Sopko, Glenn I Fishman, Steven Goldman, David S Cooper, Samia Mora, Peter J Kudenchuk, Anthony N Hollenberg, Cheryl L McDonald, Paul W Ladenson
Thyroid hormones have long been known to have a range of effects on the cardiovascular system. However, significant knowledge gaps exist concerning the precise molecular and biochemical mechanisms governing these effects and the optimal strategies for management of abnormalities in thyroid function in patients with and without preexisting cardiovascular disease. In September 2017, the National Heart, Lung, and Blood Institute convened a Working Group with the goal of developing priorities for future scientific research relating thyroid dysfunction to the progression of cardiovascular disease...
May 13, 2019: Circulation
Manon C Stam-Slob, Stuart J Connolly, Yolanda van der Graaf, Joep van der Leeuw, Jannick A N Dorresteijn, John W Eikelboom, Ron J G Peters, Marco Alings, Frank L J Visseren
BACKGROUND: We aimed to estimate absolute benefit and harm from treatment with dabigatran in individual patients with atrial fibrillation, and to select the optimal dose for each individual. METHODS: We derived and validated a prediction model for ischemic stroke/ systemic embolism (SE) and major bleeding in patients with atrial fibrillation from the 3 treatment arms of the randomized evaluation of long-term anticoagulation therapy (RE-LY) trial (n=11,955 in derivation cohort, n=6,158 in validation cohort)...
May 3, 2019: Circulation
Nitesh N Rao, Michael B Stokes, Adil Rajwani, Shahid Ullah, Kerry Williams, David King, Ewan Macaulay, Christine H Russell, Santosh Olakkengil, Robert P Carroll, Randall J Faull, Karen S L Teo, Stephen P McDonald, Matthew I Worthley, P Toby Coates
BACKGROUND: Cardiovascular morbidity and mortality remains high in recipients of a kidney transplant. The persistence of a patent arteriovenous fistula (AVF) post-transplant may contribute to ongoing maladaptive cardiovascular remodelling. The ability to reverse this maladaptive remodelling by ligation of this AVF is unknown. We conducted the first randomized controlled trial to evaluate the effect of AVF ligation on cardiac structure and function in stable kidney transplant recipients...
May 2, 2019: Circulation
Milton Packer, Paul A Grayburn
Two distinct pathways can lead to functional mitral regurgitation (MR) in patients with chronic heart failure and a reduced ejection fraction. When remodeling and enlargement of the left ventricle (LV) causes annular dilatation and tethering of the mitral valve leaflets, there is a linear relationship between LV end-diastolic volume and the effective regurgitant orifice area (EROA) of the mitral valve. These patients - designated as having proportionate MR - respond favorably to treatments that lead to reversal of LV remodeling and a decrease in LV volumes (e...
May 1, 2019: Circulation
Xiaoming Jia, Wensheng Sun, Ron C Hoogeveen, Vijay Nambi, Kunihiro Matsushita, Aaron R Folsom, Gerardo Heiss, David J Couper, Scott D Solomon, Eric Boerwinkle, Amil Shah, Elizabeth Selvin, James A de Lemos, Christie M Ballantyne
BACKGROUND: We assessed whether plasma troponin I measured by a high-sensitivity assay (hs-TnI) is associated with incident cardiovascular disease (CVD) and mortality in a community-based sample without prior CVD. METHODS: ARIC study (Atherosclerosis Risk in Communities) participants aged 54 to 74 years without baseline CVD were included in this study (n=8121). Cox proportional hazards models were constructed to determine associations between hs-TnI and incident coronary heart disease (CHD; myocardial infarction and fatal CHD), ischemic stroke, atherosclerotic CVD (CHD and stroke), heart failure hospitalization, global CVD (atherosclerotic CVD and heart failure), and all-cause mortality...
April 29, 2019: Circulation
Cheryl A M Anderson, Anne N Thorndike, Alice H Lichtenstein, Linda Van Horn, Penny M Kris-Etherton, Randi Foraker, Colleen Spees
Current dietary intakes of North Americans are inconsistent with the Dietary Guidelines for Americans. This occurs in the context of a food system that precludes healthy foods as the default choices. To develop a food system that is both healthy and sustainable requires innovation. This science advisory from the American Heart Association describes both innovative approaches to developing a healthy and sustainable food system and the current evidence base for the associations between these approaches and positive changes in dietary behaviors, dietary intakes, and when available, health outcomes...
April 29, 2019: Circulation
Pallav Garg, Dennis T Ko, Krista M Bray Jenkyn, Lihua Li, Salimah Z Shariff
BACKGROUND: In 2007, American Heart Association (AHA) recommended antibiotic prophylaxis for the prevention of infective endocarditis (IE) for only the highest-risk patients. Whether this change impacted the use of antibiotic prophylaxis and the incidence of IE is unclear. METHODS: IE-related hospitalizations were identified from 2002-2014 among all adults, and those at high and moderate-risk for IE, stratified by age. Prescriptions for antibiotic prophylaxis were obtained from the Ontario Drug Benefit database for adults 65 and older...
April 26, 2019: Circulation
Sashidar Bandaru, Chandu Ala, Reza Salimi, Murali K Akula, Matias Ekstrand, Sravani Devarakonda, Joakim Karlsson, Jimmy Van den Eynden, Göran Bergström, Erik Larsson, Max Levin, Jan Borén, Martin O Bergo, Levent M Akyürek
BACKGROUND: The actin-binding protein filamin A (FLNA) regulates signal transduction important for cell locomotion, but the role of macrophage-specific FLNA during atherogenesis has not been explored. METHODS: We analyzed FLNA expression in human carotid atherosclerotic plaques by immunofluorescence. We also produced mice with Flna-deficient macrophages by breeding conditional Flna-knockout mice ( Flnao/ fl ) with mice expressing Cre from the macrophage-specific lysosome M promoter (LC)...
April 24, 2019: Circulation
Paul Welsh, David Preiss, Caroline Hayward, Anoop S V Shah, David McAllister, Andrew Briggs, Charles Boachie, Alex McConnachie, Sandosh Padmanabhan, Claire Welsh, Mark Woodward, Archie Campbell, David Porteous, Nicholas L Mills, Naveed Sattar
BACKGROUND: There is great interest in widening the use of high sensitivity cardiac troponins for population cardiovascular disease (CVD) and heart failure screening. However, it is not clear whether cardiac troponin T (cTnT) and troponin I (cTnI) are equivalent measures of risk in this setting. We aimed to compare and contrast i) the association of cTnT and cTnI with CVD and non-CVD outcomes, and ii) their determinants in a Genome wide association study (GWAS). METHODS: High-sensitivity cTnT and cTnI were measured in serum from 19,501 individuals in Generation Scotland Scottish Family Health Study...
April 24, 2019: Circulation
Keith C Ferdinand, Fabrice Balavoine, Bruno Besse, Henry R Black, Stephanie Desbrandes, Howard C Dittrich, Shawna D Nesbitt
BACKGROUND: Despite existing therapy, successful control of hypertension [HTN] in the United States is estimated at less than 50%. In Blacks, HTN occurs earlier, is more severe, controlled less often and has a higher morbidity and mortality than in Whites. Blacks are also less responsive to monotherapy with angiotensin-I converting enzyme [ACE] inhibitors or angiotensin-II receptor type 1 blockers [ARBs]. Obesity, higher salt-sensitivity and low plasma renin activity are possible reasons of this poor blood pressure [BP] control, especially in Blacks...
April 24, 2019: Circulation
Timothy J Key, Paul N Appleby, Kathryn E Bradbury, Michael Sweeting, Angela Wood, Ingegerd Johansson, Tilman Kühn, Marinka Steur, Elisabete Weiderpass, Maria Wennberg, Anne Mette Lund Würtz, Antonio Agudo, Jonas Andersson, Larraitz Arriola, Heiner Boeing, Jolanda M A Boer, Fabrice Bonnet, Marie-Christine Boutron-Ruault, Amanda J Cross, Ulrika Ericson, Guy Fagherazzi, Pietro Ferrari, Marc Gunter, José María Huerta, Verena Katzke, Kay-Tee Khaw, Vittorio Krogh, Carlo La Vecchia, Giuseppe Matullo, Conchi Moreno-Iribas, Androniki Naska, Lena Maria Nilsson, Anja Olsen, Kim Overvad, Domenico Palli, Salvatore Panico, Elena Molina-Portillo, J Ramón Quirós, Guri Skeie, Ivonne Sluijs, Emily Sonestedt, Magdalena Stepien, Anne Tjønneland, Antonia Trichopoulou, Rosario Tumino, Ioanna Tzoulaki, Yvonne T van der Schouw, W M Monique Verschuren, Emanuele Di Angelantonio, Claudia Langenberg, Nita Forouhi, Nick Wareham, Adam Butterworth, Elio Riboli, John Danesh
BACKGROUND: There is uncertainty about the relevance of animal foods to the etiology of ischemic heart disease (IHD). We examined meat, fish, dairy products and eggs and risk for IHD in the pan-European EPIC cohort. METHODS: A prospective study of 409,885 men and women in nine European countries. Diet was assessed using validated questionnaires, calibrated using 24-hour recalls. Lipids and blood pressure were measured in a subsample. During 12.6 years mean follow up, 7198 participants had a myocardial infarction or died from IHD...
April 22, 2019: Circulation
Rohan Khera, Yuanyuan Tang, Saket Girotra, Vinay M Nadkarni, Mark S Link, Tia T Raymond, Anne-Marie Guerguerian, Robert A Berg, Paul S Chan
BACKGROUND: Cardiopulmonary resuscitation (CPR) is initiated in hospitalized children with bradycardia and poor perfusion. However, their rate of progression to pulseless cardiac arrest despite CPR, and differences in survival compared with initially pulseless arrest are unknown. We examined the prevalence and predictors of survival of children who progress from bradycardia to pulseless in-hospital cardiac arrest despite CPR. METHODS: Pediatric patients, aged >30 days and <18 years, who received CPR at hospitals participating in Get With The Guidelines-Resuscitation during 2000-2016 were included...
April 22, 2019: Circulation
Gabrielle Norrish, Joanna Jager, Ella Field, Ellie Quinn, Hannah Fell, Emma Lord, Marcos N Cicerchia, Juan Pablo Ochoa, Elena Cervi, Perry M Elliott, Juan Pablo Kaski
BACKGROUND: Hypertrophic Cardiomyopathy (HCM) is a heritable myocardial disease with age related penetrance. Current guidelines recommend clinical screening of relatives from the age of 10 years onwards but the clinical value of this approach has not been systematically evaluated. METHODS: Anonymized, clinical data were collected from children referred for family screening between 1994-2017 following diagnosis of HCM in a first-degree relative. RESULTS: 1198 consecutive children (aged ≤ 18 years) from 594 families underwent serial evaluation [median 3...
April 22, 2019: Circulation
Pablo Garcia-Pavia, Yuri Kim, Maria Alejandra Restrepo-Cordoba, Ida G Lunde, Hiroko Wakimoto, Amanda M Smith, Christopher N Toepfer, Kelly Getz, Joshua Gorham, Parth Patel, Kaoru Ito, Jonathan A Willcox, Zoltan Arany, Jian Li, Anjali T Owens, Risha Govind, Beatriz Nuñez, Erica Mazaika, Antoni Bayes-Genis, Roddy Walsh, Brian Finkelman, Josep Lupon, Nicola Whiffin, Isabel Serrano, William Midwinter, Alicja Wilk, Alfredo Bardaji, Nathan Ingold, Rachel Buchan, Upasana Tayal, Domingo A Pascual-Figal, Antonio de Marvao, Mian Ahmad, Jose Manuel Garcia-Pinilla, Antonis Pantazis, Fernando Dominguez, A John Baksi, Declan P O'Regan, Stuart D Rosen, Sanjay K Prasad, Enrique Lara-Pezzi, Mariano Provencio, Alexander R Lyon, Luis Alonso-Pulpon, Stuart A Cook, Steven R DePalma, Paul J R Barton, Richard Aplenc, Jonathan G Seidman, Bonnie Ky, James S Ware, Christine E Seidman
BACKGROUND: Cancer therapy-induced cardiomyopathy (CCM) is associated with cumulative drug exposures and pre-existing cardiovascular disorders. These parameters incompletely account for substantial inter-individual susceptibility to CCM. We hypothesized that rare variants in cardiomyopathy genes contribute to CCM. METHODS: We studied 213 CCM patients from three cohorts: retrospectively recruited adults with diverse cancers (n=99), prospectively phenotyped breast cancer adults (n=73) and prospectively phenotyped children with acute myeloid leukemia (n=41)...
April 16, 2019: Circulation
Alison K Wright, Evangelos Kontopantelis, Richard Emsley, Iain Edward Buchan, Mamas A Mamas, Naveed Sattar, Darren M Ashcroft, Martin K Rutter
BACKGROUND: With recent changes in UK clinical practice for diabetes care, contemporary estimates of sex disparities in cardiovascular risk and risk factor management are needed. METHODS: In this retrospective cohort study, using the Clinical Practice Research Datalink linked to hospital and death records for people in England, we identified 79,985 patients with incident T2DM between 2006-2013 matched to 386,547 patients without diabetes. Sex-stratified Cox models were used to assess cardiovascular risk...
April 15, 2019: Circulation
Canzhao Liu, Simone Spinozzi, Jia-Yu Chen, Xi Fang, Wei Feng, Guy Perkins, Paola Cattaneo, Nuno Guimarães-Camboa, Nancy D Dalton, Kirk L Peterson, Tongbin Wu, Kunfu Ouyang, Xiang-Dong Fu, Sylvia M Evans, Ju Chen
BACKGROUND: Membrane contact sites (MCS) are fundamental for transmission and translation of signals in multicellular organisms. A prime example is junctional membrane complexes (JMC) in the cardiac dyads, where T-tubules are juxtaposed to the sarcoplasmic reticulum (SR). T-tubule uncoupling and remodeling are well-known features of cardiac disease and heart failure. Even subtle alterations in the association between T-tubules and the Junctional SR can cause serious cardiac disorders...
April 15, 2019: Circulation
Kelly M Chin, Lewis J Rubin, Richard Channick, Lilla Di Scala, Sean Gaine, Nazzareno Galié, Hossein-Ardeschir Ghofrani, Marius M Hoeper, Irene M Lang, Vallerie V McLaughlin, Ralph Preiss, Gérald Simonneau, Olivier Sitbon, Victor F Tapson
BACKGROUND: N-terminal pro brain natriuretic peptide (NT-proBNP) levels are included in the multiparametric risk assessment approach for pulmonary arterial hypertension (PAH) outlined in PAH guidelines. However, data supporting use of NT-proBNP risk thresholds in assessing prognosis in PAH are limited. The GRIPHON trial provides an opportunity to assess the prognostic value of NT-proBNP thresholds in a controlled clinical trial and to evaluate the response to selexipag according to these thresholds...
April 15, 2019: Circulation
Yue Huang, Chris Kypridemos, Junxiu Liu, Yujin Lee, Jonathan Pearson-Stuttard, Brendan Collins, Piotr Bandosz, Simon Capewell, Laurie Whitsel, Parke Wilde, Dariush Mozaffarian, Martin O'Flaherty, Renata Micha
No abstract text is available yet for this article.
April 15, 2019: Circulation
Matti Marklund, Jason H Y Wu, Fumiaki Imamura, Liana C Del Gobbo, Amanda Fretts, Janette de Goede, Peilin Shi, Nathan Tintle, Maria Wennberg, Stella Aslibekyan, Tzu-An Chen, Marcia C de Oliveira Otto, Yoichiro Hirakawa, Helle Højmark Eriksen, Janine Kröger, Federica Laguzzi, Maria Lankinen, Rachel A Murphy, Kiesha Prem, Cécilia Samieri, Jyrki Virtanen, Alexis C Wood, Kerry Wong, Wei-Sin Yang, Xia Zhou, Ana Baylin, Jolanda M A Boer, Ingeborg A Brouwer, Hannia Campos, Paulo H M Chaves, Kuo-Liong Chien, Ulf de Faire, Luc Djoussé, Gudny Eiriksdottir, Naglaa El-Abbadi, Nita G Forouhi, J Michael Gaziano, Johanna M Geleijnse, Bruna Gigante, Graham Giles, Eliseo Guallar, Vilmundur Gudnason, Tamara Harris, William S Harris, Catherine Helmer, Mai-Lis Hellénius, Allison Hodge, Frank B Hu, Paul F Jacques, Jan-Håkan Jansson, Anya Kalsbeek, Kay-Tee Khaw, Woon-Puay Koh, Markku Laakso, Karin Leander, Hung-Ju Lin, Lars Lind, Robert Luben, Juhua Luo, Barbara McKnight, Jaakko Mursu, Toshiharu Ninomiya, Kim Overvad, Bruce M Psaty, Eric Rimm, Matthias B Schulze, David Siscovick, Michael Skjelbo Nielsen, Albert V Smith, Brian T Steffen, Lyn Steffen, Qi Sun, Johan Sundström, Michael Y Tsai, Hugh Tunstall-Pedoe, Matti I J Uusitupa, Rob M van Dam, Jenna Veenstra, W M Monique Verschuren, Nicholas Wareham, Walter Willett, Mark Woodward, Jian-Min Yuan, Renata Micha, Rozenn N Lemaitre, Dariush Mozaffarian, Ulf Risérus
BACKGROUND: Global dietary recommendations for and cardiovascular effects of linoleic acid, the major dietary omega-6 fatty acid, and its major metabolite, arachidonic acid, remain controversial. To address this uncertainty and inform international recommendations, we evaluated how in vivo circulating and tissue levels of linoleic acid (LA) and arachidonic acid (AA) relate to incident cardiovascular disease (CVD) across multiple international studies. METHODS: We performed harmonized, de novo, individual-level analyses in a global consortium of 30 prospective observational studies from 13 countries...
April 11, 2019: Circulation
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