Publications by authors named "Luisa Brant"
Objectives: Analyze the burden of diseases attributable to risk factors (RF) in Brazil according to age, sex, and Brazilian states between 1990 and 2021.
Methods: This study used data from the Global Burden of Disease study 1990 to 2021. The metrics used in this analysis included: mortality rates, disability-adjusted life years (DALYs) and Summary Exposure Value (SEV).
Development and Multinational Validation of an Ensemble Deep Learning Algorithm for Detecting and Predicting Structural Heart Disease Using Noisy Single-lead Electrocardiograms.
medRxiv
October 2024
Background And Aims: AI-enhanced 12-lead ECG can detect a range of structural heart diseases (SHDs) but has a limited role in community-based screening. We developed and externally validated a noise-resilient single-lead AI-ECG algorithm that can detect SHD and predict the risk of their development using wearable/portable devices.
Methods: Using 266,740 ECGs from 99,205 patients with paired echocardiographic data at Yale New Haven Hospital, we developed ADAPT-HEART, a noise-resilient, deep-learning algorithm, to detect SHD using lead I ECG.
Background: Identifying structural heart diseases (SHDs) early can change the course of the disease, but their diagnosis requires cardiac imaging, which is limited in accessibility.
Objective: To leverage images of 12-lead ECGs for automated detection and prediction of multiple SHDs using an ensemble deep learning approach.
Methods: We developed a series of convolutional neural network models for detecting a range of individual SHDs from images of ECGs with SHDs defined by transthoracic echocardiograms (TTEs) performed within 30 days of the ECG at the Yale New Haven Hospital (YNHH).
Objectives: The aim of this study was to analyse the burden of disease due to noncommunicable diseases (NCDs) between 1990 and 2021 in Brazil. In addition, this study compared mortality from NCDs with mortality from all causes and COVID-19, analysed NCD mortality trends and projections for 2030, and analysed NCD mortality rates and risk factors attributed to these deaths among the 27 states of Brazil.
Study Design: Ecological studies.
More With Less: Diffusing Innovations in Cardiovascular Service Delivery.
Circ Cardiovasc Qual Outcomes
August 2024
In Latin America and the Caribbean (LAC), sociodemographic context, socioeconomic disparities and the high level of urbanization provide a unique entry point to reflect on the burden of cardiometabolic disease in the region. Cardiovascular diseases are the main cause of death in LAC, precipitated by population growth and ageing together with a rapid increase in the prevalence of cardiometabolic risk factors, predominantly obesity and diabetes mellitus, over the past four decades. Strategies to address this growing cardiometabolic burden include both population-wide and individual-based initiatives tailored to the specific challenges faced by different LAC countries, which are heterogeneous.
View Article and Find Full Text PDFArticle Synopsis
- The study assesses the effectiveness of US-based cardiovascular disease (CVD) risk scores in a Brazilian cohort, revealing that these scores often overestimate risk for individuals in low- and middle-income countries (LMICs).
- A total of 12,155 adults aged 40-75 were analyzed, and all risk scores had good overall prediction ability, but particularly struggled with accuracy in white women, showing an AUC score below 0.6.
- The findings emphasize the need for customized risk assessment tools that reflect the specific demographics and health challenges of populations in LMICs, as current scores can overestimate risk by 32%-170%.
Article Synopsis
- The study highlights the challenge of effectively stratifying heart failure (HF) risk despite existing therapies, proposing that portable devices that record single-lead electrocardiograms (ECGs) could improve community-based assessments.
- An artificial intelligence (AI) algorithm was evaluated for its ability to predict HF risk from these single-lead ECGs, using data from multiple cohorts including Yale New Haven Health System, UK Biobank, and ELSA-Brasil.
- Results indicated that individuals screened positively by the AI-ECG model had a significantly higher risk for developing HF, with increases in risk correlating with higher model probabilities, suggesting it could be a valuable tool for early identification of at-risk patients
Article Synopsis
- Researchers are exploring the use of artificial intelligence (AI) on electrocardiograms (ECGs) to predict the risk of heart failure (HF), which traditionally relies on specific blood tests or thorough clinical assessments.
- The study involved data from multiple cohorts, including the Yale New Haven Health System and UK Biobank, focusing on individuals without HF at the start and monitoring their hospitalization for HF over several years.
- Results showed that a positive AI-ECG screening significantly increased the risk of developing HF, with the hazard ratios indicating a much higher risk in the UK and Brazil compared to the Yale cohort, highlighting the model's effectiveness in predicting incident HF risk.
Article Synopsis
- The American Heart Association created guidelines for tracking cardiovascular health (CVH) to shift focus from managing risk factors to preventing cardiovascular disease, but knowledge about CVH differences between high- and low-income countries remains scarce.
- A study analyzed survey data from Ethiopia, Bangladesh, Brazil, England, and the US to score CVH using specific health metrics, revealing that higher-income countries had lower high CVH scores, particularly as age increased.
- The research concluded that while CVH declines with age is a global issue, tailored interventions are necessary to maintain health across different populations, especially in high-CVH countries aiming to combat risk-factor increases.
Background: Central Illustration : Higher Arterial Stiffness Predicts Chronic Kidney Disease in Adults: The ELSA-Brasil Cohort Study.
Background: Arterial stiffening can directly affect the kidneys, which are passively perfused by a high flow. However, whether the relation between arterial stiffness and renal function depends on diabetes and hypertension conditions, is a matter of debate.
Article Synopsis
- The study investigates how improving hypertension care in low- and middle-income countries might affect different socioeconomic groups, particularly focusing on wealth quintiles.
- Researchers simulated better diagnosis and treatment levels for hypertension and assessed the resulting changes in cardiovascular disease (CVD) risk across various wealth groups.
- Results indicated that lower-income groups, especially in lower-middle-income countries, would experience the greatest health benefits, emphasizing that targeted improvements in hypertension management could help reduce health inequities.
Cardiovascular diseases (CVDs) remain the leading cause of death and disability worldwide. Digital health technologies are important public health interventions for addressing the burden of cardiovascular disease. In this article, we discuss the importance of translating digital innovations in research-funded projects to low-resource settings globally to advance global cardiovascular health equity.
View Article and Find Full Text PDFInequities in global health research are well documented. For example, training opportunities for US investigators to conduct research in low-income and middle-income countries (LMIC) have exceeded opportunities for LMIC investigators to train and conduct research in high-income countries. Reciprocal innovation addresses these inequities through collaborative research across diverse global settings.
View Article and Find Full Text PDFObjective: Evaluate the longitudinal association between BP control and the use of antihypertensive classes with arterial stiffness (AS) in Brazilian adults.
Methods: This study included 1830 participants with arterial hypertension (1092 participants with controlled BP and 738 participants with uncontrolled BP) from the Longitudinal Study of Adult Health (ELSA-Brasil). AS was assessed by pulse wave velocity (PWV) and pulse pressure (PP) at baseline and repeated after approximately 9 years.
This study aimed to estimate the prevalence of possible cases of FH and analyze associated factors in the adult Brazilian population. Cross-sectional study with laboratory data from the Brazilian National Health Survey, with 8521 participants. Possible cases of FH were defined according to the Dutch Lipid Clinic Network criteria.
View Article and Find Full Text PDFPercentiles of predicted 10-year cardiovascular disease risk by sex and age in Brazil and their association with estimated risk of long-term atherosclerotic events.
Prev Med
December 2023
Objective: Expressing the cardiovascular disease (CVD) risk in relation to peers may complement the estimation of absolute CVD risk. We aimed to determine 10-year CVD risk percentiles by sex and age in the Brazilian population and evaluate their association with estimated long-term atherosclerotic CVD (ASCVD) risk.
Methods: A cross-sectional analysis of baseline data from the ELSA-Brasil study was conducted in individuals aged 40-74 years without prior ASCVD.
Background: Guideline-directed medical therapies (GDMTs) improve quality of life and health outcomes for patients with heart failure (HF). However, GDMT utilization is suboptimal among patients with HF.
Objective: The aims of this study were to engage key stakeholders in semistructured, virtual human-centered design sessions to identify challenges in GDMT optimization posthospitalization and inform the development of a digital toolkit aimed at optimizing HF GDMTs.
Consumption of ultra-processed foods and eight-year risk of death from all causes and noncommunicable diseases in the ELSA-Brasil cohort.
Int J Food Sci Nutr
October 2023
Increased consumption of ultra-processed foods (UPF) is associated with higher incidences of many noncommunicable diseases (NCDs) and death from all causes. However, the association between UPF and cardiovascular disease (CVD) mortality remains controversial. Our study investigated whether UPF consumption is associated with a higher risk of death from all causes, NCDs, and CVD.
View Article and Find Full Text PDFImportance: Aspirin is an effective and low-cost option for reducing atherosclerotic cardiovascular disease (CVD) events and improving mortality rates among individuals with established CVD. To guide efforts to mitigate the global CVD burden, there is a need to understand current levels of aspirin use for secondary prevention of CVD.
Objective: To report and evaluate aspirin use for secondary prevention of CVD across low-, middle-, and high-income countries.
Aims: With the greatest burden of cardiovascular disease morbidity and mortality increasingly observed in lower-income countries least prepared for this epidemic, focus is widening from risk factor management alone to primordial prevention to maintain high levels of cardiovascular health (CVH) across the life course. To facilitate this, the American Heart Association (AHA) developed CVH scoring guidelines to evaluate and track CVH. We aimed to compare the prevalence and trajectories of high CVH across the life course using nationally representative adult CVH data from five diverse high- to low-income countries.
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- Deep neural networks were used to analyze ECGs to estimate ECG-age, which predicts health outcomes, and researchers examined its relevance in a long-term study involving FHS participants.
- The study found that a gap between chronological age and ECG-age (Δage) significantly correlated with increased risks of death and various cardiovascular issues over an average follow-up of 17 years.
- Specifically, every 10-year increase in Δage resulted in higher risks of all-cause mortality, atrial fibrillation, myocardial infarction, and heart failure, indicating that both accelerated and decelerated aging can impact health outcomes significantly.