Obesity as a Chronic Disease: A Narrative Review of Evolving Definitions, Management Strategies, and Cardiometabolic Prioritization.

Obesity is a multifactorial, complex disease that is driven by genetic, biological, environmental, and behavioral factors. In this review, we explain the key contributors to obesity, limitations in current definitions, its relationship with cardiometabolic health, and recent advancements in treatment. Obesity is characterized by the presence of excess and dysfunctional adipose tissue, driven by chronic inflammation and maladaptive energy homeostasis.

Participation of Women in Cardiovascular Trials From 2017 to 2023: A Systematic Review.

Importance: Cardiovascular (CV) disease is the leading cause of death globally for both men and women, yet women remain historically underrepresented in CV clinical trials, despite facing a disproportionately high burden of morbidity and mortality in many forms of CV disease.

Objective: To determine the representation of women across a broad range of CV trials.

Evidence Review: The participation of women in CV trials registered on ClinicalTrials.

Mind the Gap: Does Brain Age Improve Alzheimer's Disease Prediction?

Brain age is widely regarded as a powerful marker of general brain health. Brain age models are typically trained on large datasets to predict chronological age, which may offer advantages in predicting specific health outcomes, much like the success of finetuning large language models for specific applications. However, it is also well accepted that machine learning models trained to directly predict specific outcomes (i.

The Impact of Social Determinants of Health on Metabolic Dysfunction-Associated Steatotic Liver Disease Among Adults in the United States.

: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease. It has known multifactorial pathophysiology, but the impact of social determinants of health (SDOH) on the rising prevalence of MASLD is poorly understood. We conducted a retrospective cross-sectional study to examine the influence of SDOH on MASLD using nationwide data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) study.

A Metabolomics Study of Cardiac Dysfunction in Hyperglycemia: Findings From the Atherosclerosis Risk in Communities (ARIC) Study and the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Objective: Hyperglycemic states (prediabetes and diabetes) are associated with heart failure (HF) risk. We aimed to identify distinct metabolites for subclinical cardiac dysfunction, a precursor of HF, in hyperglycemic or euglycemic individuals.

Research Design And Methods: We conducted cross-sectional and prospective analyses of 2,492 HF-free participants from the Atherosclerosis Risk in Communities (ARIC) study visit 5, 2011-2013.

Prevalence and Phenotype of Transthyretin Val122Ile Variant in the Hispanic Community Health Study/Study of Latinos.

Background: Hereditary transthyretin amyloid cardiomyopathy is commonly caused by the Val122Ile variant, a mutation found in non-Hispanic individuals of West African descent but understudied among the Hispanic/Latino (H/L) population, despite their admixed genetic ancestry (African ancestry [AA], European ancestry [EA], and Amerindian ancestry) and heterogeneous AA proportions within disaggregated backgrounds.

Objectives: This study aimed to determine Val122Ile variant prevalence among community-dwelling H/L adults and disaggregated background groups; to evaluate associations with genetic continental ancestry; and to characterize echocardiographic phenotype.

Methods: We analyzed cross-sectional data from 12,687 H/L adults (aged 18-74) in the Hispanic Community Health Study/Study of Latinos cohort (2008-2011), who consented to genome-wide studies and continental ancestry ascertainment.

Correlates of Nocturnal Hypertension in a Real-World Cohort.

Background: Nocturnal hypertension (NH) is associated with adverse cardiovascular outcomes beyond and even independent of daytime hypertension (DH). Although cohort studies have evaluated correlates of NH, there is comparably less data available from real-world clinical practice and for population subsets that tend to be underrepresented in cohort studies.

Methods: This retrospective cohort study included all patients who underwent ABPM testing at a large U.

Impact of Cancer Subtype and Cancer Therapy Exposures on SARS-CoV-2 Outcomes in the Omicron and Subvariant Era.

Introduction: Amidst highly transmissible SARS-CoV-2 variants that continue to circulate in the community, individuals with cancer exhibit variations in immunity and susceptibility for reasons that remain poorly understood.

Methods: In a longitudinal cohort study with ongoing SARS-CoV-2 serological and outcomes surveillance, we examined adults receiving cancer treatment (cases, n = 229) or who were free of cancer and other major comorbidities (controls, n = 800), prior to the Omicron era onset and onwards (September 24, 2021-March 10, 2024). The main outcomes were longitudinal SARS-CoV-2 anti-spike receptor binding domain IgG (IgG-SRBD) antibody response and Omicron and subvariant infection frequency and severity.

Pericoronary Adipose Tissue Attenuation in Patients with Future Acute Coronary Syndromes: The ICONIC Study.

Purpose Pericoronary adipose tissue attenuation (PCATa) measured at coronary CT angiography (CCTA) is an imaging biomarker of coronary inflammation associated with long-term adverse cardiac events. The authors hypothesized that PCATa may independently identify patients at risk for acute coronary syndromes (ACS). Materials and Methods The authors performed a retrospective substudy of the Incident Coronary Syndromes Identified by Computed Tomography (ICONIC) study, a propensity-matched case-control study of patients with CCTA followed by ACS.

Rate of brain aging associates with future executive function in Asian children and older adults.

Brain age has emerged as a powerful tool to understand neuroanatomical aging and its link to health outcomes like cognition. However, there remains a lack of studies investigating the rate of brain aging and its relationship to cognition. Furthermore, most brain age models are trained and tested on cross-sectional data from primarily Caucasian, adult participants.

Using Deep Learning to Predict Cardiovascular Magnetic Resonance Findings From Echocardiographic Videos.

Background: Echocardiography is the most common modality for assessing cardiac structure and function. Although cardiac magnetic resonance (CMR) imaging is less accessible, it can provide unique tissue characterization, including late gadolinium enhancement (LGE), T1 and T2 mapping, and extracellular volume (ECV), which are associated with tissue fibrosis, infiltration, and inflammation. Deep learning has been shown to uncover findings not recognized by clinicians, but it is unknown whether CMR-based tissue characteristics can be derived from echocardiographic videos using deep learning.

Differential Characteristics and Outcomes of Urgent/Emergent Versus Elective Aortic Valve Replacement.

Background: Despite the slowly progressive nature of aortic stenosis, a proportion of aortic valve replacements (AVRs) still occur on an urgent/emergent basis. We sought to characterize the predictors, outcomes, and potential opportunities to prevent urgent/emergent AVRs.

Methods: We analyzed Medicare data to identify patients undergoing AVRs from 2017 to 2022.

Specialty disrespect in the medical learning environment: What is known and how can we intervene? A scoping review: BEME review no. 93.

Background: Specialty disrespect or badmouthing is an aspect of the hidden curriculum that can inappropriately affect medical student specialty choice. The authors sought to map the breadth and depth of knowledge on this topic and identify existing interventions.

Methods: A scoping review was conducted by systematically searching several databases, grey literature, and hand-searching reference lists.

Large language model comparisons between English and Chinese query performance for cardiovascular prevention.

Background: Large language model (LLM) offer promise in addressing layperson queries related to cardiovascular disease (CVD) prevention. However, the accuracy and consistency of information provided by current general LLMs remain unclear.

Methods: We evaluated capabilities of BARD (Google's bidirectional language model for semantic understanding), ChatGPT-3.

Arteries and Hearts in Motion: Sex Differences in Exercise-Mediated Protection Against Atherosclerotic Cardiovascular Disease Risk.

Purpose Of Review: This review summarizes the current knowledge on the benefits of various exercise training modalities on subclinical atherosclerotic cardiovascular disease (ASCVD) risk factors (i.e., endothelial dysfunction, large artery stiffening, carotid artery intima-media thickening) across the adult lifespan and the moderating role of biological sex, with the goal of informing/being to inform research gaps and future research directions.

Sex differences in adenosine deaminase activity associate with disparities in SARS-CoV-2 innate immunity.

Females demonstrate elevated type-I interferon production and a stronger antiviral immune response; however, the mechanisms underlying sex-based differences in antiviral immunity are incompletely understood. We previously reported that low adenosine deaminase (ADA) activity perturbs the methylation-based transcriptional silencing of endogenous retroviral elements (hERV), which stimulates IFN-Stimulated Genes (ISG) and primes antiviral immunity. Here we demonstrate lower ADA activity in females compared to their male counterparts, which correlated with higher hERV and ISG expression in female lungs.

Automated Deep Learning Pipeline for Characterizing Left Ventricular Diastolic Function.

Introduction: Left ventricular diastolic dysfunction (LVDD) is most commonly evaluated by echocardiography. However, without a sole identifying metric, LVDD is assessed by a diagnostic algorithm relying on secondary characteristics that is laborious and has potential for interobserver variability.

Methods: To characterize concordance in clinical evaluations of LVDD, we evaluated historical echocardiogram studies at two academic medical centers for variability between clinician text reports and assessment by 2016 American Society of Echocardiography (ASE) guidelines.

SELF-REPORTED DEMOGRAPHICS OF 154 HYPERMOBILE EHLERS-DANLOS SYNDROME PATIENTS.

Demographic data for patients with Hypermobile Ehlers-Danlos Syndrome (hEDS) has not been well established. hEDS patients often present with a constellation of symptoms; it is important to update clinical criteria for diagnosis and provide a framework for common co-morbidities. The primary objective of this study was to identify the prevalence of co-morbidities in hEDS patients to allow clinicians to better identify patients and their most common symptoms.

Automated Deep Learning Phenotyping of Tricuspid Regurgitation in Echocardiography.

Importance: Accurate assessment of tricuspid regurgitation (TR) is necessary for identification and risk stratification.

Objective: To design a deep learning computer vision workflow for identifying color Doppler echocardiogram videos and characterizing TR severity.

Design, Setting, And Participants: An automated deep learning workflow was developed using 47 312 studies (2 079 898 videos) from Cedars-Sinai Medical Center (CSMC) between 2011 and 2021.

Development and Clinical Evaluation of a Multiplexed Health Surveillance Panel Using Ultra High-Throughput PRM-MS in an Inflammatory Bowel Disease Cohort.

Despite advances in clinical proteomics, translating protein biomarker discoveries into clinical use remains challenging due to the technical complexity of the validation process. Targeted MS-based proteomics approaches such as parallel reaction monitoring (PRM) offer sensitive and specific assays for biomarker translation. In this study, we developed a multiplex PRM assay using the Stellar mass spectrometry platform to quantify 57 plasma proteins, including 21 FDA-approved proteins.

Artificial Intelligence Prediction of Age from Echocardiography as a Marker for Cardiovascular Disease.

Accurate understanding of biological aging and the impact of environmental stressors is crucial for understanding cardiovascular health and identifying patients at risk for adverse outcomes. Chronological age stands as perhaps the most universal risk predictor across virtually all populations and diseases. While chronological age is readily discernible, efforts to distinguish between biologically older versus younger individuals can, in turn, potentially identify individuals with accelerated versus delayed cardiovascular aging.

Sex differences and the role of anemia in contrast-associated acute kidney injury after percutaneous coronary intervention.

Many, though not all, studies suggest that contrast-associated acute kidney injury (CA-AKI) after percutaneous coronary intervention (PCI) rates are higher in women. The authors sought to clarify the presence of and factors contributing to possible sex differences. Among 2971 consecutive patients undergoing PCI, women experienced higher crude rates of CA-AKI.

Sex-Divergent Blood Pressure Associations With Multiorgan System Metabolic Stress-Brief Report.

Background: Women experience excess cardiovascular risk compared with men in the setting of similar metabolic disease burden. We aimed to examine sex differences in the vascular response to various forms of metabolic stress.

Methods: We conducted an observational study of 4299 adult participants (52% women, aged 59±13 years) of the National Health and Nutrition Examination Survey 2017 to 2018 cohort and 110 225 adult outpatients (55% women, aged 64±16 years) from the Cedars-Sinai Medical Center in 2019.