Markers Of Cardiovascular Health Research Articles

A diagnostic index for predicting heart rate variability decline and prognostic value in newly diagnosed non-small cell lung cancer patients

BackgroundHeart rate variability (HRV) is an important marker of autonomic nervous system function and cardiovascular health. Holter monitoring is a crucial method for evaluating HRV, but the procedure and result analysis are relatively complex. This study aims to develop a simplified diagnostic index for predicting HRV decline in newly diagnosed non-small cell lung cancer (NSCLC) patients and evaluate its prognostic value.MethodsThis retrospective cross-sectional study included 131 newly diagnosed NSCLC patients. Baseline characteristics were compared between normal HRV group and declined HRV group. Univariate and multivariate logistic regression analyses identified significant predictors of HRV decline. A diagnostic index was developed based on resting heart rate (RHR), serum sodium, and interleukin-6 (IL-6) and externally validated. Kaplan-Meier survival analysis assessed the prognostic value of the index.ResultsPatients with declined HRV had higher median RHR (84 b.p.m. vs. 70 b.p.m., p < 0.001), lower serum sodium (136.3 mmol/L vs. 138.7 mmol/L, p < 0.001), lower serum albumin (39 g/L vs. 41 g/L, p = 0.031), higher lactate dehydrogenase (LDH) (202 U/L vs. 182 U/L, p = 0.010), and higher IL-6 (11.42 pg/ml vs. 5.67 pg/ml, p < 0.001). Multivariate analysis identified RHR (OR = 3.143, p = 0.034), serum sodium (OR = 6.806, p < 0.001), and IL-6 (OR = 3.203, p = 0.033) as independent predictors of HRV decline. The diagnostic index, with an area under the curve (AUC) of 0.849, effectively predicted HRV decline. ROC analysis of the external validation data demonstrated an AUC of 0.788. Survival analysis showed that patients with a diagnostic index > 2 had significantly worse overall survival (log-rank p < 0.001).ConclusionsThe study identified key clinical parameters that predict HRV decline in newly diagnosed NSCLC patients. The developed diagnostic index, based on RHR, serum sodium, and IL-6, effectively stratifies patients by HRV status and has significant prognostic value, aiding in early identification and management of high-risk patients.

Abstract 4137465: Estimating Arterial Stiffness Using a Smart Ring and the Impact of HIIT Exercise: A Pilot Study

Introduction: Arterial stiffness is an important marker of cardiovascular health, but measuring it requires specialized equipment and trained personnel. This study aimed to evaluate a novel method for estimating arterial stiffness using photoplethysmography (PPG) signals recorded by a commercially available device (Oura Ring) and to study the impact of a high-intensity interval training (HIIT) intervention on arterial stiffness. Research Questions: 1. Can a smart ring provide accurate estimates of arterial stiffness comparable to the reference device (Sphygmocor)? 2. Does a three-month supervised HIIT cycling protocol reduce arterial stiffness? Aims: 1. Evaluate a PPG-based arterial stiffness estimation method using a smart ring. 2. Assess the efficacy of HIIT in reducing arterial stiffness and improving VO2max. Methods: The study comprised two parts: 1. A cross-sectional study (N=300, age 18-78) for collecting arterial stiffness data using the Sphygmocor and the Smart Ring to evaluate the PPG-based algorithm. 2. A randomized exercise intervention pilot study (N=80, a subset of the cross-sectional study), assigned to either a three-month HIIT protocol or a control group. Arterial stiffness was measured pre- and post-intervention using both devices. Pearson’s correlation coefficients assessed the agreement between the novel method and reference device, and effects of the intervention were analyzed using ANCOVA. Results: The novel PPG-based method demonstrated good correlation with the Sphygmocor device (R = 0.77 and 0.80 in pre- and post-timepoints, respectively). However, despite improving the participants’ aerobic fitness (average increase in VO2max of 1.41 ml/min/kg; 95% CI: [0.15, 2.67], P = 0.029) the HIIT intervention did not significantly improve arterial stiffness, as measured by both methods. Conclusions: The developed smart ring method provides a reliable, non-invasive, and continuous estimation of arterial stiffness. This innovative approach could significantly impact how arterial stiffness is monitored in an everyday setting. The null results of the HIIT intervention suggest that HIIT may not be effective in reducing arterial stiffness, highlighting the need for further research into different exercise modalities for cardiovascular health improvement. This study underscores the potential of wearable technology in cardiovascular health monitoring and the importance of evaluating diverse exercise protocols for arterial health.

Blood circulation effect of fermented citrus bioconversion product (FCBP) in EA.hy926 endothelial cells and high-fat diet-fed mouse model.

The escalating global burden of cardiovascular diseases, largely driven by unhealthy lifestyle choices and dietary patterns, has intensified the search for effective and safe interventions. With current treatments often marred by significant side effects, the exploration of natural compounds such as flavonoids presents a compelling alternative. This study investigated the effects of fermented citrus bioconversion product (FCBP), a fermented citrus bioflavonoid, on various markers of cardiovascular health in the context of a high-fat diet. In vivo, a high-fat diet-induced mouse model was used to assess the effects of FCBP on body weight, serum nitric oxide (NO) levels, activated partial thromboplastin time (aPTT), phosphatidylserine (PS) exposure on red blood cells, and the expression of inflammatory markers Intercellular Adhesion Molecule (ICAM)-1 and Vascular Cell Adhesion Molecule (VCAM)-1 in the thoracic aorta. In vitro, EA.hy926 endothelial cells were used to evaluate the compound's effects on cell viability, NO production, endothelial nitric oxide synthase (eNOS) expression, and cell adhesion molecule (CAM) levels to further understand the mechanisms behind the in vivo findings. In vivo, FCBP supplementation led to a dose-dependent reduction in weight gain, a significant decrease in serum NO levels at 10 mg/kg, and reduced ICAM-1 and VCAM-1 expressions in the thoracic aorta, indicating anti-inflammatory properties. PS exposure on red blood cells was also reduced, suggesting decreased procoagulant activity, while aPTT remained unchanged. In vitro, FCBP was non-cytotoxic to endothelial cells, showed a trend toward increased NO production and eNOS expression, and reduced the expression of ICAM-1 and VCAM-1, supporting its potential anti-inflammatory effects. FCBP demonstrates potential as a bioactive compound for managing cardiovascular health by reducing inflammation, mitigating weight gain, and influencing blood circulation-related parameters under high-fat diet conditions. Further studies, including diverse models and human trials, are warranted to elucidate its mechanisms and compare its efficacy with established cardiovascular therapeutics.

Investigating lifestyle determinants of carotid intima-media thickness: cross-sectional insights from the UK biobank cohort

Abstract Background/Introduction Carotid intima-media thickness (CIMT) is recognised as a crucial marker for cardiovascular disease (CVD) risk, inherently associated with vascular ageing and influenced by biomarkers such as elevated levels of HbA1c, dyslipidaemia, and hypertension. The significance of CIMT lies in its potential to act as a surrogate marker for CVD risk, bridging a gap in understanding the progression of vascular health. Purpose This study aims to investigate the correlation between CIMT and a composite biomarker score to enhance risk assessment and guide the prevention and treatment strategies for CVD. By examining this relationship, the study seeks to underline the importance of CIMT progression as an indicative marker for cardiovascular health. Methods A subset of participants from the UK Biobank, with valid CIMT measurements taken in 2014, was selected for this analysis. CIMT was measured through ultrasound techniques and considered the primary outcome variable, treated as continuous in the analysis. A linear regression model was used to examine the correlation between CIMT and lifestyle risk factors, with a focus on the moderating effects of sex. Results The study included 29,292 UK Biobank participants (48% female, mean age 64 years), with a mean CIMT of 687.11µm (SD 124.28). Significant predictors of CIMT were age (β=6.05) and male gender (β=13.02). Lifestyle factors such as body weight (β=0.84) and high physical activity (β=10.66) were positively correlated with CIMT. Current smokers showed a stronger association with CIMT (β=14.47) compared to former smokers (β=9.21). In females, age (β=6.07), body weight (β=0.71), CRBI score (β=9.95), and previous smoking (β=6.64) positively correlated with CIMT, while high CRP levels were negatively associated (β=-0.61). In males, significant factors included age (β=6.04), body weight (β=0.95), CRBI score (β=10.79), and smoking history, with previous smokers showing a stronger effect (β=11.67) and high physical activity notably associated with increased CIMT (β=18.73). Conclusion(s) The study's findings highlight the impact of lifestyle choices on vascular health, demonstrating that active living, maintaining a healthy weight, and abstaining from smoking can positively affect CIMT and thereby reduce CVD risk. The results confirm the importance of weight management for arterial health across all demographics and highlight the role of abnormal biomarker levels in increasing CIMT. This study contributes to a deeper understanding of the factors affecting CIMT and, by extension, cardiovascular health, advocating for targeted lifestyle interventions to mitigate CVD risk.

6602 Classification of TSH Trajectories During Levothyroxine Treatment in the ELSA-Brasil Cohort

Abstract Disclosure: M.D. Ettleson: None. G.C. Penna: Consulting Fee; Self; Ipsen, Bayer, Inc.. W. Wan: None. I.M. Bensenor: None. N. Laiteerapong: None. A.C. Bianco: Consulting Fee; Self; Abbvie. Classification of TSH Trajectories During Levothyroxine Treatment in the ELSA-Brasil Cohort Introduction: Hypothyroidism is a common endocrine disorder for which levothyroxine (LT4) serves as the primary treatment. Periods during which thyroid stimulating hormone (TSH) levels are outside the normal range have been associated with adverse cardiovascular outcomes, including mortality. In practice, serial TSH levels are measured over time to ensure therapeutic LT4 treatment is maintained. However, there is no measure of the quality of treatment maintenance over time. TSH trajectory classification represents a novel approach to define the adequacy of LT4 treatment for hypothyroidism over time utilizing multiple observation points. Methods: With longitudinal clinical data, including thyroid function from a large prospective study, we aimed to define classes of TSH trajectories and examine changes in cardiovascular (CV) health markers over a 9 year study period with three observation points. Growth mixture modeling (GMM), including latent class growth analysis (LCGA), was used to classify LT4-treated individuals participating in the Longitudinal Study of Adult Health in Brazil (ELSA-Brasil) based on serial TSH levels. Repeated measure analyses were then utilized to measure within-class changes in blood pressure, lipid levels, hemoglobin A1c, and CV-related medication utilization. Results: From the 621 LT4-treated study participants, the best-fit GMM approach identified four TSH trajectory classes, as defined by their relationship to the normal TSH range: 1) High-high normal TSH, 2) Normal TSH, 3) Normal-to-low TSH, and 4) Low-to-normal TSH. Notably, the average baseline LT4 dose was lowest in the high-high normal TSH group (77.7 mcg, p <0.001). There were no significant differences in CV health markers between the classes at baseline. At least one significant difference in CV markers occurred in all classes, highlighted by the low-to-normal class, in which total and HDL cholesterol, triglycerides, and A1c all increased significantly (p = 0.049, p <0.001, p <0.001, and p = 0.001, respectively). Medication utilization increased in all classes over the study period. Conclusion: GMM/LCGA represents a viable approach to define and examine LT4 treatment by TSH trajectory. In the future, more comprehensive datasets will allow for more complex trajectory modeling and analysis of clinical outcome differences between trajectory classes. Defining the adequacy of LT4 treatment using a longitudinal scope could allow clinicians to more accurately communicate treatment progress and identify patients at risk for adverse CV outcomes. Presentation: 6/3/2024

Associations of plasma phospholipid cis-vaccenic acid with insulin resistance markers in non-diabetic men with hyperlipidemia

BackgroundThe role of fatty acids (FA) in the pathogenesis of insulin resistance and hyperlipidemia is a subject of intensive research. Several recent works have suggested cis-vaccenic acid (cVA) in plasma lipid compartments, especially in plasma phospholipids (PL) or erythrocyte membranes, could be associated with markers of insulin sensitivity and cardiovascular health. Nevertheless, not all the results of research work testify to these beneficial effects of cVA. Therefore, we decided to investigate the relations of proportion of cVA in plasma PL to markers of insulin resistance in hyperlipidemic men.SubjectsIn 231 men (median age 50) with newly diagnosed hyperlipidemia, we analyzed basic clinical parameters together with FA composition of plasma PL and stratified them according to the content of cVA into upper quartile (Q4) and lower quartile (Q1) groups. We examined also small control group of 50 healthy men.ResultsThe individuals in Q4 differed from Q1 by lower plasma insulin (p < 0.05), HOMA-IR values (p < 0.01), and apolipoprotein B concentrations (p < 0.001), but by the higher total level of nonesterified FA (p < 0.01). Both groups had similar age, anthropometrical, and other lipid parameters. In plasma PL, the Q4 group had lower content of the sum of n-6 polyunsaturated FA, due to decrease of γ-linolenic and dihomo-γ-linolenic acids, whereas the content of monounsaturated FA (mainly oleic and palmitoleic) was in Q4 higher.ConclusionsOur results support hypothesis that plasma PL cVA could be associated with insulin sensitivity in men with hyperlipidemia.

Lifestyle, biological, and genetic factors related to brain iron accumulation across adulthood

Iron is necessary for many neurobiological mechanisms, but its overaccumulation can be harmful. Factors triggering age-related brain iron accumulation remain largely unknown and longitudinal data are insufficient. We examined associations between brain iron load and accumulation and, blood markers of iron metabolism, cardiovascular health, lifestyle factors (smoking, alcohol use, physical activity, diet), and ApoE status using longitudinal data from the IronAge study (n = 208, age = 20–79, mean follow-up time = 2.75 years). Iron in cortex and basal ganglia was estimated with magnetic resonance imaging using quantitative susceptibility mapping (QSM). Our results showed that (1) higher peripheral iron levels (i.e., composite score of blood iron markers) were related to greater iron load in the basal ganglia; (2) healthier diet was related to higher iron levels in the cortex and basal ganglia, although for the latter the association was significant only in younger adults (age = 20–39); (3) worsening cardiovascular health was related to increased iron accumulation; (4) younger ApoE ε4 carriers accumulated more iron in basal ganglia than younger non-carriers. Our results demonstrate that modifiable factors, including lifestyle, cardiovascular, and physiological ones, are linked to age-related brain iron content and accumulation, contributing novel information on potential targets for interventions in preventing brain iron-overload.

The Impact of Exercise on C-reactive Protein Levels in Hypertensive Patients: A Systematic Review.

Hypertension, defined as persistently elevated blood pressure, is a prevalent chronic condition and a significant global health issue, closely linked to cardiovascular complications, with inflammation being one of the underlying mechanisms. In hypertensive patients, C-reactive protein (CRP), an inflammatory marker, is often elevated and associated with increased cardiovascular risk. Alongside pharmacotherapy, exercise is recommended as a non-pharmacological approach to managing hypertension, with evidence suggesting that exercise can also reduce inflammation. This study examines the impact of exercise on CRP levels in hypertensive patients. Fourteen studies focusing on exercise interventions and physical fitness related to CRP in individuals with high blood pressure were identified through an extensive search of PubMed, PubMed Central, ScienceDirect, Cochrane Library, and Google Scholar. The findings indicated that most studies involving aerobic exercise consistently demonstrated reductions in CRP levels among hypertensive patients, with significant effects observed under supervised conditions, and additional benefits seen when combined with dietary control. Resistance training showed mixed results, with significant reductions in CRP observed primarily in longer-term interventions. Combined exercise training, incorporating both aerobic and resistance elements, effectively reduced CRP levels and improved cardiovascular health markers. Physical fitness assessments, such as a bicycle exercise test to exhaustion, revealed a relationship between physical fitness and decreased CRP levels. Therefore, regular, consistent aerobic and combined training, as well as prolonged resistance exercise, significantly reduce CRP levels in hypertensive patients, highlighting exercise's role as a non-pharmacological strategy for managing hypertension through the reduction of inflammation. Further research is essential to validate these findings and investigate the underlying mechanisms and differential effects of various exercise modalities.

Demographic and Lifestyle Factors Influencing Cardiovascular Health Among Construction Workers: A Cross-Sectional Analysis

This study examined cardiometabolic parameters and their relationships among construction workers with varying smoking status. This study examines construction workers' cardiovascular (CV) health status, the variations among gender, age, and education groups, and the interaction between CV health (CVH) variables and health practices. This cross-sectional study included 210 construction workers (159 non-smokers and 51 smokers). Anthropometric measures, blood pressure, fasting blood sugar, total cholesterol, and physical activity levels were evaluated. Pearson's correlation analysis was performed to evaluate associations between variables. Smokers exhibited higher physical activity levels (p=0.03), while pulse pressure was similar between groups. Body mass index had a weak positive connection with diastolic blood pressure (r=0.147, p=0.034) and pulse pressure (r=0.137, p=0.048). Systolic blood pressure (r=0.697, p&lt;0.001) and pulse pressure (r=0.965, p&lt;0.001) showed strong positive relationships, while physical activity had a modest link with fasting blood sugar (r=0.145, p=0.036). The study highlights the relationships between cardiometabolic factors and physical activity levels among construction workers, emphasizing the potential impact of lifestyle factors on cardiovascular health in this occupational group. About one-fourth of the construction workers accomplished only four of the seven "ideal" CVH markers. Because of their stressful jobs and unhealthy lifestyles, construction workers have a moderate to high risk of CV disease.

Mediterranean diet enriched with olive oil shows no consistent benefits on cardiometabolic and anthropometric parameters: a systematic review with meta-analysis of randomized controlled trials.

Cardiovascular disease (CVD) is the primary cause of death worldwide but there is a variation in its burden across some nations that seems to be related to dietary habits. Mediterranean populations have lower rates of morbidity and mortality from CVD. Thus, this systematic review and meta-analysis aimed to assess the impacts of the Mediterranean diet (MedDiet) enriched with olive oil on blood lipids, glycemic indices, blood pressure, and anthropometric indices. A comprehensive search of the Web of Science, PubMed (MEDLINE), Scopus, Cochrane Library, Google Scholar, Embase, and CINAHL databases until March 2024 was conducted to identify clinical trials studying the effects of MedDiet enriched with olive oil on the aforementioned parameters. In total, 3303 records were retrieved. A total of 18 clinical trials met the inclusion criteria after records were screened for eligibility. According to the pooled analysis from the random-effects model, the MedDiet enriched with olive oil significantly reduced triglycerides (TG) compared with the control group (WMD = -2.40mg/dl; 95%CI, -4.533 to -0.262; P = 0.027). Strong heterogeneity was observed. Sensitivity analysis did not change our results and no significant effect of any trial on the overall effect sizes of all variables were found. There was a concern about the reporting bias for some studies which reported some main outcomes. MedDiet enriched with olive oil showed no consistent effects on any of the reported markers of cardiovascular health except on TG. CRD42023424641.

Chronic low arsenic exposure in private wells and early markers of diabetes and cardiovascular health

Chronic low arsenic exposure in private wells and early markers of diabetes and cardiovascular health

The Effect of Mandibular Advancement Devices on Sympathetic Nerve Activity and Markers of Cardiovascular Health in Obstructive Sleep Apnea Patients: A Prospective Case Series Protocol

The Effect of Mandibular Advancement Devices on Sympathetic Nerve Activity and Markers of Cardiovascular Health in Obstructive Sleep Apnea Patients: A Prospective Case Series Protocol

Effects of polarised, sprint interval, high-intensity interval, and low-intensity training programs on aerobic fitness and cardiovascular health markers in active individuals

Effects of polarised, sprint interval, high-intensity interval, and low-intensity training programs on aerobic fitness and cardiovascular health markers in active individuals

Vitamin D supplementation for cardiometabolic risk markers in pregnant women based on the gestational diabetes mellitus or obesity status : a randomized clinical trial.

Women with gestational diabetes mellitus (GDM) or obesity are vulnerable to impaired gestational cardiovascular health (CVH) and cardiovascular disease (CVD) in the future. It is unclear if prenatal vitamin D supplementation improves gestational CVH, especially in women at high risk for developing CVD. Our goal was to find out if vitamin D supplementation could protect against gestational CVH, including the women with GDM or obesity. We randomly assigned women with a serum 25(OH)D concentration < 75 nmol/L to receive 1600 IU/d (intervention group) or 400 IU/d (control group) of vitamin D3 for two months at 24-28 weeks' gestation. The primary outcome was gestational CVH marks (lipids, inflammatory cytokines, endothelial function). There were 1537 participants divided into the intervention (N = 766) and control groups (N = 771). No baseline differences existed among study groups in CVH markers. At the two-month visit, the intervention group's HDL-C levels (2.01 ± 0.39 VS 1.96 ± 0.39 mmol/L) were significantly higher than those of the control group, while the hs-CRP levels were significantly lower (3.28 ± 2.02 VS 3.64 ± 2.42mg/L). Subgroup analysis found that HDL-C, TC, hs-CRP, E-Selectin, and SBP were improved in the intervention group among women with GDM or overweight/obesity, and the improvement was not found in women without GDM or overweight/obesity. Vitamin D supplementation significantly decreased the mean triglyceride-glucose index at the two-month visit in women with GDM. Vitamin D supplementation at mid-gestation might optimize the gestational CVH status for pregnant women, particularly the women with GDM or obesity, which is advantageous for later-life primary prevention of CVD. The Chinese Clinical Trial Registry (ChiCTR2100051914, 10/9/2021, Prospective registered, https://www.chictr.org.cn/showproj.aspx?proj=134700 ).

Effects of volume-matched once-weekly and thrice-weekly high-intensity interval training (HIIT) on body adiposity in adults with central obesity: Study protocol for a randomized controlled trial

ObjectiveThis study aims to examine the comparative effects of 75 min of volume-matched once-weekly and thrice-weekly high-intensity interval training (HIIT) on body adiposity in adults with central obesity. MethodsThis assessor-blinded, three-arm, randomized controlled trial will recruit 315 physically inactive adults with central obesity (aged ≥18 years, body mass index ≥23, waist circumference ≥90 cm for men and ≥80 cm for women). Participants will be randomly allocated to the once-weekly HIIT, thrice-weekly HIIT or usual care control group. Participants in the HIIT groups will receive weekly exercise training sessions for 16 weeks, prescribed either once or three times weekly. Each HIIT session will consist of a supervised program of four 4-min high-intensity intervals at 85%–95% peak heart rate (HRpeak) interspersed with 3-min active recovery intervals at 50%–70% HRpeak. Participants in the once-weekly HIIT group will perform the 25-min HIIT bout three times with a break between each 25-min HIIT bout. The usual care control group will receive bi-weekly health education classes. The outcome assessments will be conducted at baseline, 16 weeks (post-intervention) and 32 weeks (follow-up). The primary outcome will be total body adiposity assessed by dual-energy X-ray absorptiometry (DXA). The secondary outcome measures will include markers of cardiovascular and metabolic health (body composition, cardiorespiratory fitness, blood pressure, and blood lipids), mental health, cognitive performance, health-related quality of life, sleep quality, habitual physical activity, diet, medication, adverse events and adherence to the intervention. Impact of the projectThe findings from this study are expected to consolidate the therapeutic efficacy of HIIT for the management of central obesity and inform the comparative compliance, feasibility and suitability of once-weekly and thrice-weekly HIIT as exercise strategies to manage obesity. In particular, the present study is expected to provide a novel perspective on the utility of low-frequency HIIT (i.e., once-weekly) as an effective and sustainable exercise strategy to tackle the obesity pandemic. The anticipated findings will hold substantial translational value by informing public health policies and enhancing exercise compliance in the physically inactive obese population. Trial registrationClinicalTrials.gov (NCT04887454).

TSH Trajectories During Levothyroxine Treatment in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Cohort.

Thyroid-stimulating hormone (TSH) trajectory classification represents a novel approach to defining the adequacy of levothyroxine (LT4) treatment for hypothyroidism over time. This is a proof of principle study that uses longitudinal clinical data, including thyroid hormone levels from a large prospective study to define classes of TSH trajectories and examine changes in cardiovascular (CV) health markers over the study period. Growth mixture modeling (GMM), including latent class growth analysis (LCGA), was used to classify LT4-treated individuals participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) based on serial TSH levels. Repeated measure analyses were then utilized to assess within-class changes in blood pressure, lipid levels, hemoglobin A1c, and CV-related medication utilization. From the 621 LT4-treated study participants, the best-fit GMM approach identified 4 TSH trajectory classes, as defined by their relationship to the normal TSH range: (1) high-high normal TSH, (2) normal TSH, (3) normal to low TSH, and (4) low to normal TSH. Notably, the average baseline LT4 dose was lowest in the high-high normal TSH group (77.7 µg, P < .001). There were no significant differences in CV health markers between the classes at baseline. At least 1 significant difference in CV markers occurred in all classes, highlighted by the low to normal class, in which total and high-density lipoprotein cholesterol, triglycerides, and A1c all increased significantly (P = .049, P < .001, P < .001, and P = .001, respectively). Utilization of antihypertensive, antihyperlipidemic, and antidiabetes medications increased in all classes. GMM/LCGA represents a viable approach to define and examine LT4 treatment by TSH trajectory. More comprehensive datasets should allow for more complex trajectory modeling and analysis of clinical outcome differences between trajectory classes.

Association of physical activity and screen time with cardiovascular disease risk in the Adolescent Brain Cognitive Development Study

BackgroundAccording to the Physical Activity Guidelines Advisory Committee Scientific Report, limited evidence is available on sedentary behaviors (screen time) and their joint associations with physical activity (steps) for cardiovascular health in adolescence. The objective of this study was to identify joint associations of screen time and physical activity categories with cardiovascular disease (CVD) risk factors (blood pressure, hemoglobin A1c, cholesterol) in adolescence.MethodsThis study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, comprising a diverse sample of 4,718 U.S. adolescents aged 10–15 years between 2018 and 2021. Steps were measured by a Fitbit wearable device and levels were categorized as low (1,000–6,000), medium (> 6,000–12,000), and high (> 12,000) averaged daily step counts. Self-reported recreational screen time hours per day were classified as low (0–4), medium (> 4–8), and high (> 8) hours per day. CVD risk factors including blood pressure, hemoglobin A1c, and cholesterol (total and HDL) were measured.ResultsThe analytical sample averaged 6.6 h of screen time per day and 9,722 steps per day. In models including both screen time and steps, the high screen time category was associated with a 4.27 higher diastolic blood pressure percentile (95% CI 1.83–6.73) and lower HDL cholesterol (B= -2.85, 95% CI -4.77 to -0.94 mg/dL) compared to the low screen time category. Medium (B = 3.68, 95% CI 1.24–6.11) and low (B = 7.64, 95% CI 4.07–11.20) step categories were associated with higher diastolic blood pressure percentile compared to the high step category. The medium step category was associated with lower HDL cholesterol (B= -1.99, 95% CI -3.80 to -0.19 mg/dL) compared to the high step category. Findings were similar when screen time and step counts were analyzed as continuous variables; higher continuous step count was additionally associated with lower total cholesterol (mg/dL).ConclusionsCombinations of low screen time and high steps were generally associated with favorable cardiovascular health markers including lower diastolic blood pressure and higher HDL cholesterol, which can inform future adolescent health guidelines.

Echocardiographic Evaluation of Left Ventricular Hypertrophy

Abstract Left ventricular hypertrophy (LVH) can occur as a result of increase in the left ventricular (LV) wall thickness or increase in the LV cavity size, thus leading to increase in the LV mass. Strength training and aerobic exercise lead to physiological LVH, whereas conditions such as hypertension and aortic stenosis (AS) cause pathological LVH. It is one aspect of ventricular remodeling. LVH can also occur because of some primary myocardial diseases as well as due to certain infiltrative disorders. LVH is not a disease in itself, but a manifestation of some other disease. LVH is a marker of adverse cardiovascular health and remodeling and is associated with a high risk of adverse cardiac outcomes. Besides this, LVH itself can lead to heart failure or sudden cardiac death. Hence, a thorough assessment of LVH is important for proper management of the underlying condition. Echocardiography and cardiac magnetic resonance imaging are the two most important imaging modalities used for the assessment of LVH. This review describes various echocardiography techniques for LVH assessment as well as echocardiographic recognition of the underlying etiological condition.

Contributors to Diminished Cardiorespiratory Fitness in Young Users of Electronic Cigarettes

Background: Cardiorespiratory fitness, an independent marker of cardiovascular health, represents the ability of respiratory, cardiovascular, and muscular systems to effciently deliver and utilize oxygen (O2) during exercise. Recently, reduced cardiorespiratory fitness was identified in young and healthy, regular users of electronic (e-) cigarettes; however, its limiting factors are not established. Thus, the purpose of this study was to investigate the contributors to impaired cardiorespiratory fitness in young regular users of e-cigarettes. Methods: An evaluation of hemodynamics, chronotropic response, and oxygen utilization during exercise was completed in nineteen regular users of e-cigarettes (EU, age: 23±3 yr; e-cigarette usage 4±2 yr.) and sixteen demographically matched non-users (NU, age: 23±3 yr.). Hemodynamics were accessed via a non-invasive signal morphology impedance cardiography device, while chronotropic responses were measured as changes in peak heart rate (HR). Oxygen extraction ratio (difference in arterial and venous O2 content) at baseline and peak exercise was also recorded. Fold changes from rest to peak exercise were assessed to provide insight into potential factors that limit cardiorespiratory fitness. Results: At peak exercise, users of e-cigarettes exhibited significantly higher chronotropic incompetence ( p=0.033) and lower ( p=0.047) peak HR than non-users, with no differences in other hemodynamic assessments. Significantly ( p=0.025) lower skeletal muscle O2 extraction (EU=51±11 vs. NU=61±10%) was also observed in users of e-cigarettes during peak exercise. Fold changes in chronotropic (HR; p=0.915) and hemodynamic (cardiac output; p=0.279) responses were similar between both groups, while significant ( p=0.048) differences in oxygen extraction ratio were identified between the users of e-cigarettes (0.5±0.3 fold change) and non-users (0.8±0.3 fold change). Conclusions: Results from our study demonstrate that young, regular users of e-cigarettes exhibit abnormal chronotropic responses and impaired skeletal muscle oxygen utilization during exercise when compared to non-users, suggesting reduced cardiovascular and muscle health. Overall, our findings contribute to the growing body of evidence that supports the negative effects of regular e-cigarette use on young individuals. Supported in part by a Rapid Response Project NIDA/FDA (PRM). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Identification of gene networks jointly associated with depressive symptoms and cardiovascular health metrics using whole blood transcriptome in the Young Finns Study.

Studies have shown that cardiovascular health (CVH) is related to depression. We aimed to identify gene networks jointly associated with depressive symptoms and cardiovascular health metrics using the whole blood transcriptome. We analyzed human blood transcriptomic data to identify gene co-expression networks, termed gene modules, shared by Beck's depression inventory (BDI-II) scores and cardiovascular health (CVH) metrics as markers of depression and cardiovascular health, respectively. The BDI-II scores were derived from Beck's Depression Inventory, a 21-item self-report inventory that measures the characteristics and symptoms of depression. CVH metrics were defined according to the American Heart Association criteria using seven indices: smoking, diet, physical activity, body mass index (BMI), blood pressure, total cholesterol, and fasting glucose. Joint association of the modules, identified with weighted co-expression analysis, as well as the member genes of the modules with the markers of depression and CVH were tested with multivariate analysis of variance (MANOVA). We identified a gene module with 256 genes that were significantly correlated with both the BDI-II score and CVH metrics. Based on the MANOVA test results adjusted for age and sex, the module was associated with both depression and CVH markers. The three most significant member genes in the module were YOD1, RBX1, and LEPR. Genes in the module were enriched with biological pathways involved in brain diseases such as Alzheimer's, Parkinson's, and Huntington's. The identified gene module and its members can provide new joint biomarkers for depression and CVH.