Publications by authors named "Emer Brady"

Background: Coronary microvascular dysfunction (CMD) is a significant complication in type 2 diabetes (T2D) and may be more common in women. We aimed to evaluate the sex differences and sex-specific clinical determinants of CMD in adults with T2D without prevalent cardiovascular disease.

Methods: Single center pooled analysis of four prospective studies comparing asymptomatic people with T2D and controls.

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Background: Type 2 diabetes (T2D) leads to cardiovascular remodeling, and heart failure has emerged as a major complication of T2D. There is a limited understanding of the impact of T2D on the right heart. This study aimed to assess subclinical right heart alterations and their contribution to aerobic exercise capacity (peak oxygen consumption; peak VO) in adults with T2D.

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Background: Aerobic exercise capacity is an independent predictor of mortality in dilated cardiomyopathy (DCM), but the central mechanisms contributing to exercise intolerance in DCM are unknown. The aim of this study was to characterize coronary microvascular function in DCM and determine if cardiovascular magnetic resonance (CMR) measures are associated with aerobic exercise capacity.

Methods: Prospective case-control comparison of adults with DCM and matched controls.

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Rationale: Heavy-labelled internal standards increasingly represent the gold standard for absolute quantitation in mass spectrometry (MS)-based bottom-up proteomics. The biggest drawbacks of using these standards are that they have high costs and lengthy lead times.

Methods: We describe an efficient, low-cost optimised method to enable 'in-house' heavy labelling of synthetic tryptic peptides for absolute quantification using tandem LC-MS/MS mass spectrometry.

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Diabetic Foot Ulcers (DFUs) are a major complication of diabetes, with treatment requiring offloading. This study aimed to capture how the accelerometer-assessed physical activity profile differs in those with DFUs compared to those with diabetes but without ulceration (non-DFU). Participants were requested to wear an accelerometer on their non-dominant wrist for up to 8days.

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Background: Dysregulated epicardial adipose tissue (EAT) may contribute to the development of heart failure in Type 2 diabetes (T2D). This study aimed to evaluate the associations between EAT volume and composition with imaging markers of subclinical cardiac dysfunction in people with T2D and no prevalent cardiovascular disease.

Methods: Prospective case-control study enrolling participants with and without T2D and no known cardiovascular disease.

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Objectives: To perform a network meta-analysis to determine the effectiveness of lifestyle interventions in exercise tolerance and quality of life (QoL) in people with HFpEF.

Methods: Ten databases were searched for randomized controlled trials that evaluated a diet and/or exercise intervention in people with heart failure with preserved ejection fraction until May 2022. The co-primary outcomes were peak oxygen uptake (V̇O) and Quality of Life as assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ).

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Background: Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) frequently co-exist. There is a limited understanding on whether this coexistence is associated with distinct alterations in myocardial remodelling and mechanics. We aimed to determine if patients with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) represent a distinct phenotype.

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Breastfeeding is an important determinant of infant health and there is immense interest in understanding its metabolite composition so that key beneficial components can be identified. The aim of this research was to measure the fatty acid composition of human milk in an Irish cohort where we examined changes depending on lactation stage and gestational weight gain trajectory. Utilizing a chromatography approach optimal for isomer separation, we identified 44 individual fatty acid species via GCMS and showed that monomethyl branched-chain fatty acids(mmBCFA's), C15:0 and C16:1 are lower in women with excess gestational weight gain versus low gestational weight gain.

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Background: Echocardiographic studies indicate South Asian people have smaller ventricular volumes, lower mass and more concentric remodelling than White European people, but there are no data using cardiac MRI (CMR). We aimed to compare CMR quantified cardiac structure and function in White European and South Asian people.

Methods: Healthy White European and South Asian participants in the UK Biobank Imaging CMR sub-study were identified by excluding those with a history of cardiovascular disease, hypertension, obesity or diabetes.

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Article Synopsis
  • Heart failure with preserved ejection fraction (HFpEF) is a serious heart problem, especially in people with Type 2 diabetes (T2D), and it’s hard to treat.
  • This study looked at how a low-energy diet affects specific fat molecules (sphingolipids/ceramides) in people with T2D, compared to healthy people, and whether these changes help improve heart function.
  • Twenty-four adults with T2D and 25 healthy adults participated, and they found that people with T2D had different heart measurements and fat molecule levels compared to those who were healthy.
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  • The study suggests that using metformin or statins might reduce the benefits of physical activity on blood sugar control (measured by HbA1c) in type 2 diabetes patients.
  • People with type 2 diabetes who are not taking metformin or statins may see a greater positive effect on blood sugar from regular exercise.
  • These findings indicate that doctors could optimize diabetes treatment by tailoring physical activity recommendations based on individual medication use, enhancing overall patient care.
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Background: South Asians (SA) constitute a quarter of the global population and are disproportionally affected by both type 2 diabetes (T2D) and heart failure. There remains limited data of the acceptability and efficacy of low-energy meal replacement plans to induce remission of T2D in SA.

Objectives: The objective of this exploratory secondary analysis of the DIASTOLIC study was to determine if there was a differential uptake, glycometabolic and cardiovascular response to a low-energy meal replacement plan (MRP) between SA and White European (WE) people with T2D.

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Chronotype studies investigating dietary intake, eating occasions (EO) and eating windows (EW) are sparse in people with type 2 Diabetes mellitus (T2DM). This analysis reports data from the CODEC study. The Morningness-Eveningness questionnaire (MEQ) assessed chronotype preference.

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Article Synopsis
  • The study aimed to analyze the effects of diabetes on cardiac remodelling and exercise capacity in patients with aortic stenosis (AS).
  • It found that while diabetes patients had similar heart volumes and function compared to non-diabetic patients, they exhibited worse exercise capacity and higher levels of certain biomarkers.
  • Importantly, diabetes did not significantly increase cardiovascular events, but it was linked to a higher risk of all-cause mortality, highlighting its need for careful management in AS patients.
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High physical activity levels during wake are beneficial for health, while high movement levels during sleep are detrimental to health. Our aim was to compare the associations of accelerometer-assessed physical activity and sleep disruption with adiposity and fitness using standardized and individualized wake and sleep windows. People (N = 609) with type 2 diabetes wore an accelerometer for up to 8 days.

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Article Synopsis
  • Type 2 diabetes (T2D) increases the risk of heart failure and is linked to cardiovascular abnormalities even before symptoms appear.
  • A study analyzed the effects of T2D remission on heart health, showing benefits such as a better metabolic profile and improved exercise capacity, despite no major changes in cardiovascular structure.
  • Findings highlight that while T2D remission leads to some improvements in health markers, there are still ongoing risks, necessitating careful monitoring and management of cardiovascular health in these patients.
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  • The study aimed to compare physical activity and physical function in individuals with type 2 diabetes who have peripheral artery disease (PAD) versus those who do not.
  • Participants wore accelerometers to measure various levels of physical activity over a week, and their physical function was assessed using several tests.
  • Results indicated that those with PAD engaged in significantly less physical activity and had poorer physical function compared to those without PAD, although some differences were affected by other factors.
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Objective: To investigate the association between age at diagnosis of type 2 diabetes and depressive symptoms, diabetes-specific distress, and self-compassion among adults with type 2 diabetes.

Research Design And Methods: This analysis used data from the Chronotype of Patients with Type 2 Diabetes and Effect on Glycemic Control (CODEC) cross-sectional study. Information was collected on depressive symptoms, diabetes-specific distress, and self-compassion, measured using validated self-report questionnaires, in addition to sociodemographic and clinical data.

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Introduction: Low self-compassion and poor sleep quality have been identified as potential key predictors of distress in type 2 diabetes (T2D). This study investigated relationships between sleep behaviors (sleep duration, social jetlag and daytime sleepiness), diabetes-related distress (DRD) and self-compassion in people with T2D.

Research Design And Methods: This cross-sectional study used data from 467 people with T2D derived from self-report questionnaires, accelerometer-assessed sleep measures and demographic information (clinicaltrials.

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Article Synopsis
  • * In a study pooling data from three trials with 148 participants, it was found that treatments with liraglutide (GLP-1RA) and empagliflozin (SGLT2i) led to a significant reduction in daily steps compared to controls, with decreases of about 1,144 and 1,132 steps respectively.
  • * The results indicate that all glucose-lowering therapies tested were linked to decreased
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Background: Type 2 diabetes (T2D) and hypertension commonly coexist and are associated with subclinical myocardial structural and functional changes. We sought to determine the association between blood pressure (BP) and left ventricular (LV) remodeling, systolic/diastolic function, and coronary microvascular function, among individuals with T2D without prevalent cardiovascular disease.

Methods: Participants with T2D and age-, sex-, and ethnicity-matched controls underwent comprehensive cardiovascular phenotyping including fasting bloods, transthoracic echocardiography, cardiovascular magnetic resonance imaging with quantitative adenosine stress/rest perfusion, and office and 24-h ambulatory BP monitoring.

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Aims: To investigate the relationship between fibro-inflammatory biomarkers and cardiovascular structure/function in people with Type 2 Diabetes (T2D) compared to healthy controls and the effect of two lifestyle interventions in T2D.

Methods: Data were derived from the DIASTOLIC randomised controlled trial (RCT) and includes a comparison between those with T2D and the matched healthy volunteers recruited at baseline. Adults with T2D without cardiovascular disease (CVD) were randomized to a 12-week intervention either: (1) exercise training, (2) a low-energy (∼810 kcal/day) meal-replacement plan (MRP) or (3) standard care.

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Background: The diagnosis of type 2 diabetes (T2D) in younger adults, an increasingly common public health issue, is associated with a higher risk of cardiovascular complications and mortality, which may be due to a more adverse cardiovascular risk profile in individuals diagnosed at a younger age.

Aim: To investigate the association between age at diagnosis and the cardiovascular risk profile in adults with T2D.

Methods: A pooled dataset was used, comprised of data from five previous studies of adults with T2D, including 1409 participants of whom 196 were diagnosed with T2D under the age of 40 years.

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