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Article ; Online: Estimates of Incidence and Predictors of Fatiguing Illness after SARS-CoV-2 Infection.

Vu, Quan M / Fitzpatrick, Annette L / Cope, Jennifer R / Bertolli, Jeanne / Sotoodehnia, Nona / West, T Eoin / Gentile, Nikki / Unger, Elizabeth R

Emerging infectious diseases

2024 Volume 30, Issue 3, Page(s) 539–547

Abstract: This study aimed to estimate the incidence rates of post-COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during ... ...

Abstract	This study aimed to estimate the incidence rates of post-COVID-19 fatigue and chronic fatigue and to quantify the additional incident fatigue caused by COVID-19. We analyzed electronic health records data of 4,589 patients with confirmed COVID-19 during February 2020-February 2021 who were followed for a median of 11.4 (interquartile range 7.8-15.5) months and compared them to data from 9,022 propensity score-matched non-COVID-19 controls. Among COVID-19 patients (15% hospitalized for acute COVID-19), the incidence rate of fatigue was 10.2/100 person-years and the rate of chronic fatigue was 1.8/100 person-years. Compared with non-COVID-19 controls, the hazard ratios were 1.68 (95% CI 1.48-1.92) for fatigue and 4.32 (95% CI 2.90-6.43) for chronic fatigue. The observed association between COVID-19 and the significant increase in the incidence of fatigue and chronic fatigue reinforces the need for public health actions to prevent SARS-CoV-2 infections.
MeSH term(s)	Humans ; Incidence ; COVID-19/epidemiology ; Fatigue Syndrome, Chronic ; Muscle Fatigue ; SARS-CoV-2
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid3003.231194
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Zs.A 4778: Show issues

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Article ; Online: A method for continuous rhythm classification and early detection of ventricular fibrillation during CPR.

Kwok, Heemun / Coult, Jason / Blackwood, Jennifer / Sotoodehnia, Nona / Kudenchuk, Peter / Rea, Thomas

Resuscitation

2022 Volume 176, Page(s) 90–97

Abstract: Aim: We developed a method which continuously classifies the ECG rhythm during CPR in order to guide clinical care.: Methods: We conducted a retrospective study of 432 patients treated following out-of-hospital cardiac arrest. Continuous ECG ... ...

Abstract	Aim: We developed a method which continuously classifies the ECG rhythm during CPR in order to guide clinical care. Methods: We conducted a retrospective study of 432 patients treated following out-of-hospital cardiac arrest. Continuous ECG sequences from two-minute CPR cycles were extracted from defibrillator recordings and further divided into five-second clips. We developed an algorithm using wavelet analysis, hidden semi-Markov modeling, and random forest classification. The algorithm classifies individual clips as asystole, organized rhythm, ventricular fibrillation, or Inconclusive while integrating information from previous clips. Classifications were compared to manual annotations to estimate accuracy in an independent validation dataset. Continuous sequences were classified as shockable, non-shockable, or Inconclusive; classifications were used to compute shock sensitivity and specificity. Results: Of 432 patient-cases, 290 were used for development and 142 for validation. In the 12,294 validation ECG clips during CPR, accuracies were 0.88 (95% CI 0.85-0.91) for asystole, 0.98 (95% CI 0.98-0.99) for organized rhythm, and 0.97 (95% CI 0.96-0.97) for ventricular fibrillation, with 43% classified as Inconclusive. Of 457 continuous sequences, shock sensitivity was 0.90 (95% CI 0.86-0.93), shock specificity was 0.98 (95% CI 0.93-0.99), and 7% were Inconclusive. Median delay to ventricular fibrillation recognition was 10 (IQR 5-32) seconds. Conclusion: A novel algorithm continuously classified the primary resuscitation rhythms-asystole, organized rhythms, and ventricular fibrillation-with 88-98% accuracy, enabling accurate shock advisory guidance during most two-minute CPR cycles. Additional investigation is required to understand how algorithm implementation could affect rescuer actions and clinical outcomes.
MeSH term(s)	Arrhythmias, Cardiac/therapy ; Cardiopulmonary Resuscitation/methods ; Electric Countershock/methods ; Electrocardiography/methods ; Humans ; Out-of-Hospital Cardiac Arrest/diagnosis ; Out-of-Hospital Cardiac Arrest/therapy ; Retrospective Studies ; Shock ; Ventricular Fibrillation/diagnosis ; Ventricular Fibrillation/therapy
Language	English
Publishing date	2022-06-03
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2022.05.019
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Zs.A 1048: Show issues

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Article ; Online: Ankle-Brachial Index and Risk of Sudden Cardiac Death in the Community: The ARIC Study.

Suzuki, Takeki / Zhu, Xiaoqian / Adabag, Selcuk / Matsushita, Kunihiro / Butler, Kenneth R / Griswold, Michael E / Alonso, Alvaro / Rosamond, Wayne / Sotoodehnia, Nona / Mosley, Thomas H

Journal of the American Heart Association

2024 Volume 13, Issue 6, Page(s) e032008

Abstract: Background: Sudden cardiac death (SCD) is a significant global public health problem accounting for 15% to 20% of all deaths. A great majority of SCD is associated with coronary heart disease, which may first be detected at autopsy. The ankle-brachial ... ...

Abstract	Background: Sudden cardiac death (SCD) is a significant global public health problem accounting for 15% to 20% of all deaths. A great majority of SCD is associated with coronary heart disease, which may first be detected at autopsy. The ankle-brachial index (ABI) is a simple, noninvasive measure of subclinical atherosclerosis. The purpose of this study was to examine the relationship between ABI and SCD in a middle-aged biracial general population. Methods and results: Participants of the ARIC (Atherosclerosis Risk in Communities) study with an ABI measurement between 1987 and 1989 were included. ABI was categorized as low (≤0.90), borderline (0.90-1.00), normal (1.00-1.40), and noncompressible (>1.40). SCD was defined as a sudden pulseless condition presumed to be caused by a ventricular tachyarrhythmia in a previously stable individual and was adjudicated by a committee of cardiac electrophysiologists, cardiologists, and internists. Cox proportional hazards models were used to evaluate the associations between baseline ABI and incident SCD. Of the 15 081 participants followed for a median of 23.5 years, 556 (3.7%) developed SCD (1.96 cases per 1000 person-years). Low and borderline ABIs were associated with an increased risk of SCD (demographically adjusted hazard ratios [HRs], 2.27 [95% CI, 1.64-3.14] and 1.52 [95% CI, 1.17-1.96], respectively) compared with normal ABI. The association between low ABI and SCD remained significant after adjustment for traditional cardiovascular risk factors (HR, 1.63 [95% CI, 1.15-2.32]). Conclusions: Low ABI is independently associated with an increased risk of SCD in a middle-aged biracial general population. ABI could be incorporated into future SCD risk prediction models.
MeSH term(s)	Middle Aged ; Humans ; Ankle Brachial Index ; Risk Factors ; Atherosclerosis/epidemiology ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/etiology ; Coronary Disease/complications ; Risk Assessment
Language	English
Publishing date	2024-03-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.032008
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Article ; Online: Association of P-Wave Abnormalities With Sudden Cardiac and Cardiovascular Death: The ARIC Study.

Maheshwari, Ankit / Norby, Faye L / Soliman, Elsayed Z / Alonso, Alvaro / Sotoodehnia, Nona / Chen, Lin Y

Circulation. Arrhythmia and electrophysiology

2021 Volume 14, Issue 2, Page(s) e009314

MeSH term(s)	Cardiovascular Diseases/complications ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/physiopathology ; Death, Sudden, Cardiac/etiology ; Electrocardiography ; Heart Conduction System/physiopathology ; Heart Rate/physiology ; Humans ; Risk Assessment/methods ; Risk Factors
Language	English
Publishing date	2021-02-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2426129-4
ISSN	1941-3084 ; 1941-3149
ISSN (online)	1941-3084
ISSN	1941-3149
DOI	10.1161/CIRCEP.120.009314
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Zs.A 6667: Show issues

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Article ; Online: Continuous assessment of ventricular fibrillation prognostic status during CPR: Implications for resuscitation.

Coult, Jason / Kwok, Heemun / Eftestøl, Trygve / Bhandari, Shiv / Blackwood, Jennifer / Sotoodehnia, Nona / Kudenchuk, Peter J / Rea, Thomas D

Resuscitation

2022 Volume 179, Page(s) 152–162

Abstract: Background: Ventricular fibrillation (VF) waveform measures reflect myocardial physiologic status. Continuous assessment of VF prognosis using such measures could guide resuscitation, but has not been possible due to CPR artifact in the ECG. A recently- ... ...

Abstract	Background: Ventricular fibrillation (VF) waveform measures reflect myocardial physiologic status. Continuous assessment of VF prognosis using such measures could guide resuscitation, but has not been possible due to CPR artifact in the ECG. A recently-validated VF measure (termed VitalityScore), which estimates the probability (0-100%) of return-of-rhythm (ROR) after shock, can assess VF during CPR, suggesting potential for continuous application during resuscitation. Objective: We evaluated VF using VitalityScore to characterize VF prognostic status continuously during resuscitation. Methods: We characterized VF using VitalityScore during 60 seconds of CPR and 10 seconds of subsequent pre-shock CPR interruption in patients with out-of-hospital VF arrest. VitalityScore utility was quantified using area under the receiver operating characteristic curve (AUC). VitalityScore trends over time were estimated using mixed-effects models, and associations between trends and ROR were evaluated using logistic models. A sensitivity analysis characterized VF during protracted (100-second) periods of CPR. Results: We evaluated 724 VF episodes among 434 patients. After an initial decline from 0-8 seconds following VF onset, VitalityScore increased slightly during CPR from 8-60 seconds (slope: 0.18%/min). During the first 10 seconds of subsequent pre-shock CPR interruption, VitalityScore declined (slope: -14%/min). VitalityScore predicted ROR throughout CPR with AUCs 0.73-0.75. Individual VitalityScore trends during 8-60 seconds of CPR were marginally associated with subsequent ROR (adjusted odds ratio for interquartile slope change (OR) = 1.10, p = 0.21), and became significant with protracted (100 seconds) CPR duration (OR = 1.28, p = 0.006). Conclusion: VF prognostic status can be continuously evaluated during resuscitation, a development that could translate to patient-specific resuscitation strategies.
MeSH term(s)	Cardiopulmonary Resuscitation ; Electric Countershock ; Electrocardiography ; Humans ; Prognosis ; Ventricular Fibrillation/complications ; Ventricular Fibrillation/diagnosis ; Ventricular Fibrillation/therapy
Language	English
Publishing date	2022-08-27
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	189901-6
ISSN	1873-1570 ; 0300-9572
ISSN (online)	1873-1570
ISSN	0300-9572
DOI	10.1016/j.resuscitation.2022.08.015
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Zs.A 1048: Show issues

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Article ; Online: Cardiac Disease Alters Myocardial Tissue Levels of Epoxyeicosatrienoic Acids and Key Proteins Involved in Their Biosynthesis and Degradation.

Aliwarga, Theresa / Dinh, Jean C / Heyward, Scott / Prasad, Bhagwat / Gharib, Sina A / Lemaitre, Rozenn N / Sotoodehnia, Nona / Totah, Rheem A

International journal of molecular sciences

2022 Volume 23, Issue 20

Abstract: CYP2J2 is the main epoxygenase in the heart that is responsible for oxidizing arachidonic acid ... ...

Abstract	CYP2J2 is the main epoxygenase in the heart that is responsible for oxidizing arachidonic acid to
MeSH term(s)	Humans ; Epoxide Hydrolases/metabolism ; Cytochrome P-450 Enzyme System/metabolism ; Terfenadine ; NADP ; Eicosanoids/metabolism ; Arachidonic Acid/metabolism ; Heart Diseases ; Cytochrome P-450 CYP2J2 ; Cardiovascular Diseases
Chemical Substances	Epoxide Hydrolases (EC 3.3.2.-) ; Cytochrome P-450 Enzyme System (9035-51-2) ; Terfenadine (7BA5G9Y06Q) ; NADP (53-59-8) ; Eicosanoids ; Arachidonic Acid (27YG812J1I) ; Cytochrome P-450 CYP2J2 (EC 1.14.14.1)
Language	English
Publishing date	2022-10-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms232012433
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Article ; Online: Risk Prediction in Male Adolescents With Congenital Long QT Syndrome: Implications for Sex-Specific Risk Stratification in Potassium Channel-Mediated Long QT Syndrome.

Bjelic, Milica / Goldenberg, Ido / Younis, Arwa / Chen, Anita Y / Huang, David T / Yoruk, Ayhan / Aktas, Mehmet K / Rosero, Spencer / Cutter, Kristina / McNitt, Scott / Sotoodehnia, Nona / Kudenchuk, Peter J / Rea, Thomas D / Arking, Dan E / Zareba, Wojciech / Ackerman, Michael J / Goldenberg, Ilan

Journal of the American Heart Association

2024 Volume 13, Issue 3, Page(s) e028902

Abstract: Background: Sex-specific risk management may improve outcomes in congenital long QT syndrome (LQTS). We recently developed a prediction score for cardiac events (CEs) and life-threatening events (LTEs) in postadolescent women with LQTS. In the present ... ...

Abstract	Background: Sex-specific risk management may improve outcomes in congenital long QT syndrome (LQTS). We recently developed a prediction score for cardiac events (CEs) and life-threatening events (LTEs) in postadolescent women with LQTS. In the present study, we aimed to develop personalized risk estimates for the burden of CEs and LTEs in male adolescents with potassium channel-mediated LQTS. Methods and results: The prognostic model was derived from the LQTS Registry headquartered in Rochester, NY, comprising 611 LQT1 or LQT2 male adolescents from age 10 through 20 years, using the following variables: genotype/mutation location, QTc-specific thresholds, history of syncope, and β-blocker therapy. Anderson-Gill modeling was performed for the end point of CE burden (total number of syncope, aborted cardiac arrest, and appropriate defibrillator shocks). The applicability of the CE prediction model was tested for the end point of the first LTE (excluding syncope and adding sudden cardiac death) using Cox modeling. A total of 270 CEs occurred during follow-up. The genotype-phenotype risk prediction model identified low-, intermediate-, and high-risk groups, comprising 74%, 14%, and 12% of the study population, respectively. Compared with the low-risk group, high-risk male subjects experienced a pronounced 5.2-fold increased risk of recurrent CEs ( Conclusions: Personalized genotype-phenotype risk estimates can be used to guide sex-specific management in male adolescents with potassium channel-mediated LQTS.
MeSH term(s)	Humans ; Male ; Adolescent ; Female ; Young Adult ; Adult ; Child ; Potassium Channels/genetics ; Long QT Syndrome/diagnosis ; Long QT Syndrome/genetics ; Long QT Syndrome/congenital ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/etiology ; Syncope/genetics ; Syncope/epidemiology ; Genotype ; Risk Factors ; Risk Assessment ; Electrocardiography
Chemical Substances	Potassium Channels
Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.028902
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Article ; Online: Genetic variant annotation scores in congenital long QT syndrome.

Younis, Arwa / Bodurian, Christopher / Arking, Dan E / Bragazzi, Nicola Luigi / Tabaja, Chadi / Zareba, Wojciech / McNitt, Scott / Aktas, Mehmet K / Polonsky, Bronislava / Lopes, Coeli M / Sotoodehnia, Nona / Kudenchuk, Peter J / Goldenberg, Ilan

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc

2023 Volume 28, Issue 5, Page(s) e13080

Abstract: Background: Congenital Long QT Syndrome (LQTS) is a hereditary arrhythmic disorder. We aimed to assess the performance of current genetic variant annotation scores among LQTS patients and their predictive impact.: Methods: We evaluated 2025 patients ... ...

Abstract	Background: Congenital Long QT Syndrome (LQTS) is a hereditary arrhythmic disorder. We aimed to assess the performance of current genetic variant annotation scores among LQTS patients and their predictive impact. Methods: We evaluated 2025 patients with unique mutations for LQT1-LQT3. A patient-specific score was calculated for each of four established genetic variant annotation algorithms: CADD, SIFT, REVEL, and PolyPhen-2. The scores were tested for the identification of LQTS and their predictive performance for cardiac events (CE) and life-threatening events (LTE) and then compared with the predictive performance of LQTS categorization based on mutation location/function. Score performance was tested using Harrell's C-index. Results: A total of 917 subjects were classified as LQT1, 838 as LQT2, and 270 as LQT3. The identification of a pathogenic variant occurred in 99% with CADD, 92% with SIFT, 100% with REVEL, and 86% with PolyPhen-2. However, none of the genetic scores correlated with the risk of CE (Harrell's C-index: CADD = 0.50, SIFT = 0.51, REVEL = 0.50, and PolyPhen-2 = 0.52) or LTE (Harrell's C-index: CADD = 0.50, SIFT = 0.53, REVEL = 0.54, and PolyPhen-2 = 0.52). In contrast, high-risk mutation categorization based on location/function was a powerful independent predictor of CE (HR = 1.88; p < .001) and LTE (HR = 1.89, p < .001). Conclusion: In congenital LQTS patients, well-established algorithms (CADD, SIFT, REVEL, and PolyPhen-2) were able to identify the majority of the causal variants as pathogenic. However, the scores did not predict clinical outcomes. These results indicate that mutation location/functional assays are essential for accurate interpretation of the risk associated with LQTS mutations.
MeSH term(s)	Humans ; Genotype ; Electrocardiography ; Long QT Syndrome/diagnosis ; Long QT Syndrome/genetics ; Long QT Syndrome/complications
Language	English
Publishing date	2023-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1325530-7
ISSN	1542-474X ; 1082-720X
ISSN (online)	1542-474X
ISSN	1082-720X
DOI	10.1111/anec.13080
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Zs.A 4953: Show issues

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Article: Research priorities for the secondary prevention and management of acute rheumatic fever and rheumatic heart disease: a National Heart, Lung, and Blood Institute workshop report.

Karthikeyan, Ganesan / Watkins, David / Bukhman, Gene / Cunningham, Madeleine W / Haller, John / Masterson, Mary / Mensah, George A / Mocumbi, Ana / Muhamed, Babu / Okello, Emmy / Sotoodehnia, Nona / Machipisa, Tafadzwa / Ralph, Anna / Wyber, Rosemary / Beaton, Andrea

BMJ global health

2023 Volume 8, Issue Suppl 9

Abstract: Secondary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) involves continuous antimicrobial prophylaxis among affected individuals and is recognised as a cornerstone of public health programmes that address these conditions. ... ...

Abstract	Secondary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) involves continuous antimicrobial prophylaxis among affected individuals and is recognised as a cornerstone of public health programmes that address these conditions. However, several important scientific issues around the secondary prevention paradigm remain unresolved. This report details research priorities for secondary prevention that were developed as part of a workshop convened by the US National Heart, Lung, and Blood Institute in November 2021. These span basic, translational, clinical and population science research disciplines and are built on four pillars. First, we need a better understanding of RHD epidemiology to guide programmes, policies, and clinical and public health practice. Second, we need better strategies to find and diagnose people affected by ARF and RHD. Third, we urgently need better tools to manage acute RF and slow the progression of RHD. Fourth, new and existing technologies for these conditions need to be better integrated into healthcare systems. We intend for this document to be a reference point for research organisations and research sponsors interested in contributing to the growing scientific community focused on RHD prevention and control.
MeSH term(s)	United States ; Humans ; Rheumatic Fever/prevention & control ; Rheumatic Fever/complications ; Rheumatic Fever/diagnosis ; Rheumatic Heart Disease/prevention & control ; Rheumatic Heart Disease/diagnosis ; Secondary Prevention ; National Heart, Lung, and Blood Institute (U.S.) ; Research Design
Language	English
Publishing date	2023-11-01
Publishing country	England
Document type	Journal Article ; Review
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2023-012468
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Article: Research opportunities for the primary prevention and management of acute rheumatic fever and rheumatic heart disease: a National Heart, Lung, and Blood Institute workshop report.

Rwebembera, Joselyn / Cannon, Jeffrey W / Sanyahumbi, Amy / Sotoodehnia, Nona / Taubert, Kathryn / Yilgwan, Christopher Sabo / Bukhman, Gene / Masterson, Mary / Bruno, Fernando P / Bowen, Asha / Dale, James B / Engel, Mark E / Beaton, Andrea / Van Beneden, Chris

BMJ global health

2023 Volume 8, Issue Suppl 9

Abstract: Primary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) encompasses the timely diagnosis and adequate treatment of the superficial group ... ...

Abstract	Primary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) encompasses the timely diagnosis and adequate treatment of the superficial group A
MeSH term(s)	Humans ; National Heart, Lung, and Blood Institute (U.S.) ; Primary Prevention ; Rheumatic Fever/diagnosis ; Rheumatic Fever/prevention & control ; Rheumatic Fever/epidemiology ; Rheumatic Heart Disease/diagnosis ; Rheumatic Heart Disease/prevention & control ; Rheumatic Heart Disease/epidemiology ; United States
Language	English
Publishing date	2023-11-01
Publishing country	England
Document type	Journal Article ; Review
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2023-012356
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