Publications by authors named "Joao A C Lima"
Background The prognostic value of coronary CT angiography (CTA)-derived quantitative flow ratio (CT-QFR) remains unknown. Purpose To determine the prognostic value of CT-QFR in predicting the long-term outcomes of patients with suspected coronary artery disease (CAD) in comparison with invasive coronary angiography (ICA)/SPECT and to determine the influence of prior percutaneous coronary intervention (PCI) on the prognostic value of CT-QFR. Materials and Methods In this secondary analysis of the prospective international CORE320 study, 379 participants who underwent coronary CTA and SPECT within 60 days before ICA between November 2009 and July 2011 were included for follow-up.
View Article and Find Full Text PDFObjective: To generate data-driven phenogroups of cardiac structure and function based on echocardiographic measures assessed in asymptomatic middle-aged adults free of CVD, and examine associations between these newly defined phenogroups and incident premature cardiovascular disease (CVD).
Methods: Data were analyzed from participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study free of CVD who underwent an echocardiogram at the Year 25 (2010-2011) in-person examination. Continuous echocardiographic measures of left heart structure, left ventricular systolic function (including strain) and diastolic function, right ventricular systolic function, and hemodynamic measures were included in latent class analysis to generate novel phenogroups.
This cross-sectional study included 18,797 participants from 6 longitudinal cohorts (CARDIA, FHS Gen III, HCHS/SOL, MESA, MiHeart, and REGARDS), and 5,806 of them had high-sensitivity C-reactive protein (hs-CRP) measurements. We found that exclusive electronic cigarette (EC) use was associated with significantly lower hs-CRP levels compared to exclusive combustible cigarette use, suggesting a potentially lower inflammatory burden. hs-CRP levels in dual users and former smokers currently using EC were comparable to those observed in exclusive cigarette smokers.
View Article and Find Full Text PDFBackground: Lung structure and cardiac structure and function are associated cross-sectionally. The classic literature suggests relationships of airways disease to cor pulmonale and emphysema to reduced cardiac output (CO) but longitudinal data are lacking.
Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study was a multicentre longitudinal COPD case-control study of participants 50-79 years with ≥10 pack-years smoking without clinical cardiovascular disease.
Introduction: Cardiac function is important to quantify for risk stratification. Although left ventricular ejection fraction (LVEF) is commonly used, and identifies patients with poor systolic function, other easily acquired measures of cardiac function are needed, particularly to stratify patients with relatively preserved LVEF. LV relative wall thickness (RWT) has been associated with adverse clinical outcomes in patients with preserved LVEF, but the clinical relevance of this observation is not known.
View Article and Find Full Text PDFAims: Despite the highest prevalence of stroke, obesity, and diabetes across races/ethnicities, paradoxically, Hispanic/Latino populations have the lowest prevalence of atrial fibrillation and major Minnesota code-defined ECG abnormalities. We aimed to use Latent Profile Analysis in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) population to obtain insight into epidemiological discrepancies.
Methods And Results: We conducted a cross-sectional analysis of baseline HCHS/SOL visit.
Aims: Proteomic profiling offers an expansive approach to biomarker discovery and mechanistic hypothesis generation for LV remodelling, a critical component of heart failure (HF). We sought to identify plasma proteins cross-sectionally associated with left ventricular (LV) size and geometry in a diverse population-based cohort without known cardiovascular disease (CVD).
Methods And Results: Among participants of the Multi-Ethnic Study of Atherosclerosis (MESA), we quantified plasma abundances of 1305 proteins using an aptamer-based platform at exam 1 (2000-2002) and exam 5 (2010-2011) and assessed LV structure by cardiac magnetic resonance (CMR) at the same time points.
Article Synopsis
- The study focused on cardiovascular health among Chinese American immigrants in the MESA cohort, analyzing data from 746 participants over a median follow-up of 17.8 years.
- Results indicated that longer residence in the U.S. is linked to a greater risk of cardiovascular disease death, while geographical differences showed varying survival probabilities between immigrants in Los Angeles and Chicago.
- Key risk factors identified included elevated levels of certain biomarkers and cardiac imaging results, with no significant impact from the time of immigration on cardiovascular outcomes.
Background: Continuous cardiac output monitoring is not standard practice during cardiac surgery, even though patients are at substantial risk for systemic hypoperfusion. Thus, the frequency of low cardiac output during cardiac surgery is unknown.
Methods: We conducted a prospective cohort study at a tertiary medical center from July 2021 to November 2023.
Article Synopsis
- Heart failure remains a serious issue despite advances in treatment, prompting research into AZD3427, a new medication that mimics a hormone called relaxin, known for its blood vessel-relaxing properties.
- This study involved healthy individuals and heart failure patients to evaluate the safety and how the body processes AZD3427, finding it well-tolerated with slow absorption and a long half-life.
- Results indicated potential benefits for heart failure patients, including improved blood flow and kidney function, supporting further exploration of AZD3427 as a long-term treatment option.
Article Synopsis
- The study investigates how imbalances in left and right ventricular stroke volumes, measured through cardiac MRI, affect clinical outcomes in asymptomatic individuals without cardiovascular disease.
- It analyzed data from over 4,000 participants, finding that those with a greater difference in stroke volumes had a significantly higher risk of mortality, heart failure, and atrial fibrillation compared to those with balanced volumes.
- Interestingly, while a decreased differential stroke volume initially seemed to increase heart failure risk, this association disappeared when factoring in baseline left ventricular function, indicating its significance in the findings.
Background: The initiation of coronary artery calcium (CAC) is an important physiologic milestone associated with increased cardiovascular disease risk. However, traditional risk factors (RF) do not perform well for predicting incident CAC among the 54 million older U.S.
View Article and Find Full Text PDFBackground: Recent evidence has shown that reproductive factors are associated with an increased risk of heart failure with preserved ejection fraction in women. However, the pathogenic pathways underlying this relationship are unclear. Subclinical myocardial fibrosis has been found to be a common pathway in a large proportion of patients with heart failure with preserved ejection fraction.
View Article and Find Full Text PDFRisk assessment models for cardiac surgery do not distinguish between degrees of liver dysfunction. We have previously shown that preoperative liver stiffness is associated with hospital length of stay following cardiac surgery. The authors hypothesized that a liver stiffness measurement (LSM) ≥ 9.
View Article and Find Full Text PDFAim: To investigate the association between endogenous sex hormone levels and history of tooth loss related to periodontitis in healthy middle-aged to older men and post-menopausal women.
Methods: This cross-sectional study included 5649 participants aged 45-84 (mean age, 63 ± 10 years) from the Multi-Ethnic Study of Atherosclerosis cohort who had sex hormone levels measured and answered a questionnaire regarding perceived periodontal status at exam 1. Multivariable logistic regression was used to examine the association of sex hormones (exposure) with history of tooth loss (outcome), stratified by sex.
Article Synopsis
- A study investigated how changes in left atrial (LA) function may indicate the risk of developing heart failure (HF) in a diverse group of nearly 2,500 participants over an average of 9 years.
- The researchers found that a decrease in peak LA strain is closely linked to heart failure with preserved ejection fraction (HFpEF), while a decrease in indexed LA volume is linked to heart failure with reduced ejection fraction (HFrEF).
- Both LA function metrics significantly improved the prediction models for these conditions, highlighting their potential as early indicators of heart failure in subjects with early signs of cardiovascular disease.
Article Synopsis
- Cardiovascular disease is linked to frailty in individuals, but the exact reasons for this connection are not fully understood; the study aims to explore this relationship through the MESA study.
- A total of 3,045 participants underwent heart imaging procedures and completed a walking test and questionnaires to assess their frailty status, with analysis done on various cardiovascular health indicators.
- Results indicated that older age, female gender, and specific cardiac conditions (like left ventricular remodeling and myocardial fibrosis) were significantly associated with an increased likelihood of being frail and performing poorly on the walking test.
Article Synopsis
- People with HIV (PWH) are more likely to develop diastolic dysfunction, and this study investigates the relationship between different types of body fat and heart function in men both with and without HIV.
- Using echocardiography and CT scans, the study assessed various fat deposits, finding that greater epicardial fat was linked to increased chances of diastolic dysfunction, while less subcutaneous fat was also a risk factor.
- The results indicate that both higher epicardial adipose tissue and lower subcutaneous adipose tissue contribute to diastolic dysfunction, regardless of a person's HIV status and whether they are virally suppressed.
Cardiovascular magnetic resonance (CMR) imaging has become an invaluable clinical and research tool. Starting from the discovery of nuclear magnetic resonance, this article provides a brief overview of the key developments that have led to CMR as it is today, and how it became the modality of choice for large-scale population studies.
View Article and Find Full Text PDFArticle Synopsis
- Direct coronary artery evaluation using ultra-high-resolution CT (UHR-CT) is being studied for its accuracy in diagnosing coronary artery disease (CAD), particularly in patients with severe calcification or stents.
- The CORE-PRECISION study will compare UHR-CT to invasive coronary angiography (ICA) in 150 high-risk patients with a history of CAD to assess its effectiveness in detecting significant CAD.
- Results will focus on whether UHR-CT can accurately identify hemodynamically significant CAD compared to ICA, potentially establishing it as a new standard for assessment in challenging cases.