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Article: Lipoprotein(a) Elevation: A New Diagnostic Code with Relevance to Service Members and Veterans.

Engler, Renata J M / Brede, Emily / Villines, Todd / Vernalis, Marina N

Federal practitioner : for the health care professionals of the VA, DoD, and PHS

2019 Volume 36, Issue Suppl 7, Page(s) S19–S31

Abstract: Newly recognized as a clinical diagnosis, Lp(a) elevation is a major contributor to cardiovascular disease risk should be considered for patients with advanced premature atherosclerosis on imaging or a family history of premature cardiovascular disease, ... ...

Abstract	Newly recognized as a clinical diagnosis, Lp(a) elevation is a major contributor to cardiovascular disease risk should be considered for patients with advanced premature atherosclerosis on imaging or a family history of premature cardiovascular disease, particularly when there are few traditional risk factors.
Language	English
Publishing date	2019-06-13
Publishing country	United States
Document type	Journal Article
ISSN	1078-4497
ISSN	1078-4497
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Article: Gene expression profiling during intensive cardiovascular lifestyle modification: Relationships with vascular function and weight loss

Blackburn, Heather L / McErlean, Seóna / Jellema, Gera L / van Laar, Ryan / Vernalis, Marina N / Ellsworth, Darrell L

Genomics Data. 2015 June, v. 4

2015

Abstract: Heart disease and related sequelae are a leading cause of death and healthcare expenditure throughout the world. Although many patients opt for surgical interventions, lifestyle modification programs focusing on nutrition and exercise have shown ... ...

Abstract	Heart disease and related sequelae are a leading cause of death and healthcare expenditure throughout the world. Although many patients opt for surgical interventions, lifestyle modification programs focusing on nutrition and exercise have shown substantial health benefits and are becoming increasing popular. We conducted a year-long lifestyle modification program to mediate cardiovascular risk through traditional risk factors and to investigate how molecular changes, if present, may contribute to long-term risk reduction. Here we describe the lifestyle intervention, including clinical and molecular data collected, and provide details of the experimental methods and quality control parameters for the gene expression data generated from participants and non-intervention controls. Our findings suggest successful and sustained modulation of gene expression through healthy lifestyle changes may have beneficial effects on vascular health that cannot be discerned from traditional risk factor profiles. The data are deposited in the Gene Expression Omnibus, series GSE46097 and GSE66175.
Keywords	complications (disease) ; data collection ; death ; exercise ; gene expression ; gene expression regulation ; health services ; heart diseases ; lifestyle ; nutrition ; patients ; quality control ; risk factors ; risk reduction ; weight loss
Language	English
Dates of publication	2015-06
Size	p. 50-53.
Publishing place	Elsevier Inc.
Document type	Article
ZDB-ID	2751131-5
ISSN	2213-5960
ISSN	2213-5960
DOI	10.1016/j.gdata.2015.03.001
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Fatigued on Venus, sleepy on Mars-gender and racial differences in symptoms of sleep apnea.

Eliasson, Arn H / Kashani, Mariam D / Howard, Robin S / Vernalis, Marina N / Modlin, Randolph E

Sleep & breathing = Schlaf & Atmung

2014 Volume 19, Issue 1, Page(s) 99–107

Abstract: Objective: Clinical guidelines for the care of obstructive sleep apnea (OSA) recommend evaluation of daytime sleepiness but do not specify evaluation of fatigue. We studied how subjects with and without OSA experience fatigue and sleepiness, examining ... ...

Abstract	Objective: Clinical guidelines for the care of obstructive sleep apnea (OSA) recommend evaluation of daytime sleepiness but do not specify evaluation of fatigue. We studied how subjects with and without OSA experience fatigue and sleepiness, examining the role of gender and race. Design, setting, patients: Consecutive subjects entering our heart health registry completed validated questionnaires including Berlin Questionnaire for OSA, Fatigue Scale, and Epworth Sleepiness Scale. Data analysis was performed only with Whites and Blacks as there were too few subjects of other races for comparison. Results: Of 384 consecutive subjects, including 218 women (57 %), there were 230 Whites (60 %) and 154 Blacks (40 %), with average age of 55.9 ± 12.8 years. Berlin Questionnaires identified 221 subjects (58 %) as having high likelihood for OSA. Fatigue was much more common in women (75 %) than in men (46 %) with OSA (p < 0.001), while frequency of fatigue was similar in women (30 %) and men (29 %) without OSA (p = 0.86). In multivariate analysis, men with OSA were sleepier than women; Black men with OSA had higher Epworth scores (mean ± SD, 12.8 ± 5.2) compared to White men (10.6 ± 5.3), White women (10.0 ± 4.5), and Black women (10.5 ± 5.2), p = 0.05. These gender differences were not related to the effects of age, body mass index, perceived stress, sleep duration, or thyroid function. Conclusions: Women report fatigue more commonly with OSA than men. Men experience sleepiness more commonly with OSA than women. The findings suggest that evaluation of sleep disorders must include an assessment of fatigue in addition to sleepiness to capture the experience of women.
MeSH term(s)	Adult ; African Continental Ancestry Group ; Aged ; Disorders of Excessive Somnolence/diagnosis ; European Continental Ancestry Group ; Fatigue/diagnosis ; Fatigue/ethnology ; Female ; Humans ; Male ; Maryland ; Middle Aged ; Multivariate Analysis ; Prospective Studies ; Sex Factors ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/ethnology ; Statistics as Topic ; Surveys and Questionnaires
Language	English
Publishing date	2014-03-15
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1500381-4
ISSN	1522-1709 ; 1520-9512
ISSN (online)	1522-1709
ISSN	1520-9512
DOI	10.1007/s11325-014-0968-y
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Zs.A 5658: Show issues

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Article: Achievement of heart health characteristics through participation in an intensive lifestyle change program (Coronary Artery Disease Reversal Study).

Marshall, Debra A / Walizer, Elaine M / Vernalis, Marina N

Journal of cardiopulmonary rehabilitation and prevention

2009 Volume 29, Issue 2, Page(s) 84–94; quiz 95–6

Abstract: Purpose: Lifestyle habits and cardiovascular disease (CVD) risk factors are closely linked. Unfortunately, few individuals meet the goals for cardiovascular health that are recommended in public health initiatives. The purpose of this study was to ... ...

Abstract	Purpose: Lifestyle habits and cardiovascular disease (CVD) risk factors are closely linked. Unfortunately, few individuals meet the goals for cardiovascular health that are recommended in public health initiatives. The purpose of this study was to determine the effect of an intensive lifestyle intervention program on the achievement of a group of recognized heart health characteristics as well as on the reduction of individual CVD risk factors. Methods: Of 200 military healthcare beneficiaries with coronary artery disease or CVD risk factors (mean age = 61 years) who entered a 1-year, prospective, cohort, multicomponent lifestyle intervention study (lacto-ovo vegetarian diet, exercise, stress management, group support), 186 subjects enrolled and 144 participated for 1 year. Results: At 3 months and 1 year compared with baseline, the proportion of subjects meeting 5 recognized heart health characteristics improved (P < .001): fiber intake >25 g/d (94% and 72% vs 35%); exercise > or =150 min/wk (79% and 58% vs 31%); low-density lipoprotein cholesterol <100 mg/dL (75% and 63% vs 46%); body mass index <25 kg/m (34% and 38% vs 23%); and blood pressure <140/90 mm Hg (84% and 83% vs 69%). At 1 year, more subjects (72% vs 32% at baseline), especially those with intervention adherence above (94%) versus below (58%) the study population median (P < .0005), achieved 3 or more of these characteristics. Conclusion: An intensive lifestyle intervention promotes achievement of important heart health characteristics that, if maintained, may substantially reduce CVD events.
MeSH term(s)	Aged ; C-Reactive Protein/analysis ; Diet, Vegetarian ; Female ; Health Promotion/methods ; Heart Diseases/prevention & control ; Homocysteine/blood ; Humans ; Life Style ; Male ; Middle Aged ; Military Personnel ; Physical Fitness ; Prospective Studies ; Stress, Psychological/prevention & control
Chemical Substances	Homocysteine (0LVT1QZ0BA) ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2009-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2272063-7
ISSN	1932-7501
ISSN	1932-7501
DOI	10.1097/HCR.0b013e31819a00b2
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Article: Early Empowerment Strategies Boost Self-Efficacy to Improve Cardiovascular Health Behaviors.

Kashani, Mariam / Eliasson, Arn H / Walizer, Elaine M / Fuller, Clarie E / Engler, Renata J / Villines, Todd C / Vernalis, Marina N

Global journal of health science

2016 Volume 8, Issue 9, Page(s) 55119

Abstract: Background: Self-efficacy, defined as confidence in the ability to carry out behavior to achieve a desired goal, is considered to be a prerequisite for behavior change. Self-efficacy correlates with cardiovascular health although optimal timing to ... ...

Abstract	Background: Self-efficacy, defined as confidence in the ability to carry out behavior to achieve a desired goal, is considered to be a prerequisite for behavior change. Self-efficacy correlates with cardiovascular health although optimal timing to incorporate self-efficacy strategies is not well established. We sought to study the effect of an empowerment approach implemented in the introductory phase of a multicomponent lifestyle intervention on cardiovascular health outcomes. Design: Prospective intervention cohort study. Methods: Patients in the Integrative Cardiac Health Project Registry, a prospective lifestyle change program for the prevention of cardiovascular disease were analyzed for behavioral changes by survey, at baseline and one year, in the domains of nutrition, exercise, stress management and sleep. Self-efficacy questionnaires were administered at baseline and after the empowerment intervention, at 8 weeks. Results: Of 119 consecutive registry completers, 60 comprised a high self-efficacy group (scoring at or above the median of 36 points) and 59 the low self-efficacy group (scoring below median). Self-efficacy scores increased irrespective of baseline self-efficacy but the largest gains in self-efficacy occurred in patients who ranked in the lower half for self-efficacy at baseline. This lower self-efficacy group demonstrated behavioral gains that erased differences between the high and low self-efficacy groups. Conclusions: A boost to self-efficacy early in a lifestyle intervention program produces significant improvements in behavioral outcomes. Employing empowerment in an early phase may be a critical strategy to improve self-efficacy and lower risk in individuals vulnerable to cardiovascular disease.
Language	English
Publishing date	2016--01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2491737-0
ISSN	1916-9744 ; 1916-9736
ISSN (online)	1916-9744
ISSN	1916-9736
DOI	10.5539/gjhs.v8n9p322
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Article: Gene expression profiling during intensive cardiovascular lifestyle modification: Relationships with vascular function and weight loss.

Blackburn, Heather L / McErlean, Seóna / Jellema, Gera L / van Laar, Ryan / Vernalis, Marina N / Ellsworth, Darrell L

Genomics data

2015 Volume 4, Page(s) 50–53

Abstract	Heart disease and related sequelae are a leading cause of death and healthcare expenditure throughout the world. Although many patients opt for surgical interventions, lifestyle modification programs focusing on nutrition and exercise have shown substantial health benefits and are becoming increasing popular. We conducted a year-long lifestyle modification program to mediate cardiovascular risk through traditional risk factors and to investigate how molecular changes, if present, may contribute to long-term risk reduction. Here we describe the lifestyle intervention, including clinical and molecular data collected, and provide details of the experimental methods and quality control parameters for the gene expression data generated from participants and non-intervention controls. Our findings suggest successful and sustained modulation of gene expression through healthy lifestyle changes may have beneficial effects on vascular health that cannot be discerned from traditional risk factor profiles. The data are deposited in the Gene Expression Omnibus, series GSE46097 and GSE66175.
Language	English
Publishing date	2015-03-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2751131-5
ISSN	2213-5960
ISSN	2213-5960
DOI	10.1016/j.gdata.2015.03.001
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Article: Optimal healing environments for chronic cardiovascular disease.

Marshall, Debra A / Walizer, Elaine / Vernalis, Marina N

Journal of alternative and complementary medicine (New York, N.Y.)

2004 Volume 10 Suppl 1, Page(s) S147–55

Abstract: A substantial increase in chronic cardiovascular disease is projected for the next several decades. This is attributable to an aging population and accelerated rates of obesity and diabetes. Despite technological advances that have improved survival for ... ...

Abstract	A substantial increase in chronic cardiovascular disease is projected for the next several decades. This is attributable to an aging population and accelerated rates of obesity and diabetes. Despite technological advances that have improved survival for acute events, there is suboptimal translation of research knowledge for prevention and treatment of chronic cardiovascular illness. Beginning with a brief review of the demographics and pathogenesis of atherosclerotic cardiovascular disease, this paper discusses the obstacles and approaches to optimal care of patients with chronic cardiovascular disease. The novel concept of an optimal healing environment (OHE) is defined and explored as a model for integrative cardiac health care. Aspects generally underexamined in cardiac care such as intrapersonal/interpersonal characteristics of the health care provider and patient, mind/body/spirit wholeness and healing versus curing are discussed, as is the impact psychosocial factors may have on atherosclerosis and cardiovascular health. Information from research on the impact of an OHE might renew the healing mission in medicine, reveal new approaches for healing the heart and establish the importance of a heart-mind-body connection.
MeSH term(s)	Arteriosclerosis/prevention & control ; Attitude to Health ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/prevention & control ; Chronic Disease ; Health Behavior ; Health Promotion/standards ; Humans ; Life Style ; Mind-Body Relations, Metaphysical ; Patient Education as Topic/standards ; Patient-Centered Care/organization & administration ; Patient-Centered Care/standards ; Professional-Family Relations ; Quality of Life ; Risk Factors ; Self Care ; Self Efficacy ; United States/epidemiology
Language	English
Publishing date	2004-12-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1237383-7
ISSN	1075-5535
ISSN	1075-5535
DOI	10.1089/1075553042245962
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Zs.A 4366: Show issues

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Article ; Online: Recreational Music-Making alters gene expression pathways in patients with coronary heart disease.

Bittman, Barry / Croft, Daniel T / Brinker, Jeannie / van Laar, Ryan / Vernalis, Marina N / Ellsworth, Darrell L

Medical science monitor : international medical journal of experimental and clinical research

2013 Volume 19, Page(s) 139–147

Abstract: Background: Psychosocial stress profoundly impacts long-term cardiovascular health through adverse effects on sympathetic nervous system activity, endothelial dysfunction, and atherosclerotic development. Recreational Music Making (RMM) is a unique ... ...

Abstract	Background: Psychosocial stress profoundly impacts long-term cardiovascular health through adverse effects on sympathetic nervous system activity, endothelial dysfunction, and atherosclerotic development. Recreational Music Making (RMM) is a unique stress amelioration strategy encompassing group music-based activities that has great therapeutic potential for treating patients with stress-related cardiovascular disease. Material/methods: Participants (n=34) with a history of ischemic heart disease were subjected to an acute time-limited stressor, then randomized to RMM or quiet reading for one hour. Peripheral blood gene expression using GeneChip® Human Genome U133A 2.0 arrays was assessed at baseline, following stress, and after the relaxation session. Results: Full gene set enrichment analysis identified 16 molecular pathways differentially regulated (P<0.005) during stress that function in immune response, cell mobility, and transcription. During relaxation, two pathways showed a significant change in expression in the control group, while 12 pathways governing immune function and gene expression were modulated among RMM participants. Only 13% (2/16) of pathways showed differential expression during stress and relaxation. Conclusions: Human stress and relaxation responses may be controlled by different molecular pathways. Relaxation through active engagement in Recreational Music Making may be more effective than quiet reading at altering gene expression and thus more clinically useful for stress amelioration.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Cluster Analysis ; Coronary Artery Disease/genetics ; Coronary Artery Disease/psychology ; Female ; Gene Expression Regulation ; Humans ; Male ; Middle Aged ; Music/psychology ; Oligonucleotide Array Sequence Analysis ; Recreation/psychology ; Relaxation ; Signal Transduction/genetics ; Stress, Psychological/genetics
Language	English
Publishing date	2013-02-25
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1439041-3
ISSN	1643-3750 ; 1234-1010
ISSN (online)	1643-3750
ISSN	1234-1010
DOI	10.12659/MSM.883807
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Zs.A 4924: Show issues

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Article ; Online: Effects of cardiovascular lifestyle change on lipoprotein subclass profiles defined by nuclear magnetic resonance spectroscopy

Patney Heather L / Haberkorn Mary / Burke Amy / Neatrour David M / Decewicz David J / Vernalis Marina N / Ellsworth Darrell L

Lipids in Health and Disease, Vol 8, Iss 1, p

2009 Volume 26

Abstract: Abstract Background Low-density lipoprotein (LDL) cholesterol lowering is a primary goal in clinical management of patients with cardiovascular disease, but traditional cholesterol levels may not accurately reflect the true atherogenicity of plasma lipid ...

Abstract	Abstract Background Low-density lipoprotein (LDL) cholesterol lowering is a primary goal in clinical management of patients with cardiovascular disease, but traditional cholesterol levels may not accurately reflect the true atherogenicity of plasma lipid profiles. The size and concentration of lipoprotein particles, which transport cholesterol and triglycerides, may provide additional information for accurately assessing cardiovascular risk. This study evaluated changes in plasma lipoprotein profiles determined by nuclear magnetic resonance (NMR) spectroscopy in patients participating in a prospective, nonrandomized lifestyle modification program designed to reverse or stabilize progression of coronary artery disease (CAD) to improve our understanding of lipoprotein management in cardiac patients. Results The lifestyle intervention was effective in producing significant changes in lipoprotein subclasses that contribute to CAD risk. There was a clear beneficial effect on the total number of LDL particles (-8.3%, p < 0.05 compared to matched controls), small dense LDL particles (-9.5%, p < 0.05), and LDL particle size (+0.8%; p < 0.05). Likewise, participants showed significant improvement in traditional CAD risk factors such as body mass index (-9.9%, p < 0.01 compared to controls), total cholesterol (-5.5%, p < 0.05), physical fitness (+37.2%, p < 0.01), and future risk for CAD (-7.9%, p < 0.01). Men and women responded differently to the program for all clinically-relevant variables, with men deriving greater benefit in terms of lipoprotein atherogenicity. Plasma lipid and lipoprotein responses to the lifestyle change program were not confounded by lipid-lowering medications. Conclusion In at risk patients motivated to participate, an intensive lifestyle change program can effectively alter traditional CAD risk factors and plasma lipoprotein subclasses and may reduce risk for cardiovascular events. Improvements in lipoprotein subclasses are more evident in men compared to women.
Keywords	Physiology ; QP1-981 ; Science ; Q ; DOAJ:Physiology ; DOAJ:Biology ; DOAJ:Biology and Life Sciences
Subject code	610
Language	English
Publishing date	2009-06-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Importance of substantial weight loss for altering gene expression during cardiovascular lifestyle modification.

Ellsworth, Darrell L / Mamula, Kimberly A / Blackburn, Heather L / McDyer, Fionnuala A / Jellema, Gera L / van Laar, Ryan / Costantino, Nicholas S / Engler, Renata J M / Vernalis, Marina N

Obesity (Silver Spring, Md.)

2015 Volume 23, Issue 6, Page(s) 1312–1319

Abstract: Objective: To examine relationships between weight loss through changes in lifestyle and peripheral blood gene expression profiles.: Methods: A prospective nonrandomized trial was conducted over 1 year in participants undergoing intensive lifestyle ... ...

Abstract	Objective: To examine relationships between weight loss through changes in lifestyle and peripheral blood gene expression profiles. Methods: A prospective nonrandomized trial was conducted over 1 year in participants undergoing intensive lifestyle modification to reverse or stabilize progression of coronary artery disease. Cardiovascular risk factors, inflammatory biomarkers, and gene expression as a function of weight loss were assessed in 89 lifestyle participants and 71 retrospectively matched controls undergoing usual care. Results: Substantial weight loss (-15.2 ± 3.8%) in lifestyle participants (n = 33) was associated with improvement in selected cardiovascular risk factors and significant changes in peripheral blood gene expression from pre- to post-intervention: 132 unique genes showed significant expression changes (false discovery rate corrected P-value <0.05 and fold-change ≥1.4). Altered molecular pathways were related to immune function and inflammatory responses involving endothelial activation. In contrast, participants losing minimal weight (-3.1 ± 2.5%, n = 32) showed only minor changes in cardiovascular risk factors and markers of inflammation and no changes in gene expression compared to non intervention controls after 1 year. Conclusions: Weight loss (≥10%) during lifestyle modification is associated with down-regulation of genetic pathways governing interactions between circulating immune cells and the vascular endothelium and may be required to successfully reduce CVD risk.
MeSH term(s)	Aged ; Cardiac Rehabilitation ; Cardiovascular Diseases/genetics ; Feeding Behavior ; Female ; Gene Expression ; Humans ; Life Style ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Risk Reduction Behavior ; Weight Loss/genetics
Language	English
Publishing date	2015-06
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2230457-5
ISSN	1930-739X ; 1071-7323 ; 1930-7381
ISSN (online)	1930-739X
ISSN	1071-7323 ; 1930-7381
DOI	10.1002/oby.21079
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