Pub Date : 2024-09-03DOI: 10.1101/2024.09.02.24312942
Tetiana Motsak, Barend M. Mol, Joost K.R. Hoekstra, Valentina Osorio Zuluaga, Saskia Rumpff-Derksen, Ioanna Paspali-Strik, Sofon Cam Ngan, Gerard Pasterkamp, Gert J. de Borst, Siu Kwan Sze, Dominique P.V. de Kleijn
Objective Deamidation of the NGR (Asn-Gly-Arg) motif to the isoDGR (isoAsp-Gly-Arg) motif in fibronectin (IsoDGR-fibronectin) enhances in vitro monocyte and endothelial cell activation. Blocking isoDGR reduces macrophage influx in murine tissues. Although macrophage influx is an important feature of human plaque destabilization, the role for plasma and plaque isoDGR-fibronectin in macrophage influx in the atherosclerotic plaque and thereby increasing plaque vulnerability has not been investigated in large human cohorts.
{"title":"High levels of IsoDGR-modified fibronectin are associated with higher levels of macrophages and other rupture-prone plaque characteristics in patients undergoing carotid endarterectomy","authors":"Tetiana Motsak, Barend M. Mol, Joost K.R. Hoekstra, Valentina Osorio Zuluaga, Saskia Rumpff-Derksen, Ioanna Paspali-Strik, Sofon Cam Ngan, Gerard Pasterkamp, Gert J. de Borst, Siu Kwan Sze, Dominique P.V. de Kleijn","doi":"10.1101/2024.09.02.24312942","DOIUrl":"https://doi.org/10.1101/2024.09.02.24312942","url":null,"abstract":"<strong>Objective</strong> Deamidation of the NGR (Asn-Gly-Arg) motif to the isoDGR (isoAsp-Gly-Arg) motif in fibronectin (IsoDGR-fibronectin) enhances <em>in vitro</em> monocyte and endothelial cell activation. Blocking isoDGR reduces macrophage influx in murine tissues. Although macrophage influx is an important feature of human plaque destabilization, the role for plasma and plaque isoDGR-fibronectin in macrophage influx in the atherosclerotic plaque and thereby increasing plaque vulnerability has not been investigated in large human cohorts.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) index, calculated as TG levels divided by HDL-C levels, is suggested as a predictor of cardiovascular disease (CVD). We investigated the association between the TG/HDL-C index and initial CVD events in high-risk patients with type 2 diabetes mellitus (T2DM).
{"title":"Triglyceride/High Density Lipoprotein Cholesterol Index and Future Cardiovascular Events in Diabetic Patients without Known Cardiovascular Disease","authors":"Ryosuke Nakashima, Shota Ikeda, Keisuke Shinohara, Sho Matsumoto, Daisuke Yoshida, Yoshiyasu Ono, Hiroka Nakashima, Ryohei Miyamoto, Shouji Matsushima, Junji Kishimoto, Hiroshi Itoh, Issei Komuro, Hiroyuki Tsutsui, Shintaro Kinugawa, Kohtaro Abe","doi":"10.1101/2024.08.30.24312870","DOIUrl":"https://doi.org/10.1101/2024.08.30.24312870","url":null,"abstract":"<strong>Background</strong> The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) index, calculated as TG levels divided by HDL-C levels, is suggested as a predictor of cardiovascular disease (CVD). We investigated the association between the TG/HDL-C index and initial CVD events in high-risk patients with type 2 diabetes mellitus (T2DM).","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1101/2024.09.01.24312887
Moran Gendler, Girish N Nadkarni, Karin Sudri, Michal Cohen-Shelly, Benjamin S Glicksberg, Orly Efros, Shelly Soffer, Eyal Klang
Purpose This review analyzes the application of large language models (LLMs), in the field of cardiology, with a focus on evaluating their performances across various clinical tasks.
{"title":"Large Language Models in Cardiology: A Systematic Review","authors":"Moran Gendler, Girish N Nadkarni, Karin Sudri, Michal Cohen-Shelly, Benjamin S Glicksberg, Orly Efros, Shelly Soffer, Eyal Klang","doi":"10.1101/2024.09.01.24312887","DOIUrl":"https://doi.org/10.1101/2024.09.01.24312887","url":null,"abstract":"<strong>Purpose</strong> This review analyzes the application of large language models (LLMs), in the field of cardiology, with a focus on evaluating their performances across various clinical tasks.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1101/2024.09.01.24312895
John DePaolo, Siavash Zamirpour, Sarah Abramowitz, Gina Biagetti, Renae Judy, Cameron Beeche, Jeffrey Duda, James Gee, Walter R. Witschey, Julio A. Chirinos, Nicholas J. Goel, Nimesh Desai, Wilson Y. Szeto, Dongchuan Guo, Dianna M. Milewicz, Michael G. Levin, James P. Pirruccello, Scott M. Damrauer
Background Thoracic aortic dissection is a life-threatening condition that often occurs in the presence of aortic dilation. Despite a known association between ascending aortic diameter (AscAoD) and dissection risk, predicting dissection risk remains challenging.
{"title":"Predicting thoracic aortic dissection in a diverse biobank using a polygenic risk score","authors":"John DePaolo, Siavash Zamirpour, Sarah Abramowitz, Gina Biagetti, Renae Judy, Cameron Beeche, Jeffrey Duda, James Gee, Walter R. Witschey, Julio A. Chirinos, Nicholas J. Goel, Nimesh Desai, Wilson Y. Szeto, Dongchuan Guo, Dianna M. Milewicz, Michael G. Levin, James P. Pirruccello, Scott M. Damrauer","doi":"10.1101/2024.09.01.24312895","DOIUrl":"https://doi.org/10.1101/2024.09.01.24312895","url":null,"abstract":"<strong>Background</strong> Thoracic aortic dissection is a life-threatening condition that often occurs in the presence of aortic dilation. Despite a known association between ascending aortic diameter (AscAoD) and dissection risk, predicting dissection risk remains challenging.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1101/2024.08.31.24312876
Anthony Demolder, Viera Kresnakova, Michal Hojcka, Vladimir Boza, Andrej Iring, Adam Rafajdus, Simon Rovder, Timotej Palus, Martin Herman, Felix Bauer, Viktor Jurasek, Robert Hatala, Jozef Bartunek, Boris Vavrik, Robert Herman
Background The digitization of electrocardiograms (ECGs) is an important process in modern healthcare, enabling the preservation, transmission, and advanced analysis of ECG data. Traditional methods for digitizing ECGs from paper formats face significant challenges, particularly in real-world scenarios with varying image quality, paper distortions, and overlapping signals. Existing solutions often require manual input and are limited by their dependence on high-quality images and standardized layouts.
{"title":"High Precision ECG Digitization Using Artificial Intelligence","authors":"Anthony Demolder, Viera Kresnakova, Michal Hojcka, Vladimir Boza, Andrej Iring, Adam Rafajdus, Simon Rovder, Timotej Palus, Martin Herman, Felix Bauer, Viktor Jurasek, Robert Hatala, Jozef Bartunek, Boris Vavrik, Robert Herman","doi":"10.1101/2024.08.31.24312876","DOIUrl":"https://doi.org/10.1101/2024.08.31.24312876","url":null,"abstract":"<strong>Background</strong> The digitization of electrocardiograms (ECGs) is an important process in modern healthcare, enabling the preservation, transmission, and advanced analysis of ECG data. Traditional methods for digitizing ECGs from paper formats face significant challenges, particularly in real-world scenarios with varying image quality, paper distortions, and overlapping signals. Existing solutions often require manual input and are limited by their dependence on high-quality images and standardized layouts.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1101/2024.08.31.24312446
Meredith K. Srour, Minu-Tshyeto K. Bidzimou, Padmapriya Muralidharan, Saige M. Mitchell, Mary E. Moya-Mendez, Lauren E. Parker, Gabriela Reyes Valenzuela, Roberto Caraballo, Giacomo Garone, Federico Vigevano, Sarah Weckhuysen, Charissa Millevert, Monica Troncoso, Mario Matamala, Simona Balestrini, Sanjay M. Sisodiya, Josephine Poole, Claudio Zucca, Eleni Panagiotakaki, Maria T. Papadopoulou, Sébile Tchaicha, Matthildi Athina Papathanasiou Terzi, Marta Zawadzka, Maria Mazurkiewicz-Bełdzińska, Carmen Fons, Jennifer Anticona, Elisa De Grandis, Ramona Cordani, Livia Pisciotta, Sergiu Groppa, Sandra Paryjas, Francesca Ragona, Elena Mangia, Tiziana Granata, Andrey Megvinov, Rosaria Vavassori, Mohamad A. Mikati, Andrew P. Landstrom
Background Alternating hemiplegia of childhood (AHC) is a rare disorder with both neurologic and cardiac manifestations. The ATP1A3-D801N variant is associated with a pathologically short QT interval and risk of ventricular arrhythmia following bradycardia; however, the mechanism of this remains unknown. We investigated the relationship between heart rate (HR), QT, and QTc, hypothesizing that individuals with ATP1A3-D801N have abnormal, impaired shortening of QT and QTc at lower HR leading to arrhythmia predisposition.
{"title":"Children and Adolescent Patients with Variants in the ATP1A3-encoded Sodium-Potassium ATPase Alpha-3 Subunit Demonstrate an Impaired QT Response to Bradycardia and Predisposition to Sinus Node Dysfunction","authors":"Meredith K. Srour, Minu-Tshyeto K. Bidzimou, Padmapriya Muralidharan, Saige M. Mitchell, Mary E. Moya-Mendez, Lauren E. Parker, Gabriela Reyes Valenzuela, Roberto Caraballo, Giacomo Garone, Federico Vigevano, Sarah Weckhuysen, Charissa Millevert, Monica Troncoso, Mario Matamala, Simona Balestrini, Sanjay M. Sisodiya, Josephine Poole, Claudio Zucca, Eleni Panagiotakaki, Maria T. Papadopoulou, Sébile Tchaicha, Matthildi Athina Papathanasiou Terzi, Marta Zawadzka, Maria Mazurkiewicz-Bełdzińska, Carmen Fons, Jennifer Anticona, Elisa De Grandis, Ramona Cordani, Livia Pisciotta, Sergiu Groppa, Sandra Paryjas, Francesca Ragona, Elena Mangia, Tiziana Granata, Andrey Megvinov, Rosaria Vavassori, Mohamad A. Mikati, Andrew P. Landstrom","doi":"10.1101/2024.08.31.24312446","DOIUrl":"https://doi.org/10.1101/2024.08.31.24312446","url":null,"abstract":"<strong>Background</strong> Alternating hemiplegia of childhood (AHC) is a rare disorder with both neurologic and cardiac manifestations. The ATP1A3-D801N variant is associated with a pathologically short QT interval and risk of ventricular arrhythmia following bradycardia; however, the mechanism of this remains unknown. We investigated the relationship between heart rate (HR), QT, and QTc, hypothesizing that individuals with ATP1A3-D801N have abnormal, impaired shortening of QT and QTc at lower HR leading to arrhythmia predisposition.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"304 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1101/2024.08.30.24312869
Habib Layoun, Joseph Kassab, Michel Chedid El Helou, Joseph El Dahdah, Odette Iskandar, Maryam Muhammad Ali Majeed Saidan, Abdelrahman Abushouk, Toshiaki Isogai, Grant Reed, Rishi Puri, Oussama M. Wazni, Amar Krishnaswamy, Serge Harb, Samir Kapadia
Background Angulation of virtual basal ring (VBR), also known as aortic annulus, in relation to sino-tubular joint (STJ) may lead to greater exposure of implanted stent to the conduction system, consequently increasing the risk of LBBB.
{"title":"Aortic root anatomy and impact on new-onset conduction abnormalities after transcatheter aortic valve implantation","authors":"Habib Layoun, Joseph Kassab, Michel Chedid El Helou, Joseph El Dahdah, Odette Iskandar, Maryam Muhammad Ali Majeed Saidan, Abdelrahman Abushouk, Toshiaki Isogai, Grant Reed, Rishi Puri, Oussama M. Wazni, Amar Krishnaswamy, Serge Harb, Samir Kapadia","doi":"10.1101/2024.08.30.24312869","DOIUrl":"https://doi.org/10.1101/2024.08.30.24312869","url":null,"abstract":"<strong>Background</strong> Angulation of virtual basal ring (VBR), also known as aortic annulus, in relation to sino-tubular joint (STJ) may lead to greater exposure of implanted stent to the conduction system, consequently increasing the risk of LBBB.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1101/2024.08.29.24312812
Ava P. Aminbakhsh, Emilie T. Théberge, Elizabeth Burden, Cindy Kalenga Adejumo, Anna Lehman, Tara L. Sedlak
Introduction Coronary artery disease (CAD) is the leading cause of death around the world, with well-described epidemiological sex and gender differences in prevalence, pathophysiology and management outcomes. It has been hypothesized that sex steroids, like estrogen, may contribute to these sex differences. There is a relatively large genetic component to developing CAD, with heritability estimates ranging between 40-60%. In the last two decades, the computational methods, capabilities and scalability of genome-wide association studies (GWAS) have contributed substantially to advancing the understanding of which genetic candidates contribute to CAD. The aim of this study was to determine if genes discovered in CAD GWASs are affected by estrogen by means of direct modulation or indirect down-stream targets.
{"title":"Exploring associations between estrogen and gene candidates identified by coronary artery disease genome-wide association studies","authors":"Ava P. Aminbakhsh, Emilie T. Théberge, Elizabeth Burden, Cindy Kalenga Adejumo, Anna Lehman, Tara L. Sedlak","doi":"10.1101/2024.08.29.24312812","DOIUrl":"https://doi.org/10.1101/2024.08.29.24312812","url":null,"abstract":"<strong>Introduction</strong> Coronary artery disease (CAD) is the leading cause of death around the world, with well-described epidemiological sex and gender differences in prevalence, pathophysiology and management outcomes. It has been hypothesized that sex steroids, like estrogen, may contribute to these sex differences. There is a relatively large genetic component to developing CAD, with heritability estimates ranging between 40-60%. In the last two decades, the computational methods, capabilities and scalability of genome-wide association studies (GWAS) have contributed substantially to advancing the understanding of which genetic candidates contribute to CAD. The aim of this study was to determine if genes discovered in CAD GWASs are affected by estrogen by means of direct modulation or indirect down-stream targets.","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-29DOI: 10.1101/2024.08.27.24311875
Lorena Squassante Capeline, Frederico José Neves Mancuso, Gardênia Silva Lobo Oishi, Marly Uellendahl, Fernando Naylor, Acary Souza Bulle Oliveira, Valdir Ambrósio Moises
Background Transthyretin cardiac amyloidosis (ATTR-CA) is a life-threatening heart condition due to mutations in the transthyretin (TTR) gene. This study aimed to investigate ventricular global longitudinal strain (GLS) and global circumferential strain (GCS) alongside traditional echocardiographic measures in TTR carries with preserved ejection fraction (EF).
{"title":"Advanced Echocardiographic Assessment in Transthyretin Amyloidosis: Early Phenotype Markers in Mutation Carriers","authors":"Lorena Squassante Capeline, Frederico José Neves Mancuso, Gardênia Silva Lobo Oishi, Marly Uellendahl, Fernando Naylor, Acary Souza Bulle Oliveira, Valdir Ambrósio Moises","doi":"10.1101/2024.08.27.24311875","DOIUrl":"https://doi.org/10.1101/2024.08.27.24311875","url":null,"abstract":"<strong>Background</strong> Transthyretin cardiac amyloidosis (ATTR-CA) is a life-threatening heart condition due to mutations in the transthyretin (TTR) gene. This study aimed to investigate ventricular global longitudinal strain (GLS) and global circumferential strain (GCS) alongside traditional echocardiographic measures in TTR carries with preserved ejection fraction (EF).","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1101/2024.08.28.24312712
Hugo MacGowan, Oliver Brown, Michael Drozd, Andrew Walker, Marilena Giannoudi, Sam Straw, Maria Paton, John Gierula, Melanie McGinlay, Kathryn Griffin, Klaus Witte, Mark Kearney, Richard Cubbon
Background: Heart Failure (HF) is frequently associated with multiple comorbidities. We aimed to define their trajectory of accrual to identify opportunities for disease prevention. Methods: We identified all participants in the UK Biobank cohort study diagnosed with HF prior to enrolment or during follow-up, who had disease occurrence data available from both primary and secondary care records (n=9,824). We established the time between diagnosis of HF and 16 common comorbidities to determine the rate and sequence of comorbidity accrual in relation to HF. Stratified analyses considered associations with sex and age at diagnosis of HF. Findings: In chronological sequence, HF was the median fourth diagnosis for men and women. As the age at HF diagnosis increased, HF came later in the sequence of diseases (median second in under 50s to fifth in those aged 80-90). In all age strata, comorbidities accumulated for over a decade before HF and this accelerated in the years immediately before HF. The median time between comorbidity and HF diagnoses ranged from depression preceding HF by 10.7 years to dementia proceeding HF by 0.7 years; all comorbidities presented earlier in women. Atrial fibrillation/flutter was the commonest disease to immediately precede HF, followed by hypertension, cancer, myocardial infarction and osteoarthritis. Interpretation: HF is most often diagnosed in people with established multimorbidity. There is a protracted window of opportunity during which interventions to prevent HF could be applied, often in disease contexts where this is not routine care, such as cancer and osteoarthritis. Funding: British Heart Foundation (RG/F/22/110076)
{"title":"Comorbidity trajectories before and after the diagnosis of heart failure: a UK Biobank cohort study","authors":"Hugo MacGowan, Oliver Brown, Michael Drozd, Andrew Walker, Marilena Giannoudi, Sam Straw, Maria Paton, John Gierula, Melanie McGinlay, Kathryn Griffin, Klaus Witte, Mark Kearney, Richard Cubbon","doi":"10.1101/2024.08.28.24312712","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312712","url":null,"abstract":"Background: Heart Failure (HF) is frequently associated with multiple comorbidities. We aimed to define their trajectory of accrual to identify opportunities for disease prevention.\u0000Methods: We identified all participants in the UK Biobank cohort study diagnosed with HF prior to enrolment or during follow-up, who had disease occurrence data available from both primary and secondary care records (n=9,824). We established the time between diagnosis of HF and 16 common comorbidities to determine the rate and sequence of comorbidity accrual in relation to HF. Stratified analyses considered associations with sex and age at diagnosis of HF.\u0000Findings: In chronological sequence, HF was the median fourth diagnosis for men and women. As the age at HF diagnosis increased, HF came later in the sequence of diseases (median second in under 50s to fifth in those aged 80-90). In all age strata, comorbidities accumulated for over a decade before HF and this accelerated in the years immediately before HF. The median time between comorbidity and HF diagnoses ranged from depression preceding HF by 10.7 years to dementia proceeding HF by 0.7 years; all comorbidities presented earlier in women. Atrial fibrillation/flutter was the commonest disease to immediately precede HF, followed by hypertension, cancer, myocardial infarction and osteoarthritis.\u0000Interpretation: HF is most often diagnosed in people with established multimorbidity. There is a protracted window of opportunity during which interventions to prevent HF could be applied, often in disease contexts where this is not routine care, such as cancer and osteoarthritis.\u0000Funding: British Heart Foundation (RG/F/22/110076)","PeriodicalId":501297,"journal":{"name":"medRxiv - Cardiovascular Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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