A roadmap of strategies to support cardiovascular researchers: from policy to practice

Patient comfort with sexual orientation and gender identity questions in adult congenital cardiology clinics

BACKGROUND

Lack of sexual orientation and gender identity (SOGI) data creates barriers for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people in health care. Barriers to SOGI data collection include physician misperception that patients do not want to answer these questions and discomfort asking SOGI questions. This study aimed to assess patient comfort towards SOGI questions across five quaternary care adult congenital heart disease (ACHD) centres.

METHODS

A survey administered to ACHD patients (≥18 years) asked (1) two-step gender identity and birth sex, (2) acceptance of SOGI data, and (3) the importance for ACHD physicians to know SOGI data. Chi-square tests were used to analyse differences among demographic groups and logistic regression modelled agreement with statement of patient disclosure of SOGI improving patient-physician communication.

RESULTS

Among 322 ACHD patients, 82% identified as heterosexual and 16% identified as LGBTQ+, across the age ranges 18-29 years (39.4%), 30-49 years (47.8%), 50-64 years (8.7%), and > 65 years (4.0%). Respondents (90.4%) felt comfortable answering SOGI questions. Respondents with bachelor's/higher education were more likely to "agree" that disclosure of SOGI improves patient-physician communication compared to those with less than bachelor's education (OR = 2.45; 95% CI 1.41, 4.25; p = .0015).

CONCLUSION

These findings suggest that in this largely heterosexual population, SOGI data collection is unlikely to cause patient discomfort. Respondents with higher education were twice as likely to agree that SOGI disclosure improves patient-physician communication. The inclusion of SOGI data in future studies will provide larger samples of underrepresented minorities (e.g. LGBTQ+ population), thereby reducing healthcare disparities within the field of cardiovascular research.

Strategies for improving diversity, equity, and inclusion in cardiovascular research: a primer

This paper aims to empower cardiovascular (CV) researchers by promoting diversity, equity, and inclusion (DE&I) principles throughout the research cycle. It defines DE&I and introduces practical strategies for implementation in recruitment, retention, and team dynamics within CV research. Evidence-based approaches supporting underrepresented populations' participation are outlined for each research phase. Emphasizing the significance of inclusive research environments, the paper offers guidance and resources. We invite CV researchers to actively embrace DE&I principles, enhancing research relevance and addressing longstanding CV health disparities.

An electrochemical immunosensor based on polyaniline microtubules and zinc gallinate for detection of human growth differentiation factor-15

The incidence rate of cardiovascular diseases (CVDs) remains high, and their mortality rate is significantly higher than that of other diseases. Growth differentiation factor-15 (GDF-15) is a recently developed biomarker for the early diagnosis and prognostic evaluation of CVDs because its concentration in serum increases substantially after a cardiovascular injury or an inflammatory reaction. In this study, a sandwich-type immunosensor was constructed for the sensitive detection of GDF-15. Specifically, peony-like zinc gallinate (ZnGa₂O₄) prepared using a hydrothermal method, which exhibits excellent electrocatalytic performance, was coupled with Au nanoparticles (NPs) to obtain golden-peony-like ZnGa₂O₄/Au NPs. They preserved the immune activity of GDF-15 antibody molecules and further enhanced the conductivity, thereby realizing additional signal amplification. Hollow polyaniline (PANI) microtubules decorated with Pd NPs were used as the sensing platform (PANI/Pd NPs). The hollow microtubules provided abundant active sites and considerably improved the electron-transfer rate. Under optimal conditions, a linear range and remarkably low detection limit of 100 fg mL^-1-10 ng mL^-1 and 42.23 fg mL^-1, respectively, were achieved. These experimental results indicate that the strategy reported herein can be adopted as a novel approach for the convenient and rapid detection of GDF-15.

Sex-Related Differences of Matrix Metalloproteinases (MMPs): New Perspectives for These Biomarkers in Cardiovascular and Neurological Diseases

It is now established that sex differences occur in clinical manifestation, disease progression, and prognosis for both cardiovascular (CVDs) and central nervous system (CNS) disorders. As such, a great deal of effort is now being put into understanding these differences and turning them into “advantages”: (a) for the discovery of new sex-specific biomarkers and (b) through a review of old biomarkers from the perspective of the “newly” discovered sex/gender medicine. This is also true for matrix metalloproteinases (MMPs), enzymes involved in extracellular matrix (ECM) remodelling, which play a role in both CVDs and CNS disorders. However, most of the studies conducted up to now relegated sex to a mere confounding variable used for statistical model correction rather than a determining factor that can influence MMP levels and, in turn, disease prognosis. Consistently, this approach causes a loss of information that might help clinicians in identifying novel patterns and improve the applicability of MMPs in clinical practice by providing sex-specific threshold values. In this scenario, the current review aims to gather the available knowledge on sex-related differences in MMPs levels in CVDs and CNS conditions, hoping to shed light on their use as sex-specific biomarkers of disease prognosis or progression.