Matthew Nayor's research while affiliated with Beverly Hospital, Boston MA and other places

Publications (63)

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Aims/hypothesis The aim of this work was to define metabolic correlates and pathways of diabetes pathogenesis in young adults during a subclinical latent phase of diabetes development. Methods We studied 2083 young adults of Black and White ethnicity in the prospective observational cohort Coronary Artery Risk Development in Young Adults (CARDIA)...
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Objectives This study aimed to evaluate hemodynamic correlates of inducible blood pressure (BP) pulsatility with exercise in heart failure with preserved ejection fraction (HFpEF), to identify relationships to outcomes, and to compare this with heart failure with reduced ejection fraction (HFrEF). Background In HFpEF, determinants and consequences...
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Objective: We evaluated whether intra-individual changes in blood metabolites in response to an oral glucose challenge were associated with incident CVD and mortality. Methods: An oral glucose tolerance test (OGTT; 75g glucose) was administered to a subsample of non-diabetic Framingham Heart Study participants (n=361). Metabolite profiling was perf...
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Purpose of Review Metabolomics enables rapid interrogation of widespread metabolic processes making it well suited for studying diabetes. Here, we review the current status of metabolomic investigation in diabetes, highlighting its applications for improving risk prediction and mechanistic understanding. Recent findings Findings of metabolite asso...
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Introduction Cardiorespiratory fitness is not limited by pulmonary mechanical reasons in the majority of adults. However, the degree to which lung function contributes to exercise response patterns among ostensibly healthy individuals remains unclear. Methods We examined 2314 Framingham Heart Study participants who underwent cardiopulmonary exerci...
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Background Mechanisms underlying sex differences in heart failure with preserved ejection fraction (HFpEF) are poorly understood. We sought to examine sex differences in measures of arterial stiffness and the association of arterial stiffness measures with left ventricular hemodynamic responses to exercise in men and women. Methods We studied 83 m...
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Aims: While greater physical activity (PA) is associated with improved health outcomes, the direct links between distinct components of PA, their changes over time, and cardiorespiratory fitness are incompletely understood. Methods and results: Maximum effort cardiopulmonary exercise testing (CPET) and objective PA measures [sedentary time (SED)...
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Imaging genomics is a rapidly evolving field that combines state-of-the-art bioimaging with genomic information to resolve phenotypic heterogeneity associated with genomic variation, improve risk prediction, discover prevention approaches, and enable precision diagnosis and treatment. Contemporary bioimaging methods provide exceptional resolution g...
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Diabetes is characterized as an integrated condition of dysregulated metabolism across multiple tissues, with well-established consequences on the cardiovascular system. Recent advances in precision phenotyping in biofluids and tissues in large human observational and interventional studies have afforded a unique opportunity to translate seminal fi...
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Cardiorespiratory fitness (CRF) is intricately related to health status. The optimal approach for CRF quantification is through assessment of peak oxygen uptake (VO2), but such measurements have been largely confined to small referral populations. Here we describe protocols and methodological considerations for peak VO2 assessment and determination...
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The Framingham Heart Study is the longest-running cardiovascular epidemiological study, starting in 1948. This paper gives an overview of the various cohorts, collected data, and most important research findings to date. In brief, the Framingham Heart Study, funded by the National Institutes of Health and managed by Boston University, spans 3 gener...
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Background - Increased left ventricular (LV) mass is associated with adverse cardiovascular events including heart failure (HF). Both increased LV mass and HF disproportionately affect Black individuals. To understand underlying mechanisms, we undertook a proteomic screen in a Black cohort and compared the findings to results from a white cohort. M...
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Background Obesity has multifactorial effects on lung function and exercise capacity. The contributions of obesity-related inflammatory pathways to alterations in lung function remain unclear. Research Question: To examine the association of obesity-related inflammatory pathways with pulmonary function, exercise capacity, and pulmonary-specific con...
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Importance Heart failure with preserved ejection fraction (HFpEF) is a joint metabolic and cardiovascular disorder with significant noncardiac contributions. Objective To define and quantify the metabolic cost of initiating exercise in individuals with and without HFpEF and its functional consequences. Design, Setting, and Participants This prosp...
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BACKGROUND Arterial stiffness is thought to contribute to the pathophysiology of heart failure with preserved ejection fraction (HFpEF). We sought to examine arterial stiffness in HFpEF and hypertension and investigate associations of arterial and left ventricular hemodynamic responses to exercise. METHODS A total of 385 symptomatic individuals wi...
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Atherosclerotic cardiovascular disease (ASCVD) proceeds through a series of stages: initiation, progression (or regression), and complications. By integrating known biology regarding molecular signatures of each stage with recent advances in high-dimensional molecular data acquisition platforms (to assay the genome, epigenome, transcriptome, proteo...
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Introduction: The COVID-19 Pandemic has mandated limiting routine visit frequency for patients with chronic cardiovascular (CV) diseases. In patients with heart failure (HF) followed longitudinally, the period of clinical trial participation provides an opportunity to evaluate the influence of high-frequency per-protocol in-person visits compared t...
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Introduction: Exercise intolerance is common in cardiovascular disease and is a cardinal manifestation of heart failure with preserved ejection fraction (HFpEF). Decreased exercise capacity is often attributed to cardiac limitations, though HFpEF is increasingly recognized to be both a metabolic and a cardiovascular disorder. Hypothesis: Patients w...
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Introduction: Cardiopulmonary exercise testing (CPET) can help identify early stages of heart failure with preserved ejection fraction (HFpEF). We sought to determine if percent predicted peak oxygen pulse (%PredO 2 P, as defined by peak oxygen uptake/heart rate), a noninvasive measure combining stroke volume and peripheral oxygen extraction, could...
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Background: Increased left ventricular (LV) mass is associated with future adverse cardiovascular events including heart failure (HF). Both increased LV mass and HF disproportionately affect black individuals. To understand the mechanisms that drive disease, particularly in black individuals, we undertook a proteomic screen in a black cohort and co...
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Background: Whereas cardiovascular disease (CVD) metrics define risk in individuals above age 40 years, the earliest lesions of CVD appear well before this age. Despite the role of metabolism in CVD antecedents, studies in younger, biracial populations to define precise metabolic risk phenotypes are lacking. Methods: We studied 2330 white and Black...
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Background: While regular exercise exposure is associated with lower risk of cardiovascular disease (CVD) and mortality, mechanisms of exercise-mediated health benefits remain less clear. We used metabolite profiling before and after acute exercise to delineate the metabolic architecture of exercise response patterns in humans. Methods: Cardiopulmo...
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Background: Whether cardiovascular (CV) disease risk factors and biomarkers associate differentially with heart failure (HF) risk in men and women is unclear. Objectives: The purpose of this study was to evaluate sex-specific associations of CV risk factors and biomarkers with incident HF. Methods: The analysis was performed using data from 4...
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Exercise intolerance is a principal feature of heart failure with preserved ejection fraction (HFpEF), whether or not there is evidence of congestion at rest. The degree of functional limitation observed in HFpEF is comparable to patients with advanced heart failure and reduced ejection fraction. Exercise intolerance in HFpEF is characterized by im...
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Background: Ventilatory efficiency (minute ventilation required to eliminate carbon dioxide, VE/VCO2) during exercise potently predicts outcomes in advanced heart failure with reduced ejection fraction, but its prognostic significance for at-risk individuals with preserved left ventricular systolic function is unclear. We aimed to characterize mec...
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Background: We used a large-scale, high-throughput DNA aptamer-based discovery proteomic platform to identify circulating biomarkers of cardiac remodeling and incident heart failure (HF) in community-dwelling individuals. Methods: We evaluated 1895 FHS (Framingham Heart Study) participants (age 55±10 years, 54% women) who underwent proteomic pro...
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Purpose The early post-heart transplantation (HT) period entails frequent biopsies, which poses a unique challenge to administration of therapeutic anticoagulation when indicated. Heightened sensitivity to enoxaparin has been described primarily in lung transplant recipients but has not been assessed in relation to anti-Xa levels specifically in HT...
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Background: Abnormal pulmonary arterial pressure (PAP) responses to exercise have been described in select individuals; however, clinical and prognostic implications of exercise pulmonary hypertension (exPH) among broader samples remains unclear. Objectives: This study sought to investigate the association of exPH with clinical determinants and...
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Importance Sex differences in heart failure with preserved ejection fraction (HFpEF) have been established, but insights into the mechanistic drivers of these differences are limited. Objective To examine sex differences in cardiometabolic profiles and exercise hemodynamic profiles among individuals with HFpEF. Design, Setting, and Participants T...
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Introduction The expectations and outcomes of elective inotrope use as adjunctive therapy during heart failure (HF) hospitalization are not known. This prospective study aims to describe the intent and results of inotropic therapy initiated electively during HF hospitalization in hemodynamically stable patients. Methods We used a prospective, mult...
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Background: Low donor heart availability underscores the need to identify all potentially transplantable organs. We sought to determine whether pre-emptive administration of pangenotypic direct-acting antiviral therapy can safely prevent the development of chronic hepatitis C virus (HCV) infection in uninfected recipients of HCV-infected donor hea...
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Background: Heart failure with preserved ejection fraction (HFpEF) is common, yet there is currently no consensus on how to define HFpEF according to various society and clinical trial criteria. How clinical and hemodynamic profiles of patients vary across definitions is unclear. We sought to determine clinical characteristics, physiologic and pro...
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Purpose Donor availability has continued to be a major issue limiting the number of cardiac transplantations in the United States. Given this shortage, it is necessary to consider strategies aimed at increasing the donor pool. We sought to evaluate the expanded use of hepatitis C virus (HCV) donor hearts, and characterize early allograft function i...
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of Objectives Limited donor heart availability highlights the importance of identifying all potentially transplantable organs. We sought to determine if preemptive administration of pan-genotypic direct-acting antiviral therapy could prevent the development of chronic hepatitis C virus (HCV) infection while expediting access to donor hearts. Metho...
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Objectives: The authors evaluated the associations of obesity and cardiometabolic traits with incident heart failure with preserved versus reduced ejection fraction (HFpEF vs. HFrEF). Given known sex differences in HF subtype, we examined men and women separately. Background: Recent studies suggest that obesity confers greater risk of HFpEF vers...
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In Reply We thank McEvoy for his interest in our article.¹ Two important points are raised. First, there is a case made for repeated measurements of biomarkers. In particular, serial measures of high-sensitivity troponin might result in better risk prediction for future development of heart failure with preserved ejection fraction (HFpEF). We ackno...
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Background: Left ventricular diastolic dysfunction (DD) is common, particularly in women and older individuals, and it is associated with adverse cardiovascular outcomes. We evaluated the impact of age- and sex-specific diagnostic criteria on the assessment of DD in the community-based Framingham Heart Study. Methods and results: We estimated ag...
Data
Table S1. Additional Diastolic Dysfunction Classification Schemes Used for Sensitivity Analyses Table S2. Composition of Study Samples by Age Decade and Sex Table S3. Clinical Correlates of Mild or Greater Diastolic Dysfunction Table S4. Clinical Correlates of Moderate or Greater Diastolic Dysfunction Table S5. Clinical Correlates of LV Diastol...
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Objectives: This study sought to evaluate the course, correlates, and prognosis of longitudinal changes in left ventricular (LV) diastolic dysfunction (DD) in the community-based Framingham Heart Study. Background: Relationships of clinical risk factors to longitudinal progression of DD are incompletely understood. Methods: Diastolic function...
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Importance Nearly half of all patients with heart failure have preserved ejection fraction (HFpEF) as opposed to reduced ejection fraction (HFrEF), yet associations of biomarkers with future heart failure subtype are incompletely understood. Objective To evaluate the associations of 12 cardiovascular biomarkers with incident HFpEF vs HFrEF among a...
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Aims: While heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF) are well described, determinants and outcomes of heart failure with mid-range ejection fraction (HFmrEF) remain unclear. We sought to examine clinical and biochemical predictors of incident HFmrEF in the community. Methods and results: We pooled data from four...
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Objective: We evaluated the incidence of cardiovascular disease (CVD) in individuals whose blood pressure (BP) management strategy would change with adoption of recent US hypertension guidelines in two large, community-based cohorts with different racial and geographic compositions: the Framingham and Jackson Heart Studies (FHS and JHS). Methods:...
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A 34-year-old man with a history of ischemic cardiomyopathy requiring a heart transplant 11 months earlier presented to the hospital with subacute onset of shortness of breath. His posttransplant course was notable for moderate cellular rejection (International Society for Heart and Lung Transplantation grade 2R) within the first 6 weeks, which was...
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Aims: Chronic kidney disease (CKD) and microalbuminuria are associated with incident heart failure (HF), but their relative contributions to HF with preserved vs. reduced EF (HFpEF and HFrEF) are unknown. We sought to evaluate the associations of CKD and microalbuminuria with incident HF subtypes in the community-based Framingham Heart Study (FHS)...
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The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline advocated several changes from the previous Adult Treatment Panel III guidelines. Assuming full implementation, the 2013 ACC/AHA guideline would identify ≈13 million Americans as newly eligible for consideration of statin therapy. Three features of th...
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Background Circulating Galectin‐3 (Gal‐3) concentrations are associated with an increased incidence of heart failure, atrial fibrillation, chronic kidney disease, and mortality. Recent evidence suggests that Gal‐3 may also be an important modulator of cardiometabolic traits such as adiposity, insulin resistance, and hyperglycemia. We examined the a...
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Background: The American Heart Association Cardiovascular Health (CVH) score is inversely associated with cardiovascular disease, but its relations to cardiac remodeling traits and heart failure (HF) incidence have not been examined. Methods and results: A 14-point score was constructed for each participant based on the presence of poor, interme...
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Background and purpose: Exhaled carbon monoxide (CO) is associated with cardiometabolic traits, subclinical atherosclerosis, and cardiovascular disease, but its specific relations with stroke are unexplored. We related exhaled CO to magnetic resonance imaging measures of subclinical cerebrovascular disease cross-sectionally and to incident stroke/...
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Introduction: The Eighth Joint National Committee (JNC 8) recently recommended important changes to blood pressure (BP) management. Specifically, JNC 8 endorsed relaxing systolic BP (SBP) targets for adults aged ≥60 years and individuals with diabetes or kidney disease. We compared the incidence of cardiovascular disease (CVD) in individuals whose...
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Introduction: Exhaled carbon monoxide (CO) is associated with cardiometabolic traits, subclinical atherosclerosis, and cardiovascular disease, but its specific relations with stroke have not been explored. Hypothesis: We hypothesized that exhaled CO is related to MRI measures of subclinical cerebrovascular disease cross-sectionally, and to incident...
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Introduction: Chronic lung disease and heart failure have been reported to be associated, but the pathophysiologic relations between cardiac and pulmonary structure and function in the community are not well understood. We evaluated cross-sectional associations between measures of pulmonary function and echocardiographic traits related to cardiac r...
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Heart failure prevention is an important public health goal. Increased physical activity and exercise may help to prevent heart failure, as they are associated with reduced heart failure incidence and potentially act through a variety of mechanisms to slow disease progression. Increased physical activity, higher cardiorespiratory fitness, and lower...
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Introduction: The American Heart Association Heart Healthy score (AHA score or Life’s Simple 7™) is inversely associated with atherosclerotic vascular disease including heart failure (HF), but its relationship to adverse left ventricle (LV) geometric patterns (known precursors of HF) is unknown. LV geometry can be categorized into 4 distinct patter...
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A 63-year-old man with a history of systemic hypertension presented to the emergency department for evaluation of acute chest pain and shortness of breath that occurred while he was shoveling heavy snow. His heart rate was 114 bpm and blood pressure was 142/78 mm Hg. Peripheral oxyhemoglobin saturation was 91%, and his respiratory rate was 20 breat...

Citations

... Metabolomics has been applied to studies on T2D in several population studies in recent years [87]. Potentially, new metabolites and pathways can characterize pathophysiological alterations in T2D [88,89]. ...
... The consistent association between low KCO (and DL CO ) and high nadir _ VE/ _ VCO 2 in the entire cohort is believed to point to pulmonary microvascular dysfunction (8,(33)(34)(35). Based on several lines of evidence (3,10,13,35,36), reduced pulmonary microvascular reserves and impaired ventilatory efficiency (related to _ V= _ Q abnormalities) would be expected to contribute to increased inspiratory neural drive and troublesome dyspnea at a relatively low _ VO 2peak , even in patients with mild airflow obstruction. ...
... 6 Furthermore, evaluation of changes in average daily steps can help lend support for a causal relation of step counts with health outcomes in observational studies, which has not been well investigated, except for a recent study on cardiorespiratory fitness. 7 Smartphones currently are able to capture step counts continuously and thus can collect data on ...
... Classical heritability analyses use variance models that partition the phenotypic variance into the additive genetic and environmental components (See supplement for details) (Nayor et al., 2021). These models rely on the N × N matrix of CR values (where N is the sample size), known as the pedigree or kinship matrix to map the sharing of genetic variance among subjects. ...
... Studies of larger numbers of individuals are necessary also to explore the potential of using metabolomics to help define specific T2D subgroups that have implications for prognosis and treatment response [90]. Metabolomics is likely to be an important part of the toolkit for precision diabetes care, but approaches that integrate multiple "omic" techniques (e.g., genomics, transcriptomics, epigenomics, microbiome, proteomics [100]) may have the greatest potential to advance the screening, prevention, and treatment of patients with diabetes. ...
... The risk of cardiovascular events can be stratified using electronic algorithms such as the US Framingham score (http://cvdrisk.nhlbi.nih. gov) [50,51]. The European Society of Cardiology (ESC) offers an equivalent algorithm (SCORE -Systematic Coronary Risk Evaluation), which quantifies risk of cardiovascular events in the general population [52]. ...
... В исследовании Katz DH, et al. (2021) тестировались 110 белков, взаимосвязанных с увеличением ИММЛЖ, и 13 протеинов, отражающих увеличение риска госпитализаций, связанных с ХСН, в общей популяции белой и негроидной рас [21]. Цистатин C и NT-proBNP продемонстрировали устойчивые ассоциации как с ИММЛЖ, так с риском госпитализаций, связанных с ХСН, у чернокожих и белых людей. ...
... It's an anti-inflammatory hormone that has a negative relationship with the levels of IL-6 and CRP in overweight people (lesser adiponectin with raised inflammatory intermediaries) [70]. The results were supplementarily supported by the fact that obese people who lost weight saw their IL-6, CRP, and adiponectin levels reverse [75]. Obesity-related metabolic and cardiovascular problems are exacerbated by the reciprocal and inequality connection of pro-and anti-inflammatory adipokines [76]. ...
... Maximal effort CPET was performed on the same cycle ergometer (Lode, the Netherlands) and breath-by-breath gas exchange values were measured by the same metabolic cart (MedGraphics, St. Paul, MN). Data were analyzed according to previously published methods [11][12][13]. A maximal effort study is defined by a RER > 1.0. ...
... Heart failure with preserved ejection fraction (HFpEF) is characterized by left ventricular diastolic dysfunction (LVDD) and cardiac remodeling (fibrosis, inflammation, and hypertrophy), which has become a major cause of hospitalization for the elders [6][7][8]. Hypertension, diabetes and obesity were risk factors for HFpEF and were associated with arterial stiffness raise [9,10]. It was reported that microvascular dysfunction and chronic low-grade inflammation have been proposed to participate in HFpEF development [11]. ...