Journal of the American Heart Association最新文献

{"title":"Sex-Specific Cardiovascular Consequences of Long-Term High-Salt Diet in Mice.","authors":"João M N Duarte, Sevilay Sahoglu-Göktas, Lotte Vanherle, Zeinab Rafiee, Sneha Prakash, Kerstin Stemmer, Karl Swärd, Martin Magnusson, Anja Meissner","doi":"10.1161/JAHA.125.041945","DOIUrl":"https://doi.org/10.1161/JAHA.125.041945","url":null,"abstract":"<p><strong>Background: </strong>Excessive dietary salt intake is associated with elevated blood pressure and damage to organs including the heart, vasculature, and kidneys. Women are more prone to salt-sensitive hypertension, yet preclinical studies often focus on men.</p><p><strong>Methods: </strong>To examine sex-specific responses to chronic salt loading, male and female C57Bl6/J mice were fed a high-salt diet (HSD; 8% NaCl) from 7 to 14 months of age. Subsets of HSD mice were switched to a normal diet after 28 weeks. Blood pressure was measured via tail-cuff plethysmography, and cardiac function assessed by magnetic resonance imaging. Vascular responses were analyzed by wire myography, and histological and molecular analyses were performed on heart, aorta, and kidney tissues.</p><p><strong>Results: </strong>After 56 weeks, only HSD-fed females exhibited increased systolic blood pressure (<i>P</i>=0.015), whereas HSD-fed males showed elevated left ventricular stroke volume, end-diastolic volume, and mass (<i>P</i><0.05). Males displayed aortic remodeling with increased wall thickness and synthetic smooth muscle marker expression. Mesenteric arteries had impaired contractile responses in males, whereas α1-adrenergic tone was elevated in HSD-fed females. Despite no overt renal injury, renal vascular thickening was observed in HSD males and glomerulosclerosis in normal diet females. Diet reversal normalized blood pressure in females and reversed cardiac changes in males.</p><p><strong>Conclusions: </strong>Chronic high salt intake leads to distinct sex-specific cardiovascular remodeling in mice. Importantly, diet reversal mitigates these effects, highlighting the potential of dietary interventions in salt-sensitive cardiovascular risk.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041945"},"PeriodicalIF":5.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity, Gut Microbiota, and the Risk of Dyslipidemia in a Community-Based Cohort Study.","authors":"Wuqi Wang, Shaoxian Liang, Hongjuan Cao, Yong Lyu, Qihong Zhao, Zhuang Zhang, Wanshui Yang","doi":"10.1161/JAHA.125.043797","DOIUrl":"https://doi.org/10.1161/JAHA.125.043797","url":null,"abstract":"<p><strong>Background: </strong>Whether moderate-to-vigorous physical activity (MVPA) mitigates the detrimental association between sedentary behavior and dyslipidemia remains unclear, as does the link between MVPA and gut microbiota.</p><p><strong>Methods: </strong>We prospectively evaluated the joint association between MVPA and sedentary time on dyslipidemia risk in a cohort of 2942 Chinese adults, where PA was measured by a validated self-reported questionnaire. In a subcohort (<i>n</i>=754), 1-year gut microbial changes associated with MVPA were assessed via fecal samples collected twice at 1-year intervals for 16S ribosomal RNA sequencing, with PA intensively assessed by 4 quarterly 3-day PA diaries (2 weekdays and 1 weekend day) during the year.</p><p><strong>Results: </strong>From 2020 to 2025, 306 dyslipidemia were newly diagnosed. Prolonged sedentary hours increased dyslipidemia risk by 63% (highest versus lowest tertile: adjusted hazard ratio [HR], 1.63 [95% CI, 1.19-2.22], <i>P</i>_trend=0.002). Compared with participants with long sedentary hours and low MVPA levels (ie, long-low group), HRs of dyslipidemia for those in short-high, short-low, and long-high groups were 0.70 (95% CI, 0.50-0.98), 0.99 (95% CI, 0.71-1.37), and 0.83 (95% CI, 0.60-1.16), respectively. The microbial α-diversity declined in the low MVPA group (<i>P</i>=0.024), and β-diversity shifted in both low/high MVPA groups (all <i>P</i>≤0.005). We identified 7 MVPA-associated and 13 sedentary time-associated genera (all <i>P</i>_{FALSE DISCOVERY RATE}<0.05). Among these genera, <i>Eggerthella</i> and <i>Desulfovibrio</i> correlated positively with MVPA levels but inversely with sedentary time, and <i>Desulfovibrio</i> was inversely associated with dyslipidemia (odds ratio, 0.78 [95% CI, 0.606-0.997]).</p><p><strong>Conclusions: </strong>MVPA attenuates the positive association between sedentary time and dyslipidemia risk and modulates gut microbial diversity and richness, suggesting microbiota-mediated pathways for dyslipidemia prevention.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e043797"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Antiplatelet Therapy After Endovascular Aortic Repair: A Target Trial Emulation.","authors":"Ki Hong Choi, Danbee Kang, Jihee Nam, Take Kyu Park, Myung Gyu Song, Tae-Seok Seo, Woo Jin Yang, Seung-Hyuk Choi","doi":"10.1161/JAHA.125.044102","DOIUrl":"https://doi.org/10.1161/JAHA.125.044102","url":null,"abstract":"<p><strong>Background: </strong>The optimal antiplatelet regimen after standard endovascular aneurysm repair (EVAR) in patients without atherosclerotic cardiovascular disease remains uncertain. Clinical guidelines offer limited recommendations, and data specific to this population are sparse. This study aimed to compare the efficacy and safety of single versus dual antiplatelet therapy (DAPT) in patients undergoing standard EVAR for abdominal aortic aneurysms without established atherosclerotic cardiovascular disease.</p><p><strong>Methods: </strong>This study emulated a target trial using the Korean National Health Insurance Service database, which includes the entire Korean population. We identified all patients who underwent standard EVAR between January 2003 and September 2023 and excluded those with atherosclerotic cardiovascular disease or no antiplatelet therapy. Patients were categorized by discharge medication into single antiplatelet therapy or DAPT groups. The primary cardiovascular efficacy end point was major adverse cardiac and cerebrovascular events (all-cause death, myocardial infarction, or ischemic stroke). The EVAR-specific efficacy end point was abdominal aortic aneurysm reintervention or surgery. The safety end point was major or clinically relevant nonmajor bleeding. Inverse probability treatment weighting was applied to adjust baseline differences.</p><p><strong>Results: </strong>Among 8325 patients, 4162 (50.0%) received single antiplatelet therapy (80.6% aspirin, 19.4% clopidogrel), and 4163 (50.0%) received DAPT (aspirin plus clopidogrel). There were no significant differences between single antiplatelet therapy and DAPT in the risk of major adverse cardiac and cerebrovascular events (inverse probability treatment weighting-hazard ratio [HR], 1.07 [95% CI, 0.93-1.22]) or abdominal aortic aneurysm reintervention/surgery (inverse probability treatment weighting-HR, 1.07 [95% CI, 0.92-1.24]). However, DAPT was associated with a higher risk of major or clinically relevant nonmajor bleeding (inverse probability treatment weighting-HR, 1.20 [95% CI, 1.02-1.41]).</p><p><strong>Conclusions: </strong>In patients without atherosclerotic cardiovascular disease undergoing standard EVAR, DAPT did not confer cardiovascular or procedural benefit but was associated with increased bleeding. Single antiplatelet therapy may represent a safer and equally effective antiplatelet strategy in this population.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov; Unique Identifier: NCT06876727.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e044102"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction Between Chronotype and the Timing of Antihypertensive Medication on Cardiovascular Events and Death.","authors":"Scott R Garrison, Jeffrey A Bakal, Michael R Kolber, Christina S Korownyk, Lee A Green, Jessica E M Kirkwood, Finlay A McAlister, Raj S Padwal, Richard Lewanczuk, Michael D Hill, Alexander G Singer, Alan Katz, Michael D Kelmer, Armine Gayayan, Farah N Campbell, Ana Vucenovic, Nathan R Archibald, Jack M S Yeung, Erik R E Youngson, Kimberlyn McGrail, Braden G O'Neill, Michelle Greiver, Donna P Manca, Ting Wang, Braden J Manns, Dee A Mangin, Cathy MacLean, James McCormack, Sabrina T Wong, Colleen Norris, G Michael Allan","doi":"10.1161/JAHA.125.044278","DOIUrl":"https://doi.org/10.1161/JAHA.125.044278","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e044278"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime Exposure to Violence and Early Cardiometabolic Risk Factors in a Healthy Swedish Cohort.","authors":"Rebekka Lynch, Thor Aspelund, Fang Fang, Jacob Bergstedt, Arna Hauksdóttir, Filip K Arnberg, Þórdís Jóna Hrafnkelsdóttir, Nancy L Pedersen, Unnur Valdimarsdóttir","doi":"10.1161/JAHA.123.032827","DOIUrl":"https://doi.org/10.1161/JAHA.123.032827","url":null,"abstract":"<p><strong>Background: </strong>Violence exposure has been associated with cardiovascular disease. Less is known about underlying mechanisms, including early cardiometabolic risk factors, and possible sex differences of such associations.</p><p><strong>Methods: </strong>We used data from the Swedish LifeGene study on 23 215 men and women, aged 18 to 50 years. Participants answered the Life Stressor Checklist-Revised regarding physical and sexual violence alongside questions on medical diagnoses of hypertension, diabetes, dyslipidemia, and smoking history in 2009 to 2016. At a clinical visit, blood pressure, body mass index, glycated hemoglobin, total cholesterol, apolipoprotein B/apolipoprotein A1 ratio, and hs-CRP (high-sensitivity C-reactive protein) were measured. Modified Poisson and linear regression were used to test the association between violence and cardiometabolic risk factors.</p><p><strong>Results: </strong>At mean age 33±8 years, lifetime exposure to violence was reported by 23% of women and 15% of men. Those exposed to violence reported higher prevalence of smoking (prevalence ratio [PR], 1.74 [95% CI, 1.56-1.94]) and diagnosis of hypertension (PR, 1.36 [95% CI, 1.15-1.60]) but not hyperlipidemia (PR, 1.06 [95% CI, 0.82-1.36]). Men and women exposed to violence had higher body mass index (Beta, 0.45 [95% CI, 0.39-0.63]) and hs-CRP (Beta, 0.08 [95% CI, 0.04-0.13]), after multivariable adjustment, whereas no differences were observed in glycated hemoglobin (B, 0.04 [95% CI, -0.11 to 0.18]) or total cholesterol (Beta, -0.01 [95% CI, -0.05 to 0.02]), and systolic blood pressure was marginally lower among individuals exposed to violence (B, -0.42 [95% CI, -0.78 to -0.06]).</p><p><strong>Conclusions: </strong>In a young healthy Swedish sample, lifetime exposure to physical and/or sexual violence was associated with some but not all early cardiometabolic risk factors among both men and women.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e032827"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interatrial Block Detected by a Series of ECGs Before and During Acute Coronary Syndrome Predicts Atrial Fibrillation, Atrial Flutter, and Ischemic Stroke.","authors":"Ville Aarnivala, Tiia Istolahti, Matilda Hurskainen, Juho Tynkkynen, Hanna Pohjantähti, Leo-Pekka Lyytikäinen, Kjell Nikus, Jussi Hernesniemi","doi":"10.1161/JAHA.125.041313","DOIUrl":"https://doi.org/10.1161/JAHA.125.041313","url":null,"abstract":"<p><strong>Background: </strong>Interatrial block (IAB) in an ECG, manifesting atrial pathology, is a possible risk factor for atrial arrhythmias and ischemic stroke. IAB is often transiently expressed, posing a major challenge for risk estimation when only a limited number of ECGs are available.</p><p><strong>Methods: </strong>This is a retrospective study of 9674 consecutive patients diagnosed with acute coronary syndrome (ACS) between 2007 and 2018. All standard ECGs registered between January 2007 and March 2023 (n=206 668) were digitally stored and analyzed using the General Electric Marquette 12SL algorithm for the presence of an IAB, atrial fibrillation, and atrial flutter. The population was stratified by the extent of the IAB, and patients without an IAB served as controls. Clinical phenotype data and end point data for ischemic stroke were collected by a full disclosure review of hospital records and death certificate data including written accounts of deaths.</p><p><strong>Results: </strong>The prevalence of an advanced IAB was 8.5% if all previous ECGs, including those recorded during ACS, were screened, whereas it was only 2.4% during ACS. The risk of atrial fibrillation/atrial flutter after ACS increased with the severity of the IAB, and the highest risk was attributable to advanced IAB (age- and sex-adjusted hazard ratio [HR], 2.87 [95% CI, 2.48-3.32]; <i>P</i><0.00001; and fully risk-factor adjusted [including left ventricular ejection fraction] HR, 2.22 [95% CI, 1.89-2.62]; <i>P</i><0.00001). Advanced IAB was also associated with an almost 2-fold risk of ischemic stroke if adjusted for the CHA₂DS₂-VASc score (HR, 1.95 [95% CI, 1.47-2.58]; <i>P</i><0.00001).</p><p><strong>Conclusions: </strong>Automatic detection of an IAB from serial ECGs reveals a strong association between atrial pathology and the risk of atrial fibrillation, atrial flutter, and ischemic stroke in patients with ACS.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041313"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Geographic Access to Cardiac Rehabilitation Among Socially Vulnerable Communities.","authors":"Edward W Chen, Wen-Chih Wu, Ling Han, Parul U Gandhi, Lori A Bastian, Cynthia A Brandt, Kristin M Mattocks, Joyce Oen-Hsiao, Merilyn S Varghese","doi":"10.1161/JAHA.124.040815","DOIUrl":"https://doi.org/10.1161/JAHA.124.040815","url":null,"abstract":"<p><strong>Background: </strong>There is a dearth of research examining geographic disparities in access to cardiac rehabilitation (CR). We evaluated whether disparities in geographic access to CR exist among socially vulnerable communities, using the Social Vulnerability Index (SVI).</p><p><strong>Methods: </strong>Among 3113 US counties, we investigated relationships between SVI and number of hospitals with CR per 100 000 adults, modeled with SVI as a linear variable, and SVI and distance to the nearest county with CR facilities, modeled using spline terms for SVI. We used multivariable zero-inflated negative binomial regression modeling adjusted for county population, CR eligibility, percentage without health insurance, metropolitan status, and availability of existing health care infrastructure. We explored whether these relationships changed in the context of rurality.</p><p><strong>Results: </strong>After adjustment, as SVI increased by 1 percentile, number of hospitals with CR per 100 000 adults decreased by 1.2% (<i>P</i><0.001). For distance to CR, individual spline terms were not significant in our adjusted model; however, the overall predicted distance to CR increased as SVI increased. When stratified by metropolitan status, these relationships not only persisted but also intensified in rural counties. As SVI increased by 1 percentile, the odds of a county containing a CR facility decreased by 0.9% in metropolitan counties (<i>P</i>=0.002) versus 2.2% in rural counties (<i>P</i><0.001).</p><p><strong>Conclusion: </strong>More socially vulnerable communities experienced worse geographic access to CR facilities. This access disparity intensified in rural communities. Our findings call for reducing barriers to CR access among socially vulnerable and rural communities, potentially through virtual or hybrid models of CR.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040815"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Mayo Clinic Percutaneous Coronary Intervention Risk Prediction Score in Patients With Acute Coronary Syndrome.","authors":"Antonio Landi, Andrea Zito, Mandeep Singh, Dominick J Angiolillo, Davide Capodanno, Enrico Frigoli, Andrea Milzi, Sunil V Rao, Philip Urban, Marco Valgimigli","doi":"10.1161/JAHA.125.043012","DOIUrl":"https://doi.org/10.1161/JAHA.125.043012","url":null,"abstract":"<p><strong>Background: </strong>A contemporary, comprehensive risk score for the prediction of in-hospital fatal and nonfatal adverse events after percutaneous coronary intervention has been recently developed, albeit its external validation in patients with acute coronary syndrome is lacking. The objective of this study is to validate the Mayo Clinic integer risk score in a large cohort of patients with acute coronary syndrome undergoing percutaneous coronary intervention from the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial.</p><p><strong>Methods: </strong>The risk score is composed of a common set of 23 clinical and procedural variables (model A) and 18 preprocedural variables (model B). The primary objective was to appraise the receiver-operator characteristics of both models for in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke. The impact of risk score categories on 1-year outcomes was also investigated.</p><p><strong>Results: </strong>Among the 6724 patients undergoing percutaneous coronary intervention in the MATRIX trial, the receiver-operator characteristics-area under the curves for in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke were 0.88 (95% CI, 0.85-0.91), 0.66 (95% CI, 0.63-0.69), 0.70 (95% CI, 0.67-0.72), and 0.65 (95% CI, 0.52-0.78) for model A and 0.88 (95% CI, 0.84-0.92), 0.63 (95% CI, 0.60-0.66), 0.66 (95% CI, 0.63-0.69), and 0.65 (95% CI, 0.52-0.78) for model B, respectively. Mortality (model A), bleeding, and stroke risks were well calibrated, whereas mortality (model B) and contrast-associated acute kidney injury risk were underestimated. There was a gradual risk increase for 1-year mortality and bleeding as a function of the risk score tertile using both models.</p><p><strong>Conclusions: </strong>The risk score identifies patients with acute coronary syndrome at incremental risk of in-hospital mortality, bleeding, contrast-associated acute kidney injury, and stroke, representing a valuable tool for mitigation of modifiable risk factors.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01433627.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e043012"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epicardial Adipose Tissue in Duchenne Muscular Dystrophy Cardiomyopathy.","authors":"Eleanor Greiner, Kimberley G Miles, Zhiqian Gao, Sean M Lang, Thomas D Ryan, Nicholas J Ollberding, Benjamin S Mantell, Meilan M Rutter, Cuixia Tian, Chet R Villa","doi":"10.1161/JAHA.125.042300","DOIUrl":"https://doi.org/10.1161/JAHA.125.042300","url":null,"abstract":"<p><strong>Background: </strong>Duchenne muscular dystrophy (DMD) has unique characteristics when compared with other forms of non-DMD dilated cardiomyopathy. We sought to describe epicardial adipose tissue (EAT), the fat layer surrounding the myocardium, and investigate its relationship to longitudinal cardiac changes in DMD.</p><p><strong>Methods: </strong>This single-center, retrospective, cohort study included all DMD patients with ≥5 cardiac magnetic resonance studies between 2015 and 2022. EAT thickness was measured in the right atrioventricular groove during end diastole. Adiposity data were obtained from dual-energy x-ray absorptiometry scans. Linear mixed-effects regression was used for statistical modeling.</p><p><strong>Results: </strong>A total of 117 patients were included with 590 cardiac magnetic resonance studies, 333 dual-energy X-ray absorptiometry, and 255 NT-proBNP (N-terminal pro-B-type natriuretic peptide) values. The median age at first cardiac magnetic resonance was 13.1 years and at any cardiac magnetic resonance study was 15.9 years. The median EAT thickness was 15.5±4 mm. EAT thickness was positively associated with age (<i>P</i><0.001) and measures of general adiposity (<i>P</i><0.01). Increased EAT was positively associated with NT-proBNP and negatively associated with left ventricular volume and left ventricular mass indexed for body surface area (<i>P</i><0.05). There was no association with left ventricular ejection fraction (<i>P</i>=0.98) or for left ventricular volume (<i>P</i>=0.61) or mass (<i>P</i>=0.52) when indexed for height.</p><p><strong>Conclusions: </strong>DMD is associated with early, appreciable EAT, which increases over the life span and is positively related to measures of general adiposity. Increased EAT is associated with higher levels of NT-proBNP without a change in systolic function, suggesting it may contribute to diastolic dysfunction in DMD.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042300"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic Biomarkers Are Independently Associated With Secondary Adverse Cardiovascular Events in Patients With Coronary Artery Disease.","authors":"Jeffery Osei, Pradeep Tiwari, Chang Liu, Zakaria Almuwaqqat, Arshed A Quyyumi, Peter W F Wilson, Yan V Sun","doi":"10.1161/JAHA.125.043087","DOIUrl":"https://doi.org/10.1161/JAHA.125.043087","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the potential of plasma metabolites as novel biomarkers for secondary major adverse cardiovascular event (MACE) development and risk prediction in patients with coronary artery disease.</p><p><strong>Methods: </strong>We analyzed data from 10 175 UKB (UK Biobank) participants with coronary artery disease and metabolites (n=249) measured through nuclear magnetic resonance at baseline. Cross-validated elastic net regression models were used in the training cohort (n=7122) to select metabolites to be included in the metabolomic risk score (MRS). Hazard ratios (HRs) were estimated to examine the association between MRS and MACEs (composite of nonfatal myocardial infarction, ischemic stroke, and cardiovascular death) in the testing cohort (n=3053). Predictive performance of MRS was evaluated with C-index and calibration plots.</p><p><strong>Results: </strong>Over a median follow-up of 10 years, 1624 (16%) MACEs occurred. Elastic net regression identified 26 metabolites for construction of the MRS. Participants in the highest 20% of the MRS had significantly increased risk of MACEs (HR, 2.19 [95% CI, 1.61-2.99]) and cardiovascular death (HR, 3.69 [95% CI, 2.35-5.78]), compared with the lowest 20%, after adjusting for traditional risk factors. Adding MRS to a traditional risk factor model modestly improved the 10-year MACE prediction (ΔC-index: 0.012 [95% CI, -0.003 to 0.025]); calibration slopes (0.91 [95% CI, 0.79-1.03] versus 0.88 [95% CI, 0.74-1.02]).</p><p><strong>Conclusions: </strong>Metabolomic biomarkers are independently associated with and predict MACEs, particularly cardiovascular death, in middle-aged individuals with coronary artery disease, providing valuable insights into the biological pathways underlying MACEs in high-risk populations.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e043087"},"PeriodicalIF":5.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}