Publications by authors named "Hofstra L"

Background: Left ventricular ejection fraction (EF) is used to categorize heart failure (HF) into phenotypes but this information is often missing in electronic health records or non-HF registries.

Methods: We tested the applicability of a simplified version of a multivariable algorithm, that was developed on data of the Swedish Heart Failure Registry to predict EF in patients with HF. We used data from 4,868 patients with HF from the Cardiology Centers of the Netherlands database, an organization of 13 cardiac outpatient clinics that operate between the general practitioner and the hospital cardiologist.

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Background: The World Health Organization (WHO) recommends that HIV treatment scale-up is accompanied by a robust assessment of drug resistance emergence and transmission. The WHO HIV Drug Resistance (HIVDR) monitoring and surveillance strategy includes HIVDR testing in adults both initiating and receiving antiretroviral therapy (ART). Due to limited information about HIVDR in Mozambique, we conducted two nationally representative surveys of adults initiating and receiving first-line ART regimes to better inform the HIV program.

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Circulating proteins may provide insights into the varying biological mechanisms involved in heart failure (HF) with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). We aimed to identify specific proteomic patterns for HF, by comparing proteomic profiles across the ejection fraction spectrum. We investigated 4210 circulating proteins in 739 patients with normal (Stage A/Healthy) or elevated (Stage B) filling pressures, HFpEF, or ischemic HFrEF (iHFrEF).

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Article Synopsis
  • HIV persists in the central nervous system (CNS) of people living with HIV, leading to cognitive impairments even with antiretroviral therapy (ART).
  • Researchers analyzed paired cerebrospinal fluid (CSF) and blood samples from 19 untreated adults, finding higher HIV RNA levels in plasma compared to CSF and mostly consistent coreceptor usage.
  • The study revealed that some viruses in the CNS can replicate in microglia (brain immune cells) as well as T-cells, suggesting that viral evolution may help the infection spread within the CNS, which needs further investigation.
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  • The study examines how kidney dysfunction correlates with left ventricular diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF), focusing on whether these associations differ between sexes.
  • Data was collected from 880 participants, revealing that those with mild to moderate kidney dysfunction had significantly higher rates of HFpEF compared to those with normal kidney function, along with elevated measures of heart function.
  • The findings suggest that both mild and moderate kidney dysfunction are major risk factors for HFpEF, with the strongest link found in moderate dysfunction, indicating the need for early intervention in at-risk groups.
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The etiology of viral blips is not yet fully elucidated. One of the hypotheses is that blips reflect variations in residual viremia (RV) near the detectability threshold. In this study, we evaluated whether RV is associated with viral blips and which factors are associated with RV.

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Cardiovascular diseases (CVD), principally ischemic heart disease (IHD) and stroke, are the leading causes of death (18. 6 million deaths annually) and disability (393 million disability-adjusted life-years lost annually), worldwide. High blood pressure is the most important preventable risk factor for CVD and deaths, worldwide (10.

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  • Concentric remodeling (cRM) is common in both women (23.5%) and men (27.6%) visiting cardiology clinics and is linked to the onset of heart failure with preserved ejection fraction (HFpEF) and a higher mortality risk in both genders.* -
  • The study found that traditional risk factors like age, heart rate, and hypertension more significantly impacted relative wall thickness in women compared to men, and elevated levels of interferon alpha-5 (IFNA5) were specifically associated with cRM in women.* -
  • Inflammatory pathways activated in women could explain the higher prevalence of HFpEF among females, highlighting a potential for new prevention and treatment strategies tailored to sex-specific biological differences.*
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The COVID-19 pandemic has exposed the vulnerability of ethnic minorities again. Health inequity within ethnic minorities has been explained by factors such as higher prevalence of underlying disease, restricted access to care, and lower vaccination rates. In this study, we investigated the effect of cultural tailoring of communicators and media outlets, respectively, on vaccine willingness in an influenza vaccination campaign in the Netherlands.

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Aims: Incorporation of sex in study design can lead to discoveries in medical research. Deep neural networks (DNNs) accurately predict sex based on the electrocardiogram (ECG) and we hypothesized that misclassification of sex is an important predictor for mortality. Therefore, we first developed and validated a DNN that classified sex based on the ECG and investigated the outcome.

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Aims: Patients with congestive heart failure (HF) are prone to clinical deterioration leading to hospital admissions, burdening both patients and the healthcare system. Predicting hospital admission in this patient group could enable timely intervention, with subsequent reduction of these admissions. To date, hospital admission prediction remains challenging.

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Objective: To assess the prognostic value of absolute and sex-specific, age-specific and race/ethnicity-specific (Multi-Ethnic Study of Atherosclerosis, MESA) percentiles of coronary artery calcification in symptomatic women and men.

Methods: The study population consisted of 4985 symptomatic patients (2793 women, 56%) visiting a diagnostic outpatient cardiology clinic between 2009 and 2018 who were referred for cardiac CT to determine Coronary Artery Calcium Score (CACS). Regular care data were used and these data were linked to the databases of Statistics Netherlands for all-cause mortality data.

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Background: SARS-CoV-2 prevention measures impact the circulation of other respiratory viruses. Surveillance in the network of general practitioners is hampered by widespread testing for SARS-CoV-2 in public testing facilities.

Objectives: To evaluate integrated community surveillance of SARS-CoV-2 and other respiratory viruses and describe epidemiological trends.

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Article Synopsis
  • The study investigates whether differences in exercise capacity by sex affect the relationship between NYHA functional class and survival in patients suspected of heart failure.
  • Data from 7,259 patients were analyzed, revealing that men with higher NYHA classes had significantly increased mortality, while women's mortality risk was less differentiated across classes.
  • The findings indicate that exercise workload during stress tests explains a larger portion of the survival association for women compared to men, suggesting that gender influences the prognostic value of the NYHA classification.
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Currently, risk prediction models like SCORE are used for decision making in the primary prevention of cardiovascular disease. The external validity of these models is questionable since they give rise to overtreatment with statins or antihypertensive drugs. Detailed individual risk assessment may reduce this drawback and will increase cost effectiveness.

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Aims: The diagnostic performance of non-invasive imaging in patients with prior coronary artery disease (CAD) has not been tested in prospective head-to-head comparative studies. The aim of this study was to compare the diagnostic performance of qualitative single-photon emission computed tomography (SPECT), quantitative positron emission tomography (PET), and qualitative magnetic resonance imaging (MRI) in patients with a prior myocardial infarction (MI) or percutaneous coronary intervention (PCI).

Methods And Results: In this prospective clinical study, all patients with prior MI and/or PCI and new symptoms of ischaemic CAD underwent 99mTc-tetrofosmin SPECT, [15O]H2O PET, and MRI, followed by invasive coronary angiography with fractional flow reserve (FFR) in all coronary arteries.

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Objectives: Uncertainty about the benefit of (high-intensity) statins for women remains due to under-representation of women in primary prevention trials and scarcity of sex-stratified data. This study evaluates the sex-specific relation between statin treatment and survival and the additional benefit of high-intensity statins.

Methods: Electronic health record data from 47 801 patients (17 008 statin users and 30 793 non-users) without prior cardiovascular disease were extracted from thirteen Dutch outpatient cardiology clinics.

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Aims: The HFA-PEFF score was developed to optimize diagnosis and to aid in early recognition of heart failure (HF) with preserved ejection fraction (HFpEF) in patients who present with HF-like symptoms. Recognizing early-HFpEF phenogroups is essential to better understand progression towards overt HFpEF and pave the way for early intervention and treatment. Whether the HFA-PEFF domain scores can identify 'early-HFpEF' phenogroups remains unknown.

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Introduction: Pretreatment drug resistance (PDR) prevalence in sub-Saharan Africa is rising, but evidence of its impact on efavirenz (EFV)-based antiretroviral treatment (ART) is inconclusive. We determined the impact of PDR on outcomes of EFV-based ART in a subanalysis of a randomized clinical trial comparing different ART monitoring strategies implemented at a rural treatment facility in Limpopo, South Africa.

Methods: Participants initiating EFV-based first-line ART (2015-2017) were enrolled and received 96 weeks follow-up.

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Background: Knowledge about adverse drug reactions (ADRs) in the population is limited because of underreporting, which hampers surveillance and assessment of drug safety. Therefore, gathering accurate information that can be retrieved from clinical notes about the incidence of ADRs is of great relevance. However, manual labeling of these notes is time-consuming, and automatization can improve the use of free-text clinical notes for the identification of ADRs.

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Severe acute respiratory syndrome coronavirus 2 infection after coronavirus disease 2019 vaccination raises concerns about the emergence of vaccine escape variants. Here we characterize 14 breakthrough infections among 5860 fully vaccinated Dutch health care workers ≥14 days after the final dose of vaccination with either BNT162b2, mRNA-1273, or Ad26.COV2.

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This survey study measures how opinions on trusting government and misconceptions about the COVID-19 vaccine are associated with vaccine hesitancy in the Netherlands.

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