Abstract MP04: 25 year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium: the CARDIA Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jamal S Rana ◽  
Rosenda Murillo ◽  
Charles P Quesenberry ◽  
Michael E Sorel ◽  
Barbara Sternfeld ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Middle Age ◽  
Subclinical Atherosclerosis ◽  
Prospective Longitudinal Study ◽  
Men And Women ◽  
Prospective Longitudinal

Background: Physical activity (PA) has been shown to be protective against the development of clinical cardiovascular disease. There is paucity of data regarding the association of long term PA patterns and development of subclinical atherosclerosis, as measured by coronary artery calcium (CAC). Studies so far are limited by evaluation of PA only at baseline. The goal of this study was to identify 25 year patterns of PA from young to middle age and its association with development of CAC. Methods: CARDIA is a prospective longitudinal study of black and white men and women, ages 18-30 years at baseline in 1985-86, with up to 7 follow-up exams over 25 years of follow-up. PA was determined at each exam by a questionnaire that assessed typical PA during the past 12 months for 13 types of activities. Men and women who had at least 3 measures of PA during the 25 years of follow up and CAC assessment at the Year 25 exam were included (N= 3178). CARDIA Physical Activity Score > 300 units is approximately equivalent to >150 min/week of moderate or vigorous physical activity and was considered as meeting PA guidelines (MPAG). Latent class modeling was used to identify unique trajectories of PA. Odds ratios for CAC were estimated from a multivariable logistic model controlling for age, sex, ethnicity, hypertension, diabetes, BMI, smoking status and education. Results: Our analyses showed 5 unique PA trajectories (figure). 1. Maintaining-not MPAG (46.5%); 2. maintaining-MPAG (35.6%); 3 increasing-MPAG (8.5%); 4. decreasing-MPAG (6.5%), and 5. maintaining- > 3 fold MPAG (2.4%). Compared with the maintaining-not MPAG, the multivariable adjusted odds ratio for presence of CAC (non-zero CAC score) was 1.02 (95% CI, 0.84-1.24) for maintaining-MPAG, 1.07 (95% CI, 0.78-1.44) for increasing-MPAG , 1.01(95% CI, 0.72- 1.41) for decreasing-MPAG , and 1.37 (95% CI, 0.82-2.27) for maintaining- > 3 fold MPAG. Conclusion: Long-term trajectories for levels of PA through young adulthood are not associated with development of subclinical atherosclerosis by middle age.

Abstract P281: All-cause and Cardiovascular Mortality in Men With High Levels of Physical Activity and Coronary Artery Calcification

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Laura F Defina ◽  
Nina B Radford ◽  
David Leonard ◽  
Stephen W Farrell ◽  
Andjelka Pavlovic ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Proportional Hazards ◽  
Subclinical Atherosclerosis ◽  
Activity Level ◽  
Mortality Hazard ◽  
Hazard Ratios ◽  
All Cause Mortality

Introduction: Recent studies have suggested that extreme levels of physical activity (endurance athletes) are associated with subclinical atherosclerosis as well as increased mortality. The safety of continuing high levels of physical activity is uncertain once coronary artery calcification (CAC) is discovered. Hypothesis: We hypothesized that men performing &ge3000 MET·minutes/week of physical activity would have greater all-cause and cardiovascular (CV) mortality compared to those with &lt1500 or 1500-&lt3000 MET·minutes/week of physical activity and that mortality risk would be greater in those with CAC&ge100 compared to &lt100 Agatston units. Methods: The cohort studied included 16,109 men without prevalent CV disease who reported physical activity levels and underwent EBT or MDCT scan. Physical activity was categorized into &ge3000 (n=1,266), 1500-3000 (n=3,027), and &lt1500 (n=11,816) MET·minutes/week. CAC scanning included EBT scans (1997-2007) or MDCT scans (2007-2013), and CAC score was categorized into &ge100 (n=3,547) and &lt100 (n=12,562) Agatston units. We fit separate proportional hazards regression models to follow-up times for all-cause and CV mortality. The models included all combinations of CAC and physical activity categories and were adjusted for baseline age, smoking, BMI, cholesterol, HDLc, and systolic blood pressure. Results: The average age of participants at baseline was 51.3±8.3 years. Men with the highest activity level had a lower BMI and higher HDLc. After an average follow-up of 8.9 years, there were 329 all-cause and 60 CV deaths, including 174 all-cause and 38 CV deaths in those with CAC&ge100. The sample had 80% power to detect all-cause mortality hazard ratios &ge 1.9 and 1.8 for physical activity &ge3000 versus &lt1500 in those with CAC&lt100 and &ge100, respectively. The corresponding minimum detectable CV mortality hazard ratios were 3.5 and 2.8. Comparing physical activity &ge3000 to &lt1500 in those with CAC&ge100, the hazard ratios (95% CI) were 0.9 (0.5, 1.5) for all-cause mortality and 0.9 (0.3, 3.1) for CV mortality. Hazard ratios were similar when comparing physical activity &ge3000 to 1500-&lt3000 in those with CAC &ge100. Finally, when comparing physical activity categories, there was no evidence that hazard ratios varied by CAC category, p&gt0.7. Conclusions: This sample offers no evidence that levels of activity &ge3000 MET·minutes/week are associated with increased all-cause or CV mortality compared to those with &lt1500 or 1500- &lt3000 MET·minutes/week, regardless of CAC level.

scholarly journals MON-307 Prospective, Longitudinal Study of Glucose-Suppressed GH Levels in 87 Acromegaly Patients with IGF-1 Normalization After Surgical Therapy: Prognostic Value of Nadir GH Levels for Long-Term Remission or Recurrence

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Pamela Freda ◽  
Jeffrey N Bruce ◽  
Carlos Reyes-Vidal ◽  
Yessica De Leon ◽  
Zhezhen Jin ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Prognostic Value ◽  
Relevant Information ◽  
Oral Glucose ◽  
Surgical Removal ◽  
Prospective Longitudinal Study ◽  
Normal Ranges ◽  
Prospective Longitudinal

Abstract Surgical removal of the GH-secreting tumor is the initial treatment of choice for acromegaly. Outcome of surgery is assessed by measuring IGF-1 and glucose-suppressed GH levels. IGF-1 normalization is an essential biochemical criterion for remission. The cut-off for nadir GH after oral glucose that signifies remission, however, is debated. It also remains unclear whether GH levels provide additional prognostic or clinically relevant information when IGF-1 results are definitive. To address this question, we examined how initial postoperative glucose-suppressed GH levels change over time on serial testing in patients who achieve initial remission as defined by IGF-1 normalization. We studied 87 acromegaly patients (48M, 39F) who achieved a normal IGF-1 level after surgery alone longitudinally from 1996 to 2019. All had GH measured before and 60, 90 and 120 minutes after 75 or 100 mg oral glucose (OGTT) at ≥ 3 months after surgery and GH and IGF-1 repeated ≥ 1 year later. GH was by measured by sensitive, 22KDa GH specific assays, either a IRMA (DSL, International Reference Standard (IRS) 88/624) or a chemiluminescence immunoassay (IDS-iSYS, IRS 98/574). OGTT Nadir GH levels were also measured in healthy subjects; n=46 (26 M, 20 F, ages 19-71 yr.) by DSL and n=46 (29 M, 17 F; ages 20-66 yr.) by IDS-iSYS. Nadir GH levels in acromegaly patients were compared to the 95%CI of healthy subjects’ mean and categorized relative to healthy subjects’ 97.5 percentile, which was 0.14 µg/L for both assays. IGF-1 levels were compared to age and gender adjusted normal ranges. Subjects were grouped based on initial nadir GH ≤ or > 0.14 µg/L and the patterns of change in nadir GH and IGF-1 at last follow up or until IGF-1 became elevated (i.e. recurrence). Follow up durations are given as median(range). In follow up, 73 patients remained in remission (normal IGF-1) and 14 had a recurrence (elevated IGF-1). Of the 73 in remission, 55 had initial nadir GH ≤ 0.14 µg/L that persisted to 10 yr.(1-22yr.) of follow up, 5 had initial GH ≤ 0.14 µg/L that rose to > 0.14 µg/L by 9(3-21)yr., 10 had GH > 0.14 µg/L that persisted at 5.5(2-22)yr., and 3 had GH > 0.14 µg/L that fell to ≤ 0.14 µg/L at 5(4-7)yr. of follow up. Of the 14 that recurred, 11 had an initial and persistent GH > 0.14 µg/L and developed an elevated IGF-1 level after 6(1-23) yr.. The 3 other patients that recurred had an initial GH ≤ 0.14 µg/L that rose to > 0.14 µg/L by 1-6 years later and subsequently developed an elevated IGF-1 level by 14-16 years of follow up. In summary, we found that the pattern of normal IGF-1 along with nadir GH > 0.14 µg/L on initial testing or developing with time, was associated with recurrence in 14/32 patients. We also found that initial nadir GH ≤ 0.14 µg/L was highly predictive of long-term persistent remission: 60/63 such patients remained in remission. In conclusion, glucose-suppressed GH levels are of prognostic value in acromegaly patients with normal IGF-1 after surgery.

scholarly journals Associations of recreational and non-recreational physical activity with coronary artery calcium density vs. volume and cardiovascular disease events: the Multi-Ethnic Study of Atherosclerosis

2019 ◽  
Author(s):  
Isac C Thomas ◽  
Michelle L Takemoto ◽  
Nketi I Forbang ◽  
Britta A Larsen ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Standard Deviation ◽  
Coronary Artery Calcium ◽  
Recreational Physical Activity ◽  
Cvd Risk ◽  
Ethnic Study ◽  
Subclinical Marker

Abstract Aims  The benefits of physical activity (PA) on cardiovascular disease (CVD) are well known. However, studies suggest PA is associated with coronary artery calcium (CAC), a subclinical marker of CVD. In this study, we evaluated the associations of self-reported recreational and non-recreational PA with CAC composition and incident CVD events. Prior studies suggest high CAC density may be protective for CVD events. Methods and results  We evaluated 3393 participants of the Multi-Ethnic Study of Atherosclerosis with prevalent CAC. After adjusting for demographics, the highest quintile of recreational PA was associated with 0.07 (95% confidence interval 0.01–0.13) units greater CAC density but was not associated with CAC volume. In contrast, the highest quintile of non-recreational PA was associated with 0.08 (0.02–0.14) units lower CAC density and a trend toward 0.13 (−0.01 to 0.27) log-units higher CAC volume. There were 520 CVD events over a 13.7-year median follow-up. Recreational PA was associated with lower CVD risk (hazard ratio 0.88, 0.79–0.98, per standard deviation), with an effect size that was not changed with adjustment for CAC composition or across levels of prevalent CAC. Conclusion  Recreational PA may be associated with a higher density but not a higher volume of CAC. Non-recreational PA may be associated with lower CAC density, suggesting these forms of PA may not have equivalent associations with this subclinical marker of CVD. While PA may affect the composition of CAC, the associations of PA with CVD risk appear to be independent of CAC.

Early Exposure to Direct Instruction and Subsequent Juvenile Delinquency: A Prospective Examination

2002 ◽  
Vol 69 (1) ◽  
pp. 85-96 ◽  
Author(s):  
Paulette E. Mills ◽  
Kevin N. Cole ◽  
Joseph R. Jenkins ◽  
Philip S. Dale
Keyword(s):  
Early Childhood ◽  
Juvenile Delinquency ◽  
Direct Instruction ◽  
Preschool Education ◽  
Prospective Longitudinal Study ◽  
Young Children With Disabilities ◽  
Long Term Impact ◽  
Prospective Longitudinal

In a widely cited follow-up study of disadvantaged preschool attendees, Schweinhart, Weikart, and Larner (1986a) found that graduates of an early childhood program using direct instruction (DI) methods exhibited higher rates of juvenile delinquency at age 15 than did graduates of two other preschool education models. The present research examined juvenile delinquency outcomes for young children with disabilities in a prospective longitudinal study that tracked the long-term impact of two preschool models—one using DI, the other using a cognitively oriented, child-directed model. We followed 171 children who had been randomly assigned to the two early childhood models. At age 15, the groups did not differ significantly in their level of reported delinquency. Analyses suggest that gender differences in delinquent behavior may provide a more parsimonious explanation than program effects for the earlier Schweinhart et al. findings.

Abstract 40: Duration of Prediabetes is Associated with Subclinical Atherosclerosis and Cardiac Dysfunction in Middle-Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Jared P Reis ◽  
Norrina B Allen ◽  
Michael P Bancks ◽  
Jeffrey J Carr ◽  
Cora E Lewis ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Cardiac Dysfunction ◽  
Middle Age ◽  
Subclinical Atherosclerosis ◽  
Global Longitudinal Strain ◽  
Oral Glucose ◽  
Cardiac Structure ◽  
Cvd Risk ◽  
And Function

Background: A prolonged duration of diabetes has been shown to be independently associated with incident cardiovascular disease (CVD). Whether duration of prediabetes is similarly associated with CVD is unknown. We sought to determine whether the duration of prediabetes during young adulthood is associated with the presence of coronary artery calcified plaque (CAC) and cardiac structure/function in middle-age. Methods: Participants were 3244 white and black adults aged 18-30 years without prediabetes or diabetes at baseline (1985-86) or diabetes during follow-up in the multicenter community-based CARDIA Study. Prediabetes was defined at follow-up examinations 7, 10, 15, 20, and 25 years after baseline as fasting glucose 100-125 mg/dL, 2-hour oral glucose tolerance 140-199 mg/dL or HbA1c 5.7-6.4%. Presence of CAC was measured by computed tomography at follow-up years 15, 20, and 25. Measures of cardiac structure and function were obtained from echocardiography performed at year 25. Results: Of the 3244 individuals, 1561 (48.2%) developed prediabetes during follow-up. Among those who developed prediabetes, the median (IQR) duration was 10 (5-12) years. After adjustment for age, sex, race, education, study center, and CVD risk factors, the hazard ratio for the presence of CAC was 1.21 times higher for each 10-year increase in duration of prediabetes (95% CI: 1.06, 1.37). Duration of prediabetes was also associated with worse global longitudinal strain (per 10 years: 0.2%; 95% CI: 0.1, 0.4; P=.005), e′ (-0.2 cm/s; 95% CI: -0.3, -0.1; P < .001), and E/e′ ratio (0.113; 95% CI: -0.007, 0.233; P=.06) ( Table ). These results did not differ significantly by race or sex. Conclusions: Exposure to a longer duration of prediabetes is associated with subclinical atherosclerosis and cardiac dysfunction in middle-age. Further research is needed to better understand the pathophysiology of these relationships.

scholarly journals Long-term outcomes of rotating gamma knife for vestibular schwannoma: A 4-year prospective longitudinal study of 89 consecutive patients in Vietnam

2021 ◽  
Vol 12 ◽  
pp. 585
Author(s):  
Hung Dinh Kieu ◽  
Duong Ngoc Vuong ◽  
Khoa Trong Mai ◽  
Phuong Cam Pham ◽  
Tam Duc Le
Keyword(s):  
Longitudinal Study ◽  
Gamma Knife ◽  
Trigeminal Nerve ◽  
Vestibular Schwannoma ◽  
Tumor Control ◽  
Prospective Longitudinal Study ◽  
Nerve Preservation ◽  
Prospective Longitudinal

Background: Microsurgical total removal of vestibular schwannoma (VS) is the definitive treatment but has a high incidence of postoperative neurological deficits. Rotating Gamma Knife (RGK) is a preferred option for a small tumor. This study aims to evaluate long-term neurological outcomes of RGK for VS. Methods: This prospective longitudinal study was conducted at the Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam. Eighty-nine consecutive patients were enrolled from October 2011 to October 2015 and followed up to June 2017. RGK was indicated for VS measuring <2.2 cm, while RGK for tumors measuring 2.2–3 cm was considered in patients with severe comorbidities, high-risk surgery, and who denied surgery. Concurrently, VS consisted of newly diagnosed, postoperative residual, and recurrent tumors. Patients with neurofibromatosis type 2 were excluded from the study. Primary outcomes were radiological tumor control rate, vestibulocochlear functions, facial and trigeminal nerve preservation. Stereotactic radiosurgery was performed by the Rotating Gamma System Gamma ART 6000. Results: The tumors were measured 20.7 ± 5.6 mm at pre treatment and 17.6 ± 4.1 mm at 3-year post treatment. The mean radiation dose was 13.5 ± 0.9 Gy. Mean follow-up was 40.6 ± 13.3 months. The radiological tumor control rate was achieved 95.5% at 5-year post treatment. The hearing and vestibular functions were preserved in 70.3% and 68.9%, respectively. The facial and trigeminal nerve preservation rates were 94.4% and 73.3%, respectively. Conclusion: RGK is an effective and safe treatment for VS measuring ≤3 cm with no significant complications during long-term follow-up.

scholarly journals The fall in antibody response to SARS-CoV-2: a longitudinal study of asymptomatic to critically ill patients up to 10 months after recovery

2021 ◽  
Author(s):  
Maddalena Peghin ◽  
Maria De Martino ◽  
Martina Fabris ◽  
Alvisa Palese ◽  
Erica Visintini ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Antibody Response ◽  
Seroconversion Rate ◽  
Disease Onset ◽  
Acute Onset ◽  
Serological Response ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

Background. The aim was to assess long-term dynamics and factors associated with the serological response against the Severe Acute Respiratory Syndrome Coronavirus 2 after primary infection. Methods. A prospective longitudinal study with monthly serological follow-up during the first 4 months, and then at 6, 8 and 10 months after the disease onset of all recovered adult in- and out-patients with Coronavirus Disease 2019 (COVID-19) attending Udine Hospital (Italy) during the first wave (from March to May 2020). Results. 542 individuals were included (289 female, mean age 53.1 years), mostly with mild COVID-19 (370, 68.3%). Patients were followed for a median of 302 days (Interquartile Range, 186-311). Overall seroconversion rate within two months was 32% for IgM and 90% for IgG. Seroreversion was observed in 90% of patients for IgM at 4 months and in 47% for IgG at 10 months. older age, number of symptoms at acute onset, severity of acute COVID-19, were all independent predictors of long-term immunity both for IgM (β, linear regression coefficient, 1.10, p=0.001; β 5.15 p=0.014; β 43.84 p=0.021, respectively) and for IgG (β 1.43 p<0.001; β 10.46 p<0.001; β 46.79 p<0.001, respectively), whereas the initial IgG peak was associated only with IgG duration (β 1.12, p <0.001). Conclusions. IgM antibodies disappeared at four months and IgG antibodies declined in about half of patients 10 months after acute COVID-19. These effects varied depending on the intensity of the initial antibody response, age and burden of acute COVID-19.

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