Journal of the American Heart Association最新文献

{"title":"Women Under Pressure: Sex-Specific Cardiovascular Consequences of Childhood Trauma in Black Adults.","authors":"Katherine A Maki, Nicole Farmer, Gwenyth R Wallen","doi":"10.1161/JAHA.124.039825","DOIUrl":"https://doi.org/10.1161/JAHA.124.039825","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e039825"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494702","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":"Sex Differences in Permanent Discontinuation of Trial Medication in Chronic Coronary Artery Disease: The LoDoCo2 Trial.","authors":"Marte F van der Bijl, Jenny van der Veen, Aernoud T L Fiolet, Eric Boersma, Jan H Cornel, John W Eikelboom, Stefan M Nidorf, Peter L Thompson, Jalina Jannink, Iris C D Westendorp, Arend Mosterd, Hester M den den Ruijter, Jeanine E Roeters van Lennep","doi":"10.1161/JAHA.124.040412","DOIUrl":"https://doi.org/10.1161/JAHA.124.040412","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040412"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494668","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":"Excessive Hypercholesterolemia in Pregnancy Impairs Later-Life Maternal Vascular Function in Rats.","authors":"Amanda A de Oliveira, Emma Elder, Murilo E Graton, Floor Spaans, Amy L Wooldridge, Anita Quon, Raven Kirschenman, Christy-Lynn M Cooke, Sandra T Davidge","doi":"10.1161/JAHA.124.038123","DOIUrl":"https://doi.org/10.1161/JAHA.124.038123","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a risk factor for the development of later-life cardiovascular disease. However, the underlying mechanisms are poorly understood. Excessive hypercholesteremia in pregnancy induces a preeclampsia-like phenotype, but whether this also impacts maternal vascular function later in life has not been fully characterized.</p><p><strong>Methods and results: </strong>Sprague Dawley rats received a control diet (CD) or a high-cholesterol (HCD) diet from gestational day 6 to 20, after which maternal vascular function was assessed 3 months postpartum. Exposure to an HCD in pregnancy reduced later-life endothelium-dependent vasodilation in carotid arteries (-15.24±3.27%), which was mediated via prostaglandin H synthase 2. There were no differences in vasodilation between CD and HCD postpartum rats in the mesenteric arteries, coronary arteries, or aortas. Vasoconstriction to phenylephrine increased in carotid arteries (61.02±21.48%) and reduced in aortas (-23.24±6.19%) of the HCD postpartum group versus CD dams, without differences in mesenteric and coronary arteries. The increased vasoconstriction in carotid arteries was due to lower nitric oxide modulation of constriction. Moreover, carotid artery myogenic response was reduced (-37.68±10.07%) and stiffness was increased (19.67±6.21%) in the HCD postpartum rats compared with CD along with decreased elastin density (-20.85±4.52%). The impact of the HCD on vascular function did not occur in age-matched never-pregnant female rats.</p><p><strong>Conclusions: </strong>Excessive hypercholesterolemia in pregnancy impairs later-life maternal vascular function in rats with varying impacts across different vascular beds. Understanding mechanisms for <i>pregnancy-specific</i> excessive hypercholesterolemia provides avenues for targeted intervention strategies to reduce the burden of cardiovascular disease in women who had a complicated pregnancy.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038123"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494570","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":"Effect of Early Life Trauma Exposure on Vascular Dysfunction in Black Men and Women.","authors":"Telisa A Spikes, Roland J Thorpe, Vasiliki Michopoulos, Whitney Wharton, Jordan Pelkmans, Sandra B Dunbar, Puja K Mehta, Priscilla Pemu, Herman Taylor, Arshed Quyyumi","doi":"10.1161/JAHA.124.036498","DOIUrl":"https://doi.org/10.1161/JAHA.124.036498","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial stressors such as childhood trauma have been associated with an increased risk of hypertension. The impact of childhood trauma on vascular dysfunction in Black adults remains less clear. We examined the association between childhood trauma and vascular function in Black adults.</p><p><strong>Methods and results: </strong>Childhood trauma exposure and vascular function were assessed in a cohort of healthy Black participants without known cardiovascular disease (n=404) from a large metropolitan city. Childhood trauma was assessed using the Early Trauma Inventory Short Form with higher scores indicative of higher traumatic life events assessed before age 18 years. Outcomes of central augmentation index (CAIx) and carotid femoral pulse wave velocity were measured as indices of wave reflections and arterial stiffness using applanation tonometry (Sphygmocor Inc.), and central pulse pressure (CPP) was calculated as the difference between the central aortic systolic and diastolic blood pressures. Relationships between Early Trauma Inventory Short Form and outcomes were assessed using multivariate-adjusted and sex-stratified linear regression models. The mean age of the cohort was 53 (SD=10.3), 61% women. Cumulative childhood trauma was not associated with CAIx, central pulse pressure, or carotid femoral pulse wave velocity in the minimal or fully adjusted models for sociodemographic, sex, clinical factors, medical history, health behaviors, and depression. Significant trauma × sex interactions were identified for CAIx (<i>P</i>=0.003) and central pulse pressure (<i>P</i>=0.025). Childhood trauma was associated with lower CAIx (<i>β</i>=-0.55% [95% CI, -1.07 to -0.03] in men, but higher CAIx (<i>β</i>=0.35% [95% CI, 0.08-0.63]) and central pulse pressure (<i>β</i>=0.23 mm Hg [95% CI, 0.01-0.43]) in women.</p><p><strong>Conclusions: </strong>Childhood trauma is independently associated with impaired arterial compliance in Black women.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e036498"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494539","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":"Optimizing Psychological Health Across the Perinatal Period: An Update on Maternal Cardiovascular Health: A Scientific Statement From the American Heart Association.","authors":"Garima Sharma, Allison E Gaffey, Afshan Hameed, Nadine A Kasparian, Rina Mauricio, Elisabeth Breese Marsh, Dana Beck, Jenna Skowronski, Diana Wolfe, Glenn N Levine","doi":"10.1161/JAHA.125.041369","DOIUrl":"https://doi.org/10.1161/JAHA.125.041369","url":null,"abstract":"<p><p>Perinatal psychological health conditions (eg, perinatal depression, anxiety) are some of the leading causes of maternal mortality in the United States and are associated with adverse pregnancy outcomes, long-term cardiovascular outcomes, and intergenerational effects on offspring neurodevelopment. These risks underscore the importance of addressing maternal psychological health as a key determinant of perinatal cardiovascular health. Thus, it is vital to recognize the spectrum of perinatal psychological health and to provide guidance for both patients and clinicians on screening and management options across the perinatal period. In this scientific statement from the American Heart Association, we redefine maternal cardiovascular health to include psychological health, provide robust evidence on the association of psychological health with cardiovascular outcomes, highlight the social and environmental underpinnings, and finally, offer guidance about how to integrate psychological health into maternal cardiovascular health with a specific focus on the perinatal period (ie, pregnancy through 1 year postpartum). We also describe opportunities for creating care delivery models that recurrently address perinatal psychological health in cardio-obstetric care, using behavioral and pharmacological interventions, with an emphasis on better integration of psychological health care, longer postpartum follow-up, and opportunities for evaluating the comparative effectiveness of these models with stakeholder partners.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041369"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494656","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":"Association of Kidney Function With Incident Heart Failure: An Analysis of the Women's Health Initiative.","authors":"Richard K Cheng, Mary B Roberts, Nisha Bansal, Kerryn Reding, Taufiq Salahuddin, Mamas Mamas, Michael LaMonte, Aladdin H Shadyab, Nora Franceschini, Liviu Klein, JoAnn E Manson, Charles B Eaton","doi":"10.1161/JAHA.124.037051","DOIUrl":"https://doi.org/10.1161/JAHA.124.037051","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown an association of chronic kidney disease with heart failure (HF); however, this association has not been adequately examined in postmenopausal women, who are at heightened risk of both chronic kidney disease and HF. Additionally, association with HF subtypes is not well characterized.</p><p><strong>Methods and results: </strong>Incident HF was defined as first hospitalization for acute decompensated HF, obtained by self-reported outcomes followed by physician adjudication through review of hospital records. Chronic kidney disease was defined using estimated glomerular filtration rate (eGFR). Restricted cubic splines tested the association of eGFR with incident overall HF, and HF with reduced ejection fraction (HFrEF) and preserved EF (HFpEF). Cox proportional hazards regression models evaluated the multivariable-adjusted association of eGFR categories with incident HF and its subtypes. The primary analysis included 23 309 women with 11 814 eGFR ≥90, 10 191 eGFR between 60 and 89, 1048 eGFR between 45 and 59 and 256 eGFR <45 mL/min per 1.73 m². For overall HF, HFrEF and HFpEF, there was a stepwise increase in risk for incident HF with declining eGFR category. Associations were stronger for HFpEF (hazard ratio [HR], 2.80 [95% CI, 2.36-3.32]) than for HFrEF (HR, 2.18 [95% CI, 1.66-2.87]) for eGFR <45 as compared with eGFR ≥90. Heterogeneity of the HF subdistributions (HFpEF versus HFrEF) was significant (<i>P</i>=0.017).</p><p><strong>Conclusions: </strong>Kidney dysfunction is associated with incident HF in postmenopausal women. Although lower eGFR is associated with both incident HFrEF and HFpEF, the association is stronger with HFpEF.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov; Unique Identifier: NCT00000611.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e037051"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494364","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":"Sex Differences in the Relationship of Socioeconomic Position With Cardiovascular Disease, Cardiovascular Risk Factors, and Estimated Cardiovascular Disease Risk: Results of the German National Cohort.","authors":"Ilais Moreno Velásquez, Sanne A E Peters, Nico Dragano, Karin Halina Greiser, Marcus Dörr, Beate Fischer, Klaus Berger, Anke Hannemann, Renate B Schnabel, Matthias Nauck, Susanne Göttlicher, Susanne Rospleszcz, Stefan N Willich, Lilian Krist, Matthias B Schulze, Kathrin Günther, Tilman Brand, Tamara Schikowski, Carina Emmel, Börge Schmidt, Karin B Michels, Rafael Mikolajczyk, Alexander Kluttig, Volker Harth, Nadia Obi, Stefanie Castell, Carolina J Klett-Tammen, Wolfgang Lieb, Heiko Becher, Volker Winkler, Heike Minnerup, André Karch, Claudia Meinke-Franze, Michael Leitzmann, Michael J Stein, Barbara Bohn, Ben Schöttker, Kira Trares, Annette Peters, Tobias Pischon","doi":"10.1161/JAHA.124.038708","DOIUrl":"https://doi.org/10.1161/JAHA.124.038708","url":null,"abstract":"<p><strong>Background: </strong>Using data from the largest German cohort study, we aimed to investigate sex differences in the relationship of socioeconomic position (SEP) with cardiovascular disease (CVD), CVD risk factors, and estimated CVD risk.</p><p><strong>Methods and results: </strong>A total of 204 780 (50.5% women) participants from the baseline examination of the population-based NAKO (German National Cohort) were included. Logistic, multinomial, and linear regression models were used to estimate sex-specific odds ratios (ORs) and β coefficients with 95% CIs of CVD, CVD risk factors, and very high-risk score (Systemic Coronary Risk Estimation-2) for CVD associated with SEP. Women-to-men ratios of ORs (RORs) with 95% CIs were estimated. In women compared with men, low versus high SEP (educational attainment and relative income) was more strongly associated with myocardial infarction, hypertension, obesity, overweight, elevated blood pressure, antihypertensive medication, and current alcohol consumption, but less strongly with current and former smoking. In women with the lowest versus highest educational level, the OR for a very high 10-year CVD risk was 3.61 (95% CI, 2.88-4.53) compared with 1.72 (95% CI, 1.51-1.96) in men. The women-to-men ROR was 2.33 (95% CI, 1.78-3.05). For the comparison of low versus high relative income, the odds of having a very high 10-year CVD risk was 2.55 (95% CI, 2.04-3.18) in women and 2.25 (95% CI, 2.08-2.42) in men (women-to-men ROR, 1.31 [95% CI, 1.05-1.63]).</p><p><strong>Conclusions: </strong>In women and men, there was an inverse relationship between indicators of SEP and the likelihood of having several CVD risk factors and a very high 10-year CVD risk. This association was stronger in women, suggesting that CVD risk is more strongly influenced by SEP in women compared with men.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038708"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494765","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":"Neighborhood Disinvestment and Racial and Ethnic Disparities in Peripartum Cardiomyopathy in California, From 2004 to 2019.","authors":"Curisa M Tucker, Chen Ma, Mahasin S Mujahid, Afshan B Hameed, Audrey Lyndon, Elliott K Main, Suzan L Carmichael","doi":"10.1161/JAHA.124.036710","DOIUrl":"https://doi.org/10.1161/JAHA.124.036710","url":null,"abstract":"<p><strong>Background: </strong>Peripartum cardiomyopathy (PPCM) is a rare medical condition presenting as idiopathic heart failure. The aim of this study was to (1) examine the contribution of neighborhood disinvestment to PPCM risk and to racial and ethnic disparities in PPCM; (2) examine the extent to which sociodemographic factors and chronic hypertension explain these outcomes; and (3) describe severe maternal morbidity cases and the timing of PPCM.</p><p><strong>Methods: </strong>We conducted an observational cohort study using vital records longitudinally linked with hospital discharge records for mothers and infants up to 9 months postpartum for births in California from 1997 to 2019. Using the Neighborhood Deprivation Index as a proxy measure for neighborhood disinvestment, we sequentially adjusted multivariable logistic regression models to estimate the association of Neighborhood Deprivation Index and race and ethnicity with PPCM.</p><p><strong>Results: </strong>Our study included 7 354 662 births and 918 (0.012%) PPCM cases. Those residing in neighborhoods with higher disinvestment had an increased odds of PPCM (OR [95% CI] Quartile 2: 1.2 [1.0-1.5]; Quartile 3: 1.7 [1.4-2.1]; Quartile 4: 1.5 [1.2-1.9]). When considering the contribution of Neighborhood Deprivation Index to racial and ethnic disparities in PPCM, the odds ratio slightly decreased for Non-Hispanic Black births from 3.8 (3.1-4.6) to 3.4 (2.8-4.1). For chronic hypertension in Non-Hispanic Black births there was a slight decrease in odds from 3.4 (2.8-4.1) to 3.1 (2.6-3.8). The severe maternal morbidity indicator with the highest frequency was pulmonary edema/acute heart failure.</p><p><strong>Conclusions: </strong>Our results show that neighborhood deprivation and pre-pregnancy hypertension partially explain PPCM risk but does not explain the racial or ethnic disparity. Future research should examine the impact of specific measures of neighborhood deprivation on the racial and ethnic disparity in outcomes such as PPCM.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e036710"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494651","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":"Immune Cell Therapy: Promising Approach to Reduce Chronic Kidney Disease Risk in Heart Failure.","authors":"H David Humes","doi":"10.1161/JAHA.124.039871","DOIUrl":"https://doi.org/10.1161/JAHA.124.039871","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e039871"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494619","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":"Understanding Sex Differences in Hypertrophic Cardiomyopathy Surgery: Insights From a Decade-Long Cohort Study From China.","authors":"Tao Lu, Changsheng Zhu, Changrong Nie, Yanhai Meng, Qiulan Yang, Zhengyang Lu, Yunhu Song, Shuiyun Wang","doi":"10.1161/JAHA.124.038421","DOIUrl":"https://doi.org/10.1161/JAHA.124.038421","url":null,"abstract":"<p><strong>Background: </strong>Sex differences in patients with hypertrophic cardiomyopathy have been elaborated by many studies. However, large studies of the association of patient sex with outcomes after surgical myectomy are scarce. This study evaluated sex disparities in a large Chinese cohort undergoing hypertrophic cardiomyopathy surgery.</p><p><strong>Methods: </strong>The cohort encompassed 1613 patients, including 627 (38.9%) women who underwent septal myectomy between 2009 and 2018.</p><p><strong>Results: </strong>At the time of surgery, women were 6 years older and had 1 year longer disease onset-to-surgery delay than men. They were more frequently in New York Heart Association class III/IV and had more severe left ventricular outflow tract obstruction. Compared with men, women had a notably higher left ventricular wall thickness index and a lower extent of late gadolinium enhancement. Women also had more mutations in <i>MYH7</i> and fewer in <i>MYBPC3</i>. Postoperatively, women had a higher operative mortality rate (1.3% versus 0.1%, <i>P</i>=0.006). The follow-up results showed no significant difference between the sexes in all-cause death (hazard ratio [HR], 0.67 [95% CI, 0.38-1.18]; <i>P</i>=0.166). A U-shaped association was observed between age and death in the overall population. However, women exhibited this association more obviously at age ≥55 years and men at <35 years. Moreover, women also had a higher risk of cardiovascular rehospitalization after surgery (HR, 1.40 [95% CI, 1.03-1.89]; <i>P</i>=0.030).</p><p><strong>Conclusions: </strong>In patients with obstructive hypertrophic cardiomyopathy, women had a similar fatal outcome but a worse nonfatal outcome than men after surgery. Measures improving quality of life may further enhance the event-free survival of female patients. Close monitoring and follow-up are warranted, especially in younger men and older women.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038421"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494700","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}