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  • 1
    In: European Journal of Heart Failure, Wiley, Vol. 23, No. 10 ( 2021-10), p. 1633-1644
    Abstract: Recent evidence points towards a distinct obese phenotype among patients with heart failure with preserved ejection fraction (HFpEF). We aimed to identify differentially expressed circulating biomarkers in obese HFpEF patients and link them to disease severity and outcomes. Methods and results From the LIFE‐Heart study, 999 patients with HFpEF and 999 patients without heart failure (no‐HF) were selected and 92 circulating serum biomarkers were measured using a proximity extension assay. Elevation of identified biomarkers was validated in 220 patients from the Aldo‐DHF trial with diagnosed HFpEF. HFpEF patients were older and had more comorbidities including coronary artery disease and type 2 diabetes as compared to no‐HF patients ( P   〈  0.05 for all). After adjusting for covariates, adrenomedullin (ADM), galectin‐9 (Gal‐9), thrombospondin‐2 (THBS‐2), CD4, and tumour necrosis factor‐related apoptosis‐inducing ligand receptor 2 (TRAIL‐R2) were significantly higher in obese HFpEF patients [body mass index (BMI) ≥30 kg/m 2 , n  = 464] as compared to lean HFpEF (BMI 〈 30 kg/m 2 , n  = 535) and obese no‐HF patients (BMI ≥30 kg/m 2 , n  = 387) ( P   〈  0.001 for both); these findings were verified in the Aldo‐DHF validation cohort ( P   〈  0.001). Except for CD4 these proteins were associated with increased estimates of left atrial pressure in a linear fashion. Importantly, ADM and CD4 were associated with increased mortality in obese HFpEF patients after adjusting for covariates. Conclusion Obese HFpEF patients exhibit higher circulating biomarkers of volume expansion (ADM), myocardial fibrosis (THBS‐2) and systemic inflammation (Gal‐9, CD4) compared to obese non‐HFpEF or lean HFpEF patients. These findings support the clinical definition of a distinct obese HFpEF phenotype and might merit further investigation.
    Type of Medium: Online Resource
    ISSN: 1388-9842 , 1879-0844
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1500332-2
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  • 2
    In: Cancers, MDPI AG, Vol. 15, No. 13 ( 2023-06-26), p. 3356-
    Abstract: (1) Background: Several lines of evidence established a link between high-risk (HR) sexual behavior (SB), the persistence of human papillomavirus (HPV) DNA in saliva, and the presence of oncogenic HR-HPV subtypes in oropharyngeal squamous cell carcinoma (OPSCC). A highly influential case-control study by D’Souza et al. comparing OPSCC patients and ENT patients with benign diseases (hospital controls) established HR-SB as a putative etiological risk factor for OPSCC. Aiming to replicate their findings in a nested case-control study of OPSCC patients and propensity score (PS)-matched unaffected controls from a large population-based German cohort study, we here demonstrate discrepant findings regarding HR-SB in OPSCC. (2) Methods: According to the main risk factors for HNSCC (age, sex, tobacco smoking, and alcohol consumption) PS-matched healthy controls invited from the population-based cohort study LIFE and HNSCC (including OPSCC) patients underwent interviews, using AUDIT and Fagerström, as well as questionnaires asking for SB categories as published. Afterwards, by newly calculating PSs for the same four risk factors, we matched each OPSCC patient with two healthy controls and compared responses utilizing chi-squared tests and logistic regression. (3) Results: The HNSCC patients and controls showed significant differences in sex distribution, chronologic age, tobacco-smoking history (pack years), and alcohol dependence (based on AUDIT score). However, PS-matching decreased the differences between OPSCC patients and controls substantially. Despite confirming that OPSCC patients were more likely to self-report their first sexual intercourse before age 18, we found no association between OPSCC and HR-SB, neither for practicing oral-sex, having an increased number of oral- or vaginal-sex partners, nor for having casual sex or having any sexually transmitted disease. (4) Conclusions: Our data, by showing a low prevalence of HR-SB in OPSCC patients, confirm findings from other European studies that differ substantially from North American case-control studies. HR-SB alone may not add excess risk for developing OPSCC.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2527080-1
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  • 3
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  International Journal of Epidemiology Vol. 49, No. 5 ( 2020-10-01), p. 1439-1440h
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 49, No. 5 ( 2020-10-01), p. 1439-1440h
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1494592-7
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  • 4
    In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, Springer Science and Business Media LLC, Vol. 66, No. 4 ( 2023-04), p. 402-409
    Abstract: Resilience describes good adaptation to adversity and is a significant factor for well-being in old age. Initial studies indicate a high relevance of social resources. So far, only few studies have investigated resilience patterns in the elderly population. Therefore, the present study aims to investigate sociodemographic and social correlates of resilience in a large population-based sample aged 65 years and older. Methods Analyses were conducted on n  = 2410 people aged 65 years and older from the follow-up survey of the LIFE-Adult-Study. The survey included the variables resilience (Resilience Scale – RS-11), social support (ENRICHD Social Support Inventory – ESSI), and social network (Lubben Social Network Scale – LSNS-6). The association of sociodemographic and social variables with resilience was analyzed using multiple linear regression analysis. Results The age of 75 years and older was associated with lower resilience compared with the age of 65–74 years. Further, widowed marital status was related to higher resilience. Better social support and a larger social network were significantly associated with higher resilience. No association was found for gender and education. Discussion The results reveal sociodemographic correlates of resilience in the elderly population that can help identify at-risk groups with lower resilience. Social resources are significant in older age for resilient adaptation and represent a starting point for deriving preventive measures. Social inclusion of older people should be promoted to strengthen resilience in this population and provide favorable conditions for successful aging.
    Type of Medium: Online Resource
    ISSN: 1436-9990 , 1437-1588
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1470303-8
    SSG: 20,1
    SSG: 8,1
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  • 5
    In: Nutrients, MDPI AG, Vol. 14, No. 16 ( 2022-08-20), p. 3433-
    Abstract: Knowledge about cardiac and inflammatory biomarkers in patients with stable coronary artery disease (CAD) is limited. To address this, we analyzed 3072 patients (36% female) with a median follow-up of 10 years in the Leipzig LIFE Heart Study with suspected CAD with coronary angiography. Selected biomarkers included troponin T (hsTNT), N-terminal pro B-type natriuretic peptide (NT-proBNP), copeptin, C-reactive protein (hsCRP), and interleukin-6 (IL-6). Patients were stratified by CAD severity: CAD0 (no sclerosis), CAD1 (non-obstructive, i.e., stenosis 〈 50%), and CAD2 (≥one stenosis ≥ 50%). Group comparison (GC) included GC1: CAD0 + 1 vs. CAD2; GC2: CAD0 vs. CAD1 + 2. CAD0, CAD1, and CAD2 were apparent in 1271, 631, and 1170 patients, respectively. Adjusted for classical risk factors, hs-cTnT, NT-proBNP, and IL-6 differed significantly in both GC and hsCRP only in GC2. After multivariate analysis, hs-cTnT, NT-proBNP, and IL-6 remained significant in GC1. In GC2, hs-cTnT (p 〈 0.001) and copeptin (p = 0.014) reached significance. Ten-year survival in groups CAD0, CAD1, and CAD2 was 88.3%, 77.3%, and 72.4%. Incorporation of hs-cTnT, NT-proBNP, copeptin, and IL-6 improved risk prediction (p 〈 0.001). The studied cardiac and inflammatory biomarkers enable fast and precise non-invasive identification of mortality risk in CAD patients, allowing the tailoring of primary and secondary CAD prevention.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518386-2
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 141, No. Suppl_1 ( 2020-03-03)
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 141, No. Suppl_1 ( 2020-03-03)
    Abstract: Background: Pro-fibrotic changes create a substrate for initiation and perpetuation of arrhythmias. PR interval prolongation ( pPR ) reflects the electrophysiological conduction disturbances in atria, while bundle branch block ( BBB ) mirrors impaired conduction in ventricles. Both pPR and BBB might be caused by fibrosis leading to remodeling processes, which can be recognized using ECG. Coronary artery disease ( CAD ) may impair blood circulation and facilitate cardiomyocytes’ death with their consequent replacement by fibrotic cells. Aims: To analyze the association between BBB and coronary artery status in the LIFE-Heart Study. We hypothesized that fibrotic patterns in ECG measured as BBB and pPR are associated with CAD. Methods: We analyzed patients with available demographic, echocardiographic, ECG and coronary catheterization data recruited at the Heart Center Leipzig between 2006 and 2014. CAD was defined as stenosis ≥50%, coronary artery sclerosis (CAS) - as plaque obstruction 〈 50%, pPR interval as PR≥200 ms, BBB as QRS ≥120 ms. Results: In total, 1.750 patients (median age 65 (IQR 55-71) years, females 36%) were included. There were 376 (22%) patients with CAS and 669 (38%) with CAD, pPR and BBB were documented in 181 (10.3%) and 176 (10.1%) patients, respectively. There was a significant association between pPR and BBB (OR 2.70, 95%CI 1.78-4.03, p 〈 0.001). CAD extent and origin were not associated with pPR and BBB. However, after adjustment for age and gender, CAS (OR 1.51, p=0.021) was associated with BBB. On multivariable analysis, beside age (OR 1.05, 95%CI 1.03-1.08, p 〈 0.001), males (OR 1.72, 95%CI 1.12-2.64, p=0.013), and EF (OR 0.95, 95%CI 0.93-0.96, p 〈 0.001), both CAS (OR 1.61, 95%CI 1.08-2.39, p=0.019), and pPR (OR 2.07, 95%CI 1.30-3.32, p=0.002) remained robustly associated with BBB. Conclusion: The prevalence of BBB and pPR was similar in LIFE-Heart Study. Patients with CAS have more often BBB than patients with CAD or normal coronary vessels. Neither CAD extent, nor origin were associated with BBB.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 7
    In: Metabolites, MDPI AG, Vol. 12, No. 3 ( 2022-02-27), p. 216-
    Abstract: A variety of atherosclerosis and cardiovascular disease (ASCVD) phenotypes are tightly linked to changes in the cardiac energy metabolism that can lead to a loss of metabolic flexibility and to unfavorable clinical outcomes. We conducted an association analysis of 31 ASCVD phenotypes and 97 whole blood amino acids, acylcarnitines and derived ratios in the LIFE-Adult (n = 9646) and LIFE-Heart (n = 5860) studies, respectively. In addition to hundreds of significant associations, a total of 62 associations of six phenotypes were found in both studies. Positive associations of various amino acids and a range of acylcarnitines with decreasing cardiovascular health indicate disruptions in mitochondrial, as well as peroxisomal fatty acid oxidation. We complemented our metabolite association analyses with whole blood and peripheral blood mononuclear cell (PBMC) gene-expression analyses of fatty acid oxidation and ketone-body metabolism related genes. This revealed several differential expressions for the heart failure biomarker N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in peripheral blood mononuclear cell (PBMC) gene expression. Finally, we constructed and compared three prediction models of significant stenosis in the LIFE-Heart study using (1) traditional risk factors only, (2) the metabolite panel only and (3) a combined model. Area under the receiver operating characteristic curve (AUC) comparison of these three models shows an improved prediction accuracy for the combined metabolite and classical risk factor model (AUC = 0.78, 95%-CI: 0.76–0.80). In conclusion, we improved our understanding of metabolic implications of ASCVD phenotypes by observing associations with metabolite concentrations and gene expression of the mitochondrial and peroxisomal fatty acid oxidation. Additionally, we demonstrated the predictive potential of the metabolite profile to improve classification of patients with significant stenosis.
    Type of Medium: Online Resource
    ISSN: 2218-1989
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662251-8
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  • 8
    In: Clinical Cardiology, Wiley, Vol. 43, No. 12 ( 2020-12), p. 1616-1623
    Abstract: Coronary artery disease (CAD) is a significant risk factor for atrial fibrillation (AF). Experimental studies demonstrated that atrial ischemia induced by right coronary artery (RCA) stenosis promote AF triggers and development of electro‐anatomical substrate for AF. Aim To analyze the association between AF prevalence and coronary arteries status in the LIFE‐Heart Study. Methods This analysis included patients with available coronary catheterization data recruited between 2006 and 2014. Patients with acute myocardial infarction were excluded. CAD was defined as stenosis ≥75%, while coronary artery sclerosis (CAS) was defined as non‐critical plaque(s) 〈 75%. Results In total, 3.458 patients (median age 63 years, 34% women) were included into analysis. AF was diagnosed in 238 (6.7%) patients. There were 681 (19.7%) patients with CAS and 1.411 (40.8%) with CAD (27.5% with single, 32.4% with double, and 40.1% with triple vessel CAD). In multivariable analysis, there was a significant association between prevalent AF and coronary artery status (OR 0.64, 95% CI 0.53‐0.78, P trend   〈  .001). Similarly, AF risk was lower in patients with higher CAD extent (OR 0.54, 95%CI 0.35‐0.83, P trend = .005). Compared to single vessel CAD, the risk of AF was lower in double (OR 0.42, 95%CI 0.19‐0.95, P = .037) and triple CAD (OR 0.31, 95%CI 0.13‐0.71, P = .006). Finally, no association was found between AF prevalence and CAD origin among patients with single vessel CAD. Conclusion In the LIFE‐Heart Study, CAS but not CAD was associated with increased risk of AF.
    Type of Medium: Online Resource
    ISSN: 0160-9289 , 1932-8737
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2048223-1
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  • 9
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 15 ( 2022-08-04), p. 9601-
    Abstract: Resilience is closely related to mental health and well-being. Identifying risk groups with lower resilience and the variables associated with resilience informs preventive approaches. Previous research on resilience patterns in the general population is heterogeneous, and comprehensive large-scale studies are needed. The aim of our study is to examine sociodemographic and social correlates of resilience in a large population-based sample. We examined 4795 participants from the LIFE-Adult-Study. Assessments included resilience (RS-11), social support (ESSI), and social network (LSNS), as well as the sociodemographic variables age, gender, marital status, education, and occupation. The association of resilience with sociodemographic and social correlates was examined using linear regression analyses. Higher resilience was associated with female gender, married marital status, high education, and full-time occupation. Social support and social network were positively associated with resilience. Our results implicate that resilience is related to various sociodemographic variables. Social variables seem to be particularly important for resilience. We identified risk groups with lower resilience, which should be given special attention by public health policies, especially in times of crisis. Reducing loneliness and promoting social connectedness may be promising ways to build resilience in the general population.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 10
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 52, No. 1 ( 2023-02-08), p. e66-e79
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1494592-7
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