Search Results for: Come stress e attacchi di cuore sono collegati

Circulation, Volume 150, Issue Suppl_1, Page A4125691-A4125691, November 12, 2024. Introduction:Physical activity (PA) is an important modifiable factor for cardiovascular disease (CVD). Sexual and gender minority (SGM; e.g., lesbian/gay, bisexual, transgender) adults face higher risks of inadequate PA and CVD due to increased exposure to minority stressors, such as experienced and anticipated discrimination, which may influence SGM adults’ willingness to engage in PA. To our knowledge, researchers have not investigated the impact of minority stressors on objectively-measured PA among SGM adults.Goal:Using k-means clustering, we sought to identify whether clusters characterized by greater exposure to minority stressors were associated with lower moderate and vigorous PA (MVPA) and higher sedentary behavior among SGM adults.Methods:This daily diary study included an online sample of SGM adults living in the United States. Participants completed daily surveys about personally experienced discrimination and anticipated discrimination (i.e., expectation of experiencing discrimination) and wore wrist accelerometers for 28 days to objectively measure PA. We used k-means clustering to identify clusters based on reports of experienced and anticipated discrimination. We first determined the optimal number of clusters using established partition criteria. Next, we ran linear regression models (adjusted for demographic factors) to examine the associations of minority stress clusters with MVPA and sedentary time per week.Results:Among 42 SGM adults (mean age 27.0±7.7 years) with 1133 person-days of accelerometry data (~3% missing data), we identified four minority stress clusters: low anticipated/low experienced (LALE; reference group); low anticipated/high experienced (LAHE); high anticipated/low experienced (HALE); and high anticipated/high experienced discrimination (HAHE). Participants in the HALE cluster (n=12) engaged in 202 fewer minutes of MVPA than those in the LALE cluster (n=7). Participants in the LAHE cluster (n=10) had 123 fewer minutes of vigorous PA than those in the LALE cluster. No differences were identified for sedentary time.Conclusions:This is the first study to examine the association of minority stressors with objective PA among SGM adults. Participants in the HALE and LAHE clusters engaged in significantly lower PA than those with low levels of both experienced and anticipated discrimination. Findings underscore the importance of assessing minority stressors and the need for interventions to improve PA among SGM adults.

Circulation, Volume 150, Issue Suppl_1, Page A4145408-A4145408, November 12, 2024. Background:Stress cardiomyopathy (SCM) is rarely triggered by ketamine and seldom leads to cardiogenic shock. Ketamine-induced catecholaminergic surge can lead to myocardial stunning with transient ischemia and subsequent reversible heart failure. Mechanical circulatory support can be successfully leveraged in SCM-associated cardiogenic shock while awaiting myocardial recovery.Case Presentation:A 28-year-old female with chronic pain was admitted for failure to thrive secondary to opioid-induced gastroparesis. The patient was weaned off opiates while on ketamine over 4 days. After halting ketamine, the patient had a cardiac arrest with eventual return of spontaneous circulation. After being extubated, she developed chest pain, hypotension, and ventricular tachycardia with anterolateral ST elevations, troponin leak, and lactic acidosis. TTE revealed an EF

Circulation, Volume 150, Issue Suppl_1, Page A4147849-A4147849, November 12, 2024. Introduction:Heart failure (HF) poses a significant clinical challenge, necessitating a deeper understanding of its molecular mechanisms for effective therapeutic interventions. Long non-coding RNAs (lncRNAs) have emerged as key regulators in cardiovascular diseases. However, their role in HF progression, particularly in human pericytes and association with cardiac remodeling, remains poorly understood.Hypothesis:We hypothesize that LINC00989, a novel lncRNA identified through plasma extracellular vesicle (EV) transcriptomics of ADHF patients, plays a significant role in human pericytes towards its profibrotic function and contributes to HF remodeling.Methods:We characterized LINC00989 expression in primary human pericytes and its response to stressors mimicking HF. Cellular and extracellular fractionation experiments were performed to examine LINC00989 localization and its association with EVs. Loss-of-function experiments were conducted using RNA anti-sense oligos, while gain-of-function experiments involved overexpression vectors. Further downstream interactors were characterized using RNA sequencing analysis. Profibrotic effects of LINC00989 were investigated using adoptive transfer model with induced pluripotent stem cell-derived cardiac fibroblasts.Results:Our findings demonstrate high expression of LINC00989 in primary human pericytes, with differential regulation under stress conditions. Loss-of-function experiments revealed alterations in epithelial-mesenchymal transition and angiogenesis markers, implicating LINC00989 in maintaining pericyte phenotype. Gain-of-function experiments supported its role in modulating pericyte morphology. Additionally, LINC00989 indicated a profibrotic role on cardiac fibroblasts.Conclusion:These findings underscore the significance of LINC00989 in human pericyte function and its potential as a therapeutic target in HF progression. Understanding its molecular mechanisms could lead to novel therapeutic interventions in heart failure. Further studies are needed to validate these findings and explore clinical implications.

Circulation, Volume 150, Issue Suppl_1, Page A4142676-A4142676, November 12, 2024. Background:Interview techniques for angina pectoris in patients with chest pain have demonstrated a low positive probability of 35.7% (PROMISE study) when using the Diamond-Forrester approach, which evaluates pre-test probability (PTP) based on classic chest symptoms, age, and gender. Therefore, it is beneficial to use artificial intelligence (AI) to create a more precise medical interview system by combining patient clinical data. Our objective is to create such a system.Methods:A medical interview is taken from patients presenting with chest pain as a chief complaint. Then, coronary artery examinations (CAG, contrast-enhanced CT, stress tests) will be conducted to definitively diagnose angina. The results of these definitive diagnoses will be combined with the patients’ baseline data to develop an AI algorithm. The input attributes used for the interview are listed in Table 1. A multilayer perceptron (MLP) was applied to predict patients diagnosed with angina pectoris, and these models were validated using 10-fold cross-validation.Results:There were a total of 315 patients, of whom 135 were diagnosed with angina pectoris. Additionally, patient information including atherosclerosis risk factors such as diabetes (102 cases), dyslipidemia (216 cases), hypertension (225 cases), and smoking status (never: 141 cases, past: 124 cases, current: 23 cases) were added as attributes and analyzed. Using only medical interviews and setting the threshold at 80% (where the AI determined the probability of angina to be 80% or higher), the prediction accuracy was 62.6%, with a sensitivity of 30.8% and a specificity of 87.7%. The precision was 66.6%. Additionally, when the four atherosclerosis risk factors were included, the prediction accuracy increased to 69.9%. Notably, the precision reached 79.9%. (Figure1)Conclusion:Our AI system based on interview data demonstrated high accuracy for diagnosis of angina while it was improved by adding the attribute of the four atherosclerosis risk factors. Further investigation is needed to complete a highly accurate AI-based application by increasing the number of samples.

Circulation, Volume 150, Issue Suppl_1, Page A4144426-A4144426, November 12, 2024. Introduction:Intensive blood pressure (BP) control is associated with a significant reduction in the risk of heart failure (HF) or all-cause death. However, the extent to which intensive BP control-associated HF risk reduction is mediated by changes in subclinical markers of cardiovascular (CV) disease (CVD) and stage B HF is not well-characterized.Methods:Participants of the Systolic Blood Pressure Intervention Trial (SPRINT) with hypertension and available data on subclinical CVD markers at baseline and follow-up (1- or 2-year visit) were included. The key subclinical markers of CVD analyzed included chronic myocardial injury (assessed by high-sensitivity cardiac troponin I [hs-cTnI]), neurohormonal stress (assessed by N-terminal pro-B-type natriuretic peptide [NT-proBNP]), left ventricular (LV) mass (assessed by electrocardiogram Cornell voltage [CV]), and arterial stiffness (assessed by estimated pulse wave velocity [ePWV]). A counterfactual framework was used to assess the effects of the exposure and mediator on key outcomes, including 1) HF / all-cause death; 2) atherosclerotic CVD (ASCVD), including nonfatal myocardial infarction, nonfatal stroke, or CV death.Results:The present study included 8,872 participants (35% women, 31% Black). Over the 3.3-year median follow-up, there were 333 (3.8%) HF / all-cause death events and 200 (2.3%) ASCVD events. Reductions in neurohormonal stress and LV mass mediated up to 15% of the reduction in risk of HF / all-cause death with intensive BP control (Table). In contrast, treatment-related changes in chronic myocardial injury and arterial stiffness did not mediate the benefits of intensive BP reduction on HF / all-cause death risk. Furthermore, changes in any subclinical CVD markers did not mediate the effect of intensive BP control on ASCVD risk (Table).Conclusions:In this post-hoc analysis of SPRINT, improvements in neurohormonal stress and LV mass, as identified by surrogate markers of hs-cTnI and CV, were important mediators of the beneficial effects of intensive BP control in reducing the risk of HF / all-cause death. Mediators of the effect of intensive vs. standard BP control for reducing HF / all-cause death differ from those for ASCVD.

Circulation, Volume 150, Issue Suppl_1, Page A4146263-A4146263, November 12, 2024. The cardiac adverse effects of radiation therapy include both radiation-induced valvular disease and radiation-induced coronary artery disease (RICAD). However, the management of each when present concurrently is minimally described by current research and guidelines.A 60 year-old infectious disease physician with history of Stage IIA Hodgkin Disease s/p radiation therapy in 1976 (age 13) presented to cardiology for new dyspnea on exertion. She had known valvular heart disease followed with serial echocardiograms. Repeat TTE completed showing now moderate to severe aortic stenosis, moderate aortic regurgitation, moderate tricuspid regurgitation, and mild to moderate mitral regurgitation. After exercise stress testing aborted due to decrease in systolic blood pressure with exertion, patient underwent cardiac catheterization and found to have moderate-severe aortic stenosis as well as hemodynamically significant ostial disease of the right coronary artery and distal left main coronary artery; classic bi-ostial coronary stenosis characteristic of RICAD. After multidisciplinary discussion with interventional cardiology, cardiothoracic surgery, and second opinion with tertiary valve center, she was referred for surgical revascularization and aortic valve replacement (AVR). Patient underwent AVR with a 23mm bioprosthetic aortic tissue valve replacement, aortic root enlargement, tricuspid valve repair with 28mm ring, and three vessel coronary artery bypass grafting.Notably, several retrospective studies have found increased mortality with surgical aortic valve replacement in patients with prior history of radiation with many centers preferring transcatheter aortic valve replacement as a safe and effective alternative in this demographic. Despite acknowledging this predilection, SAVR chosen in this patient specifically given her concurrent RICAD requiring revascularization. This case intimately highlights the need for further studies regarding management of radiation-induced valvular disease when complicated by RICAD.

Circulation, Volume 150, Issue Suppl_1, Page A4140178-A4140178, November 12, 2024. Background:Physical frailty is highly prevalent in heart failure (HF), but we lack an understanding of the underlying pathophysiology. Proteomics evaluation of plasma samples may elucidate potential mechanisms and biomarkers of physical frailty in HF.Purpose:To identify plasma proteomic biomarkers that are differentially expressed between physically frail and non-physically frail adults with HF.Methods:This was a secondary analysis of a subset of data and plasma samples from a study of frailty among patients with New York Heart Association (NYHA) Functional Classification I-IV HF. Physical frailty was measured using the Frailty Phenotype Criteria. Propensity score matching was used to match pairs of physically frail (n = 20) vs. non-physically frail (n = 20) patients on clinical characteristics. Plasma samples were processed using a sensitive liquid chromatography mass spectrometry platform, utilizing a multiplexed tandem mass tag-labeled quantitative proteomics approach. Differentially expressed proteins were quantified individually using paired t tests with associated log2 fold change of 0.3 and using Fisher’s combined p values.Results:The sample (n = 40) was 62.8±16.9 years old, 58% female, and 55% NYHA class III/IV. The log2 fold changes for each of the 2684 proteins were compared with the corresponding -log10 p-values in a volcano plot (Figure), which identified 27 proteins significantly different (10 downregulated and 17 upregulated with physical frailty). Of these, 7 proteins were differentially expressed across all three plexes: matrix metalloproteinase-14 was downregulated in frailty, and copine-1, low affinity immunoglobulin gamma Fc region receptor III-A and III-B, probable non-functional immunoglobulin kappa variable 2D-24, glutathione S-transferase Mu 1, and argininosuccinate lyase were upregulated in frailty.Conclusions:Proteomic biomarkers related to the immune system, stress response, and detoxification were differentially expressed between physically frail and non-physically frail adults with HF. Patients with HF who are physically frail appear to be in a state of chronic immune and stress response upregulation coupled with downregulation of cellular activation.

Circulation, Volume 150, Issue Suppl_1, Page A4136884-A4136884, November 12, 2024. Introduction:Breast cancer (BC) is the most common non-cutaneous cancer in women. Several BC treatments increase the risk of conduction abnormalities and heart failure, potentially requiring cardiac implantable electrical devices (CIEDs). Due to vascular access devices, surgical management, and chest wall radiation, these patients are subject to upper extremity vascular alterations. There is limited data regarding CIED use in this population.Research question:Do patients with BC and CIEDs have different procedural approaches or complications compared to the general population?Aims:This study aimed to evaluate CIED placement and periprocedural complications in patients with a history of BC.Methods:This was a retrospective study of CIEDs placed at our institution between 2005 and 2023. Patients with a diagnosis of BC prior to time of placement were included. Complications included those within 30 days of the procedure.Results:We analyzed 109 female patients (median age of 73 years, IQR 66-80) who received pacemaker (PPM, 58.7%), cardiac resynchronization therapy defibrillator (CRT-D, 22%), implantable cardioverter defibrillator (ICD, 16.5%), or cardiac resynchronization therapy pacemaker (CRT-P, 2.8%). The median time from cancer diagnosis to device placement was 13 years (IQR 7-21). Oncologic therapies are included in Figure 1. In patients with unilateral cancer, most devices (78.4%) were placed contralaterally, with 32% of all devices being right sided. Anatomy related to chemotherapy port altered intraoperative approach in 2 cases and bilateral lymph node dissection necessitated subcutaneous ICD in 1 case. Complications were noted in 12 patients (11%) and included hematoma, lead revision, upper extremity DVT, pericardial effusion, stress cardiomyopathy, perforation, site infection, and worsening of chronic lymphedema.Conclusions:BC survivors undergoing CIED placement appear to be at higher risk of periprocedural complications when compared to the general population. They are more likely to undergo right sided device placement to avoid vascular access ipsilateral to prior surgery or radiation. Further studies are required to understand the long-term outcomes of CIED placement in this cohort of patients.

Circulation, Volume 150, Issue Suppl_1, Page A4146330-A4146330, November 12, 2024. Background:Hutchinson-Gilford Progeria Syndrome (HGPS) is caused by a mutation in LaminA (progerin), and is characterized by accelerated aging and death from coronary or carotid disease in the mid-teens. We have shown that vascular smooth muscle cells (VSMCs) and endothelial cells (ECs) derived from HGPS children manifest many of the hallmarks of aging including telomere erosion, reduced proliferation, impaired function, DNA damage and senescence markers, altered cellular and nuclear morphology, and an aberrant transcriptional profile. These hallmarks of aging are substantially reversed by treatment with telomerase (hTERT) linear RNA,with greater benefit in HGPS cells than the current therapy, lonafarnib. However, linear RNA has a short half-life, which necessitates frequent administration. By contrast, circular (circ) RNA is more stable than linear RNA, and with an internal ribosome entry site can be translated into protein. We hypothesized the hTERT circRNA would provide for longer duration of telomerase expression, and would have a greater benefit for HGPS ECs.HGPS ECs were treated with hTERT linear or circ RNAs. A single treatment with 1 µg/ml hTERT circRNA reversed multiple stigmata of senescence. However, at day 28 post treatment, the benefit of hTERT circRNA exceeded that of hTERT linear RNA in all measured variables. hTERT circRNA provided for greater recovery of telomere length as determined by quantitative fluorescence in situ hybridization; induced a three-fold greater reduction in beta-gal positive cells and morphologically aberrant nuclei. In HGPS ECs, hTERT circRNA provided for a 2-3 fold greater reduction of senescentfactors, inflammatory cytokines and DNA damage signals, including Progerin, p16, p21, IL-1B, IL-6, IL-8 MCP-1 and gH2A.X. In addition, hTERT circRNA to a greater degree restored NO production, promoted cell proliferation, enhanced angiogenesis and improved LDL uptake. Importantly, mitochondrial functions, as evaluated by the oxidative stress marker (MitoSOX) and mitochondrial membrane potential marker (JC-1 staining), were restored more completely by hTERT circRNA.Conclusion:hTERT circRNA is more effective than hTERT linear RNA in rejuvenating senescent ECs, possibly because of its longer half-life. The novel hTERT circRNA is a promising therapy for HGPS and other disorders associated with accelerated vascular aging.

Circulation, Volume 150, Issue Suppl_1, Page A4146434-A4146434, November 12, 2024. Background:PET/CT stress test may be performed to risk stratify patients including those without known coronary artery disease (CAD) who may be at risk for short-term adverse cardiac events. In patients with low- to moderate (LTM) risk for short-term MACE and without a known history of CAD, a small percentage of these patients will undergo a coronary angiogram within 90-days, of which some will be diagnosed with high-grade stenosis. The purpose of this study is to determine factors associated with this approach and findings.Methods:Patients without a history of known CAD (n=43,271) undergoing a PET/CT from 2018-2023 at Intermountain Health, with scan interpreted clinically as LTM short-term risk for adverse cardiac events, and ischemic burden 70% stenosis in any vessel), an a priori list of clinical data and PET/CT results were examined.Results:Within 90 days of the LTM risk PET/CT, 3,163 (8.2%) had a coronary angiogram. Of these, 806 (25.5% of angiograms and 2.1% of total LTM) had high-grade CAD. The PET/CT ancillary findings were associated with the largest odds of performing an angiogram and the presence of high-grade CAD (Tables). Factors most likely to be associated with performing an angiogram were an ischemic burden of 7.5-10% (adjusted-OR [adj. OR]=11.54), coronary artery calcification (CAC) score of >300 (adj.-OR =1.62), and myocardial blood flow (MBF) of MBF 2.3). Other clinical parameters associated, after adjustment, with an angiogram were age, male sex, hypertension, elevated troponin, and inpatient status. Many of the same factors were found to be associated with the identification of high-grade CAD. However, being an inpatient was associated with increased odds of angiogram but a decrease in odds of high-grade CAD.Conclusions:In patients without a known history of CAD who underwent PET/CT clinically adjudicated as LTM short-term risk and ischemic burden

Circulation, Volume 150, Issue Suppl_1, Page A4146495-A4146495, November 12, 2024. Background:Valine, leucine, and isoleucine are the branched amino acids (BCAA). Elevated BCAAs predict worse outcomes in several cardiovascular diseases with metabolic origins, but the role of BCAAs in pulmonary arterial hypertension (PAH) remains unclear. Moreover, the effects of BCAAs on the emerging lung-liver axis are unexplored.Methods:The effects of small molecule (BT2) activation of BCAA catabolism and a low BCAA diet were evaluated in monocrotaline rats. Multi-omics analyses of the lung and liver were conducted in the BT2 arm. Confocal microscopy evaluated hepatocyte nuclear size in rodents and humans with PAH. Human livers were subjected to proteomic analysis. Human single nucleotide polymorphisms (SNPs) associated with elevated BCAAs and their relationship with PAH were investigated in the BioVU database.Results:Proteomics and metabolomics profiling demonstrated BT2 restructured lung fat metabolism, which increased exercise capacity, reduced PAH severity, and improved RV function. A low BCAA diet also mitigated PAH severity and improved RV function. Pathological hepatic shear stress phenotypes induced by RV dysfunction (nuclear hypertrophy, AKT signaling, electron transport chain (ETC) homeostasis, and ceramide accumulation) were blunted by BT2. Human PAH livers partially phenocopied the rodent hepatic shear stress phenotype (nuclear enlargement, AKT activation, and ETC protein downregulation). Finally, patients harboring SNP rs117643180 had increased risk of PAH.Conclusion:Rodent and human data link altered BCAA catabolism to the pathogenic lung-liver axis in PAH.

Circulation, Volume 150, Issue Suppl_1, Page A4145153-A4145153, November 12, 2024. Introduction:Cardiac cephalgia is an under-recognized type of headache.Description of Case:A 68-year-old female with past medical history of chronic headaches presents with one week of non-radiating central chest pain, exertional dyspnea, palpitations, lightheadedness, and worsening headaches. The headaches were described as a “stabbing and throbbing” pain starting at the vertex and radiating anteriorly. Triggers included stress, and associated symptoms included photophobia and nausea. An electrocardiogram was notable for new T-wave inversions in the inferior leads. An echocardiogram demonstrated an ejection fraction of 44% with regional akinesis of the inferior and inferolateral walls. Patient proceeded for left heart catheterization, which depicted total occlusion of the middle segment of the right coronary artery; a stent was successfully placed and dual antiplatelet therapy was initiated. Following stent placement, she endorsed resolution of her chronic headaches and has not had recurrence.Discussion:This case presents a patient with chronic headaches, initially diagnosed as migraines and occipital neuralgia. She had previously been treated with triptans and botulinum toxin without effect. Resolution of her headaches following revascularization suggest that cardiac cephalgia may be the underlying etiology. Cardiac cephalgia is a secondary headache disorder that is related to cardiac ischemia. It has classically been described as a headache that is triggered by exertion or stress and alleviated by rest or nitrates. Pathophysiology is incompletely understood but current theories include referred pain, simultaneous constriction of cerebral and coronary vessels, reduced cardiac output resulting in increased cardiac pressures and therefore decreased venous return from the brain, and cardiac ischemia-induced neurotransmitter release leading to cerebral vasodilation. The diagnosis of this condition is supported by a temporal relationship between coronary ischemia and headache onset. Interestingly, this patient had a headache onset several months before exhibiting signs of coronary ischemia but had an acute worsening at the time of presentation. It is important to keep cardiac cephalgia on the differential for patients with headaches in order to prevent treatment with agents, such as triptans and ergot derivatives, that are contraindicated in coronary artery disease.

Circulation, Volume 150, Issue Suppl_1, Page A4142869-A4142869, November 12, 2024. Introduction:Adverse childhood experiences, also known as early life stress (ELS), are associated with increased risk of cardiovascular disease in later life, yet the underlying mechanisms remain elusive. Recent evidence indicates that parental life experiences can be transmitted to the offspring.Aim:To investigate the effects of ELS on cardiac structure and function in exposed parents and in their offspring, across 3 generations.Methods:We used ELS mouse model based on unpredictable separation of mouse pups (F1) from their mother (F0) each day for 3 hours from postnatal day 1 (PND1) to PND14 combined with dams exposure to an additional unpredictable stressor (forced swim in 18°C water for 5 minutes or 20-minute physical restraint in a tube) during separation. Control litters were raised normally. Echocardiography was performed at 6, 12 and 18 months in exposed animals (F0), their unexposed offspring (F1) and grand-offspring (F2). Both male and female mice were studied. Heart weight/tibia length was used to assess cardiac mass while Masson’s Trichrome was employed to detect fibrosis. Lung congestion was assessed as lung wet/dry weight ratio. Single-cell RNA sequencing (scRNAseq) was performed in MSUS and control hearts. A 6-week environmental enrichment (EE) program (cages containing running wheels, maze) was employed to test the possible rescue of ELS effects in adult males and their offspring.Results:F1 MSUS mice displayed increased LV mass, impaired diastolic function (assessed by conventional and tissue Doppler analysis) myocardial fibrosis and lung congestion. Time-dependent worsening of cardiac performance was observed from 6 to 18 months, both in males and females. ScRNAseq unveiled dysregulation of transcriptional programs underlying inflammation and lipotoxicity in the cardiomyocyte and endothelial cell clusters. MSUS offsprings did not show changes of cardiac function at 6 months, however diastolic dysfunction and lung congestion were observed at 12 and 18 months. A similar impairment of cardiac function was observed in the MSUS grandoffspring (F3). Of interest, 6-week exposure to an environmental enrichment protocol was able to improve LV mass, diastolic function and lung congestion in 12 months-old MSUS mice.Conclusions:ELS induces a transgenerational transmission of cardiac phenotypic alterations which can be rescued by EE. Our results shed light on the potential role of ELS on heart failure development and potential mitigation strategies.

Circulation, Volume 150, Issue Suppl_1, Page A4141311-A4141311, November 12, 2024. Background:The association between oxidative stress score (OBS) and hypertension remains unclear in the US population.Hypothesis:We hypothesized that higher OBS was associated with a lower risk of hypertension.Methods:A total of 22,938 adults (mean age: 47.2 years) were enrolled from 8 survey cycles of NHANES (2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016 and 2017-2018). The total OBS consisted of the dietary OBS and the lifestyle OBS, based on 16 dietary components (including dietary iron, zinc, total fat, copper, selenium, magnesium, calcium, vitamin C, E, B6 and B12, total folate, carotene, niacin, riboflavin, and fiber) and 4 lifestyle components (including body mass index, alcohol, smoking, and physical activity). Weighted multivariate logistic regression was used to investigate the association between OBS and hypertension, and restricted cubic spline (RCS) assessed the nonlinear relationship.Results:In the multivariate-adjusted model, a substantially inverse association was observed between total OBS and risk of hypertension. Comparing the extreme quartile groups, the OR and 95% CI were 0.62 (0.52-0.73). Furthermore, higher dietary OBS and lifestyle OBS were similarly associated with a lower risk of hypertension (OR (95%CI): 0.78(0.66,0.93); 0.38(0.33,0.44), respectively). The RCS exhibited a nonlinear dose-response association between total OBS and hypertension (Pnon-linearity< 0.001).Conclusion:These findings support the potential beneficial role of OBS for the prevention of hypertension in adults.

Circulation, Volume 150, Issue Suppl_1, Page A4132657-A4132657, November 12, 2024. Background:Cardiac rehabilitation (CR) patients demonstrate a high burden of chronic conditions (CC). Both multimorbidity (MM; ≥2 coexisting CC) and aging negatively impact functional capacity, whereas CR improves performance. Age-related difference in cardiorespiratory fitness (CRF, peak oxygen uptake (VO2)) in CR patients with MM has not been studied.Hypothesis:We hypothesized improvement in CRF will be attenuated by MM with increasing age in CR patients.Aims:We aimed to identify age-related differences in CRF improvement in CR patients with MM.Methods:Patients ≥18 yrs old who attended ≥1 CR sessions from 1999-2017 and completed cardiopulmonary exercise stress test before and after CR were included. The prevalence of CC was assessed using Rochester Epidemiology Project records-linkage system. Age categories included: Younger (18-49 yrs), Midlife (50-64 yrs) and Older (≥65 yrs). CRF categories included: 8%. Analysis included Kruskal-Wallis and Chi-squared.Results:Of 622 patients, 75.4% were male. Mean age: 62.9±11.2 yrs; Younger (n=70) age: 42.7±6.8 yrs, 67.1% male; Midlife (n=283) age: 58.3±4.3 yrs, 78.8% male; Older (n=269) age: 73.0±5.2 yrs, 74.0% male. BMI was 29.9±5.4 kg/m2(Younger: 30.0±6.7, Midlife: 30.4±5.6, Older: 29.3±4.7; p

Circulation, Volume 150, Issue Suppl_1, Page A4139918-A4139918, November 12, 2024. Introduction:Myocardial transcriptional changes in the right ventricle (RV) during stress and failure are poorly understood. We hypothesized that myocardial transcriptomic signatures would differ among decompensated (d-RV), compensated (c-RV), and healthy RV (h-RV) myocardium.Methods:We obtained RV free-wall myocardial samples from pts undergoing transplant for end-stage HF (n=33). Control samples were obtained from unused donor hearts. We defined d-RV by pulmonary arterial pulsatility index