Faculty Opinions recommendation of Sex differences in the association between leptin and CRP: results from the Dallas Heart Study.

Abstract Background: Our aim was to characterize the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with coronary and aortic atherosclerosis in a large population-based study. Methods: Lp-PLA2 mass and activity were measured in 2171 subjects 30–65 years old participating in the Dallas Heart Study. We examined the association of Lp-PLA2 levels with 3 atherosclerosis phenotypes: coronary artery calcium (CAC) measured by electron-beam computed tomography and abdominal aortic plaque (AAP) and aortic wall thickness (AWT) measured by magnetic resonance imaging. Results: CAC and AAP were detected in 21% and 40% of subjects, respectively, and mean AWT (SD) was 1.70 (0.32) mm. In univariable analyses, Lp-PLA2 mass (but not activity) was higher in both men (P = 0.04) and women (P = 0.02) with detectable CAC. Lp-PLA2 mass and activity were higher (P = 0.004 and P = 0.01, respectively) and AWT was greater (P < 0.001 and P = 0.02, respectively) in women with aortic atheroma, but not in men. After adjustment for traditional atherosclerosis risk factors and C-reactive protein concentrations, Lp-PLA2 mass and activity were not associated with AAP or AWT in either sex, but Lp-PLA2 mass remained modestly associated with detectable CAC only in men (odds ratio 1.20 per 1 standard deviation increase, 95% CI 1.01–1.42, P = 0.04). Conclusions: Although Lp-PLA2 mass was independently associated with CAC in men, it was not associated with AAP or AWT in men or with any of the atherosclerosis phenotypes in women. These findings suggest that if Lp-PLA2 independently influences clinical events, it does so by promoting atherosclerotic plaque instability rather than by stimulating atherogenesis.

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Abstract 003: Change in Cardiovascular Risk Factors Associated with Weight Gain in the Dallas Heart Study

Circulation ◽

10.1161/circ.125.suppl_10.a003 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Tiffany M Powell ◽

Colby R Ayers ◽

James A de Lemos ◽

Amit Khera ◽

Susan G Lakoski ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Weight Gain ◽

Cardiovascular Risk Factors ◽

Average Weight ◽

Men And Women ◽

Significant Weight Gain ◽

Heart Study ◽

Dallas Heart Study ◽

The Impact

Background: Concerning trends in weight gain from 2000-2009 exist in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents aged 30-65. However, the impact of significant weight gain (≥ 5% increase in body weight) on cardiovascular risk factors (CVRF) in this contemporary, multi-ethnic population is not known. Methods: We measured weight, LDL-c, blood pressure (SBP and DBP), and fasting glucose (FG) in 2,022 DHS participants (58% female) at study entry in 2000 and in 2009. Using logistic regression stratified by sex and race/ethnicity, we determined the age-adjusted odds of worsening CVRF (any increase in LDL-c, SBP, DBP or FG) for people who gained significant weight compared to those who did not. Results: Among women, 43% (N=500) gained significant weight, compared to 42% of men (N=355). Despite similar average weight gain (9.7±5.8 kg for women vs. 10±5.6 kg for men, p=0.4), women who gained significant weight had almost twice as large an increase in LDL-c (14±34 vs. 8±39 mg/dl, p=0.01) and SBP (12±18 vs. 6±19 mmHg, p<0.001) compared with men who gained significant weight. Increases in DBP (5±10 vs. 4±11 mmHg, p=0.05) and FG (4±29 vs. 2±32 mg/dl, p=0.30) were not significantly different between men and women. Among those with significant weight gain who were not on medications, SBP and LDL-c increases were higher in women compared with men (p<0.05). Differences in the amount of weight gained stratified by race and sex were modest (Table). Black women who gained significant weight were likely to have a worsening of all CVRF, while Hispanic women had the highest likelihood of having an increase in SBP associated with weight gain. In contrast, significant weight gain among men was not associated with worsening CVRF. Conclusions: Significant weight gain was associated with a deleterious impact on CVRF among women but not men. Disparate effects of weight gain between men and women highlight the importance of targeting aggressive weight control interventions toward women to help prevent adverse cardiac outcomes.

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Abstract MP88: Neighborhood-Level Socioeconomic Deprivation Predicts Weight Gain in a Multi-Ethnic Population: Longitudinal Data from the Dallas Heart Study

Circulation ◽

10.1161/circ.127.suppl_12.amp88 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Priscilla Agyemang ◽

Colby Ayers ◽

Min Lian ◽

Sandeep Das ◽

Christine Hoehner ◽

...

Keyword(s):

Physical Activity ◽

Weight Gain ◽

Weight Change ◽

Socioeconomic Deprivation ◽

Neighborhood Environment ◽

Dallas County ◽

Heart Study ◽

Deprived Neighborhoods ◽

Dallas Heart Study ◽

Neighborhood Level

Background: Although neighborhood-level socioeconomic deprivation associates with prevalent obesity, its relationship to individual-level weight change over time is poorly elucidated. Few studies have evaluated the impact of behavioral and psychosocial factors on this relationship. Methods: We examined the relationship between neighborhood-level socioeconomic deprivation and weight change among those who did not move in the 7-year study period (N=955) of the Dallas Heart Study (DHS), a multi-ethnic, population-based sample of Dallas County residents aged 18-65. Baseline weight measurements were performed in 2000-02 and weight was re-measured at 7-year follow-up. Home addresses obtained at baseline and follow-up were geocoded and linked to residential census tracts in Dallas County. A neighborhood deprivation index (NDI) for DHS participants was created using factor analysis of 21 census-tract neighborhood characteristics, with higher scores indicating more socioeconomic deprivation. Repeated-measures linear mixed modeling with random effects was used to determine weight change (kg) relative to tertiles of NDI. Reported physical activity (yes/no: exercised <150 mets/min-wk) and perceptions of neighborhood environment (questionnaire-derived score with higher score = more unfavorable perceptions of neighborhood violence, aesthetics, and social cohesion) were examined as mediators. Results: DHS participants living in more socioeconomically deprived neighborhoods had lower income and education (p-trend <0.001 for both). Blacks were more likely to live in more socioeconomically deprived neighborhoods than whites and Hispanics (p<0.001). Adjusting for age, sex, race, smoking, education, and income as fixed effects, DHS participants living in the most socioeconomically deprived neighborhoods (highest NDI tertile) gained 5.8±2.5 more kilograms (p=0.02) over the 7-year period compared to those in the least deprived neighborhoods. Living in the most socioeconomically deprived neighborhoods remained associated with a 6.4±2.5 kg greater increase in weight (p=0.01) compared to living in the least deprived neighborhoods after adjustment for physical activity levels and a 6.6±2.6 kg greater increase in weight (p=0.01) after adjustment for perceptions of neighborhood environment. Conclusions: Living in more socioeconomically deprived neighborhoods is associated with greater weight gain among DHS participants over a 7-year period. This relationship does not appear to be fully explained by lower levels of physical activity or unfavorable perceptions of the neighborhood environment. In Dallas County, the high risk for greater weight gain among people living in socioeconomically deprived neighborhoods supports the need to develop targeted community-based interventions to address obesity and reduce disparities in cardiovascular risk.

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The association between plasma caspase-3, atherosclerosis, and vascular function in the Dallas Heart Study

APOPTOSIS ◽

10.1007/s10495-008-0254-1 ◽

2008 ◽

Vol 13 (10) ◽

pp. 1281-1289 ◽

Cited By ~ 10

Author(s):

Susan Matulevicius ◽

Anand Rohatgi ◽

Amit Khera ◽

Sandeep R. Das ◽

Andrew Owens ◽

...

Keyword(s):

Vascular Function ◽

Caspase 3 ◽

Heart Study ◽

Dallas Heart Study

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Abstract 4401: Two Independent Genetic Variants in NOS1AP are Associated with QT interval in a Multi-Ethnic Population: the Dallas Heart Study

Circulation ◽

10.1161/circ.118.suppl_18.s_882 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Dan E Arking ◽

Amit Khera ◽

Chao Xing ◽

Wen H Kao ◽

Aravinda Chakravarti

Keyword(s):

Heart Rate ◽

Genetic Variants ◽

Qt Interval ◽

Genetic Model ◽

Black Population ◽

European Ancestry ◽

Ethnic Population ◽

Heart Study ◽

Increased Risk ◽

Dallas Heart Study

Extremes of QT interval are associated with increased risk for sudden cardiac death (SCD), and thus identification and characterization of genetic variants that modulate QT interval may elucidate the underlying etiology of SCD. Previous work revealed an association between a common genetic variant in NOS1AP and QT interval in populations of European ancestry, but this finding has not been extended to other ethnic populations. We thus sought to characterize the effects of NOS1AP genetic variants in the multi-ethnic population-based Dallas Heart Study (DHS). Among 3,557 participants in DHS with available DNA, those without QT interval, heart rate, age, and/or sex information, and those with QRS >120 or undetermined ethnicity were excluded, resulting in 2,949 samples available for analysis (501 Hispanic, 1,506 Black, 942 White). Sex- and ethnicity-stratified linear regression was used to correct QT interval for heart rate and age. Eight SNPs spanning the region previously associated with QT interval were genotyped, and ethnic-specific analyses were performed under an additive genetic model. The SNP most strongly associated with QT interval in previous samples of European ancestry, rs16847548, was the most strongly associated in the White participants (+2.6 ms, P<0.005) as well as in Blacks (+3.2 ms, P<3.6 × 10 –5), with the same direction of effect in Hispanics (+1.5 ms, P<0.17). A second SNP, rs16856785, which was uncorrelated with rs16847548 (r2 < 0.01 in Blacks) was also associated with QT interval in Blacks (+1.6 ms, P<0.01), with qualitatively similar results in Whites (+0.9 ms, P<0.33) and Hispanics (+0.6 ms, P<0.66). Adjusting for local and global ancestry using Ancestry Informative Markers did not significantly alter the results. Comparing Blacks homozygous at both SNPs for the QT lengthening allele to Blacks homozygous for the complementary alleles revealed a 13.9 ms difference in QT interval. These data extend the association of genetic variants in NOS1AP with QT interval to a Black population, with similar trends in Hispanics. Further, a second, independent site within NOS1AP has been implicated in modulating QT interval, highlighting the importance of NOS1AP genetic variants in regulating QT interval.

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Abstract P026: Early Repolarization Pattern is Associated With Increased Left Ventricular Mass and Left Ventricular Hypertrophy: Results From the Dallas Heart Study

Circulation ◽

10.1161/circ.137.suppl_1.p026 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

David A McNamara ◽

Ari Bennett ◽

Jarett D Berry ◽

Mark S Link

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Left Ventricular ◽

Percent Body Fat ◽

Early Repolarization ◽

Heart Study ◽

Dallas Heart Study

Introduction: Recent studies have shown an association between early repolarization pattern (ERP) ECG morphology and sudden cardiac death. The role of left ventricular mass (LVM) as a potential mediator of ERP has not been well explored. Methods: Participants in the Dallas Heart Study who underwent an ECG and cardiac MRI (CMR) were assessed for ERP, defined as J-point elevation ≥1 mm in any 2 contiguous leads. We compared participants with and without ERP by age, gender, race/ethnicity, established cardiovascular risk factors of diabetes, hypertension and hyperlipidemia, lean body mass and percent body fat, and CMR-derived LVM, LVM/body surface area, and LVH defined by standard criteria, using Student’s T-tests and chi-squared tests where appropriate. Results: Of the 3,015 participants in our study, 276 (9.2%) had ERP. Participants with ERP were younger (43±9 vs 44±10 yrs, p=0.04), more prevalent in blacks than non-blacks (14 vs 5.0%, p<0.00001), and in men than women (18 vs 2.0%, p<0.00001). Baseline cardiovascular risk factors were not significantly different. Participants with ERP demonstrated higher lean body mass (59±10 vs 52±11 kg, p<0.00001) and lower percent body fat (27±8 vs 36±9%, p<0.00001). The presence of ERP was associated with greater LVM, increased LVM/body surface area, and the presence of LVH in the overall population and in analyses stratified by sex (Table 1). Conclusion: In a large, multi-ethnic cohort, ERP is associated with increased total LVM, increased LVM/body surface area, and LVH. These novel associations may provide insight into the biology of ERP. Further studies investigating the relationship of LVM and LVH with ERP are warranted.

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Factors associated with baseline and serial changes in circulating NT-proBNP and high-sensitivity cardiac troponin T in a population-based cohort (Dallas Heart Study)

Biomarkers in Medicine ◽

10.2217/bmm-2021-0055 ◽

2021 ◽

Author(s):

Christopher W Puleo ◽

Colby R Ayers ◽

Sonia Garg ◽

Ian J Neeland ◽

Alana A Lewis ◽

...

Keyword(s):

Body Composition ◽

Cardiac Troponin ◽

Troponin T ◽

High Sensitivity ◽

Left Ventricular ◽

Cardiac Troponin T ◽

C Reactive Protein ◽

Reactive Protein ◽

Heart Study ◽

Dallas Heart Study

Aim: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) associate with structural heart disease and heart failure risk in individuals without known cardiovascular disease (CVD). However, few data are available regarding whether factors influencing levels of these two biomarkers are similar or distinct. We performed serial measurement of NT-proBNP and hs-cTnT in a contemporary multiethnic cohort with extensive phenotyping, with the goal of identifying their respective biological determinants in a population without known or suspected CVD. Methods: We evaluated 1877 participants of the Dallas Heart Study who had NT-proBNP and hs-cTnT measured and were free from clinical CVD at the each of its two examinations (2000–2002 and 2007–2009). Variables collected included demographic and risk factors, high-sensitivity C-reactive protein, body composition via dual-energy x-ray absorptiometry, coronary artery calcium by computed tomography, and cardiac dimensions and function by cardiac MRI. Linear regression was used to identify associations of these factors with each biomarker at baseline and with changes in biomarkers over follow-up. Results: NT-proBNP and hs-cTnT were poorly correlated at baseline (Spearman rho 0.083, p = 0.015), with only moderate correlation between change values (rho 0.18, p < 0.001). hs-cTnT positively associated and NT-proBNP inversely associated with male gender and black race. At baseline, both NT-proBNP and hs-cTnT associated with left ventricular end-diastolic volume and wall thickness, but only NT-proBNP associated with left atrial size. Changes in cardiac dimensions between phases were more strongly associated with changes in NT-proBNP than hs-cTnT. NT-proBNP was more strongly associated with high-sensitivity C-reactive protein and measures of body composition than hs-cTnT. Conclusion: Among individuals without CVD in the general population, NT-proBNP and hs-cTnT are nonredundant biomarkers that are differentially associated with demographic and cardiac factors. These findings indicate that hs-cTnT and NT-proBNP may reflect different pathophysiological pathways.

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Abstract 5085: Cardiovascular Risk Factors and Coronary Atherosclerosis in Retired National Football League Players: Implications for Coronary Risk of Large Body Size in Athletes

Circulation ◽

10.1161/circ.118.suppl_18.s_1143 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Alice Y Chang ◽

Shannon J FitzGerald ◽

John Cannaday ◽

Song Zhang ◽

Amit Patel ◽

...

Keyword(s):

Risk Factors ◽

Body Size ◽

Coronary Atherosclerosis ◽

National Football League ◽

Large Body ◽

Physically Active ◽

The Metabolic Syndrome ◽

Heart Study ◽

Community Controls ◽

Dallas Heart Study

A high prevalence of obesity exists among national football league (NFL) players as classified by body mass index (BMI). It has not been established whether this elevated BMI is associated with a greater prevalence of cardiovascular (CV) risk factors or coronary artery disease in former NFL players as in non-athletes. This study compared CV risk factors and subclinical coronary atherosclerosis among retired NFL players versus community controls. The design was a case-control study of retired NFL players against matched controls from the population-based Dallas Heart Study (DHS) and a second physically active sample from the Aerobics Center Longitudinal Study (ACLS). CV risk factors were assessed by survey and health screening visit. Coronary atherosclerosis was determined with computed tomography measurements of coronary artery calcium (CAC). 201 NFL players completed measurements of CAC. Compared to DHS men, retired NFL players had a significantly lower prevalence of diabetes, hypertension, a sedentary lifestyle and the metabolic syndrome, yet a higher prevalence of impaired fasting glucose and hyperlipidemia. However, there was no significant difference in the prevalence of positive CAC (46 v 48.3%, p=0.69) or the distribution across subgroups of CAC (0 –10, 10 –100, 100 – 400, 400+, p=0.11) between the retired NFL players and DHS men. These results were not significantly different when controlling for ethnicity or linemen status. When compared to physically active controls (ACLS), retired NFL players had a greater BMI, waist size and prevalence of the metabolic syndrome, but no difference in other CV risk factors or CAC scores. Conclusions: Despite their large body size, former NFL players do not have a greater prevalence of CV risk factors or amount of CAC than community controls when matched by BMI and/or age. Age and hyperlipidemia, not body size, were the most significant predictors of subclinical coronary atherosclerosis among retired NFL players. This research has received full or partial funding support from the American Heart Association, AHA National Center. CV Risk Factors, Retired NFL Players versus Dallas Heart Study Participants

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