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El‐Harasis MA, Quintana JA, Martinez‐Parachini JR, Jackson GG, Varghese BT, Yoneda ZT, Murphy BS, Crawford DM, Tomasek K, Su YR, Wells QS, Roden DM, Michaud GF, Saavedra P, Estrada JC, Richardson TD, Kanagasundram AN, Shen ST, Montgomery JA, Ellis CR, Crossley GH, Eberl M, Gillet L, Ziegler A, Shoemaker MB. Recurrence After Atrial Fibrillation Ablation and Investigational Biomarkers of Cardiac Remodeling. J Am Heart Assoc 2024; 13:e031029. [PMID: 38471835 PMCID: PMC11010019 DOI: 10.1161/jaha.123.031029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/23/2023] [Indexed: 03/14/2024]
Abstract
BACKGROUND Recurrence after atrial fibrillation (AF) ablation remains common. We evaluated the association between recurrence and levels of biomarkers of cardiac remodeling, and their ability to improve recurrence prediction when added to a clinical prediction model. METHODS AND RESULTS Blood samples collected before de novo catheter ablation were analyzed. Levels of bone morphogenetic protein-10, angiopoietin-2, fibroblast growth factor-23, insulin-like growth factor-binding protein-7, myosin-binding protein C3, growth differentiation factor-15, interleukin-6, N-terminal pro-brain natriuretic peptide, and high-sensitivity troponin T were measured. Recurrence was defined as ≥30 seconds of an atrial arrhythmia 3 to 12 months postablation. Multivariable logistic regression was performed using biomarker levels along with clinical covariates: APPLE score (Age >65 years, Persistent AF, imPaired eGFR [<60 ml/min/1.73m2], LA diameter ≥43 mm, EF <50%; which includes age, left atrial diameter, left ventricular ejection fraction, persistent atrial fibrillation, and estimated glomerular filtration rate), preablation rhythm, sex, height, body mass index, presence of an implanted continuous monitor, year of ablation, and additional linear ablation. A total of 1873 participants were included. A multivariable logistic regression showed an association between recurrence and levels of angiopoietin-2 (odds ratio, 1.08 [95% CI, 1.02-1.15], P=0.007) and interleukin-6 (odds ratio, 1.02 [95% CI, 1.003-1.03]; P=0.02). The area under the receiver operating characteristic curve of a model that only contained clinical predictors was 0.711. The addition of any of the 9 studied biomarkers to the predictive model did not result in a statistically significant improvement in the area under the receiver operating characteristic curve. CONCLUSIONS Higher angiopoietin-2 and interleukin-6 levels were associated with recurrence after atrial fibrillation ablation in multivariable modeling. However, the addition of biomarkers to a clinical prediction model did not significantly improve recurrence prediction.
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Affiliation(s)
- Majd A. El‐Harasis
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Joseph A. Quintana
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | | | - Gregory G. Jackson
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Bibin T. Varghese
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Zachary T. Yoneda
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Brittany S. Murphy
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Diane M. Crawford
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Kelsey Tomasek
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Yan Ru Su
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Quinn S. Wells
- Departments of Medicine, Pharmacology, and Biomedical InformaticsVanderbilt University Medical CenterNashvilleTN
| | - Dan M. Roden
- Departments of Medicine, Pharmacology, and Biomedical InformaticsVanderbilt University Medical CenterNashvilleTN
| | - Gregory F. Michaud
- Division of Cardiovascular Medicine, Massachusetts General HospitalBostonMA
| | - Pablo Saavedra
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Juan Carlos Estrada
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Travis D. Richardson
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | | | - Sharon T. Shen
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Jay A. Montgomery
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - Christopher R. Ellis
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
| | - George H. Crossley
- Division of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTN
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Tao L, Chan A, Maris A, Schmitz JE. Internationally standardized respiratory viral load testing with limited resources: A derivative-of-care calibration strategy for SARS-CoV-2. Influenza Other Respir Viruses 2024; 18:e13207. [PMID: 38268611 PMCID: PMC10805620 DOI: 10.1111/irv.13207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction SARS-CoV-2 has demonstrated that, in targeted circumstances, viral quantification within respiratory specimens can valuably inform patient management, as well as research. Nevertheless, the pandemic has illustrated concomitant challenges for obtaining high-quality (and broadly comparable) respiratory viral loads. This includes a critical need for standardization and calibration, even though the necessary resources may not always be available for emergent pathogens and non-bloodstream specimens. Methods To these ends, we describe a novel strategy for implementing quantitative SARS-CoV-2 testing with International Unit-based calibration. Earlier in the course of the pandemic-when analytic resources were far more limited-select residual SARS-CoV-2 positive specimens from routine care in our diagnostic laboratory were pooled to formulate a clinically realistic secondary standard of high volume and analyte concentration, which was cross-calibrated to the primary SARS-CoV-2 standard of the World Health Organization. Results The resultant calibrators were integrated into the original CDC RT-qPCR assay for SARS-CoV-2, whose (now broadened) performance characteristics were defined to generate a test appropriate for both clinical and research use. This test allowed for the quantification of virus in respiratory specimens down to a validated lower limit of quantification of 103.4 IU/ml. Conclusions By self-formulating calibrators from this derivative-of-care secondary standard, we successfully validated respiratory viral loads without the commercial availability (at that time) of quantitative assays or calibrators. As the SARS-CoV-2 pandemic continues to decline-and even beyond this pathogen-this strategy may be applicable for laboratories seeking to implement viral load testing for nontraditional specimen types despite limited resources.
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Affiliation(s)
- Lili Tao
- Department of Pathology, Microbiology, and ImmunologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Allison Chan
- Department of Pathology, Microbiology, and ImmunologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Alex Maris
- Department of Pathology, Microbiology, and ImmunologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Jonathan E. Schmitz
- Department of Pathology, Microbiology, and ImmunologyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of UrologyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Institute for Infection, Immunology, and InflammationVanderbilt University Medical CenterNashvilleTennesseeUSA
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Sekhar KR, Codreanu SG, Williams OC, Rathmell JC, Rathmell WK, McLean JA, Sherrod SD, Baregamian N. Metabolism of parathyroid organoids. Front Endocrinol (Lausanne) 2023; 14:1223312. [PMID: 37492197 PMCID: PMC10364603 DOI: 10.3389/fendo.2023.1223312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/21/2023] [Indexed: 07/27/2023] Open
Abstract
Introduction We successfully developed a broad spectrum of patient-derived endocrine organoids (PDO) from benign and malignant neoplasms of thyroid, parathyroid, and adrenal glands. In this study, we employed functionally intact parathyroid PDOs from benign parathyroid tissues to study primary hyperparathyroidism (PHPT), a common endocrine metabolic disease. As proof of concept, we examined the utility of parathyroid PDOs for bioenergetic and metabolic screening and assessed whether parathyroid PDO metabolism recapitulated matched PHPT tissues. Methods Our study methods included a fine-needle aspiration (FNA)-based technique to establish parathyroid PDOs from human PHPT tissues (n=6) in semi-solid culture conditions for organoid formation, growth, and proliferation. Mass spectrometry metabolomic analysis of PHPT tissues and patient-matched PDOs, and live cell bioenergetic profiling of parathyroid PDOs with extracellular flux analyses, were performed. Functional analysis cryopreserved and re-cultured parathyroid PDOs for parathyroid hormone (PTH) secretion was performed using ELISA hormone assays. Results and discussion Our findings support both the feasibility of parathyroid PDOs for metabolic and bioenergetic profiling and reinforce metabolic recapitulation of PHPT tissues by patient-matched parathyroid PDOs. Cryopreserved parathyroid PDOs exhibited preserved, rapid, and sustained secretory function after thawing. In conclusion, successful utilization of parathyroid PDOs for metabolic profiling further affirms the feasibility of promising endocrine organoid platforms for future metabolic studies and broader multiplatform and translational applications for therapeutic advancements of parathyroid and other endocrine applications.
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Affiliation(s)
- Konjeti R. Sekhar
- Division of Surgical Oncology & Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Simona G. Codreanu
- Department of Chemistry and Center for Innovative Technology, Vanderbilt University, Nashville, TN, United States
| | - Olivia C. Williams
- Division of Surgical Oncology & Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jeffrey C. Rathmell
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - W. Kimryn Rathmell
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - John A. McLean
- Department of Chemistry and Center for Innovative Technology, Vanderbilt University, Nashville, TN, United States
| | - Stacy D. Sherrod
- Department of Chemistry and Center for Innovative Technology, Vanderbilt University, Nashville, TN, United States
| | - Naira Baregamian
- Division of Surgical Oncology & Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, United States
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Clark JM, Garvey WT, Niswender KD, Schmidt AM, Ahima RS, Aleman JO, Battarbee AN, Beckman J, Bennett WL, Brown NJ, Chandler‐Laney P, Cox N, Goldberg IJ, Habegger KM, Harper LM, Hasty AH, Hidalgo BA, Kim SF, Locher JL, Luther JM, Maruthur NM, Miller ER, Sevick MA, Wells Q. Obesity and Overweight: Probing Causes, Consequences, and Novel Therapeutic Approaches Through the American Heart Association's Strategically Focused Research Network. J Am Heart Assoc 2023; 12:e027693. [PMID: 36752232 PMCID: PMC10111504 DOI: 10.1161/jaha.122.027693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/03/2023] [Indexed: 02/09/2023]
Abstract
As the worldwide prevalence of overweight and obesity continues to rise, so too does the urgency to fully understand mediating mechanisms, to discover new targets for safe and effective therapeutic intervention, and to identify biomarkers to track obesity and the success of weight loss interventions. In 2016, the American Heart Association sought applications for a Strategically Focused Research Network (SFRN) on Obesity. In 2017, 4 centers were named, including Johns Hopkins University School of Medicine, New York University Grossman School of Medicine, University of Alabama at Birmingham, and Vanderbilt University Medical Center. These 4 centers were convened to study mechanisms and therapeutic targets in obesity, to train a talented cadre of American Heart Association SFRN-designated fellows, and to initiate and sustain effective and enduring collaborations within the individual centers and throughout the SFRN networks. This review summarizes the central themes, major findings, successful training of highly motivated and productive fellows, and the innovative collaborations and studies forged through this SFRN on Obesity. Leveraging expertise in in vitro and cellular model assays, animal models, and humans, the work of these 4 centers has made a significant impact in the field of obesity, opening doors to important discoveries, and the identification of a future generation of obesity-focused investigators and next-step clinical trials. The creation of the SFRN on Obesity for these 4 centers is but the beginning of innovative science and, importantly, the birth of new collaborations and research partnerships to propel the field forward.
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Affiliation(s)
- Jeanne M. Clark
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
| | - W. Timothy Garvey
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAL
| | - Kevin D. Niswender
- Tennessee Valley Healthcare SystemVanderbilt University Medical CenterNashvilleTN
- Division of Diabetes, Department of Medicine, Endocrinology and MetabolismVanderbilt University Medical CenterNashvilleTN
| | - Ann Marie Schmidt
- Department of Medicine, Diabetes Research Program, Division of Endocrinology, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
| | - Rexford S. Ahima
- Department of Medicine, Division of Endocrinology, Diabetes and MetabolismThe Johns Hopkins University School of MedicineBaltimoreMD
| | - Jose O. Aleman
- Division of Endocrinology, Department of Medicine, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
| | - Ashley N. Battarbee
- Division of Maternal Fetal Medicine, Department of Obstetrics and GynecologyUniversity of Alabama at BirminghamBirminghamAL
| | - Joshua Beckman
- Division of Cardiovascular Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTN
| | - Wendy L. Bennett
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
- Department of Population, Family and Reproductive HealthThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | | | | | - Nancy Cox
- Vanderbilt Genetics Institute and Division of Genetic Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Ira J. Goldberg
- Division of Endocrinology, Department of Medicine, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
| | - Kirk M. Habegger
- Division of Endocrinology, Department of Medicine, Diabetes, and MetabolismUniversity of Alabama at BirminghamBirminghamAL
| | - Lorie M. Harper
- Division of Maternal Fetal Medicine, Department of Obstetrics and GynecologyUniversity of Alabama at BirminghamBirminghamAL
- Division of Maternal‐Fetal Medicine, Department of Women’s Health, Dell Medical SchoolUniversity of Texas at AustinAustinTXUSA
| | - Alyssa H. Hasty
- Department of Molecular Physiology and BiophysicsVanderbilt University School of MedicineNashvilleTN
- VA Tennessee Valley Healthcare SystemNashvilleTN
| | - Bertha A. Hidalgo
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAL
| | - Sangwon F. Kim
- Department of Medicine, Division of Endocrinology, Diabetes and MetabolismThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of NeuroscienceThe Johns Hopkins University School of MedicineBaltimoreMD
| | - Julie L. Locher
- Division of Gerontology, Department of Medicine, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamAL
| | - James M. Luther
- Division of Clinical Pharmacology, Department of MedicineVanderbilt University Medical Center TennesseeNashvilleTN
| | - Nisa M. Maruthur
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
| | - Edgar R. Miller
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
| | - Mary Ann Sevick
- Division of Endocrinology, Department of Medicine, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
- Department of Population Health, Center for Healthful Behavior ChangeNew York University Langone HealthNew YorkNY
| | - Quinn Wells
- Department of PharmacologyVanderbilt UniversityNashvilleTN
- Department of MedicineVanderbilt University Medical CenterNashvilleTN
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Pike MM, Schildcrout J, Baldwin S, Edwards T, Lipworth L, Robinson‐Cohen C. Genetic Variants Associated With Systolic Blood Pressure in Children and Adolescents. J Am Heart Assoc 2023; 12:e027993. [PMID: 36718908 PMCID: PMC9973622 DOI: 10.1161/jaha.122.027993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Abstract
Background Genetics, along with lifestyle and behavioral characteristics, play an important role in hypertension in adults. Our aim was to identify genetic variants associated with blood pressure in childhood and adolescence. Methods and Results We conducted a candidate single-nucleotide polymorphism (SNP) analysis and genome-wide association study among 9778 participants aged <18 years in BioVU, the Vanderbilt University Medical Center biobank. The outcome was childhood blood pressure percentile from age 0 to 18 years. For the candidate SNP analysis, a total of 457 previously identified SNPs were examined. Linear regression was used to test the association between genetic variants and median systolic blood pressure (SBP) percentile. Adjusted models included median age, self-reported sex, race, the first 4 principal components of ancestry, and median body mass index Z score. Analyses were conducted in the overall cohort and stratified by age group. A polygenic risk score was calculated for each participant, and the association between polygenic risk score and median SBP percentile in childhood was examined using linear regression. In the overall candidate SNP analysis, 2 SNPs reached significance: rs1018148 (FBN1; P=1.0×10-4) and rs11105354 (ATP2B1; P=1.4×10-4). In the postpuberty age group, 1 SNP reached significance: rs1018148 (FBN1; P=2.2×10-5). In the genome-wide association study of all participants, no SNPs reached genome-wide significance. Higher polygenic risk score was associated with higher SBP percentile (β, 0.35 [95% CI, 0.10-0.60)], and there was a significant interaction with age (P for interaction<0.01). Conclusions These findings suggest that genetic variants play an important role in SBP in childhood and adolescence and provide evidence for age-specific genetic associations with SBP.
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Affiliation(s)
- Mindy M. Pike
- Division of Epidemiology, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | | | - Scott Baldwin
- Division of Pediatric Cardiology, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Todd Edwards
- Division of Epidemiology, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Loren Lipworth
- Division of Epidemiology, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Cassianne Robinson‐Cohen
- Division of Nephrology, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
- Vanderbilt‐O’Brien Center for Kidney DiseaseVanderbilt University Medical CenterNashvilleTNUSA
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Rankin DA, Yanis A, Talj R, Howe HL, Bloos SM, Fernandez KN, Amarin JZ, Bruce M, Salib S, Hargrave S, Chappell JD, Spieker AJ, Halasa NB, Howard LM. Clinical presentations of adult and pediatric SARS-CoV-2-positive cases in a community cohort, Nashville, Tennessee. J Med Virol 2022; 94:5560-5566. [PMID: 35815457 PMCID: PMC9350274 DOI: 10.1002/jmv.27988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/20/2022] [Accepted: 07/08/2022] [Indexed: 12/15/2022]
Abstract
Compared to adults, the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) illness in children has been lower and less severe. However, reports comparing SARS-CoV-2 infection among children and adults are limited. As part of our longitudinal cohort study of adults and children with SARS-CoV-2 infection and their household contacts in Nashville, Tennessee, we compared the clinical characteristics and outcomes of SARS-CoV-2 infections between children and adults. Children were more likely to be asymptomatically infected and had a shorter illness duration compared to adults. The differences observed in clinical presentation across ages may inform symptom-specific testing, screening, and management algorithms.
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Affiliation(s)
- Danielle A. Rankin
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Epidemiology PhD ProgramVanderbilt University School of MedicineNashvilleTennesseeUSA
| | - Ahmad Yanis
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Rana Talj
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Harrison L. Howe
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Sean M. Bloos
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
- Tulane University School of MedicineTulane UniversityNew OrleansLouisianaUSA
| | - Kailee N. Fernandez
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Justin Z. Amarin
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Mercedes Bruce
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Seifein Salib
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Samarian Hargrave
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - James D. Chappell
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Andrew J. Spieker
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Natasha B. Halasa
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Leigh M. Howard
- Department of PediatricsVanderbilt University Medical CenterNashvilleTennesseeUSA
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Balzer C, Cleveland WJ, Li Z, Riess ML. Buffer glucose adjustment affects myocardial function after ischemia-reperfusion in long-term diabetic rat isolated hearts. Physiol Rep 2022; 10:e15387. [PMID: 36324287 PMCID: PMC9630758 DOI: 10.14814/phy2.15387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/06/2022] Open
Abstract
Due to its comorbidities type 2 diabetes mellitus (T2DM) and hypertension, the Zucker Spontaneous Hypertensive Fatty (ZSF1) rat is a clinically relevant animal model when assessing ischemia-reperfusion (IR) injury. Most IR studies in hearts isolated from diabetic animals have been conducted at normal glucose concentrations, providing a different environment compared to in-vivo. We hypothesized IR injury to be attenuated in isolated hearts of diabetic ZSF1 rats when adjusting the Krebs-buffer (KB) to their in-vivo, i.e., elevated blood glucose (BG) levels. Diabetic and non-diabetic ZSF1 rats were anesthetized, hearts isolated and Langendorff-prepared. While standard KB was used for the non-diabetic and diabetic unadjusted groups, KB with glucose levels increased to each rat's prior BG level was used for the adjusted diabetic group. All hearts underwent 30 min ischemia and 120 min reperfusion. Diastolic contracture during ischemia and early reperfusion was delayed and temporarily attenuated in the adjusted compared to the unadjusted diabetic and the non-diabetic groups. The decrease in coronary flow on reperfusion was attenuated in diabetic animals. Left ventricular developed pressure and contractility were not different among the three groups. Infarct size was significantly lower in non-diabetic animals; buffer adjustment made no difference in diabetic animals. In our study, T2DM did not worsen myocardial function in ZSF1 rat isolated hearts. Since our results reveal that hearts with an adjusted glucose level exhibit an at least temporary improvement of function following IR, further studies should consider adapting glucose levels to create more realistic conditions in isolated, perfused hearts.
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Affiliation(s)
- Claudius Balzer
- Department of AnesthesiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of AnesthesiologyUniversity Medicine GreifswaldGreifswaldGermany
| | - William J. Cleveland
- Department of AnesthesiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Zhu Li
- Department of AnesthesiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Matthias L. Riess
- Department of AnesthesiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of AnesthesiologyTVHS VA Medical CenterNashvilleTennesseeUSA
- Department of PharmacologyVanderbilt UniversityNashvilleTennesseeUSA
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Shuey MM, Huang S, Levinson RT, Farber‐Eger E, Cahill KN, Beckman JA, Koethe JR, Silver HJ, Niswender KD, Cox NJ, Harrell FE, Wells QS. Exploration of an alternative to body mass index to characterize the relationship between height and weight for prediction of metabolic phenotypes and cardiovascular outcomes. Obes Sci Pract 2022; 8:124-130. [PMID: 35127128 PMCID: PMC8804920 DOI: 10.1002/osp4.543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Body mass index (BMI) is the most commonly used predictor of weight-related comorbidities and outcomes. However, the presumed relationship between height and weight intrinsic to BMI may introduce bias with respect to prediction of clinical outcomes. A series of analyses comparing the performance of models representing weight and height as separate interacting variables to models using BMI were performed using Vanderbilt University Medical Center's deidentified electronic health records and landmark methodology. METHODS Use of BMI or height-weight interaction in prediction models for established weight-related cardiometabolic traits and metabolic syndrome was evaluated. Specifically, prediction models for hypertension, diabetes mellitus, low high-density lipoprotein, and elevated triglycerides, atrial fibrillation, coronary artery disease, heart failure, and peripheral artery disease were developed. Model performance was evaluated using likelihood ratio, R 2, and Somers' Dxy rank correlation. Differences in model predictions were visualized using heat maps. RESULTS Compared to BMI, the maximally flexible height-weight interaction model demonstrated improved prediction, higher likelihood ratio, R 2, and Somers' Dxy rank correlation, for event-free probability for all outcomes. The degree of improvement to the prediction model differed based on the outcome and across the height and weight range. CONCLUSIONS Because alternative measures of body composition such as waist-to-hip ratio are not routinely collected in the clinic clinical risk models quantifying risk based on height and weight measurements alone are essential to improve practice. Compared to BMI, modeling height and weight as independent, interacting variables results in less bias and improved predictive accuracy for all tested traits. Considering an individual's height and weight opposed to BMI is a better method for quantifying individual disease risk.
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Affiliation(s)
- Megan M. Shuey
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Shi Huang
- Department of BiostatisticsVanderbilt University School of MedicineNashvilleTNUSA
| | | | - Eric Farber‐Eger
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | | | - Joshua A. Beckman
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - John R. Koethe
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Heidi J. Silver
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
- Department of Veteran AffairsTennessee Valley Healthcare SystemNashvilleTNUSA
| | - Kevin D. Niswender
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
- Department of Veteran AffairsTennessee Valley Healthcare SystemNashvilleTNUSA
| | - Nancy J. Cox
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Frank E. Harrell
- Department of BiostatisticsVanderbilt University School of MedicineNashvilleTNUSA
| | - Quinn S. Wells
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
- Department of PharmacologyVanderbilt University Medical CenterNashvilleTNUSA
- Department of Biomedical InformaticsVanderbilt University Medical CenterNashvilleTNUSA
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