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  • Online Resource  (17)
  • Ovid Technologies (Wolters Kluwer Health)  (17)
  • 1
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    Online Resource
    Evaluation of Right Ventricular Systolic Function in Chagas Disease Using Cardiac Magnetic Resonance Imaging
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Circulation: Cardiovascular Imaging Vol. 10, No. 3 ( 2017-03)
    Details
    In: Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 3 ( 2017-03)
    Abstract: Right ventricular (RV) impairment is postulated to be responsible for prominent systemic congestion in Chagas disease. However, occurrence of primary RV dysfunction in Chagas disease remains controversial. We aimed to study RV systolic function in patients with Chagas disease using cardiac magnetic resonance. Methods and Results— This cross-sectional study included 158 individuals with chronic Chagas disease who underwent cardiac magnetic resonance. RV systolic dysfunction was defined as reduced RV ejection fraction based on predefined cutoffs accounting for age and sex. Multivariable logistic regression was used to verify the relationship of RV systolic dysfunction with age, sex, functional class, use of medications for heart failure, atrial fibrillation, and left ventricular systolic dysfunction. Mean age was 54±13 years, 51.2% men. RV systolic dysfunction was identified in 58 (37%) individuals. Although usually associated with reduced left ventricular ejection fraction, isolated RV systolic dysfunction was found in 7 (4.4%) patients, 2 of them in early stages of Chagas disease. Presence of RV dysfunction was not significantly different in patients with indeterminate/digestive form of Chagas disease (35.7%) compared with those with Chagas cardiomyopathy (36.8%) ( P =1.000). Conclusions— In chronic Chagas disease, RV systolic dysfunction is more commonly associated with left ventricular systolic dysfunction, although isolated and early RV dysfunction can also be identified.
    Type of Medium: Online Resource
    ISSN: 1941-9651 , 1942-0080
    URL: Article
    DOI: 10.1161/CIRCIMAGING.116.005571
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 2
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    Maternal age at birth of last child and cardiovascular disease mortality later in life among a national cohort of postmenopausal women from the United States
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Menopause Vol. 30, No. 4 ( 2023-4), p. 393-400
    Details
    In: Menopause, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 4 ( 2023-4), p. 393-400
    Abstract: Maternal age at last birth of child is increasing in the United States, and it has been reported to influence future chronic diseases. In this study of nationally-representative sample of postmenopausal women, there was no conclusive association between maternal age at last birth of child and cardiovascular disease mortality later in life. Objective Maternal age at last birth (ALB) of child is increasing in the United States, and it has been reported to influence future chronic diseases. However, the relationship of ALB and cardiovascular disease (CVD) events later in life has not been widely studied. We evaluated the association of ALB with CVD mortality. Methods Data were from 7,971 parous postmenopausal women older than 45 years who participated in the US National Health and Nutritional Examination Survey from 1999 to 2018 and had mortality follow-up data through to December 31, 2019. ALB was self-reported, whereas CVD mortality was assessed using International Classification of Diseases codes. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results The mean age of participants was 63 ± 9.8 years, with 9.5% being non-Hispanic Black, 9.7% being Hispanic women, and 21% reporting ALB ≥35 years. During a median follow-up of 8.1 years, 443 participants died from CVD. In age-adjusted models, CVD mortality was elevated for women with ALB of 〈 25 years (HR, 1.68; 95% CI, 1.23-2.29) and ALB of ≥35 years (HR, 1.37; 95% CI, 1.00-1.88). However, after additional adjustment for race and ethnicity, foreign born, education, marital status, poverty income ratio, parity, smoking status, age at menarche, oral contraceptive pills use and family history of myocardial infarction, these estimates were attenuated resulting in no association between ALB and CVD mortality. Conclusions In this study of nationally representative sample of postmenopausal women, there was no conclusive association between maternal ALB and CVD mortality later in life.
    Type of Medium: Online Resource
    ISSN: 1072-3714
    URL: Article
    DOI: 10.1097/GME.0000000000002158
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 3
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    Abstract MP082: Sex Hormone Levels and Change in Left Ventricular Structure Among Men and Women With Preserved Ejection Fraction The Multi Ethnic Study of Atherosclerosis
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Circulation Vol. 135, No. suppl_1 ( 2017-03-07)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 135, No. suppl_1 ( 2017-03-07)
    Abstract: Background: Heart failure with preserved ejection fraction (HFpEF) is more common in older women than men. Differences in sex hormone (SH) levels may contribute to sex differences in HFpEF risk. Left ventricular (LV) hypertrophy and concentric remodeling [increased Mass (M): Volume (V) ratio] are risk markers of HFpEF. In a multi-ethnic cohort of men and women with preserved EF, we examined whether SH levels were associated with LV structure. We hypothesized that a more androgenic pattern would predict adverse concentric remodeling in women but not men. Methods: We studied 4279 MESA participants (49% women) aged 45-84 yrs with serum SH levels and cardiac MRI performed at baseline (2000-2002) and baseline EF ≥50%. Among these, 2957 participants underwentMRI at Exam 5 (2010-2012). Stratified by sex, we used linear regression for cross-sectional analyses and mixed model effect methods for longitudinal analyses to test the associations of SH and binding globulin (SHBG) levels [per 1 SD greater log(SH)] with baseline levels and changes in LV mass (LVM), end diastolic volume (LVEDV) and M:V ratio. Models were adjusted for age, ethnicity, center, height, weight, education, physical activity and smoking, and for hormone use and menopause in women. Results: The mean (SD) age was 64 (9) for women and 62 (10) yrs for men. Cross-sectionally, among women, higher Testosterone (T) and Dehydroepiandrosterone (DHEA) levels were associated with greater LVM ( Table ). Among both men and women, higher free T and lower SHBG were associated lower LVEDV and greater M:V ratio. In men, greater estradiol levels were associated with lower LVEDV and greater M:V ratio. After a mean followup of 10 yrs, higher free T and lower SHBG were associated with an increase in LVM in both sexes. Findings were generally consistent after adjustment for possible mediators of these associations such as blood pressure and other CV risk factors. Conclusion: A more androgenic profile of higher free T and lower SHBG is associated with greater increase in LVM over 10 yrs in both men and women.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.135.suppl_1.mp082
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 4
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    Abstract 16614: Left Ventricular Global Function Index (A Novel Marker of Cardiac Performance) Predicts Incident Cardiovascular Events: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Introduction: Left ventricle (LV) function is typically evaluated independent of LV structure and vice versa. LV global function index (LVGFI) is a novel marker of cardiac performance that accounts for LV structural alterations and has been previously validated using magnetic resonance imaging. Hypothesis: We evaluated the prognostic utility of LVGFI assessed by echocardiography for incident cardiovascular disease (CVD) and heart failure (HF) events in comparison to LV ejection fraction (LVEF) and LV mass Methods: Included were 4107 Coronary Artery Risk Development in Young Adults (CARDIA) study participants with available m-mode echocardiographic parameters in 1990-1991 (Year-5). LV volumes were obtained using the Teichholz formula. LVGFI defined as LV stroke volume/LV global volume* 100, where LV global volume was calculated as the sum of the LV mean cavity volume (LVEDV + LVESV)/2) and myocardium volume (LV mass/density). Median follow-up time was 21.9 years. Cox regression models, adjusted for risk factors, were utilized to predict the endpoints of HF, hard CVD and all CVD events. Results: Mean age of participants at Year-5 was 29.8 ± 3.7 years, 55% were female, 51.3% white and mean LVGFI was 34.7 ± 6.2%. A total of 174 incident CVD events were observed during the 21.9 years median follow-up. In multivariable adjusted models, 1-SD increase in LVGFI was significantly associated with lower hazard of HF, Hazard Ratio (HR) =0.55 95% confidence interval (CI) [0.40 - 0.74]; hard CVD, HR=0.74 95% CI [0.63 - 0.88] and all CVD events, HR=0.76 95% CI [0.65 -0.88] . (Table 1). LVGFI provided incremental predictive value for incident CVD compared to LV mass and LV ejection fraction alone.(Figure 1). Conclusions: LVGFI in early adulthood was associated with incident HF, hard CVD and all CVD events. In this longitudinal community study, LVGFI provided robust, independent and incremental predictive value for incident CVD events.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.16614
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 5
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    Coronary Artery Calcium From Early Adulthood to Middle Age and Left Ventricular Structure and Function
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Circulation: Cardiovascular Imaging Vol. 12, No. 6 ( 2019-06)
    Details
    In: Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 6 ( 2019-06)
    Abstract: The relationship of coronary artery calcium (CAC) with adverse cardiac remodeling is not well established. We aimed to study the association of CAC in middle age and change in CAC from early adulthood to middle age with left ventricular (LV) function. Methods: CAC score was measured by computed tomography at CARDIA study (Coronary Artery Risk Development in Young Adults) year-15 examination and at year-25 examination (Y25) in 3043 and 3189 participants, respectively. CAC score was assessed as a continuous variable and log-transformed to account for nonlinearity. Change in CAC from year-15 examination to Y25 was evaluated as the absolute difference of log-transformed CAC from year-15 examination to Y25. LV structure and function were evaluated by echocardiography at Y25. Results: At Y25, mean age was 50.1±3.6 years, 56.6% women, 52.4% black. In the multivariable analysis at Y25, higher CAC was related to higher LV mass (β=1.218; adjusted P =0.007), higher LV end-diastolic volume (β=0.811; adjusted P =0.007), higher LV end-systolic volume (β=0.350; adjusted P =0.048), higher left atrial volume (β=0.214; adjusted P =0.009), and higher E/e′ ratio (β=0.059; adjusted P =0.014). CAC was measured at both year-15 examination and Y25 in 2449 individuals. Higher change in CAC score during follow-up was independently related to higher LV mass index in blacks (β=4.789; adjusted P 〈 0.001), but not in whites (β=1.051; adjusted P =0.283). Conclusions: Higher CAC in middle age is associated with higher LV mass and volumes and worse LV diastolic function. Being free of CAC from young adulthood to middle age correlates to better LV function at middle age. Higher change in CAC score during follow-up is independently related to higher LV mass index in blacks.
    Type of Medium: Online Resource
    ISSN: 1941-9651 , 1942-0080
    URL: Article
    DOI: 10.1161/CIRCIMAGING.119.009228
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 6
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    Associations between menopause, cardiac remodeling, and diastolic function: the CARDIA study
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Menopause Vol. 28, No. 10 ( 2021-06-14), p. 1166-1175
    Details
    In: Menopause, Ovid Technologies (Wolters Kluwer Health), Vol. 28, No. 10 ( 2021-06-14), p. 1166-1175
    Abstract: Heart failure with preserved ejection fraction (HFpEF) affects more women than men. Menopause may influence HFpEF development in women. We assessed cross-sectional and longitudinal associations between menopause and echocardiographic measures of left ventricular (LV) function and cardiac remodeling. Methods: We studied 1,723 women with available echo data from at least two of: year 5 (Y5) (1990-1991), Y25 (2010-2011), or Y30 (2015-2016) in the Coronary Artery Risk Development in Young Adults study. Cardiac structure and function were measured using 2D and Doppler echocardiography. Cross-sectional associations between menopausal status and repeated echo measures at Y25 and Y30 were analyzed using linear mixed models. Two-segmented models were used to compare longitudinal changes in echocardiographic measures in the premenopausal period to changes in the postmenopausal period. Results: Mean ± SD age (years) at enrollment was 27 ± 3 in those with menopause by Y25, 25 ± 3 in those with menopause between Y25 and Y30, and 21 ± 3 in those premenopausal at Y30. There were no significant differences in race, body mass index, systolic blood pressure, or diabetes between the groups. Postmenopausal women had higher early diastolic mitral inflow ( E ) to annular ( e ’) velocity ratio than premenopausal after adjusting for demographics and risk factors ( P   〈  0.05). Menopause was associated with relative increases in the rates of change in LV mass and left atrial volume, even after adjustment. Change in E / e ’ ratio was similar before and after menopause. Conclusions: Menopause is associated cross-sectionally with worse diastolic function and longitudinally with adverse LV and left atrial remodeling. This may contribute to the increased HFpEF risk in postmenopausal women. Video Summary: http://links.lww.com/MENO/A787.
    Type of Medium: Online Resource
    ISSN: 1530-0374
    URL: Article
    DOI: 10.1097/GME.0000000000001815
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 7
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    Abstract P224: The Association of Surgical versus Natural Menopause with Future Left Ventricular Structure and Function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation Vol. 133, No. suppl_1 ( 2016-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. suppl_1 ( 2016-03)
    Abstract: Introduction: The association of surgical and natural menopause (SM and NM, respectively) with CVD outcomes is controversial. We assessed the hypothesis that CVD risk factor levels antecedent to menopause explain differences in future left ventricular (LV) structure and function parameters rather than type of menopause. Methods: We studied 825 premenopausal women (49% black) from the CARDIA study in 1990-1991 (baseline, mean age: 32 years) who later reached menopause by 2010-2011 and had echocardiographs at these two time points. Results: During 20 years of follow up, 508 women reached NM while 317 underwent SM (34% with bilateral oophorectomy). At baseline, women who later underwent SM were more likely to be black, younger, have higher mean values of systolic blood pressure, body mass index as well as lower mean HDL cholesterol, physical activity, parity and years of education. With the exception of race, no statistically significant differences were found by ovarian status among women with SM. In 1990-1991, no differences in LV structure and function were found between women who later reach NM or SM. In 2010-2011, women with SM had significantly higher LV mass, LV mass/volume ratio, E/e’ ratio, and impaired longitudinal and circumferential strain than women with NM (Table 1). No significant differences in these measures were found among SM by ovarian status. Controlling for baseline echocardiographic parameters, demographics, BMI, physical activity, parity, smoking, systolic blood pressure and age at menarche in linear regression models attenuated these differences between groups (Table 1). Further adjustment for age at menopause and hormone therapy use did not change these results. Conclusion: In this study, presurgical CVD risk factors among women with SM attenuated the adverse postsurgical measures of LV structure and function found among such women. These data suggest that premenopausal CVD risk factors rather than gynecologic surgery predispose women with SM to elevated future CVD risk.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.133.suppl_1.p224
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
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  • 8
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    Association of Circulating Ceramides With Cardiac Structure and Function in the Community: The Framingham Heart Study
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of the American Heart Association Vol. 8, No. 19 ( 2019-10)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 19 ( 2019-10)
    Abstract: A higher circulating plasma ceramide ratio (C16:0/C24:0) is associated with an increased risk of heart failure, even after accounting for standard risk factors including lipid markers. However, the pathobiological mechanisms that underlie this association are incompletely understood. We tested the hypothesis that plasma ceramide ratio (C16:0/C24:0) is associated with adverse cardiac remodeling in the community. Methods and Results We evaluated 2652 Framingham Offspring Study participants (mean age, 66±9 years; 55% women) who attended their eighth examination cycle and underwent routine echocardiography and liquid chromatography–tandem mass spectrometry–based assays for circulating ceramide concentrations. We used multivariable linear regression models to relate C16:0/C24:0 (independent variable) to the following echocardiographic measures (dependent variables; separate models for each): left ventricular mass, left ventricular ejection fraction, left atrial emptying fraction, left atrial end‐systolic volume, E/e′ (a measure of left ventricular diastolic function), and left ventricular global circumferential and longitudinal strain by speckle‐tracking echocardiography. In multivariable‐adjusted analyses, higher C16:0/C24:0 per standard deviation increment was associated with lower left ventricular ejection fraction (0.991‐fold change in left ventricular ejection fraction; P =0.0004), worse global circumferential strain (β=0.34, P =0.004), higher left atrial end‐systolic volume (β=2.48, p 〈 0.0001), and lower left atrial emptying fraction (0.99‐fold change; P 〈 0.0001). The C16:0/C24:0 ratio was not associated with either E/e′ or global longitudinal strain, and the association with higher left ventricular mass was rendered statistically nonsignificant upon correction for multiple comparisons. Conclusions Our cross‐sectional observations in a large community‐based sample are consistent with a potential detrimental impact of higher ceramide ratio (C16:0/24:0) on cardiac remodeling traits, which may partly explain the associations of these molecular species with clinical heart failure.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.119.013050
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 9
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    The association of age at natural menopause with pre- to postmenopausal changes in left ventricular structure and function: the Coronary Artery Risk Development in Young Adults (CARDIA) study
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Menopause Vol. 29, No. 5 ( 2022-03-25), p. 564-572
    Details
    In: Menopause, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 5 ( 2022-03-25), p. 564-572
    Abstract: The association between menopause and incident cardiovascular disease (CVD) is controversial. We evaluated the relationships of estrogen deficiency (ovarian reproductive aging) assessed by age at natural menopause (ANM), chronological aging, and antecedent CVD risk factors (biological aging) with left ventricular (LV) structure and function among women transitioning from pre- to postmenopause. Methods: We studied 771 premenopausal women (37% Black) from the Coronary Artery Risk Development in Young Adults Study with echocardiographic data in 1990 to 1991 (mean age: 32 y) who later reached natural menopause by 2015 to 2016 and had repeated echocardiographic measurements. Linear regression models were used to evaluate the association of ANM with parameters of LV structure and function. Results: Mean ANM was 50 (± 3.8) years and the average time from ANM to the last echocardiograph was 7 years. In cross-sectional analyses, a 1-year increase in ANM was significantly associated with lower postmenopausal LV mass (LVM), LVM indexed to body surface area, LV mass-to-volume ratio, and relative wall thickness. In age-adjusted longitudinal analyses, higher ANM was inversely associated with pre- to postmenopausal changes in LVM (β = –0.97; 95% CI: –1.81 to –0.13, P  = 0.024) and LVM indexed (β = –0.48; 95% CI: –0.89 to –0.07, P  = 0.021). Controlling for baseline LV structure parameters and traditional CVD risk factors attenuated these associations. Further adjustment for hormone therapy uses did not alter these results. Conclusion: In this study, premenopausal CVD risk factors attenuated the association of ANM with changes in LV structure parameters. These data suggest that premenopausal CVD risk factors may predispose women to elevated future CVD risk more than ovarian aging.
    Type of Medium: Online Resource
    ISSN: 1530-0374
    URL: Article
    DOI: 10.1097/GME.0000000000001950
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 10
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    The association of surgical versus natural menopause with future left ventricular structure and function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Menopause Vol. 24, No. 11 ( 2017-11), p. 1269-1276
    Details
    In: Menopause, Ovid Technologies (Wolters Kluwer Health), Vol. 24, No. 11 ( 2017-11), p. 1269-1276
    Abstract: To evaluate the association between surgical menopause (SM) versus natural menopause (NM) in relation to later left ventricular (LV) structure and function, while taking into account the LV parameters and other cardiovascular disease risk factor (CVDRF) levels that predate the menopausal transition. Methods: We studied 825 premenopausal women from the Coronary Artery Risk Development in Young Adults study in 1990 to 1991 (baseline, mean age 32 years) who later reached menopause by 2010 to 2011 and had echocardiograms at these two time points. Results: During 20 years of follow-up, 508 women reached NM, whereas 317 underwent SM (34% had bilateral oophorectomy). At baseline, women who later underwent SM were more likely to be black, younger, have greater parity, and higher mean values of systolic blood pressure, body mass index, and also lower mean high-density lipoprotein cholesterol and physical activity than women who reached NM. No significant differences in LV structure/function were found between groups. In 2010 to 2011, SM women had significantly higher LV mass, LV mass/volume ratio, E/e’ ratio, and impaired longitudinal and circumferential strain than NM women. SM women with bilateral oophorectomy had adverse LV measures than women with hysterectomy with ovarian conservation. Controlling for baseline echocardiographic parameters and CVDRF in linear regression models eliminated these differences between groups. Further adjustment for age at menopause/surgery and hormone therapy use did not change these results. Conclusion: In this study, the adverse LV structure and function observed among women with SM compared with NM were explained by their unfavorable presurgical CVDRF profiles, suggesting that premenopausal CVDRF rather than gynecologic surgery predispose SM women to elevated future cardiovascular disease risk.
    Type of Medium: Online Resource
    ISSN: 1072-3714 , 1530-0374
    URL: Article
    DOI: 10.1097/GME.0000000000000919
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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