Abstract 15962: Validation of the Senescence-Associated Secretome to Predict Mortality in Patients With Degenerative Aortic Valve Stenosis

Circulation, Volume 148, Issue Suppl_1, Page A15962-A15962, November 6, 2023. Introduction:The senescence-associated secretory phenotype (SASP) is a potential driver of age-related risk reflecting advanced biological aging. Circulating SASP components include pro-inflammatory cytokines, growth modulators and matrix remodelling proteases. Aortic valve stenosis (AVS) is the prototypical inflammatory age-associated cardiovascular disease.Hypothesis:To identify circulating SASP components with an impact on prognosis in elderly pts with AVS.Methods:In a derivation cohort (n=120), circulating levels of 24 SASP components were measured using Luminex Multiplex ELISA, before undergoing TAVR. ROC curves and Youden-index derived optimal cut-off values were used to assess the predictive power of each SASP for long-term mortality. In a validation cohort (n=198), the significant predictors of mortality identified in the derivation cohort, as well as a panel of 3 independent predictors in multivariate analyses, were prospectively validated.Results:In the derivation cohort, 9 out of 24 SASP components significantly predicted mortality in univariate analyses with AUC >0.62; only 3 (GDF-15, ICAM-1, and osteoprotegerin) remained independent predictors in multivariate analyses (all p

Read More
Novembre 2023

Abstract 15184: Moderate-to-Vigorous Intensity Physical Activity and Incident Left-Sided Degenerative Valvular Heart Disease

Circulation, Volume 148, Issue Suppl_1, Page A15184-A15184, November 6, 2023. Hypothesis:This study aimed to examine the impact of moderate-to-vigorous intensity physical activity (MVPA) on the prevention of left-sided degenerative valvular heart disease (VHD) among middle-aged adults.Methods:In the UK biobank study, data from wrist-worn accelerometer and physical activity questionnaires were utilized to assess the role of MVPA volume on the incidence of aortic valve stenosis (AS), aortic valve regurgitation (AR), and mitral valve regurgitation (MR). The primary cohort involved 90,865 participants ( median 8.1-year follow-up period) without prevalent VHD and heart failure, who wore accelerometers for one week. The validation cohort included 397,335 participants (median 13.8-year follow-up period) who completed physical activity questionnaires. MVPA volume was categorized according to the American Heart Association’s recommendation.Results:Accelerometer-measured MVPA showed a curvilinear relationship with reduced AS risk, with the risk reduction plateauing above 300 min/week. Compared to no MVPA, those engaging in 150-299 minutes of MVPA per week showed the most significant risk reduction [1-149 min/week: adjusted hazard ratio (HR), 0.79 (0.58, 1.08); 150-299 min/week: HR, 0.52 (0.36, 0.75); ≥300 min/week: HR, 0.57 (0.39, 0.83)]. Similar results were found when repeating the above analyses in self-reported MVPA cohort, with a relatively smaller reduction in HR ratio [150-299 min/week: HR, 0.81 (0.73, 0.91)]. No significant association was found between the MVPA volume and the risk of AR and MR in both cohorts.Conclusions:Meeting current MVPA recommendations (150-300 min/week) was associated with the lowest AS risk. Targeting adherence to accelerometer-measured MVPA thresholds may enhance AS risk reduction. Additionally, MVPA showed limited effectiveness in preventing valvular regurgitation, indicating distinct mechanisms between stenotic lesions and regurgitation lesions in degenerative VHD.

Read More
Novembre 2023

Abstract 11647: Effectiveness of Micro Continuing Medical Education at Improving Clinician Knowledge Related to the Management of Degenerative Mitral Regurgitation

Circulation, Volume 148, Issue Suppl_1, Page A11647-A11647, November 6, 2023. Introduction:We sought to determine the impact of online CME consisting of micro-chapters on clinician knowledge related to the diagnosis and treatment of DMR.Methods:The educational initiative consisted of a collection of six online video-based micro-CME chapters, presented by 3 experts, allowing learners to choose the chapters for participation. The education effects were assessed using a repeated pairs pre-assessment/post-assessment study design, where individual participants served as their own control. McNemar’s tests (P

Read More
Novembre 2023