M-FADD HF Research Findings
Research findings will be posted in this section as they are available after publication. Please continue to check back as we continue to work with the study data.
Adaptation of Metabolomics and Microbiomic Research Protocols During the COVID-19 Pandemic.
Want to learn how this study and other related studies adapted their research during COVID? Check out our paper:
Butts B, Alford T, Brewster G, et al. Adaptation of Metabolomics and Microbiomic Research Protocols During the COVID-19 Pandemic. Nurs Res. Mar-Apr 01 2022;71(2):128-137. doi:10.1097/nnr.0000000000000574
You can download the article here.
The abstract below provides an overview of the paper.
Butts B, Alford T, Brewster G, et al. Adaptation of Metabolomics and Microbiomic Research Protocols During the COVID-19 Pandemic. Nurs Res. Mar-Apr 01 2022;71(2):128-137. doi:10.1097/nnr.0000000000000574
You can download the article here.
The abstract below provides an overview of the paper.
Abstract
Background: When the COVID-19 pandemic hit in 2020, researchers in the P30 Center for the Study of Symptom Science, Metabolomics, and Multiple Chronic Conditions at Emory University's Nell Hodgson Woodruff School of Nursing faced major challenges in recruitment and data collection because of limited access to the clinic and community facilities and the risk of COVID-19 exposure associated with in-person study contact.
Objectives: The purpose of this article is to (a) describe how a cadre of pilot/supplement principal investigators adapted their studies to allow for safe and trustworthy data collection during the COVID-19 pandemic (March 2020 through date of publication) and (b) discuss steps that facilitated the technical aspects of remote data collection, especially involving biological specimens.
Results: Four pilot studies and two administrative supplements within the center-all at different stages of execution-adopted various alternative remote recruitment, enrollment, and data and specimen collection approaches to continue their research endeavors in a way that maximized the safety of both the research participants and the research teams.
Discussion: The article concludes with a discussion on the importance of a participant-centered approach when using remote methods, actions, or steps initiated to facilitate the technical aspects of remote data collection and reflections on the continued use of remote research strategies beyond the COVID-19 pandemic.
Background: When the COVID-19 pandemic hit in 2020, researchers in the P30 Center for the Study of Symptom Science, Metabolomics, and Multiple Chronic Conditions at Emory University's Nell Hodgson Woodruff School of Nursing faced major challenges in recruitment and data collection because of limited access to the clinic and community facilities and the risk of COVID-19 exposure associated with in-person study contact.
Objectives: The purpose of this article is to (a) describe how a cadre of pilot/supplement principal investigators adapted their studies to allow for safe and trustworthy data collection during the COVID-19 pandemic (March 2020 through date of publication) and (b) discuss steps that facilitated the technical aspects of remote data collection, especially involving biological specimens.
Results: Four pilot studies and two administrative supplements within the center-all at different stages of execution-adopted various alternative remote recruitment, enrollment, and data and specimen collection approaches to continue their research endeavors in a way that maximized the safety of both the research participants and the research teams.
Discussion: The article concludes with a discussion on the importance of a participant-centered approach when using remote methods, actions, or steps initiated to facilitate the technical aspects of remote data collection and reflections on the continued use of remote research strategies beyond the COVID-19 pandemic.
Heart Failure Symptoms Are Associated With Markers of T Cell Activation and Tissue Remodeling
Butts B, Davis E, Morris AA, Dunbar SB. Abstract 14816: Heart Failure Symptoms Are Associated With Markers of T Cell Activation and Tissue Remodeling. Circulation. 2022;146(Suppl_1):A14816-A14816. doi:doi:10.1161/circ.146.suppl_1.14816
The abstract below, which was presented at the American Heart Association Scientific Sessions 2022 in Chicago, IL, are preliminary findings. Final results related to these data are in progress, and will be submitted for publication.
The abstract below, which was presented at the American Heart Association Scientific Sessions 2022 in Chicago, IL, are preliminary findings. Final results related to these data are in progress, and will be submitted for publication.
Abstract
Introduction: Heart failure (HF) is a complex syndrome involving the interplay of pathophysiologic processes, such as inflammation and myocardial remodeling. T cell activation contributes to HF progression through cytokine release leading to cardiac fibrosis and hypertrophy. HF is characterized by physical symptoms that have been shown to predict morbidity and mortality. However, the pathophysiologic mechanisms driving symptoms are not well understood. Despite disparities in HF severity and morbidity among Black adults, relationships between inflammation and symptom burden are not well characterized in this population.
Hypothesis: HF physical symptoms are positively associated with T-cell associated cytokines and chemokines.
Methods: Black adults with HF (N=30) and LVEF <50% were enrolled in this study. Symptoms were assessed with the PROMIS Dyspnea Severity Short Form 10a and Heart Failure Somatic Perception Scale (HFSPS). Biomarkers were measured via multiplex immunoassay.
Results: The mean age was 55.38 ± 12.4 years, and 67% were female. Mean LVEF was 30 ± 13%. Dyspnea severity was positively associated with matrix metalloproteinase (MMP)-1 (r=0.412, p=0.041) and MMP-12 (r=0.496, p=0.014). HFSPS was positively related to cytokines associated with T-cell activation and differentiation [interleukin (IL)-1β (r=0.526, p=0.007), IL-6 (p=0.510, p=0.011), and IL-15 (p=0.528, p=0.019)], and with chemokines involved in T cell recruitment [C-C motif chemokine ligand(CCL)-11 (r=0.399, p=0.048), CCL-19 (r=0.421, p=0.036), C-X-C motif chemokine ligand (CXCL)-8 (r=0.528, p=0.007), and CXCL-11 (r=0.418, p=0.037)].
Conclusions: Somatic symptoms were associated with T cell-related cytokines and chemokines. Dyspnea was associated with enzymes that promote tissue remodeling and breakdown of collagen and elastin. These findings suggest tissue remodeling may play a role in HF symptoms, providing a potential therapeutic target for attenuating factors associated with HF symptom burden. Considering the pleiotropic nature of cytokines, further mechanistic work is needed for a better understanding of the pathophysiologic processes that could be targeted with interventions to reduce symptom burden in persons with HF.
Introduction: Heart failure (HF) is a complex syndrome involving the interplay of pathophysiologic processes, such as inflammation and myocardial remodeling. T cell activation contributes to HF progression through cytokine release leading to cardiac fibrosis and hypertrophy. HF is characterized by physical symptoms that have been shown to predict morbidity and mortality. However, the pathophysiologic mechanisms driving symptoms are not well understood. Despite disparities in HF severity and morbidity among Black adults, relationships between inflammation and symptom burden are not well characterized in this population.
Hypothesis: HF physical symptoms are positively associated with T-cell associated cytokines and chemokines.
Methods: Black adults with HF (N=30) and LVEF <50% were enrolled in this study. Symptoms were assessed with the PROMIS Dyspnea Severity Short Form 10a and Heart Failure Somatic Perception Scale (HFSPS). Biomarkers were measured via multiplex immunoassay.
Results: The mean age was 55.38 ± 12.4 years, and 67% were female. Mean LVEF was 30 ± 13%. Dyspnea severity was positively associated with matrix metalloproteinase (MMP)-1 (r=0.412, p=0.041) and MMP-12 (r=0.496, p=0.014). HFSPS was positively related to cytokines associated with T-cell activation and differentiation [interleukin (IL)-1β (r=0.526, p=0.007), IL-6 (p=0.510, p=0.011), and IL-15 (p=0.528, p=0.019)], and with chemokines involved in T cell recruitment [C-C motif chemokine ligand(CCL)-11 (r=0.399, p=0.048), CCL-19 (r=0.421, p=0.036), C-X-C motif chemokine ligand (CXCL)-8 (r=0.528, p=0.007), and CXCL-11 (r=0.418, p=0.037)].
Conclusions: Somatic symptoms were associated with T cell-related cytokines and chemokines. Dyspnea was associated with enzymes that promote tissue remodeling and breakdown of collagen and elastin. These findings suggest tissue remodeling may play a role in HF symptoms, providing a potential therapeutic target for attenuating factors associated with HF symptom burden. Considering the pleiotropic nature of cytokines, further mechanistic work is needed for a better understanding of the pathophysiologic processes that could be targeted with interventions to reduce symptom burden in persons with HF.
Connections Between the Western Diet and Inflammation in Heart Failure
Davis E, Dunbar SB, Higgins M, Wood KA, Morris AA, Butts B. Abstract 15795: Connections Between the Western Diet and Inflammation in Heart Failure. Circulation. 2022;146(Suppl_1):A15795-A15795. doi:doi:10.1161/circ.146.suppl_1.15795
This abstract was presented by postdoctoral fellow, Erica Davis, at the American Heart Association Scientific Sessions 2022 in Chicago, IL.
This abstract was presented by postdoctoral fellow, Erica Davis, at the American Heart Association Scientific Sessions 2022 in Chicago, IL.
Abstract
Introduction: The Western Diet (WD) is associated with deleterious processes linked with chronic disease and may play a role in the pathophysiology of heart failure (HF). Trimethylamine-N-oxide (TMAO) is a diet-linked metabolite that contributes to inflammation and is associated with higher TNF-α, especially in HF populations. The dietary inflammatory index (DII) score measures the inflammatory potential of a diet and the inflammatory effects of foods. More studies are needed to determine how the WD impacts immunological pathways and cytokines in the context of clinical and population characteristics.
Purpose: The aim of this study was to explore associations between the WD, DII, TMAO, and TNF-α in Black patients living with HF.
Methods: Thirty Black participants (mean age 55.3, 67.7% women) with HF were included in this study. TMAO and TNF-α levels were analyzed from dried blood spots using immunoassays. Participants completed a Food Frequency Questionnaire (FFQ) from which a DII score was derived. Food groups and nutrients, like choline, were measured with the FFQ. Sociodemographic variables were measured. Analyses included correlational and inferential statistics.
Results: Mean DII score was -.38 revealing an overall anti-inflammatory diet with higher inflammatory scores among men (-.23) as compared to women (-.43). Women consumed greater kilocalories with more saturated fat, sodium, dairy, sugar, and fruit while men consumed more cholesterol, choline, proteins, alcohol, legumes, poultry, red meats, eggs, and phosphatidylcholine. DII score was negatively correlated with dietary choline (r= -.73, p<.001), but did not correlate with TMAO or TNF-α. TNF-α and TMAO were positively related (r=.30, p=.057).
Conclusions: This sample of well-educated HF patients from a busy HF referral center did not consume a highly pro-inflammatory diet, yet our findings provide insight for specific food groups such as those with choline. In patients with HF, it is important to monitor intake of inflammatory foods and appreciate that increasing age may play a role in the retention of dietary metabolites. Further study of these relationships in patients with HF could lead to tailored dietary educational interventions based on dietary patterns, age, and cultural relevance.
Introduction: The Western Diet (WD) is associated with deleterious processes linked with chronic disease and may play a role in the pathophysiology of heart failure (HF). Trimethylamine-N-oxide (TMAO) is a diet-linked metabolite that contributes to inflammation and is associated with higher TNF-α, especially in HF populations. The dietary inflammatory index (DII) score measures the inflammatory potential of a diet and the inflammatory effects of foods. More studies are needed to determine how the WD impacts immunological pathways and cytokines in the context of clinical and population characteristics.
Purpose: The aim of this study was to explore associations between the WD, DII, TMAO, and TNF-α in Black patients living with HF.
Methods: Thirty Black participants (mean age 55.3, 67.7% women) with HF were included in this study. TMAO and TNF-α levels were analyzed from dried blood spots using immunoassays. Participants completed a Food Frequency Questionnaire (FFQ) from which a DII score was derived. Food groups and nutrients, like choline, were measured with the FFQ. Sociodemographic variables were measured. Analyses included correlational and inferential statistics.
Results: Mean DII score was -.38 revealing an overall anti-inflammatory diet with higher inflammatory scores among men (-.23) as compared to women (-.43). Women consumed greater kilocalories with more saturated fat, sodium, dairy, sugar, and fruit while men consumed more cholesterol, choline, proteins, alcohol, legumes, poultry, red meats, eggs, and phosphatidylcholine. DII score was negatively correlated with dietary choline (r= -.73, p<.001), but did not correlate with TMAO or TNF-α. TNF-α and TMAO were positively related (r=.30, p=.057).
Conclusions: This sample of well-educated HF patients from a busy HF referral center did not consume a highly pro-inflammatory diet, yet our findings provide insight for specific food groups such as those with choline. In patients with HF, it is important to monitor intake of inflammatory foods and appreciate that increasing age may play a role in the retention of dietary metabolites. Further study of these relationships in patients with HF could lead to tailored dietary educational interventions based on dietary patterns, age, and cultural relevance.