Although the association between coronary artery calcium (CAC) and future heart failure (HF) has been shown previously, the value of CAC progression in the prediction of HF has not been investigated. ...In this study, we investigated the association of CAC progression with subclinical left ventricular (LV) dysfunction and incident HF in the Multi-Ethnic Study of Atherosclerosis.
The Multi-Ethnic Study of Atherosclerosis is a population-based study consisting of 6814 men and women aged 45 to 84, free of overt cardiovascular disease at enrollment, who were recruited from 4 ethnicities. We included 5644 Multi-Ethnic Study of Atherosclerosis participants who had baseline and follow-up cardiac computed tomography and were free of HF and coronary heart disease before the second cardiac computed tomography. Mean (±SD) age was 61.7±10.2 years and 47.2% were male. The Cox proportional hazard models and multivariable linear regression models were deployed to determine the association of CAC progression with incident HF and subclinical LV dysfunction, respectively. Over a median follow-up of 9.6 (interquartile range: 8.8-10.6) years, 182 participants developed incident HF. CAC progression of 10 units per year was associated with 3% of increased risk of HF independent of overt coronary heart disease (
=0.008). In 2818 participants with available cardiac magnetic resonance images, CAC progression was associated with increased LV end diastolic volume (β=0.16;
=0.03) and LV end systolic volume (β=0.12;
=0.006) after excluding participants with any coronary heart disease.
CAC progression was associated with incident HF and modestly increased LV end diastolic volume and LV end systolic volume at follow-up exam independent of overt coronary heart disease.
Background Periodontitis is a chronic inflammatory disease common among adults. It has been suggested that periodontal disease (PD) may be a contributing risk factor for cardiovascular disease; ...however, pathways underlying such a relationship require further investigation. Methods and Results A total of 665 men (mean age 68±9 years) and 611 women (mean age 67±9 years) enrolled in the MESA (Multiethnic Study of Atherosclerosis) underwent PD assessment using a 2-item questionnaire at baseline (2000-2002) and had cardiovascular magnetic resonance 10 years later. PD was defined when participants reported either a history of periodontitis or gum disease or lost teeth caused by periodontitis or gum disease. Multivariable linear regression models were constructed to assess the associations of baseline self-reported PD with cardiovascular magnetic resonance-obtained measures of interstitial myocardial fibrosis (IMF), including extracellular volume and native T1 time. Men with a self-reported history of PD had greater extracellular volume percent (ß=0.6%±0.2,
=0.01). This association was independent of age, left ventricular mass, traditional cardiovascular risk factors, and history of myocardial infarction. In a subsequent model, substituting myocardial infarction for coronary artery calcium score, the association of PD with IMF remained significant (ß=0.6%±0.3,
=0.03). In women, a self-reported history of PD was not linked to higher IMF. Importantly, a self-reported history of PD was not found to be associated with myocardial scar independent of sex (odds ratio, 1.01 95% CI, 0.62-1.65;
=0.9). Conclusions In a community-based setting, men but not women with a self-reported PD history at baseline were found to be associated with increased measures of IMF. These findings support a plausible link between PD, a proinflammatory condition, and subclinical IMF.
Subclinical cardiovascular disease (CVD) measures may reflect biological pathways that contribute to increased risk for coronary heart disease (CHD) events, stroke, and dementia beyond conventional ...risk scores.
The Multi-Ethnic Study of Atherosclerosis (MESA) followed 6814 participants (45–84 years of age) from baseline in 2000–2002 to 2018 over 6 clinical examinations and annual follow-up interviews. MESA baseline subclinical CVD procedures included: seated and supineblood pressure, coronary calcium scan, radial artery tonometry, and carotid ultrasound. Baseline subclinical CVD measures were transformed into z-scores before factor analysis to derive composite factor scores. Time to clinical event for all-cause CVD, CHD, stroke and ICD code-based dementia events were modeled using Cox proportional hazards models reported as area under the curve (AUC) with 95% Confidence Intervals (95%CI) at 10 and 15 years of follow-up. All models included all factor scores together, and adjustment for conventional risk scores for global CVD, stroke, and dementia.
After factor selection, 24 subclinical measures aggregated into four distinct factors representing: blood pressure, atherosclerosis, arteriosclerosis, and cardiac factors. Each factor significantly predicted time to CVD events and dementia at 10 and 15 years independent of each other and conventional risk scores. Subclinical vascular composites of atherosclerosis and arteriosclerosis best predicted time to clinical events of CVD, CHD, stroke, and dementia. These results were consistent across sex and racial and ethnic groups.
Subclinical vascular composites of atherosclerosis and arteriosclerosis may be useful biomarkers to inform the vascular pathways contributing to events of CVD, CHD, stroke, and dementia.
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•Subclinical cardiovascular disease (CVD) measures aggregate as constructs representing distinct forms of pathophysiology.•Subclinical CVD can clarify the pathways through which vascular disorders relate to cardiac, stroke, and dementia events.•Factor analysis created uncorrelated composites of atherosclerosis, arteriosclerosis, blood pressure, and cardiac function.•These factors were differentially associated with incident CVD and dementia events over 18 years of follow-up.
Abstract
Aims
Diabetes mellitus (DM) is associated with the development of cardiovascular disease (CVD). Morphological changes in the left atrium (LA) may appear before symptoms. We aimed to ...investigate the association between cardiac magnetic resonance imaging (CMR) measured LA structure and function and incident CVD in asymptomatic individuals with DM.
Methods and results
Tissue tracking CMR was used to measure LA size and phasic function (emptying fractions and strain) on all 536 Multi-Ethnic Study of Atherosclerosis (MESA) participants with DM and available CMR at baseline in 2000–2002. At the time of enrolment, all participants were free of clinically recognized CVD, which was defined as MI, resuscitated cardiac arrest, angina, stroke, heart failure, and atrial fibrillation. Cox regression was used to assess the association of LA parameters with incident CVD adjusted for traditional cardiovascular risk factors, LV mass, NT Pro-BNP and maximum LA volume. Kaplan–Meier curves, adjusted for traditional risk factors, were generated for each LA measurement for the 25% of participants with the most abnormal values versus the remaining 75%. After a mean follow up of 11.4 ± 3.4 years, 141 individuals developed CVD. Individuals with incident CVD (mean age 66 years, 66% male vs. mean age 64 years, 50% male) had larger maximum and minimum LA volume index (LAVI) (32.1 vs. 26.8 mm3/m2; 19.4 vs. 14.2 mm3/m2 respectively, P < 0.001 for both), and lower total, passive, and active EF than those without CVD (P < 0.01 for all). In the fully adjusted model, there was a significant association of minimum LAVI, LA total EF, LA passive EF and LA active EF with incident CVD (HR 1.12 per mm3/m2, P < 0.001; HR 0.95 per %, P < 0.001; HR 0.97 per %, P = 0.021; HR 0.98 per %, P < 0.027, respectively).
Conclusions
CMR measured LA minimum volume and LA function as measured by emptying fraction are predictive of CVD in a diabetic multi-ethnic population free of any clinically recognized CVD at baseline.
Background: Increased arterial stiffness could represent an intermediate subclinical outcome in the mechanistic pathway underlying associations between average long-term pollution exposure and ...cardiovascular events. Objective: We hypothesized that 20 years of exposure to paniculate matter (PM) < 2.5 and 10 μm in aerodynamic diameter (PM2.5 and PM₁₀, respectively) would be positively associated with arterial stiffness in 3,996 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) who were seen at six U.S. study sites. Methods: We assigned pollution exposure during two decades preceding a clinical exam (2000–2002) using observed PM₁₀ from monitors nearest participants' residences and PM₁₀ and PM2.5 imputed from a space-time model. We examined three log-transformed arterial stiffness outcome measures: Young's modulus (YM) from carotid artery ultrasound and large (C₁) and small (C₂) artery vessel compliance from the radial artery pulse wave. All associations are expressed per 10 μg/m³ increment in PM and were adjusted for weather, age, sex, race, glucose, triglycerides, diabetes, waist:hipratio, seated mean arterial pressure, smoking status, pack-years, cigarettes per day, environmental tobacco smoke, and physical activity. C₁ and C₂ models were further adjusted for heart rate, weight, and height. Results: Long-term average particle exposure was not associated with greater arterial stiffness measured by YM, C₁, or C₂, and the few associations observed were not robust across metrics and adjustment schemes. Conclusions: Long-term particle mass exposure did not appear to be associated with greater arterial stiffness in this study sample.
Sex hormones are linked to right ventricular (RV) function, but the relationship between genetic variation in these pathways and RV function is unknown.We performed a cross-sectional study of 2761 ...genotyped adults without cardiovascular disease. The relationships between RV measures and single nucleotide polymorphisms (SNPs) in 10 candidate genes were assessed. Urinary oestradiol (E2) metabolites produced by cytochrome P4501B1 (CYP1B1) and serum testosterone were measured in women and men respectively.In African-American (AA) women, the CYP1B1 SNP rs162561 was associated with RV ejection fraction (RVEF), such that each copy of the A allele was associated with a 2.0% increase in RVEF. Haplotype analysis revealed associations with RVEF in AA (global p<7.2×10(-6)) and white (global p=0.05) women. In white subjects, higher E2 metabolite levels were associated with significantly higher RVEF. In men, androgen receptors SNPs (rs1337080; rs5918764) were significantly associated with all RV measures and modified the relationship between testosterone and RVEF.Genetic variation in E2 metabolism and androgen signalling was associated with RV morphology in a sex-specific manner. The CYP1B1 SNP identified is in tight linkage disequilibrium with SNPs associated with pulmonary hypertension and oncogenesis, suggesting these pathways may underpin sexual dimorphism in RV failure.
•New experimental η data for 3 biodiesels (293.15–393.15K; 0.1–140MPa).•A correlation was proposed to predict the experimental data with OARDs of only 3.9%.•Biodiesel+diesel mixtures η were predicted ...with OARDs of just 3.3%.
Nowadays common rail injection systems use high pressures to pump the fuel, even if at these conditions the liquid viscosity increases substantially over atmospheric levels. For the proper operation of these injection systems the knowledge of fuels high-pressure viscosities becomes crucial to optimize the engine performance. This work reports new experimental data of high-pressure viscosities for three biodiesels (soybean, rapeseed and their binary mixture) measured at temperatures from 293.15K to 393.15K and pressures from atmospheric up to 140MPa, and proposes a correlation capable of describing the experimental data. The predictions results are excellent for the biodiesels studied, presenting overall average relative deviations (OARD) of only 3.9% in the entire ranges of pressures and temperatures studied. This correlation was also extended to describe the viscosities of biodiesels mixtures with diesel with an OARD of just 3.3%.
Cardiac Magnetic Resonance Assessment of Dyssynchrony and Myocardial Scar Predicts Function Class Improvement Following Cardiac Resynchronization Therapy Kenneth C. Bilchick, Veronica Dimaano, ...Katherine C. Wu, Robert H. Helm, Robert G. Weiss, Joao A. Lima, Ronald D. Berger, Gordon F. Tomaselli, David A. Bluemke, Henry R. Halperin, Theodore Abraham, David A. Kass, Albert C. Lardo There remains a significant nonresponse rate to cardiac resynchronization therapy (CRT), with recent data also questioning the reproducibility of standard echocardiography-based dyssynchrony metrics. A circumferential mechanical dyssynchrony index (circumferential uniformity ratio estimate CURE) derived from cardiac magnetic resonance (CMR) myocardial tagging was tested for predicting clinical function class improvement following CRT. The CURE index predicted improved functional class in CRT patients with 90% accuracy (positive predictive value: 87%; negative predictive value: 100%). Adding late gadolinium-enhanced data improved accuracy further. Combined CMR tagging and late enhancement data offers promise in the prediction of functional improvement after CRT. As pointed out by Dr. Gorcsan in the accompanying editorial, further studies in larger prospective cohorts will be useful to confirm these findings.
In this work we carried out both a theoretical and experimental study of the interactions between the sulfate species with graphene sheets, in order to understand the possible formation mechanisms ...behind the graphene oxide (GO) synthesis. As the results, it is shown a series of theoretical structures which were found in our conformational searches via quantum methods, such as the well-known epoxy group and the cyclic sulfate bridges, a new species that, up until now, was not reported for this kind of system. These results were also compared with the data acquired from a sequence of chemical tests and spectroscopic analyses of a GO prepared using the modified Hummers method. Finally, it was possible to give some answers to open questions that can guide future experiments in the GO synthesis.
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•Interacting with graphene, ion sulfate can generate epoxy group or cyclic sulfate.•A reaction mechanism was proposed for graphite exfoliation and oxidization.•Oxigenated groups were formed in two different stages of the synthesis process.•Yellow particles in final steps of the synthesis were associated to MnO derivatives.•The full synthesis process was described by spectroscopy and qualitative analysis.
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