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Shaaban A, Petersen A, Beckwith H, Florea N, Potter DA, Yee D, Vogel RI, Duprez D, Blaes AH. Endothelial dysfunction in breast cancer survivors on aromatase inhibitors: changes over time. Cardiooncology 2024; 10:27. [PMID: 38693561 PMCID: PMC11062002 DOI: 10.1186/s40959-024-00227-z] [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] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/04/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Breast cancer is estimated to comprise about 290,560 new cases in 2022. Aromatase inhibitors (AIs) are recommended as adjuvant treatment for estrogen-receptor positive (ER+) breast carcinoma in postmenopausal women, which includes approximately two-thirds of all women with breast cancer. AIs inhibit the peripheral conversion of androgens to estrogen by deactivation of the aromatase enzyme, leading to a reduction in serum estrogen level in postmenopausal women with ER+ breast carcinoma. Estrogen is known for its cardiovascular (CV) protective properties through a variety of mechanisms including vasodilation of blood vessels and inhibition of vascular injury resulting in the prevention of atherosclerosis. In clinical trials and prospective cohorts, the long-term use of AIs can increase the risk for hypertension and hyperlipidemia. Studies demonstrate mixed results as to the impact of AIs on actual CV events and overall survival. METHODS A single arm longitudinal study of 14 postmenopausal women with ER+ breast cancer prescribed adjuvant AIs at the University of Minnesota (UMN). Subjects with a history of known tobacco use, hypertension, hyperlipidemia, and diabetes were excluded to eliminate potential confounding factors. Participants underwent routine labs, blood pressure assessments, and vascular testing at baseline (prior to starting AIs) and at six months. Vascular assessment was performed using the EndoPAT 2000 and HDI/PulseWave CR-2000 Cardiovascular Profiling System and pulse contour analysis on two occasions as previously described. Vascular measurements were conducted by one trained vascular technician. Assessments were performed in triplicate, and the mean indices were used for analyses. All subjects were on an AI at the follow-up visit. The protocol was approved by the UMN Institutional Review Board and all participants were provided written informed consent. Baseline and follow-up characteristics were compared using Wilcoxon signed-rank tests. Analyses were performed using R version 3.6.1 (R Foundation for Statistical Computing, Vienna, Austria). RESULTS After six months of AI treatment, EndoPAT® ratio declined to a median 1.12 (Q1: 0.85, Q3: 1.86; p = 0.045; Figure 1) and median estradiol levels decreased to 2 pg/mL (Q1: 2, Q3: 3; p=0.052). There was no evidence of association between change in EndoPAT® and change in estradiol level (p = 0.91). There were no statistically significant changes in small or large arterial elasticity. CONCLUSIONS We hypothesize that long-term use of AI can lead to persistent endothelial dysfunction, and further investigation is necessary. In our study, patients were on AI for approximately 5-10 years. As a result, we do not have data on whether these changes, such as EndoPAT® ratio and the elasticity of small and large arterial, are reversible with discontinuation of AI. These findings set the stage for a larger study to more conclusively determine the association between AI exposure and cardiovascular outcomes. Further studies should evaluate for multivariate associations withmodifiable risk factors for CV disease.
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Affiliation(s)
- Adnan Shaaban
- Department of Internal Medicine, Division of Hospital Medicine, The Ohio State University, OH, Columbus , USA
| | - Ashley Petersen
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN, USA
| | - Heather Beckwith
- Department of Internal Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Natalia Florea
- Department on Internal Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - David A Potter
- Department of Internal Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Douglas Yee
- Department of Internal Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Anne H Blaes
- , 420 Delaware Street, S.E. MMC 480, Minneapolis, MN, 55455, USA.
- Department of Internal Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA.
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Hu X, Logan JG, Kwon Y, Lima JAC, Jacobs DR, Duprez D, Brumback L, Taylor KD, Durda P, Johnson WC, Cornell E, Guo X, Liu Y, Tracy RP, Blackwell TW, Papanicolaou G, Mitchell GF, Rich SS, Rotter JI, Van Den Berg DJ, Chirinos JA, Hughes TM, Garrett-Bakelman FE, Manichaikul A. Multi-ancestry epigenome-wide analyses identify methylated sites associated with aortic augmentation index in TOPMed MESA. Sci Rep 2023; 13:17680. [PMID: 37848499 PMCID: PMC10582077 DOI: 10.1038/s41598-023-44806-z] [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: 06/29/2023] [Accepted: 10/12/2023] [Indexed: 10/19/2023] Open
Abstract
Despite the prognostic value of arterial stiffness (AS) and pulsatile hemodynamics (PH) for cardiovascular morbidity and mortality, epigenetic modifications that contribute to AS/PH remain unknown. To gain a better understanding of the link between epigenetics (DNA methylation) and AS/PH, we examined the relationship of eight measures of AS/PH with CpG sites and co-methylated regions using multi-ancestry participants from Trans-Omics for Precision Medicine (TOPMed) Multi-Ethnic Study of Atherosclerosis (MESA) with sample sizes ranging from 438 to 874. Epigenome-wide association analysis identified one genome-wide significant CpG (cg20711926-CYP1B1) associated with aortic augmentation index (AIx). Follow-up analyses, including gene set enrichment analysis, expression quantitative trait methylation analysis, and functional enrichment analysis on differentially methylated positions and regions, further prioritized three CpGs and their annotated genes (cg23800023-ETS1, cg08426368-TGFB3, and cg17350632-HLA-DPB1) for AIx. Among these, ETS1 and TGFB3 have been previously prioritized as candidate genes. Furthermore, both ETS1 and HLA-DPB1 have significant tissue correlations between Whole Blood and Aorta in GTEx, which suggests ETS1 and HLA-DPB1 could be potential biomarkers in understanding pathophysiology of AS/PH. Overall, our findings support the possible role of epigenetic regulation via DNA methylation of specific genes associated with AIx as well as identifying potential targets for regulation of AS/PH.
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Affiliation(s)
- Xiaowei Hu
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Younghoon Kwon
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Joao A C Lima
- Department of Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - David R Jacobs
- Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA
| | - Lyndia Brumback
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Kent D Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Peter Durda
- Laboratory for Clinical Biochemistry Research, University of Vermont, Burlington, VT, USA
| | - W Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Elaine Cornell
- Laboratory for Clinical Biochemistry Research, University of Vermont, Burlington, VT, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Yongmei Liu
- Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA
| | - Russell P Tracy
- Laboratory for Clinical Biochemistry Research, University of Vermont, Burlington, VT, USA
| | - Thomas W Blackwell
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - George Papanicolaou
- Epidemiology Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA
| | | | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - David J Van Den Berg
- Department of Preventive Medicine and Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Julio A Chirinos
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Timothy M Hughes
- Department of Internal Medicine - Section of Gerontology and Geriatric Medicine, and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Francine E Garrett-Bakelman
- Department of Biochemistry and Molecular Genetics, Department of Medicine, University of Virginia, 1340 Jefferson Park Ave., Pinn hall 6054, Charlottesville, VA, 22908, USA.
| | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, 22908, USA.
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Cha J, Bustamante G, Lê-Scherban F, Duprez D, Pankow JS, Osypuk TL. Ethnic Enclaves and Incidence of Cancer Among US Ethnic Minorities in the Multi-Ethnic Study of Atherosclerosis. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01814-z. [PMID: 37801279 PMCID: PMC11110072 DOI: 10.1007/s40615-023-01814-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Since immigrants and their descendants represent a growing proportion of the US population, there is a strong demographic imperative for scientists to better understand the cancer risk factors at multiple levels that exist for these populations. Understanding the upstream causes of cancer, including neighborhood context, may help prevention efforts. Residence in ethnic enclaves may be one such contextual cause; however, the evidence is mixed, and past research has not utilized prospective designs examining cancer incidence or mortality. METHODS We examined the association between residency in ethnic enclaves and cancer events among Hispanic (n = 753) and Chinese (n = 451) participants without a history of cancer in the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study that enrolled participants ages 45-84 in six US cities. Cancer events included deaths and hospitalization for any cancer diagnosis from 2000-2012. Residency in an ethnic enclave was operationalized as their geocoded baseline census tract having a concentration of residents of the same ethnicity greater than the 75th percentile (compared to non-ethnic enclave otherwise). Potential confounders were blocked into three categories: sociodemographic, acculturation, and biomedical/health behavior variables. To examine the association between ethnic enclaves and cancer, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards models. RESULTS Among Hispanic participants, residing in ethnic enclaves (vs. not) was associated with a 39% reduction in cancer risk (HR 0.61, 95%CI: 0.31, 1.21) after adjusting for sociodemographic variables. Among Chinese participants, residing in ethnic enclaves was associated with a 2.8-fold increase in cancer risk (HR 2.86, 95%CI; 1.38, 5.94) after adjusting for sociodemographic variables. CONCLUSIONS Our results suggest that the association between ethnic enclaves and cancer events differs by ethnic group, suggesting that different social and contextual factors may operate in different communities.
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Affiliation(s)
- Jinhee Cha
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Gabriela Bustamante
- Program in Health Disparities Research, Medical School, University of Minnesota, Minneapolis, MN, USA
- Instituto de Medicina Social & Desafíos Globales, School of Public Health, Universidad San Francisco de Quito, Quito, Ecuador
| | - Félice Lê-Scherban
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Daniel Duprez
- Cardiovascular Division, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - James S. Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Theresa L. Osypuk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
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Duprez D, Jacobs DR. LDL-cholesterol lowering: to be or not to be too low. Eur J Prev Cardiol 2023; 30:1205-1206. [PMID: 37158485 DOI: 10.1093/eurjpc/zwad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/04/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Daniel Duprez
- Cardiovascular Division, Department of Medicine, University of Minnesota, 420 Delaware Street SE, MMC 508, Minneapolis, MN 55455, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 420 Delaware Street SE, MMC 508, Minneapolis, MN 55455, USA
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5
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Manichaikul A, Hu X, Logan J, Kwon Y, Lima J, Jacobs D, Duprez D, Brumback L, Taylor K, Durda P, Johnson C, Cornell E, Guo X, Liu Y, Tracy R, Blackwell T, Papanicolaou G, Mitchell G, Rich S, Rotter J, Van Den Berg D, Chirinos J, Hughes T, Garrett-Bakelman F. Multi-ancestry epigenome-wide analyses identify methylated sites associated with aortic augmentation index in TOPMed MESA. Res Sq 2023:rs.3.rs-3125948. [PMID: 37502922 PMCID: PMC10371087 DOI: 10.21203/rs.3.rs-3125948/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Despite the prognostic value of arterial stiffness (AS) and pulsatile hemodynamics (PH) for cardiovascular morbidity and mortality, epigenetic modifications that contribute to AS/PH remain unknown. To gain a better understanding of the link between epigenetics (DNA methylation) and AS/PH, we examined the relationship of eight measures of AS/PH with CpG sites and co-methylated regions using multi-ancestry participants from Trans-Omics for Precision Medicine (TOPMed) Multi-Ethnic Study of Atherosclerosis (MESA) with sample sizes ranging from 438 to 874. Epigenome-wide association analysis identified one genome-wide significant CpG (cg20711926-CYP1B1) associated with aortic augmentation index (AIx). Follow-up analyses, including gene set enrichment analysis, expression quantitative trait methylation analysis, and functional enrichment analysis on differentially methylated positions and regions, further prioritized three CpGs and their annotated genes (cg23800023-ETS1, cg08426368-TGFB3, and cg17350632-HLA-DPB1) for AIx. Among these, ETS1 and TGFB3 have been previously prioritized as candidate genes. Furthermore, both ETS1 and HLA-DPB1 have significant tissue correlations between Whole Blood and Aorta in GTEx, which suggests ETS1 and HLA-DPB1 could be potential biomarkers in understanding pathophysiology of AS/PH. Overall, our findings support the possible role of epigenetic regulation via DNA methylation of specific genes associated with AIx as well as identifying potential targets for regulation of AS/PH.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kent Taylor
- The Institute for Translational Genomics and Population Sciences
| | | | | | | | | | | | | | | | | | | | - Stephen Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia
| | - Jerome Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
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6
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Safo SE, Haine L, Baker J, Reilly C, Duprez D, Neaton JD, Jain MK, Arenas‐Pinto A, Polizzotto M, Staub T. Derivation of a Protein Risk Score for Cardiovascular Disease Among a Multiracial and Multiethnic HIV+ Cohort. J Am Heart Assoc 2023; 12:e027273. [PMID: 37345752 PMCID: PMC10356060 DOI: 10.1161/jaha.122.027273] [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: 06/22/2022] [Accepted: 02/28/2023] [Indexed: 06/23/2023]
Abstract
Background Cardiovascular disease risk prediction models underestimate CVD risk in people living with HIV (PLWH). Our goal is to derive a risk score based on protein biomarkers that could be used to predict CVD in PLWH. Methods and Results In a matched case-control study, we analyzed normalized protein expression data for participants enrolled in 1 of 4 trials conducted by INSIGHT (International Network for Strategic Initiatives in Global HIV Trials). We used dimension reduction, variable selection and resampling methods, and multivariable conditional logistic regression models to determine candidate protein biomarkers and to generate a protein score for predicting CVD in PLWH. We internally validated our findings using bootstrap. A protein score that was derived from 8 proteins (including HGF [hepatocyte growth factor] and interleukin-6) was found to be associated with an increased risk of CVD after adjustment for CVD and HIV factors (odds ratio: 2.17 [95% CI: 1.58-2.99]). The protein score improved CVD prediction when compared with predicting CVD risk using the individual proteins that comprised the protein score. Individuals with a protein score above the median score were 3.10 (95% CI, 1.83-5.41) times more likely to develop CVD than those with a protein score below the median score. Conclusions A panel of blood biomarkers may help identify PLWH at a high risk for developing CVD. If validated, such a score could be used in conjunction with established factors to identify CVD at-risk individuals who might benefit from aggressive risk reduction, ultimately shedding light on CVD pathogenesis in PLWH.
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Affiliation(s)
| | | | - Jason Baker
- Hennepin County Medical CenterMinneapolisMNUSA
| | | | | | | | | | - Alejandro Arenas‐Pinto
- MRC Clinical Trials Unit at University College London Institute of Clinical Trials & MethodologyLondonUK
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Jacobi N, Ortman S, Buda L, Duprez D. Effect of insulin resistance on CAC scores in cancer survivors. Cardiooncology 2023; 9:21. [PMID: 37060010 PMCID: PMC10103502 DOI: 10.1186/s40959-023-00168-z] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/20/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Many ca. survivors exhibit signs of IR, an important risk factor for the development of CAD. CAC scans offer a risk assessment of CV disease before cardiac damage has occurred. We investigated how IR affects CAC scores in cancer survivors. OBJECTIVES The aim of this study was to show that CAC scores differ significantly between insulin-sensitive- and -resistant cancer survivors. METHODS We enrolled 90 cancer survivors of a large community hospital from March 2021 to January 2022 into this pilot study. Patients were subdivided into three groups: insulin-sensitive (IS), insulin-resistant/prediabetic and insulin-resistant/diabetic. All patients received a CAC scan. RESULTS 70% of asymptomatic survivors overall and 81% of asymptomatic IR patients show CAD on CAC scans. 17 CAC scans in the IS group, 6 CAC scans in the IR/prediabetic group and 5 CAC scans in the IR/diabetic group showed an Agatston score of 0. The p-value between the three groups was statistically significant (p = 0.005) whereas the IR/prediabetic- and the IR/diabetic group did not differ statistically from each other. The mean MESA 10-year CHD risk with CAC was 7.8. There was a highly significant difference between the 3 groups (p < 0.001). The two IR groups did not differ statistically (p = 0.076). CONCLUSIONS Survivors with IR including prediabetes have less frequent zero CAC scores than insulin-sensitive survivors. Our study also showed that IR including prediabetes significantly increases the MESA 10-yr. CHD Risk with CAC in cancer survivors. This trial highlights the importance of screening survivors for IR and draws attention to the association of IR to CAC not only in diabetes but also in prediabetes. The high fraction of asymptomatic survivors with CAD is concerning and calls for further investigation. CAC scans are an inexpensive and efficient way of screening asymptomatic cancer survivors for CAD.
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Affiliation(s)
- N Jacobi
- Department of Hematology, Oncology, Hennepin Healthcare, Minneapolis, MN, USA.
| | - S Ortman
- Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA
| | - L Buda
- Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA
| | - Daniel Duprez
- Department of Cardiology, University of Minnesota, Minneapolis, MN, USA
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8
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Shaaban A, Petersen A, Beckwith H, Florea N, Potter DA, Yee D, Vogel RI, Duprez D, Blaes AH. Endothelial Dysfunction in Breast Cancer Survivors on Aromatase Inhibitors: Changes over Time. Res Sq 2023:rs.3.rs-2758909. [PMID: 37066265 PMCID: PMC10104271 DOI: 10.21203/rs.3.rs-2758909/v1] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background Aromatase inhibitors (AIs) are recommended as adjuvant treatment for estrogen-receptor positive breast carcinoma in postmenopausal women. Studies demonstrate mixed results as to the impact of AIs on cardiovascular (CV) events and overall survival. With the increasing number of pre- and postmenopausal women on AIs for five to ten years, understanding the long-term impact of AIs on blood vessels and CV risk in cancer survivors is vital. Methods A single arm longitudinal study of 14 postmenopausal women with ER+ breast cancer prescribed adjuvant AIs at the University of Minnesota. Subjects with a history of tobacco use, hypertension, or hyperlipidemia were excluded. Participants underwent routine labs, blood pressure assessments, and vascular testing at baseline (prior to starting AIs) and at six months. Vascular assessment was performed using the EndoPAT 2000 and HDI/PulseWave CR-2000 Cardiovascular Pro ling System and pulse contour analysis on two occasions as previously described. Vascular measurements were conducted by one trained vascular technician. Assessments were performed in triplicate, and the mean indices were used for analyses. All subjects were on an AI at the follow-up visit. The protocol was approved by the UMN Institutional Review Board and all participants were provided written informed consent. Baseline and follow-up characteristics were compared using Wilcoxon signed-rank tests. Analyses were performed using R version 3.6.1 (R Foundation for Statistical Computing, Vienna, Austria). Results After six months of AI treatment, EndoPAT® ratio declined to a median 1.12 (Q1: 0.85, Q3: 1.86; p=0.045) and median estradiol levels decreased to 2 pg/mL (Q1: 2, Q3: 3; p=0.052). There was no evidence of association between change in EndoPAT® and change in estradiol level (p=0.91). There were no statistically significant changes in small or large arterial elasticity. Conclusion Endovascular dysfunction is an early sign for atherosclerosis and vascular impairment. This study suggests that postmenopausal breast cancer survivors on aromatase inhibitor therapy develop endothelial dysfunction as early as six months which is a predictor of adverse CV disease. We hypothesize that long-term use of AIs can lead to persistent endothelial dysfunction. It is unclear if these changes are reversible once AI use is discontinued and further investigation is necessary.
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Brumback LC, Andrews LI, Jacobs DR, Duprez D, Hom Thepaksorn EK, Kaufman JD, Denenberg J, Allison M. Reproducibility of PTC1 and PTC2, indices of arterial compliance, from the radial artery waveform: The Multi-Ethnic Study of Atherosclerosis. Vasc Med 2023; 28:141-143. [PMID: 36721317 PMCID: PMC10578356 DOI: 10.1177/1358863x221151089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Lyndia C Brumback
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Leah Ib Andrews
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Department of Medicine, Cardiovascular Division, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | | | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Julie Denenberg
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
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Nomura SO, Karger AB, Garg P, Cao J, Bhatia H, Duran EK, Duprez D, Guan W, Tsai MY. Small dense low-density lipoprotein cholesterol compared to other lipoprotein biomarkers for predicting coronary heart disease among individuals with normal fasting glucose: The Multi-Ethnic Study of Atherosclerosis. Am J Prev Cardiol 2022; 13:100436. [PMID: 36545388 PMCID: PMC9760650 DOI: 10.1016/j.ajpc.2022.100436] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/07/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
Objective This study compared small dense low-density lipoprotein cholesterol (sdLDL-C) with apolipoprotein B (apo B), and low-density lipoprotein particles (LDL-P) in predicting CHD risk in generally healthy adults with normal fasting glucose (NFG). Methods This study was conducted among participants with NFG in the Multi-Ethnic Study of Atherosclerosis (MESA) prospective cohort with measurements of sdLDL-C, LDL-P, and apo B available at baseline (2000-2002) and follow-up CHD data (through 2015) (N = 3,258). Biomarkers were evaluated as quartiles, and in categories using clinically and 75th percentile-defined cut-points. Discordance/concordance of sdLDL-C relative to other biomarkers was calculated using 75th percentile cut-points and linear regression residuals. Associations between individual biomarkers, sdLDL-C discordance and CHD incidence were evaluated using Cox proportional hazards regression. Results There were 241 incident CHD events in this population through 2015. Higher sdLDL-C, apo B, LDL-P were similarly associated with increased CHD in individuals with NFG. Discordance of sdLDL-C with apo B or LDL-P by 75th percentiles was not significantly associated with CHD. Residuals discordantly higher/lower sdLDL-C relative to apo B (discordant high HR=1.26, 95% CI: 0.89, 1.78; discordant low HR=0.94, 95% CI: 0.68, 1.29) and LDL-P (discordant high HR=1.25, 95% CI: 0.88, 1.75; discordant low HR=0.84, 95% CI:0.60, 1.16), compared to those with concordant measures, had non-statistically significant higher/lower risk of CHD. Conclusions Results suggest sdLDL-C, apo B and LDL-P are generally comparable for predicting CHD events in normoglycemic individuals. Larger studies are needed to confirm findings and to investigate whether measurement of sdLDL-C may be beneficial to evaluate as an additional risk-enhancing factor.
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Affiliation(s)
- Sarah O. Nomura
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware St SE, Mayo Mail Code 609, Minneapolis, MN 55455, United States
| | - Amy B. Karger
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware St SE, Mayo Mail Code 609, Minneapolis, MN 55455, United States
| | - Parveen Garg
- Keck Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jing Cao
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Harpreet Bhatia
- Division of Cardiovascular Medicine, University of California San Diego, San Diego, CA, United States
| | - Edward K. Duran
- Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, MN, United States
| | - Daniel Duprez
- Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, MN, United States
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware St SE, Mayo Mail Code 609, Minneapolis, MN 55455, United States
- Corresponding author.
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11
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Garg PK, Guan W, Nomura S, Weir NL, Karger AB, Duprez D, Tsai MY. Associations of plasma omega-3 and omega-6 pufa levels with arterial elasticity: the multi-ethnic study of atherosclerosis. Eur J Clin Nutr 2022; 76:1770-1775. [PMID: 35680969 DOI: 10.1038/s41430-022-01172-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Literature examining the relationship of circulating omega-3 and omega-6 polyunsaturated fatty acids [n-3(ω-3) and n-6 (ω-6) PUFAs] and arterial elasticity in large cohort-based populations are lacking. We investigated the association of circulating ω-3and ω-6 PUFAs with large artery elasticity (LAE) and small artery elasticity (SAE) in participants from the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS A total of 6124 participants (mean age 61.9; 52% female; 38% White, 27% Black, 22% Hispanic, and 13% Chinese-American) with plasma phospholipid PUFAs and arterial elasticity measured at baseline were included. LAE and SAE were derived from pulse contour analysis of the radial artery in all subjects in a supine position using tonometry. Linear regression models were used to determine associations for levels of (1) each circulating fatty acid, (2) total ω-3PUFAs, and (3) total ω-6 PUFAs with log-transformed LAE and SAE. RESULTS Each standard deviation (SD) increment in circulating levels of total ω-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid were associated with a 0.017 ml/mmHg, 0.017 ml/mmHg, and 0.015 ml/mmHg higher LAE respectively (p values all <0.01). No significant trends were observed for ω-3 PUFAs levels with SAE.22 Similarly, no significant trends were observed for ω-6 PUFA levels with either LAE or SAE. CONCLUSIONS In a multi-ethnic cohort of individuals free of baseline cardiovascular disease, higher plasma levels of total and individual ω-3 PUFAs were associated with an increased LAE. Further understanding into differential associations of ω-6 PUFAs with LAE and SAE is needed.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, University of Southern California, Los Angeles, CA, USA.
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Sarah Nomura
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Natalie L Weir
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Amy B Karger
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
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Chahine J, Kreykes S, Van't Hof JR, Duprez D, Nijjar P. Variable and Severe Phenotypic Expression of the "Lebanese Allele" in Two Sisters with Familial Hypercholesterolemia. Vasc Health Risk Manag 2021; 17:415-419. [PMID: 34321884 PMCID: PMC8312315 DOI: 10.2147/vhrm.s314704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/15/2021] [Indexed: 01/02/2023] Open
Abstract
The "Lebanese allele" {LDLR c.2043 C>A (p.cys681X)} is a nonsense mutation in the low-density lipoprotein receptor (LDLR) gene that results in a truncated non-functioning LDLR protein. We report two sisters of Lebanese descent who presented with familial hypercholesterolemia (FH) and were both heterozygous for the Lebanese allele, but had very distinct LDL-C levels and clinical phenotypes. Whereas one of the sisters had LDL-C in the expected range of Heterozygous FH (HeFH) with the Lebanese allele (LDL-C of 292 mg/dl), the other sister had a more severe LDL-C phenotype in the Homozygous FH (HoFH) range (LDL-C of 520 mg/dl) along with manifest atherosclerosis. Surprisingly, she did not demonstrate a compound heterozygote or double heterozygote status. We discuss different mechanisms that are purported to play a role in modifying the phenotype of FH, including different variants and polygenic modifiers. HeFH patients with the Lebanese allele can have a wide spectrum of LDL-C levels that range from the typical heterozygous to homozygous phenotypes.
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Affiliation(s)
- Johnny Chahine
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sarah Kreykes
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jeremy R Van't Hof
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Daniel Duprez
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Prabhjot Nijjar
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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Choi Y, Gallaher D, Svendsen K, Meyer K, Steffen L, Schreiner P, Duprez D, Shikany J, Rana J, Jacobs DJ. Which Predicts Incident Cardiovascular Disease Better: A Plant-Centered Diet or a Low-Saturated Fat Diet? The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab053_012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
A low-saturated fat diet has been suggested to reduce serum cholesterol and thereby presumably lower the risk of atherosclerotic cardiovascular disease (CVD). We compared associations of a low-saturated fat diet vs a plant-centered diet with lower serum low-density lipoprotein cholesterol (LDL-C) concentration and risk of incident CVD, coronary heart disease (CHD), and stroke.
Methods
We followed 4,887 Black and White men and women in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, ages 18–30 years and free of CVD at baseline from 1985–86 (exam year 0) to 2018 (year 32). The A Priori Diet Quality Score (APDQS), a measure of plant-centered diet quality, was assessed in an interviewer-administered diet history at years 0, 7, and 20. Higher APDQS implies higher intake of nutritionally-rich plant foods with less high-fat meats and unhealthy plant foods. Low-saturated fat diet was judged by lower the Keys score, based on saturated fat, polyunsaturated fat, and dietary cholesterol intake. Linear and proportional hazards regression models were used, the latter with time-varying average APDQS and CVD outcomes, both adjusted for age, sex, race, education, energy intake, physical activity, smoking, and parental history of CVD (CVD outcome only).
Results
Higher APDQS had higher dietary fiber and lower total and saturated fat. Keys score and APDQS 7-year changes correlated similarly with lower concurrent LDL-C change. During the 32 year follow-up, we documented 280,135, and 92 incident cases of CVD, CHD, and stroke, respectively. LDL-C predicted CVD and CHD, but not stroke. APDQS, but not Keys score, was associated with a lower risk of each CVD outcome. Multivariable-adjusted HRs per 1-SD increment for the APDQS were 0.81 (95% CI: 0.68 − 0.96) for CVD, 0.78 (95% CI: 0.61 − 1.00) for CHD, and 0.71 (95% CI: 0.52 − 0.98) for stroke. The primary results for APDQS and for LDL-C were not substantially altered in mutually adjusted models.
Conclusions
Both a plant-centered and a low-saturated fat diet were associated with lower LDL-C. A plant-centered diet and LDL-C, but not a low-saturated fat diet, were associated with long-term CVD risk. Our findings imply that dietary strategies aimed solely to lower saturated fat may be less effective in reducing CVD burden than recommendations for a plant-centered diet.
Funding Sources
HFHL, MnDRIVE, NHLBI.
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Affiliation(s)
- Yuni Choi
- Division of Epidemiology and Community Health, University of Minnesota
| | - Daniel Gallaher
- Department of Food Science and Nutrition, University of Minnesota
| | | | - Katie Meyer
- Nutrition Department, University of North Carolina
| | - Lyn Steffen
- Division of Epidemiology and Community Health, University of Minnesota
| | - Pamela Schreiner
- Division of Epidemiology and Community Health, University of Minnesota
| | - Daniel Duprez
- Cardiovascular Division, Department of Medicine, University of Minnesota
| | - James Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
| | - Jamal Rana
- Divisions of Cardiology and Research, Kaiser Permanente Northern California, Oakland. Department of Medicine, University of California
| | - David Jr Jacobs
- Division of Epidemiology and Community Health, University of Minnesota
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Prisco A, Deakyne A, Upchurch W, Kapa S, Jacobs D, Iaizzo P, Duprez D. DEEP LEARNING FROM NON-INVASIVE RADIAL ARTERY BLOOD PRESSURE WAVEFORM PREDICTS CARDIOVASCULAR DISEASE EVENTS IN A MULTI-ETHNIC STUDY COHORT: THE MESA STUDY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04568-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Garg PK, Guan W, Nomura S, Weir N, Karger AB, Duprez D, Heckbert SR, Tsai MY. Plasma ω-3 and ω-6 PUFA Concentrations and Risk of Atrial Fibrillation: The Multi-Ethnic Study of Atherosclerosis. J Nutr 2021; 151:1479-1486. [PMID: 33693794 PMCID: PMC8243886 DOI: 10.1093/jn/nxab016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/13/2020] [Accepted: 01/19/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Current literature examining the prospective relation of circulating omega-3 (n-3) and omega-6 (n-6) PUFAs and atrial fibrillation (AF) is limited to predominantly white populations. OBJECTIVES We investigated the association of circulating n-3 and n-6 PUFAs with incident AF in participants from the Multi-Ethnic Study of Atherosclerosis. METHODS A total of 6229 participants (mean age = 62 y; 53% female; 39% white, 27% black, 22% Hispanic, and 12% Chinese) who were free of baseline AF and with plasma phospholipid PUFAs measured at baseline using GC were prospectively followed for the development of AF. Incident AF was ascertained using International Classification of Diseases-9 codes from hospital discharge records and Medicare claims data with follow-up through 2014. Multivariable Cox proportional hazards regression analysis was performed to determine the risk of incident AF. RESULTS During a median follow-up of 12.9 y, 813 (13%) participants developed AF. Each higher SD increment in arachidonic acid (AA; 20:4n-6) concentrations was associated with an 11% decreased risk of incident AF (HR: 0.89; 95% CI: 0.82, 0.96). Similarly, higher overall n-6 PUFA concentrations were also associated with a reduced AF risk (HR per SD increment: 0.93; 95% CI: 0.87, 1.00). Although no significant overall associations were observed for any individual n-3 PUFAs, higher circulating concentrations of DHA (22:6n-3) and EPA (20:5n-3) were associated with a decreased AF risk in blacks and Hispanics (DHA only) but not whites or Chinese Americans. CONCLUSIONS In a multiethnic cohort of individuals free of baseline cardiovascular disease, higher plasma concentrations of n-6 PUFAs, particularly AA, were associated with a reduced risk of incident AF. Important differences in AF risk were also noted across race/ethnicity for the n-3 PUFAs DHA and EPA.
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Affiliation(s)
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University
of Minnesota, Minneapolis, MN, USA
| | - Sarah Nomura
- Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, USA
| | - Natalie Weir
- Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, USA
| | - Amy B Karger
- Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Division of Cardiology, University of Minnesota,
Minneapolis, MN, USA
| | - Susan R Heckbert
- Department of Epidemiology, University of
Washington, Seattle, WA, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, USA
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16
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Steffen LM, Yi SY, Duprez D, Zhou X, Shikany JM, Jacobs DR. Walnut consumption and cardiac phenotypes: The Coronary Artery Risk Development in Young Adults (CARDIA) study. Nutr Metab Cardiovasc Dis 2021; 31:95-101. [PMID: 33097410 PMCID: PMC8574984 DOI: 10.1016/j.numecd.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 04/24/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS Observational studies and clinical trials have shown cardiovascular benefits of nut consumption, including walnuts. However, the relations of walnut consumption with systolic and diastolic function, risk factors for heart failure, are unknown. We examined the associations of walnut consumption with cardiac structure and function parameters in black and white adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS AND RESULTS After exclusions, the study population included 3341 participants. Dietary intake was assessed using the CARDIA Diet History questionnaire at baseline, year 7 and year 20 exams. Cardiac structure and function were measured by echocardiography at year 25. Multivariable linear regression evaluated the associations of walnut consumption with blood pressure (BP), heart rate, and cardiac phenotypes, adjusting for age, sex, race, lifestyle habits, and clinical characteristics. We found the majority of walnut consumers compared to non-consumers were females, whites, and more highly educated, and had lower waist circumference, diastolic BP, and heart rate, and higher diet quality score. Even though cardiac structure and function measures were generally within normal ranges among participants, walnut consumers had significantly better values for diastolic function parameters A wave, E/A ratio, septal and lateral e' than non-consumers. Further adjustment for body mass index and diabetes status did not materially change the significance between walnut consumer groups. Systolic function parameters did not differ by walnut group. CONCLUSION Compared to non-consumers, walnut consumption is associated with better diastolic dysfunction in young to middle-aged adults.
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Affiliation(s)
- Lyn M Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - So Yun Yi
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Cardiology Division, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Xia Zhou
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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17
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Yi SY, Steffen LM, Terry JG, R Jacobs D, Duprez D, Steffen BT, Zhou X, Shikany JM, Harnack L, J Carr J. Added sugar intake is associated with pericardial adipose tissue volume. Eur J Prev Cardiol 2020; 27:2016-2023. [PMID: 32594762 DOI: 10.1177/2047487320931303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM The purpose of this study was to determine the relationships of pericardial adipose tissue and visceral adipose tissue volume with added sugar and sugar-sweetened beverage intakes. We hypothesized that both added sugar and sugar-sweetened beverages were positively associated with pericardial adipose tissue and visceral adipose tissue volumes in black and white men and women enrolled in the prospective Coronary Artery Risk Development in Young Adults study. METHODS AND RESULTS Dietary intake was assessed by diet history at baseline, year 7 and year 20 examinations in 3070 participants aged 18-30 and generally healthy at baseline. After 25 years follow-up, participants underwent a computed tomography scan of chest and abdomen; the computed tomography scans were read, and pericardial adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue volumes were calculated. Quintiles were created for the average of baseline, year 7 and year 20 added sugar and for the average of sugar-sweetened beverages. General linear regression analysis evaluated the associations of pericardial adipose tissue and visceral adipose tissue volumes across quintiles of added sugar and across quintiles of sugar-sweetened beverage intakes adjusted for potential confounding factors. In a multivariable model, pericardial adipose tissue volume was higher across increasing quintiles of added sugar and sugar-sweetened beverage intakes (ptrend = 0.001 and ptrend < 0.001, respectively). A similar relation was observed for visceral adipose tissue (ptrend < 0.001 for both added sugar and sugar-sweetened beverages). CONCLUSIONS Long-term intakes of added sugar and sugar-sweetened beverages were associated with higher pericardial adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue volumes. Because these ectopic fat depots are associated with greater risk of disease incidence, these findings support limiting intakes of added sugar and sugar-sweetened beverages.
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Affiliation(s)
- So-Yun Yi
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - James G Terry
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - Daniel Duprez
- Department of Medicine, University of Minnesota Medical School, USA
| | - Brian T Steffen
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, USA
| | - Xia Zhou
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, USA
| | - Lisa Harnack
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, USA
| | - John J Carr
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center USA
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18
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Logan JG, Kang H, Kim S, Duprez D, Kwon Y, Jacobs DR, Forbang N, Lobo JM, Sohn MW. Association of obesity with arterial stiffness: The Multi-Ethnic Study of Atherosclerosis (MESA). Vasc Med 2020; 25:309-318. [PMID: 32484395 DOI: 10.1177/1358863x20918940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Arterial stiffness (AS) and obesity are recognized as important risk factors of cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between AS and obesity. AS was defined as high augmentation index (AIx) and low elasticity (C1, large artery elasticity; C2, small artery elasticity) in participants enrolled in the Multi-Ethnic Study of Atherosclerosis at baseline. We compared AIx, C1, and C2 by body mass index (BMI) (< 25, 25-29.9, 30-39.9, ⩾ 40 kg/m2) and waist-hip ratio (WHR) (< 0.85, 0.85-0.99, ⩾ 1). The obesity-AS association was tested across 10-year age intervals. Among 6177 participants (62 ± 10 years old, 52% female), a significant inverse relationship was observed between obesity and AS. After adjustments for CVD risk factors, participants with a BMI > 40 kg/m2 had 5.4% lower AIx (mean difference [Δ] = -0.82%; 95% CI: -1.10, -0.53), 15.4% higher C1 (Δ = 1.66 mL/mmHg ×10; 95% CI: 1.00, 2.33), and 40.2% higher C2 (Δ = 1.49 mL/mmHg ×100; 95% CI: 1.15, 1.83) compared to those with a BMI < 25 kg/m2 (all p for trend < 0.001). Participants with a WHR ⩾ 1 had 5.6% higher C1 (∆ = 0.92 mL/mmHg ×10; 95% CI: 0.47, 1.37) compared to those with a WHR < 0.85. The WHR had a significant interaction with age on AIx and C2, but not with BMI; the inverse relationships of the WHR with AIx and C2 were observed only in participants < 55 years between the normal (WHR < 0.85) and the overweight (0.85 ⩽ WHR < 0.99) groups. Different associations of WHR and BMI with arterial stiffness among older adults should be further investigated.
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Affiliation(s)
- Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Hyojung Kang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Soyoun Kim
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Daniel Duprez
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA
| | - Younghoon Kwon
- UVA Heart and Vascular Center Fontaine, University of Virginia, Charlottesville, VA, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Nketi Forbang
- Department of Family Medicine and Public Health, Division of Preventive Medicine, UC San Diego, La Jolla, CA, USA
| | - Jennifer Mason Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Min-Woong Sohn
- Department of Health Management and Policy, University of Kentucky, Lexington, KY, USA
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Choi Y, Jacobs D, Chu H, Duprez D, Gallaher D, Larson N, Shikany J, Schreiner P, Shroff G, Steffen L. A Plant-Centered Diet and Onset of Chronic Kidney Disease in 20 Years of Follow-Up: Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Cohort. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa061_016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Chronic kidney disease (CKD) is an increasing health problem in young adults and may be associated with dietary patterns. We examined the association of a plant-centered diet with incident moderate-to-very high risk CKD in young adults who were initially free of CKD.
Methods
We followed 3026 community-based participants (Black and White men and women) from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (1985–86 to 2015–16). Diet was assessed by an interviewer-administered diet history at exam years (Y) 0, 7, and 20. Higher plant-centered diet quality was judged by higher cumulative average value of the A Priori Diet Quality Score (APDQS, range 0–132), a hypothesis-driven index based on 46 food groups. A higher APDQS is characterized by high consumption of nutritionally rich plant foods and limited meat, added sugars, and other less nutritious foods. Kidney status, assessed at 5-year intervals from Y10 to Y30, was based on estimated glomerular filtration rate (eGFR) using CKD-EPI creatinine equation and spot urine albumin-to-creatinine ratio (ACR). CKD diagnosis included new onset of micro- or macro-albuminuria (ACR ≥30 mg/g), eGFR <60 mL/min/1.73m,2, or (hospitalized or fatal) end stage renal disease. Prevalent CKD cases throughout Y10 were excluded. Proportional hazards regression estimated the association of time-varying cumulative average APDQS with incident CKD, adjusted for age, sex, race, education, energy intake, % energy from protein, physical activity, and smoking.
Results
Mean Y10 age was 35.1 y (±3.6 y) and mean cumulative average APDQS was 65.0 (±11.4). We identified 358 incident CKD cases (59 of whom were severe cases) during mean follow-up of 17.7 years (±4.4) after Y10. Eating a plant-centered, high quality diet was associated with a lower risk of incident CKD. In multivariable analysis, participants in the highest quintile of the APDQS had 37% (95% confidence interval: 0.41–0.97) lower risk of CKD as compared with those in the lowest quintile of the APDQS. For each 11-point increment in APDQS, there was 15% lower risk of CKD (0.74–0.97). The association remained similar after further adjustment for prevalent cases of hypertension and diabetes.
Conclusions
A plant-centered, high quality diet was associated with a lower risk of developing CKD.
Funding Sources
CARDIA and MnDRIVE (University of Minnesota).
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Affiliation(s)
- Yuni Choi
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities
| | - David Jacobs
- Division of Epidemiology & Community Health, University of Minnesota-Twin Cities
| | - Haitao Chu
- Division of Biostatistics, University of Minnesota-Twin Cities
| | - Daniel Duprez
- Cardiovascular Division, University of Minnesota Medical School
| | - Daniel Gallaher
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities
| | - Nicole Larson
- Division of Epidemiology & Community Health, University of Minnesota-Twin Cities
| | - James Shikany
- Depatment of Medicine, University of Alabama Birmingham
| | - Pamela Schreiner
- Division of Epidemiology & Community Health, University of Minnesota-Twin Cities
| | - Gautam Shroff
- Cardiovascular Division, Hennepin County Medical Center; University of Minnesota Medical School
| | - Lyn Steffen
- Division of Epidemiology & Community Health, University of Minnesota-Twin Cities
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Jurgens P, Carr JJ, Terry J, Rana JS, Jacobs DR, Duprez D. ASSOCIATION OF CORONARY ARTERY CALCIUM AND ABDOMINAL AORTA CALCIUM WITH INCIDENT FATAL AND NON-FATAL CARDIOVASCULAR DISEASE EVENTS: THE CORONARY ARTERY RISK DEVELOPMENT IN YOUNG ADULTS STUDY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32506-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Mulrooney DA, Hyun G, Ness KK, Ehrhardt MJ, Yasui Y, Duprez D, Howell RM, Leisenring WM, Constine LS, Tonorezos E, Gibson TM, Robison LL, Oeffinger KC, Hudson MM, Armstrong GT. Major cardiac events for adult survivors of childhood cancer diagnosed between 1970 and 1999: report from the Childhood Cancer Survivor Study cohort. BMJ 2020; 368:l6794. [PMID: 31941657 PMCID: PMC7190022 DOI: 10.1136/bmj.l6794] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the impact of modifications to contemporary cancer protocols, which minimize exposures to cardiotoxic treatments and preserve long term health, on serious cardiac outcomes among adult survivors of childhood cancer. DESIGN Retrospective cohort study. SETTING 27 institutions participating in the Childhood Cancer Survivor Study. PARTICIPANTS 23 462 five year survivors (6193 (26.4%) treated in the 1970s, 9363 (39.9%) treated in the 1980s, and 7906 (33.6%) treated in the 1990s) of leukemia, brain cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, renal tumors, neuroblastoma, soft tissue sarcomas, and bone sarcomas diagnosed prior to age 21 years between 1 January 1970 and 31 December 1999. Median age at diagnosis was 6.1 years (range 0-20.9) and 27.7 years (8.2-58.3) at last follow-up. A comparison group of 5057 siblings of cancer survivors were also included. MAIN OUTCOME MEASURES Cumulative incidence and 95% confidence intervals of reported heart failure, coronary artery disease, valvular heart disease, pericardial disease, and arrhythmias by treatment decade. Events were graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. Multivariable subdistribution hazard models were used to estimate hazard ratios by decade, and mediation analysis examined risks with and without exposure to cardiotoxic treatments. RESULTS The 20 year cumulative incidence of heart failure (0.69% for those treated in the 1970s, 0.74% for those treated in the 1980s, 0.54% for those treated in the 1990s) and coronary artery disease (0.38%, 0.24%, 0.19%, respectively), decreased in more recent eras (P<0.01), though not for valvular disease (0.06%, 0.06%, 0.05%), pericardial disease (0.04%, 0.02%, 0.03%), or arrhythmias (0.08%, 0.09%, 0.13%). Compared with survivors with a diagnosis in the 1970s, the risk of heart failure, coronary artery disease, and valvular heart disease decreased in the 1980s and 1990s but only significantly for coronary artery disease (hazard ratio 0.65, 95% confidence interval 0.45 to 0.92 and 0.53, 0.36 to 0.77, respectively). The overall risk of coronary artery disease was attenuated by adjustment for cardiac radiation (0.90, 0.78 to 1.05), particularly among survivors of Hodgkin lymphoma (unadjusted for radiation: 0.77, 0.66 to 0.89; adjusted for radiation: 0.87, 0.69 to 1.10). CONCLUSIONS Historical reductions in exposure to cardiac radiation have been associated with a reduced risk of coronary artery disease among adult survivors of childhood cancer. Additional follow-up is needed to investigate risk reductions for other cardiac outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT01120353.
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Affiliation(s)
- Daniel A Mulrooney
- Division of Cancer Survivorship, Department of Oncology, St Jude Children's Research Hospital, MS 735, 262 Danny Thomas Place, Memphis, TN 38105, USA
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Geehong Hyun
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Matthew J Ehrhardt
- Division of Cancer Survivorship, Department of Oncology, St Jude Children's Research Hospital, MS 735, 262 Danny Thomas Place, Memphis, TN 38105, USA
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Daniel Duprez
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca M Howell
- Department of Radiation Physics, University of Texas at MD Anderson Cancer Center, Houston, TX, USA
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Louis S Constine
- Departments of Radiation Oncology and Pediatrics, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Emily Tonorezos
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Todd M Gibson
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Melissa M Hudson
- Division of Cancer Survivorship, Department of Oncology, St Jude Children's Research Hospital, MS 735, 262 Danny Thomas Place, Memphis, TN 38105, USA
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
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22
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Boulanger CM, Baretella O, Blaise G, Bond RA, Cai Y, Chan CKY, Chataigneau T, Chen MJ, Chen H, Cheng Y, Clement DL, Cohen RA, Collis M, Danser AHJ, de Mey J, Detremmerie CMS, Duprez D, Feletou M, Flavahan N, Gao Y, Guo Y, Hoeffner U, Houston DS, Huang IB, Huang Y, Iliano S, Junquero D, Katusic ZS, Komori K, Lee MYK, Leung SWS, Li Z, Liang SC, Liu JTC, Luscher TF, Michel F, Miller VM, Mombouli JV, Morrison K, Muldoon SM, O'Rourke S, Perrault L, Quignard JF, Rusch NJ, Sanchez-Ferrer CF, Schini-Kerth V, Shen K, Shi Y, Song E, Sun KWY, Taddei S, Tang EHC, Tuncer M, van den Ende R, Vedernikov Y, Verbeuren TJ, Webb C, Weigert A, Wong KHK, Xu C, Yang K, Ying F, Zellers T, Zhao Y, Zou Q, Shimokawa H. Tribute to Paul M. Vanhoutte, MD, PhD (1940-2019). Arterioscler Thromb Vasc Biol 2019; 39:2445-2447. [PMID: 31770032 DOI: 10.1161/atvbaha.119.313461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | - Yin Cai
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | | | | | | | - Hui Chen
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | - Yanhua Cheng
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | | | | | | | | | - Jo de Mey
- University of Southern Denmark (J.D.M.)
| | | | | | | | | | | | - Yumeng Guo
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | - Ute Hoeffner
- Glenmark Pharmaceuticals, Gröbenzell, Germany (U.H.)
| | | | | | - Yu Huang
- Chinese University of Hong Kong, Hong Kong, PRC (I.B.H., Y.H., F.Y.)
| | | | | | | | | | - Mary Y K Lee
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | - Susan W S Leung
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | - Zhuoming Li
- Sun Yat-sen University, Guangzhou, China (Z.L.)
| | - Sophie Chaofan Liang
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | - Jacky Tsz Chiu Liu
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | - Thomas F Luscher
- Royal Brompton & Harefield Hospitals, London, United Kingdom (T.F.L.)
| | - Frederic Michel
- University of the Witwatersrand, Johannesburg, South Africa (F.M.)
| | | | | | - Keith Morrison
- Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland (K.M.)
| | | | | | | | | | - Nancy J Rusch
- University of Arkansas for Medical Sciences, Little Rock (N.J.R.)
| | | | | | - Kaikai Shen
- Shanghai University of Traditional Chinese Medicine, China (K.S.)
| | - Yi Shi
- Zhongshan Hospital Fudan University, China (Y.S.)
| | - Erfei Song
- Jinan University, Guangzhou, China (E.S.)
| | - Kiwi W Y Sun
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | | | - Eva Hoi Ching Tang
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | | | | | | | | | | | - André Weigert
- Hospital S. Cruz, University of Lisbon, Portugal (A.W.)
| | - Kenneth H K Wong
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
| | - Cheng Xu
- Shenzhen University, China (C.X.)
| | | | - Fan Ying
- Chinese University of Hong Kong, Hong Kong, PRC (I.B.H., Y.H., F.Y.)
| | - Thomas Zellers
- University of Texas Southwestern Medical Center, Dallas (T.Z.)
| | - Yingzi Zhao
- Chinese Academy of Sciences, Shenzhen, China (Y.Z.)
| | - Qian Zou
- University of Hong Kong, PRC (Y. Cai, H.C., Y. Cheng, Y. Guo, M.Y.K.L., S.W.S.L., S.C.L., J.T.C.L., K.W.Y.S., E.H.C.T., K.H.K.W., Q.Z.)
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Steffen BT, Duprez D, Bertoni AG, Guan W, Tsai MY. Lp(a) [Lipoprotein(a)]-Related Risk of Heart Failure Is Evident in Whites but Not in Other Racial/Ethnic Groups. Arterioscler Thromb Vasc Biol 2019; 38:2498-2504. [PMID: 30354212 DOI: 10.1161/atvbaha.118.311220] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective- Lp(a) [lipoprotein(a)] levels vary by race/ethnicity and were recently found to be associated with risk of heart failure (HF). We aimed to determine whether Lp(a)-related risk of HF is similar across different races and whether Lp(a) may further be related to HF with reduced ejection fraction or HF with preserved ejection fraction (HFpEF). Approach and Results- In 6809 participants of the MESA (Multi-Ethnic Study of Atherosclerosis), aged 45 to 84 years and free of cardiovascular disease, 308 incident HF events occurred during a median 13-year follow-up. Baseline Lp(a) concentrations were determined by immunoassay. Incident HF was adjudicated, distinguishing HF with reduced ejection fraction (ejection fraction, <45%) from HFpEF (ejection fraction, ≥45%). Cox regression assessed relations between Lp(a) and HF risk among 4 races/ethnicities. Lp(a) was examined as a continuous variable (per log unit) and using clinical cutoff values, 30 and 50 mg/dL. Lp(a) was related to greater risk of HF in whites alone: per log unit Lp(a) (hazard ratio [HR], 1.20; P=0.02); Lp(a) ≥30 mg/dL (HR, 1.69; P=0.01), Lp(a) ≥50 mg/dL (HR, 1.87; P=0.006). No significant relations were found in black, Hispanic, or Chinese participants, and significant race interactions were observed. Lp(a) was additionally related to greater risk of HFpEF in white participants: per log unit Lp(a) (HR, 1.48; P=0.001), Lp(a) ≥30 mg/dL (HR, 2.15; P=0.01), Lp(a) ≥50 mg/dL (HR, 2.60; P=0.004). Lp(a)-related risk of HF and HFpEF in whites was independent of aortic valve disease. Conclusions- In a multiethnic sample, Lp(a)-related risks of HF and HFpEF were only evident in white participants. If confirmed, these findings have implications in further Lp(a) research and clinical practice.
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Affiliation(s)
- Brian T Steffen
- From the Department of Laboratory Medicine and Pathology (B.T.S., M.Y.T.), University of Minnesota, Minneapolis
| | - Daniel Duprez
- Department of Medicine (D.D.), University of Minnesota, Minneapolis
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.)
| | - Weihua Guan
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis (W.G.)
| | - Michael Y Tsai
- From the Department of Laboratory Medicine and Pathology (B.T.S., M.Y.T.), University of Minnesota, Minneapolis
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24
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Kwon Y, Logan J, Redline S, Duprez D, Jacobs DR, Ouyang P, Hundley WG, Lima J, Bluemke DA, Lutsey PL. Obstructive Sleep Apnea and Structural/Functional Properties of the Thoracic Ascending Aorta: The Multi-Ethnic Study of Atherosclerosis (MESA). Cardiology 2019; 142:180-188. [PMID: 31189162 DOI: 10.1159/000499500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/10/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Structural and functional properties of the proximal thoracic aorta have important implications in clinical and subclinical cardiovascular disease (CVD). We examined whether obstructive sleep apnea (OSA) is associated with proximal aortic size and aortic stiffness in a multi-ethnic community-based cohort. METHODS The sample included the Multi-Ethnic Study of Atherosclerosis (MESA) Sleep Ancillary study participants without known CVD who underwent cardiac magnetic resonance imaging. The main exposure variable was OSA severity based on the polysomnography-derived apnea hypopnea index (AHI; normal, AHI <5/h; mild, 5≤ AHI <15/h; moderate to severe, AHI ≥15/h). The study outcomes were ascending aortic diameter (AoD, cm), aortic pulse wave velocity (AoPWV, m/s), and ascending aortic distensibility (AAD, %/mm Hg). Analyses were performed in the overall sample and in sex-specific strata, adjusted for multiple potential confounders. RESULTS The 708 participants were 55.9% female and on average 68 years old (54-93 years). There was a significant trend (p < 0.0001) of greater mean (SD) AoD across the three OSA groups: normal (n = 87), 3.13 cm (0.35); mild (n = 215), 3.25 (0.34); moderate to severe (n = 406), 3.37 (0.36). In adjusted analysis, participants with moderate to severe OSA had a greater mean AoD compared with the normal group: adjusted mean difference (95% CI), 0.12 cm (0.05, 0.20), p = 0.002. This AoD gradient was observed in women but not in men (p for interaction = 0.02). No differences were found in AoPWV or AAD among the OSA groups. CONCLUSION In a diverse community-based cohort, moderate to severe OSA (vs. no OSA) was associated with a larger ascending AoD in women.
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Affiliation(s)
- Younghoon Kwon
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA,
| | - Jeongok Logan
- School of Nursing, University of Virginia, Charlottesville, Virginia, USA
| | - Susan Redline
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel Duprez
- Department of Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - David R Jacobs
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Pamela Ouyang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - W Greg Hundley
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Joao Lima
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA
| | - Pamela L Lutsey
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Mulrooney DA, Hyun G, Ness KK, Ehrhardt MJ, Yasui Y, Duprez D, Howell RM, Leisenring W, Constine LS, Oeffinger KC, Gibson TM, Tonorezos ES, Robison LL, Hudson MM, Armstrong GT. Cardiac events in survivors of childhood cancer treated in more recent eras: A report from the Childhood Cancer Survivor Study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.10058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10058 Background: Contemporary cancer protocols have incorporated modifications to minimize cardiotoxic exposures and preserve long-term health. We investigated the impact of these changes on late cardiac outcomes in a large cohort of adult survivors of childhood cancer. Methods: Congestive heart failure (CHF), myocardial infarction (MI), valvular disease, pericardial disease, and arrhythmias were graded by the National Cancer Institute’s Common Terminology Criteria for Adverse Events among 23,462 five-year cancer survivors [6,193 (26%) treated in the 1970s, 9,363 (40%) in the 1980s, and 7,906 (34%) in the 1990s] and 5,057 siblings. Cumulative incidence and 95% confidence intervals (95% CI) were estimated by treatment decade. Adjusted multivariable subdistribution hazard models were used to estimate hazard ratios (HR) and 95% CI for cardiac outcomes by decade. Mediation analysis examined risks with and without cardiotoxic exposures. Results: For survivors [median age 6 years (range: 0-21) at diagnosis, 28 years (8.2-58) at follow-up], cardiac radiation (RT) exposure declined from 77% of those treated in the 1970s to 55% and 40% in the 1980s and 1990s. Anthracycline exposure increased from 28% to 50% to 64%. The 20-year cumulative incidence of CHF (0.69% for those treated in 1970s, 0.74% in the 1980s, 0.54% in the 1990s) and MI (0.38%, 0.24%, 0.19%) declined in more recent treatment eras (p < 0.01). This change was not seen for valvular disease (0.06%, 0.06%, 0.05%), pericardial disease (0.04%, 0.02%, 0.03%) or arrhythmias (0.08%, 0.09%, 0.13%). Compared to survivors diagnosed in the 1970s, the risk of CHF, MI, and valvular disease decreased in the 1980s and 1990s, but only significantly for MI (HR 0.64 95% CI 0.47-0.89 and 0.52 95% CI 0.32-0.83). The overall MI risk was attenuated by adjustment for cardiac RT exposure (HR 0.94 95% CI 0.80-1.11), mostly among Hodgkin lymphoma (HL) survivors (HR 0.82 95% CI 0.69-0.98 [unadjusted for RT]; 1.03 95% CI 0.83-1.28 [adjusted for RT]). Conclusions: Reductions in exposure to cardiotoxic cancer therapies have resulted in declines in adverse cardiac outcomes, particularly for the RT-associated risk of myocardial infarction among HL survivors.
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Affiliation(s)
| | - Geehong Hyun
- St. Jude Children's Research Hospital, Memphis, TN
| | | | | | - Yutaka Yasui
- St. Jude Children's Research Hospital, Memphis, TN
| | | | - Rebecca M. Howell
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - Emily S. Tonorezos
- Adult Long Term Follow-Up Program, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY
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Steffen BT, Thanassoulis G, Duprez D, Stein JH, Karger AB, Tattersall MC, Kaufman JD, Guan W, Tsai MY. Race-Based Differences in Lipoprotein(a)-Associated Risk of Carotid Atherosclerosis. Arterioscler Thromb Vasc Biol 2019; 39:523-529. [PMID: 30727753 PMCID: PMC6393189 DOI: 10.1161/atvbaha.118.312267] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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] [Indexed: 01/01/2023]
Abstract
Objective- Lp(a) [lipoprotein(a)] is a well-described risk factor for atherosclerosis, but Lp(a)-associated risk may vary by race/ethnicity. We aimed to determine whether race/ethnicity modifies Lp(a)-related risk of carotid atherosclerotic plaque outcomes among black, white, Chinese, and Hispanic individuals. Approach and Results- Carotid plaque presence and score were assessed by ultrasonography at baseline (n=5155) and following a median 9.4 year period (n=3380) in MESA (Multi-Ethnic Study of Atherosclerosis) participants. Lp(a) concentrations were measured by immunoassay and examined as a continuous and categorical variable using clinically-based cutoffs, 30 and 50 mg/dL. Lp(a) was related to greater risk of prevalent carotid plaque at baseline in whites alone (all P<0.001): per log unit (relative risk, 1.05); Lp(a)≥30 mg/dL (relative risk, 1.16); and Lp(a)≥50 mg/dL (relative risk, 1.20). Lp(a) levels over 50 mg/dL were associated with a higher plaque score at baseline in whites (all P<0.001) and Hispanics ( P=0.04). In prospective analyses, whites with Lp(a) ≥50 mg/dL were found to have greater risk of plaque progression (relative risk, 1.12; P=0.03) and higher plaque scores (all P<0.001) over the 9.4-year follow-up. Race-based differences between whites and black participants were significant for cross-sectional associations and for carotid plaque score following the 9.4 year study period. Conclusions- Race was found to be a modifying variable in Lp(a)-related risk of carotid plaque, and Lp(a) levels may have greater influence on plaque burden in whites than in black individuals. Borderline results in Hispanics suggest that elevated Lp(a) may increase the risk of carotid plaque, but follow-up studies are needed.
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Affiliation(s)
- Brian T. Steffen
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA
| | | | - Daniel Duprez
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - James H. Stein
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin, Madison, WI 53792
| | - Amy B. Karger
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Mathew C. Tattersall
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin, Madison, WI 53792
| | - Joel D. Kaufman
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98105
| | - Weihua Guan
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Michael Y. Tsai
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA
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Blaes AH, Petersen A, Beckwith H, Potter D, Florea N, Yee D, Vogel R, Duprez D. Abstract P1-12-06: Endothelial dysfunction in breast cancer survivors on aromatase inhibitors (AIs) over time. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-12-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Endothelial dysfunction in breast cancer survivors on aromatase inhibitors (AIs) over time
Background: AIs reduce breast cancer-related mortality however they may increase cardiovascular (CV) risk. Our previously published cross-sectional study suggested women on AIs were more likely to have endothelial dysfunction when measured by EndoPAT ratio as compared to healthy postmenopausal women. Reductions in EndoPAT ratio (<1.67) and small artery elasticity (SAE) and increases in highly sensitive C-reactive protein (CRP) are associated with worsening endothelial dysfunction and increased cardiovascular events. We present data from a longitudinal pilot study looking at endothelial dysfunction over time in women on AIs.
Methods: Fourteen women with locally advanced breast cancer prescribed an AI underwent vascular testing at baseline (pre-AI) and at 6 months. Subjects with tobacco use, hypertension or hyperlipidemia were excluded. Consented subjects underwent biomarker analysis and radial artery pulse wave analysis using the HDI/Pulse Wave CR-2000 CV Profiling System and pulse contour analysis using the Endo-PAT2000 system. Biomarkers were obtained using a fasting blood draw to evaluate the following lipids and inflammatory markers: serum ultrasensitive estradiol, serum glucose, total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides (TG), CRP, plasminogen-activator 1 (PA1), and tissue-type plasminogen activator (tPA). Changes between baseline and follow-up using Wilcoxon signed-rank tests were analyzed.
Results: Mean baseline age was 59 years and median body mass index was 26.5 kg/m2. Median systolic blood pressure and total cholesterol were 120/70 mm/Hg and 228 mg/dL, respectively. Baseline ultrasensitive estradiol levels were 7 pg/mL and hsCRP was 2.45 mg/dL. Prior to AI therapy, endoPAT ratio was 2.18 (1.19, 2.43). After six months, EndoPAT ratio declined to a median 1.12 (0.85, 1.86) (p=0.045). There were no statistically significant changes in serum glucose, TC, LDL, HDL, hsCRP, PA1 and tPA. HsCRP remained elevatedat median 2.98 mg/L. At six months, estradiol levels decreased to a median of 2 pg/mL (p=0.052), however, there appeared to be no linear association between changes in EndoPAT and estradiol (p=0.91).
Conclusion: Breast cancer survivors on AIs have endothelial dysfunction, a predictor of adverse CV disease. These changes develop while on AIs. Underlying pathophysiology requires further evaluation.
Cardiovascular markersMeasuresBaselineFollow-Up at 6 MonthsChangeP-valueBMI (kg/m2)26.5 (24.4, 31.6)27.1 (23.9, 32.9)0.5 (0.0, 1.3)0.056SBP (mmHg)120 (115, 124)123 (114, 127)-0.8 (-7.4, 3.6)0.91DBP (mmHg)70 (61, 73)69 (62, 71)0.0 (-3.0, 2.6)0.88Total Cholesterol (mg/dL)228 (202, 244)213 (210, 229)-1 (-18, 27)0.70HDL (mg/dL)64 (58, 69)73 (61, 77)2 (-3, 14)0.44LDL (mg/dL)143 (121, 159)129 (120, 142)6 (-11, 14)0.65Estradiol (pg/mL)7 (4, 15)2 (2, 3)-8 (-12, -3)0.05hsCRP (mg/dL)2.45 (1.14, 6.07)2.98 (0.90, 4.81)-8 (-12, -3)0.85EndoPAT Ratio2.18 (1.19, 2.43)1.12 (0.85, 1.86)-0.16 (-1.45, -0.02)0.0451.Summaries shown are median (1st quartile, 3rd quartile).
Citation Format: Blaes AH, Petersen A, Beckwith H, Potter D, Florea N, Yee D, Vogel R, Duprez D. Endothelial dysfunction in breast cancer survivors on aromatase inhibitors (AIs) over time [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-12-06.
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Affiliation(s)
- AH Blaes
- University of Minnesota, Minneapolis, MN
| | - A Petersen
- University of Minnesota, Minneapolis, MN
| | - H Beckwith
- University of Minnesota, Minneapolis, MN
| | - D Potter
- University of Minnesota, Minneapolis, MN
| | - N Florea
- University of Minnesota, Minneapolis, MN
| | - D Yee
- University of Minnesota, Minneapolis, MN
| | - R Vogel
- University of Minnesota, Minneapolis, MN
| | - D Duprez
- University of Minnesota, Minneapolis, MN
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Fonseca J, Bion N, Licea YE, Morais CM, Rangel MDC, Duprez D, Epron F. Unexpected redox behaviour of large surface alumina containing highly dispersed ceria nanoclusters. Nanoscale 2019; 11:1273-1285. [PMID: 30603748 DOI: 10.1039/c8nr07898j] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cerium-containing oxide materials have several very interesting applications due to their capacity to store and release oxygen under oxidizing and reducing conditions respectively. In the case of pure ceria this property is highly size dependent inasmuch as the phenomenon is limited to the surface and subsurface oxygen atoms. As a consequence, the design of nanocrystals of ceria has been attracting much attention. In this paper, the evaporation-induced self-assembly method was used to prepare a series of mixed oxide materials composed of nanoclusters of ceria very well dispersed over large surface mesoporous alumina. We observed a total and reversible reduction of Ce4+ into Ce3+ at 400 °C for the materials with a Ce loading between 20 and 35 wt%. A combination of analyses including in situ X-ray diffraction, temperature-programmed reduction, oxygen storage capacity, isotopic exchange, 27-Al and 17-O solid state NMR, and X-ray absorption spectroscopy at the Ce L3-edge was employed to investigate this unexpected redox behavior. The results reveal that the strong structural disorder observed in both CeO2 and Al2O3 nanoclusters favors the formation of non-crystallized CeAlO3 pseudo phase at the interface between the two oxides.
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Affiliation(s)
- Juliana Fonseca
- Institut de Chimie des Milieux et Matériaux de Poitiers (IC2MP), University of Poitiers, CNRS, 4 rue Michel Brunet, TSA51106, F86073 Poitiers Cedex 9, France.
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White WB, Duprez D. Aldosterone Antagonism and Arterial Stiffness. Hypertension 2019. [DOI: 10.1161/01.hyp.0000112027.53492.5a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Kwon Y, Misialek JR, Duprez D, Jacobs DR, Alonso A, Heckbert SR, Zhao YY, Redline S, Soliman EZ. Sleep-disordered breathing and electrocardiographic QRS-T angle: The MESA study. Ann Noninvasive Electrocardiol 2018; 23:e12579. [PMID: 29963729 DOI: 10.1111/anec.12579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 06/06/2018] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Sleep-disordered breathing (SDB) has been linked to sudden cardiac death (SCD) but the mechanism is unclear. Abnormal QRS-T angle, a novel electrocardiographic (ECG) marker of ventricular repolarization, has been linked to adverse cardiovascular outcomes including SCD. We hypothesized that individuals with SDB have more pronounced abnormality in QRS-T angle. METHODS We performed a cross-sectional analysis from the Multi-Ethnic Study of Atherosclerosis (MESA) Exam Sleep ancillary study. We calculated the odds ratio (OR) of abnormal frontal and spatial QRS-T angle (defined as >sex-specific 95th percentile thresholds) related to the apnea-hypopnea index (AHI) using logistic regression, adjusting for demographics, body habitus, cardiovascular risks, and prevalent cardiovascular disease. Linear associations between AHI and frontal and spatial QRS-T angle, separately, were also examined using multiple regression models. RESULTS A total of 1,804 participants (mean age 67.9 (±9.0) years, 55.3% women and 64.1% non-whites) were included in the study. Sleep-disordered breathing was common among participants (median AHI 8.6 events/hr IQR [3.2-19.5/hr]). Higher AHI was associated with the odds of abnormal frontal (≥81° in men and ≥79° in women) and spatial QRS-T angle (≥129.7° in men and ≥115.9° in women; OR [95%CI]: 1.25 [1.02-1.51], p = 0.03; 1.23 [1.01-1.50], p = 0.04 respectively per 1 SD [16.8 events/hr] increase in AHI). Similarly, linear associations were observed (frontal QRS-T angle: beta coefficient: 2.30° [0.92, 3.66], p = 0.001; spatial QRS-T angle: beta coefficient: 2.16° [0.67, 3.64], p = 0.005). CONCLUSION In a racially/ethnically diverse community cohort, severity of SDB is associated with abnormal ventricular repolarization as measured by QRS-T angle.
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Affiliation(s)
- Younghoon Kwon
- Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Jeffrey R Misialek
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Daniel Duprez
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Ying Y Zhao
- Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.,Sleep Disorders Clinic, Hamilton, Ontario, Canada
| | - Susan Redline
- Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Elsayed Z Soliman
- Department of Epidemiology, Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Department of Medicine-Cardiology Section, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Kwon Y, Misialek JR, Duprez D, Alonso A, Jacobs DR, Heckbert SR, Redline S, Soliman EZ. Association between sleep disordered breathing and electrocardiographic markers of atrial abnormalities: the MESA study. Europace 2018; 19:1759-1766. [PMID: 28017934 DOI: 10.1093/europace/euw328] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 09/21/2016] [Indexed: 11/14/2022] Open
Abstract
Aims Electrocardiographic (ECG) markers of left atrial (LA) abnormalities have been linked to increased risk of atrial fibrillation (AF). Sleep disordered breathing (SDB) has been associated with increased risk of AF. We aimed to examine the association of ECG markers of LA abnormalities with SDB. Methods and results 1546 participants (mean age 67.2 years, 53.4% women, and 63.3% non-whites) from the Multi-Ethnic Study of Atherosclerosis Exam 5 Sleep ancillary study were included in this analysis. ECG markers of LA abnormalities (P wave terminal force in V1 (PTFV1), maximum P wave duration, PR interval and heart rate corrected PR interval) were measured from resting standard digital ECG tracings using standardized processing. Linear and logistic regression analyses were utilized to examine the cross-sectional associations of measures of SDB (apnea hypopnea index [AHI] and % time spent with oxygen saturation <90% [%SpO290]) with each ECG marker. In a multivariable analysis adjusting for demographics, cardiovascular risk factors, and comorbidities, AHI was associated with greater PTFV1 but not with other ECG markers of LA abnormalities. A 1-SD increase of AHI (16.6/hr) was associated with higher levels of PTFV1 (175.1 µV.ms, 95% confidence interval [95%CI] 75.4, 274.7) and higher odds of abnormally elevated PTFV1 (≥4000 µV.ms) (Odds Ratio: 1.21 [95%CI 1.05, 1.39]). No association was found between %SpO290 and ECG markers of LA abnormalities. Conclusion Severity of SDB, as measured by AHI, is associated with subclinical LA disease, as indicated by PTFV1. PTFV1 may be an important ECG marker linking SDB and AF.
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Affiliation(s)
- Younghoon Kwon
- Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, 55455 MN, USA.,Division of Cardiovascular Medicine, University of Virginia, 800158 Charlottesville, VA, USA
| | - Jeffrey R Misialek
- Division of Cardiology, University of Minnesota, Minneapolis, 55455 MN, USA
| | - Daniel Duprez
- Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, 55455 MN, USA.,Division of Cardiology, University of Minnesota, Minneapolis, 55455 MN, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, 30322 GA, USA
| | - David R Jacobs
- School of Public Health, University of Minnesota, Minneapolis, 55455 MN, USA
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, 98101 WA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, 02115 MA, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, 27157 NC, USA
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Blaes AH, Beckwith HC, Hebbel RP, Solovey AS, Potter D, Yee D, Petersen A, Vogel RI, Luepker RV, Duprez D. Longitudinal follow-up of endothelial function in breast cancer survivors on aromatase inhibitors (AIs). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e12525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - David Potter
- University of Minnesota Department of Medicine, Minneapolis, MN
| | - Douglas Yee
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
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Peterson TE, Huppler Hullsiek K, Wyman Engen N, Kumarasamy N, Lebech AM, Liappis A, Papadopoulos A, Polizzotto MN, Schreiner PJ, Duprez D, Baker JV. Inflammation Associates With Impaired Small Arterial Elasticity Early in HIV Disease. Open Forum Infect Dis 2018; 5:ofy117. [PMID: 29942822 PMCID: PMC6007791 DOI: 10.1093/ofid/ofy117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/17/2018] [Indexed: 01/26/2023] Open
Abstract
We estimated small arterial elasticity and used linear regression to evaluate its association with inflammatory biomarkers among antiretroviral therapy–naïve, HIV-positive patients with high CD4+ counts. After adjustment, high-sensitivity C-reactive protein and interleukin-6 were inversely associated with small arterial elasticity. These data suggest that systemic inflammation may contribute to vascular dysfunction even in very early HIV disease.
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Affiliation(s)
| | | | - Nicole Wyman Engen
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | | | - Anne-Mette Lebech
- Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Angelike Liappis
- Section of Infectious Diseases, Washington DC Veterans Affairs Medical Center, Washington, DC
| | - Antonios Papadopoulos
- 4th Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Mark N Polizzotto
- Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia
| | | | - Daniel Duprez
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Jason V Baker
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota.,Infectious Diseases, Hennepin County Medical Center, Minneapolis, Minesota
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Kwon Y, Logan J, Redline S, Duprez D, Jacobs DR, Ouyang P, Hundley WG, Lima J, Bluemke DA, Lutsey PL. 0465 Structural And Functional Properties Of Thoracic Ascending Aorta In Obstructive Sleep Apnea (the Multi-ethnic Study Of Atherosclerosis [mesa] Study). Sleep 2018. [DOI: 10.1093/sleep/zsy061.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Kwon
- University of Virginia School of Medicine, Charlottesvillee, VA
| | - J Logan
- University of Virginia School of Nursing, Charlottesville, VA
| | - S Redline
- Brigham & Women’s Hospital; Harvard Medical School, Boston, MA
| | - D Duprez
- University of Minnesota School of Medicine, Minneapolis, MN
| | - D R Jacobs
- University of Minnesota School of Public Health, Minneapolis, MN
| | - P Ouyang
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - W G Hundley
- Wake Forest University School of Medicine, Winston-Salem, NC
| | - J Lima
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - D A Bluemke
- University of Wisconsin School of Medicine, Madison, WI
| | - P L Lutsey
- University of Minnesota School of Public Health, Minneapolis, MN
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Duprez D, Toleuova A. Mineralocorticoid Receptor Antagonists Treatment in Resistant Hypertension and HFpEF: Evidence and Courage. Am J Hypertens 2018; 31:405-406. [PMID: 29329357 DOI: 10.1093/ajh/hpy003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/05/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Daniel Duprez
- Cardiovascular Division, Department of Medicine, Medical School University of Minnesota, Minneapolis, Minnesota, USA
| | - Aigerim Toleuova
- Department of Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
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Steffen BT, Duprez D, Szklo M, Guan W, Tsai MY. Circulating oleic acid levels are related to greater risks of cardiovascular events and all-cause mortality: The Multi-Ethnic Study of Atherosclerosis. J Clin Lipidol 2018; 12:1404-1412. [PMID: 30201531 PMCID: PMC6289878 DOI: 10.1016/j.jacl.2018.08.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Limited evidence has suggested that circulating levels of the omega-9 fatty acid, oleic acid, may be related to greater risks of adverse cardiovascular outcomes. OBJECTIVE We aimed to determine whether plasma oleic acid may be independently associated with clinical and subclinical cardiovascular disease (CVD) and all-cause mortality in a large multiethnic cohort. METHODS Plasma fatty acids were measured by gas chromatography-flame ionization in 6568 participants of the Multi-Ethnic Study of Atherosclerosis. The presence of coronary artery calcium (CAC) and aortic valve calcification (AVC) was determined by computed tomography, and carotid plaque was assessed by ultrasound. Incident CVD was defined as myocardial infarction, fatal coronary heart disease, resuscitated cardiac arrest, stroke, or stroke death. Heart failure (HF) was adjudicated from clinical records. Relative risk regression estimated plasma oleic acid-related rate ratios for prevalent CAC, AVC, and carotid plaque. Cox regression estimated hazard ratios (HRs) for CVD, HF, and all-cause mortality over a median 13-year follow-up. RESULTS Individuals in top quartiles of oleic acid showed greater rate ratios of CAC, AVC, and carotid plaque (all P < .001), but associations were rendered nonsignificant after adjustment for other risk factors. By contrast, those in top quartiles of plasma oleic acid showed significantly greater risks of incident HF (HR: 2.03; P < .001), CVD (HR: 1.41; P = .008), and all-cause mortality (HR: 1.55; P < .001) than those in referent quartiles independent of typical risk factors as well as plasma omega-3 fatty acid levels. CONCLUSIONS Plasma oleic acid appears to be a risk factor for CVD events and all-cause mortality independent of typical risk factors and plasma omega-3 fatty acids. Additional studies are warranted for confirmation and to further examine whether plasma oleic acid directly contributes to, or serves as a marker of, disease pathogenesis. These findings should not be extrapolated to dietary oleic acid intake.
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Affiliation(s)
- Brian T. Steffen
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN 55455
| | - Daniel Duprez
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21224
| | - Weihua Guan
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Michael Y. Tsai
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN 55455
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Pettee Gabriel K, Whitaker KM, Duprez D, Sternfeld B, Lewis CE, Sidney S, Knell G, Jacobs DR. Clinical importance of non-participation in a maximal graded exercise test on risk of non-fatal and fatal cardiovascular events and all-cause mortality: CARDIA study. Prev Med 2018; 106:137-144. [PMID: 29080827 PMCID: PMC6400469 DOI: 10.1016/j.ypmed.2017.10.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 08/23/2017] [Revised: 10/18/2017] [Accepted: 10/22/2017] [Indexed: 10/18/2022]
Abstract
While poor performance during a maximal graded exercise test (GXT) predicts cardiovascular events and premature mortality, the potential clinical importance of non-participation in a GXT, either for medical or non-medical reasons, is currently unknown. Data are from 4086 and 3547 Coronary Artery Risk Development in Young Adults (CARDIA) participants who attended the Year 7 (ages 25-37years) and/or 20 exams (ages 38-50years), respectively, which included a GXT. Cox proportional hazard models were used to examine the effect of GXT disposition (at Year 7 and 20, separately) on risk of non-fatal and fatal cardiovascular events and all-cause mortality obtained through 28years of follow-up. A GXT was not conducted or completed according to protocol in 12.9% and 19.1% of participants attending the Year 7 and 20 exams, respectively. After adjustment, participants who missed the Year 20 GXT for medical reasons had a higher risk of cardiovascular events [HR: 4.06 (95% CI: 1.43, 11.5)] and all-cause mortality [HR: 3.07 (95% CI: 1.11, 12.3)] compared to GXT completers; participants who missed at Year 20 for non-medical reasons also had higher risk of all-cause mortality [HR: 2.53 (95% CI: 1.61, 3.99)]. Findings suggest that non-participation in a GXT, regardless of medical or non-medical reason, to be an important predictor of excess risk of adverse health outcomes and premature mortality. Additional patient follow-up, including identification of potential targets for intervention (e.g., weight management and smoking cessation programs), should be conducted at the point of a missed GXT.
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Affiliation(s)
- Kelley Pettee Gabriel
- UTHealth School of Public Health in Austin, Department of Epidemiology, Human Genetics, and Environmental Sciences, Michael & Susan Dell Center for Healthy Living, Austin, TX 78701, USA; The University of Texas at Austin, Dell Medical School, Department of Women's Health, Austin, TX 78712, USA.
| | - Kara M Whitaker
- University of Minnesota School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN 55454, USA
| | - Daniel Duprez
- University of Minnesota School of Medicine, Cardiovascular Division, Minneapolis, MN 55455, USA
| | - Barbara Sternfeld
- Kaiser Permanente Northern California, Division of Research, Oakland, CA 94612, USA
| | - Cora E Lewis
- University of Alabama at Birmingham, Division of Preventive Medicine, Birmingham, AL 35205, USA
| | - Steve Sidney
- Kaiser Permanente Northern California, Division of Research, Oakland, CA 94612, USA
| | - Gregory Knell
- UTHealth School of Public Health in Austin, Department of Epidemiology, Human Genetics, and Environmental Sciences, Michael & Susan Dell Center for Healthy Living, Austin, TX 78701, USA
| | - David R Jacobs
- University of Minnesota School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN 55454, USA
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Rehm J, Anderson P, Prieto JAA, Armstrong I, Aubin HJ, Bachmann M, Bastus NB, Brotons C, Burton R, Cardoso M, Colom J, Duprez D, Gmel G, Gual A, Kraus L, Kreutz R, Liira H, Manthey J, Møller L, Okruhlica Ľ, Roerecke M, Scafato E, Schulte B, Segura-Garcia L, Shield KD, Sierra C, Vyshinskiy K, Wojnar M, Zarco J. Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union. BMC Med 2017; 15:173. [PMID: 28954635 PMCID: PMC5618725 DOI: 10.1186/s12916-017-0934-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 08/22/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hazardous and harmful alcohol use and high blood pressure are central risk factors related to premature non-communicable disease (NCD) mortality worldwide. A reduction in the prevalence of both risk factors has been suggested as a route to reach the global NCD targets. This study aims to highlight that screening and interventions for hypertension and hazardous and harmful alcohol use in primary healthcare can contribute substantially to achieving the NCD targets. METHODS A consensus conference based on systematic reviews, meta-analyses, clinical guidelines, experimental studies, and statistical modelling which had been presented and discussed in five preparatory meetings, was undertaken. Specifically, we modelled changes in blood pressure distributions and potential lives saved for the five largest European countries if screening and appropriate intervention rates in primary healthcare settings were increased. Recommendations to handle alcohol-induced hypertension in primary healthcare settings were derived at the conference, and their degree of evidence was graded. RESULTS Screening and appropriate interventions for hazardous alcohol use and use disorders could lower blood pressure levels, but there is a lack in implementing these measures in European primary healthcare. Recommendations included (1) an increase in screening for hypertension (evidence grade: high), (2) an increase in screening and brief advice on hazardous and harmful drinking for people with newly detected hypertension by physicians, nurses, and other healthcare professionals (evidence grade: high), (3) the conduct of clinical management of less severe alcohol use disorders for incident people with hypertension in primary healthcare (evidence grade: moderate), and (4) screening for alcohol use in hypertension that is not well controlled (evidence grade: moderate). The first three measures were estimated to result in a decreased hypertension prevalence and hundreds of saved lives annually in the examined countries. CONCLUSIONS The implementation of the outlined recommendations could contribute to reducing the burden associated with hypertension and hazardous and harmful alcohol use and thus to achievement of the NCD targets. Implementation should be conducted in controlled settings with evaluation, including, but not limited to, economic evaluation.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Peter Anderson
- Substance Use, Policy and Practice, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Alcohol and Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | | | - Iain Armstrong
- Health and Wellbeing Directorate, Public Health England, London, UK
| | - Henri-Jean Aubin
- CESP, University Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France
| | | | | | - Carlos Brotons
- Sardenya Primary Health Care Center, Biomedical Research Institute Sant Pau, Barcelona, Spain
| | - Robyn Burton
- Health and Wellbeing Directorate, Public Health England, London, UK
| | - Manuel Cardoso
- General Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD), Lisbon, Portugal
| | - Joan Colom
- Program on Substance Abuse, Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Barcelona, Spain
| | - Daniel Duprez
- Cardiovascular Division, School of Medicine, University of Minnesota, Minneapolis, USA
| | - Gerrit Gmel
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Implant Systems Group, National ICT Australia, Eveleigh, Australia
- Faculty of Engineering, University of New South Wales, Sydney, Australia
| | - Antoni Gual
- Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich, Germany
- Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden
| | - Reinhold Kreutz
- Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Helena Liira
- General Practice, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Australia
- University of Helsinki, Department of General Practice, and Helsinki University Central Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Lars Møller
- Division of Noncommunicable Diseases through the Life Course, WHO Regional Office for Europe, Copenhagen, Denmark
| | | | - Michael Roerecke
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Emanuele Scafato
- National Observatory on Alcohol, National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
- Società Italiana di Alcologia (SIA), Italian Society of Alcohology, Bologna, Italy
| | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research, Hamburg University, Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany
| | - Lidia Segura-Garcia
- Program on Substance Abuse, Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Barcelona, Spain
| | - Kevin David Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Cristina Sierra
- Hypertension and Vascular Risk Unit, Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Konstantin Vyshinskiy
- Research Institute on Addictions, Federal Medical Research Centre for Psychiatry and Narcology n.a. V. Serbsky, Moscow, Russia
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - José Zarco
- Drugs Intervention Group, semFYC, Ibiza Primary Health Care Center, Madrid, Spain
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Blaes A, Beckwith H, Florea N, Hebbel R, Solovey A, Potter D, Yee D, Vogel R, Luepker R, Duprez D. Vascular function in breast cancer survivors on aromatase inhibitors: a pilot study. Breast Cancer Res Treat 2017; 166:541-547. [PMID: 28801846 DOI: 10.1007/s10549-017-4447-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/05/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE Aromatase inhibitors (AI) have been shown to reduce breast cancer-related mortality in women with estrogen positive (ER+) breast cancer. The use of AIs, however, has been associated with higher rates of hypertension, hyperlipidemia, and cardiovascular (CV) events. METHODS A cross-sectional study of 25 healthy postmenopausal women and 36 women with curative intent breast cancer on an AI was performed to assess endothelial dysfunction, an indicator of risk for CV events. Consented subjects underwent vascular testing using the HDI/Pulse Wave CR-2000 Cardiovascular Profiling System and the EndoPAT2000 system. RESULTS Mean age was 61.7 and 59.6 years (cases, controls). Most subjects were Caucasian and overweight. Controls had a lower mean systolic blood pressure (128.6 mmHg vs. 116.2 mmHg, p = 0.004). Median estradiol levels were reduced in cases (2 vs. 15 pg/ml, p < 0.0001). EndoPAT ratio (0.8 vs. 2.7, p < 0.0001) was significantly reduced in cases as compared to controls. Median large artery elasticity (12.9 vs. 14.6 ml/mmHg × 10, p = 0.12) and small artery elasticity (5.2 vs. 7.0 ml/mmHg × 100, p = 0.07) were also reduced though not statistically significant. There was no correlation between use of chemotherapy, radiation therapy, type of AI, or duration of AI use and endothelial function. When adjusting for differences in blood pressure, results remained significant. CONCLUSION Breast cancer cases on AIs have reductions in endothelial function, a predictor of adverse CV disease. IMPACT Vascular function changes in breast cancer cases on AIs compared to postmenopausal women. Further work is needed to evaluate vascular changes over time.
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Affiliation(s)
- Anne Blaes
- Division of Hematology/Oncology, University of Minnesota, 420 Delaware Street, S.E., MMC 480, Minneapolis, MN, 55455, USA. .,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
| | - Heather Beckwith
- Division of Hematology/Oncology, University of Minnesota, 420 Delaware Street, S.E., MMC 480, Minneapolis, MN, 55455, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Natalia Florea
- Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Robert Hebbel
- Division of Hematology/Oncology, University of Minnesota, 420 Delaware Street, S.E., MMC 480, Minneapolis, MN, 55455, USA
| | - Anna Solovey
- Division of Hematology/Oncology, University of Minnesota, 420 Delaware Street, S.E., MMC 480, Minneapolis, MN, 55455, USA
| | - David Potter
- Division of Hematology/Oncology, University of Minnesota, 420 Delaware Street, S.E., MMC 480, Minneapolis, MN, 55455, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Douglas Yee
- Division of Hematology/Oncology, University of Minnesota, 420 Delaware Street, S.E., MMC 480, Minneapolis, MN, 55455, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Rachel Vogel
- Division of Gynecology/Oncology, University of Minnesota, Minneapolis, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Russell Luepker
- Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Duprez
- Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
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Bhatia S, Qualls C, Crowell TA, Arynchyn A, Thyagarajan B, Smith LJ, Kalhan R, Jacobs DR, Kramer H, Duprez D, Celli B, Sood A. Rapid decline in lung function in healthy adults predicts incident excess urinary albumin excretion later in life. BMJ Open Respir Res 2017; 4:e000194. [PMID: 29071073 PMCID: PMC5647541 DOI: 10.1136/bmjresp-2017-000194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/15/2017] [Indexed: 12/16/2022] Open
Abstract
Introduction Chronic lung disease, often characterised by rapid decline in lung function, is associated with vascular endothelial dysfunction (characterised by moderate to severe excess urinary albumin excretion (eUAE) but their longitudinal relationship is inadequately studied. In a bidirectional longitudinal examination of healthy adults, we analysed the following two hypotheses: (1) rapid decline (ie, highest tertile of lung function decline) predicts eUAE and (2) eUAE predicts rapid decline. Methods We performed a secondary data analysis from 3052 eligible participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study. For analysis 1, the predictor was rapid decline in lung function between the peak value (attained at or before CARDIA visit year 10 or Y10 at a mean age of 35 years) and Y20; and the outcome was incident eUAE at Y20 and/or Y25. For analysis 2, the predictor was eUAE at Y10 and the outcome was rapid decline between Y10 and Y20. Results After adjustment for covariates in analysis 1, rapid decline in FEV1 or FVC between peak and Y20 predicted incident eUAE at Y20 and/or Y25 (OR 1.51 and 1.44, respectively; p≤0.05 for both analyses). In analysis 2, eUAE at Y10 did not predict subsequent rapid decline. Conclusions Healthy adults with rapid decline in lung function are at risk for developing vascular endothelial dysfunction, as assessed by incident eUAE, later in life.
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Affiliation(s)
- Sapna Bhatia
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Clifford Qualls
- Office of Research, Clinical Translational Science Center,University of New Mexico, Albuquerque, New Mexico, USA
| | - Thomas A Crowell
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Alexander Arynchyn
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, USA
| | - Lewis J Smith
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ravi Kalhan
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Holly Kramer
- Department of Medicine, Loyola University School of Medicine, Maywood, Illinois, USA
| | - Daniel Duprez
- Department of Medicine, University of Minnesota, Minneapolis, USA
| | | | - Akshay Sood
- Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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Brahmi R, Kappenstein C, Cernák J, Duprez D, Sadel A. Catalyseurs cuivre-zinc. X. Comparaison de quelques méthodes de préparation : coprécipitation, précipitations successives ou précurseur bimétallique. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp:1999155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Olivier-Bourbigou H, Chizallet C, Dumeignil F, Fongarland P, Geantet C, Granger P, Launay F, Löfberg A, Massiani P, Maugé F, Ouali A, Roger AC, Schuurman Y, Tanchoux N, Uzio D, Jérôme F, Duprez D, Pinel C. Cover Picture: The Pivotal Role of Catalysis in France: Selected Examples of Recent Advances and Future Prospects. (ChemCatChem 12/2017). ChemCatChem 2017. [DOI: 10.1002/cctc.201700929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Céline Chizallet
- Catalysis and Separation Division; IFP Energies nouvelles; F-69360 Solaize France
| | - Franck Dumeignil
- Unité de Catalyse et Chimie du Solide; Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois; F-59000 Lille France
| | - Pascal Fongarland
- Laboratoire de Génie des Procédés Catalytiques (LGPC); Univ. Lyon, Université Claude Bernard Lyon 1, CPE, CNRS; F-69616 Villeurbanne France
| | - Christophe Geantet
- Institut de Recherches sur la Catalyse et l'Environnement de Lyon (IRCELYON); Université Claude Bernard Lyon 1, CNRS; F-69626 Villeurbanne France
| | - Pascal Granger
- Unité de Catalyse et Chimie du Solide; Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois; F-59000 Lille France
| | - Franck Launay
- Laboratoire de Réactivité de Surface (LRS); Sorbonne Universités, UPMC Univ Paris 06, CNRS; F-75005 Paris France
| | - Axel Löfberg
- Unité de Catalyse et Chimie du Solide; Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois; F-59000 Lille France
| | - Pascale Massiani
- Laboratoire de Réactivité de Surface (LRS); Sorbonne Universités, UPMC Univ Paris 06, CNRS; F-75005 Paris France
| | - Françoise Maugé
- Laboratoire Catalyse et Spectrochimie (LCS); ENSICAEN, CNRS; F-14000 Caen France
| | - Armelle Ouali
- Institut Charles Gerhardt Montpellier (ICGM); Université Montpellier, CNRS; F-34095 Montpellier France
| | - Anne-Cécile Roger
- Institut de Chimie et Procédés pour l'Energie, l'Environnement et la Santé (ICPEES); Université de Strasbourg, CNRS; F-67087 Strasbourg France
| | - Yves Schuurman
- Institut de Recherches sur la Catalyse et l'Environnement de Lyon (IRCELYON); Université Claude Bernard Lyon 1, CNRS; F-69626 Villeurbanne France
| | - Nathalie Tanchoux
- Institut Charles Gerhardt Montpellier (ICGM); Université Montpellier, CNRS; F-34095 Montpellier France
| | - Denis Uzio
- Catalysis and Separation Division; IFP Energies nouvelles; F-69360 Solaize France
| | - François Jérôme
- Institut de Chimie des Milieux et Matériaux de Poitiers (IC2MP); Université de Poitiers, ENSIP, CNRS; F-86073 Poitiers France
| | - Daniel Duprez
- Institut de Chimie des Milieux et Matériaux de Poitiers (IC2MP); Université de Poitiers, ENSIP, CNRS; F-86073 Poitiers France
| | - Catherine Pinel
- Institut de Recherches sur la Catalyse et l'Environnement de Lyon (IRCELYON); Université Claude Bernard Lyon 1, CNRS; F-69626 Villeurbanne France
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Olivier-Bourbigou H, Chizallet C, Dumeignil F, Fongarland P, Geantet C, Granger P, Launay F, Löfberg A, Massiani P, Maugé F, Ouali A, Roger AC, Schuurman Y, Tanchoux N, Uzio D, Jérôme F, Duprez D, Pinel C. The Pivotal Role of Catalysis in France: Selected Examples of Recent Advances and Future Prospects. ChemCatChem 2017. [DOI: 10.1002/cctc.201700426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Céline Chizallet
- Catalysis and Separation Division; IFP Energies nouvelles; F-69360 Solaize France
| | - Franck Dumeignil
- Unité de Catalyse et Chimie du Solide; Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois; F-59000 Lille France
| | - Pascal Fongarland
- Laboratoire de Génie des Procédés Catalytiques (LGPC); Univ. Lyon, Université Claude Bernard Lyon 1, CPE, CNRS; F-69616 Villeurbanne France
| | - Christophe Geantet
- Institut de Recherches sur la Catalyse et l'Environnement de Lyon (IRCELYON); Université Claude Bernard Lyon 1, CNRS; F-69626 Villeurbanne France
| | - Pascal Granger
- Unité de Catalyse et Chimie du Solide; Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois; F-59000 Lille France
| | - Franck Launay
- Laboratoire de Réactivité de Surface (LRS); Sorbonne Universités, UPMC Univ Paris 06, CNRS; F-75005 Paris France
| | - Axel Löfberg
- Unité de Catalyse et Chimie du Solide; Univ. Lille, CNRS, Centrale Lille, ENSCL, Univ. Artois; F-59000 Lille France
| | - Pascale Massiani
- Laboratoire de Réactivité de Surface (LRS); Sorbonne Universités, UPMC Univ Paris 06, CNRS; F-75005 Paris France
| | - Françoise Maugé
- Laboratoire Catalyse et Spectrochimie (LCS); ENSICAEN, CNRS; F-14000 Caen France
| | - Armelle Ouali
- Institut Charles Gerhardt Montpellier (ICGM); Université Montpellier, CNRS; F-34095 Montpellier France
| | - Anne-Cécile Roger
- Institut de Chimie et Procédés pour l'Energie, l'Environnement et la Santé (ICPEES); Université de Strasbourg, CNRS; F-67087 Strasbourg France
| | - Yves Schuurman
- Institut de Recherches sur la Catalyse et l'Environnement de Lyon (IRCELYON); Université Claude Bernard Lyon 1, CNRS; F-69626 Villeurbanne France
| | - Nathalie Tanchoux
- Institut Charles Gerhardt Montpellier (ICGM); Université Montpellier, CNRS; F-34095 Montpellier France
| | - Denis Uzio
- Catalysis and Separation Division; IFP Energies nouvelles; F-69360 Solaize France
| | - François Jérôme
- Institut de Chimie des Milieux et Matériaux de Poitiers (IC2MP); Université de Poitiers, ENSIP, CNRS; F-86073 Poitiers France
| | - Daniel Duprez
- Institut de Chimie des Milieux et Matériaux de Poitiers (IC2MP); Université de Poitiers, ENSIP, CNRS; F-86073 Poitiers France
| | - Catherine Pinel
- Institut de Recherches sur la Catalyse et l'Environnement de Lyon (IRCELYON); Université Claude Bernard Lyon 1, CNRS; F-69626 Villeurbanne France
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Hou L, Zhang H, Dong L, Zhang L, Duprez D, Royer S. A simple non-aqueous route to nano-perovskite mixed oxides with improved catalytic properties. Catal Today 2017. [DOI: 10.1016/j.cattod.2017.01.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Duprez D, Delahay G, Abderrahim H, Grimblot J. Caractérisation de catalyseurs Rh/Al2O3 par adsorption de gaz et par spectroscopie de photoélectrons X. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1986830465] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Duprez D, Bastick M, Bastick J. Étude théorique des réactions catalytiques à l’aide d’un réacteur chromatographique en régime pulsé cinétique d’ordre n et cinétique de langmuir. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1974710278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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