Publications by authors named "Douglas L Mann"

314 Publications

Unsupervised cluster analysis of patients with recovered left ventricular ejection fraction identifies unique clinical phenotypes.

PLoS One 2021 18;16(3):e0248317. Epub 2021 Mar 18.

Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America.

Background: Patients with heart failure (HF) with recovered ejection fraction (HFrecEF) are a recently identified cohort that are phenotypically and biologically different from HFrEF and HFpEF patients. Whether there are unique phenotypes among HFrecEF patients is not known.

Methods: We studied all patients at a large medical center, who had an improvement in LVEF from ≤ 35% to ≥ 50% (LVrecEF) between January 1, 2005 and December 31, 2013. We identified a set of 11 clinical variables and then performed unsupervised clustering analyses to identify unique clinical phenotypes among patients with LVrecEF, followed by a Kaplan-Meier analysis to identify differences in survival and the proportion of LVrecEF patients who maintained an LVEF ≥ 50% during the study period.

Results: We identified 889 patients with LVrecEF who clustered into 7 unique phenotypes ranging in size from 37 to 420 patients. Kaplan-Meier analysis demonstrated significant differences in mortality across clusters (logrank p<0.0001), with survival ranging from 14% to 87% at 1000 days, as well as significant differences in the proportion of LVrecEF patients who maintained an LVEF ≥ 50%.

Conclusion: There is significant clinical heterogeneity among patients with LVrecEF. Clinical outcomes are distinct across phenotype clusters as defined by clinical cardiac characteristics and co-morbidities. Clustering algorithms may identify patients who are at high risk for recurrent HF, and thus be useful for guiding treatment strategies for patients with LVrecEF.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248317PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7971566PMC
March 2021

Publisher Correction: Reappraising the role of inflammation in heart failure.

Nat Rev Cardiol 2021 Mar 12. Epub 2021 Mar 12.

Center for Cardiovascular Research, Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.

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http://dx.doi.org/10.1038/s41569-021-00534-3DOI Listing
March 2021

Associations of methyl donor and methylation inhibitor levels during anti-oxidant therapy in heart failure.

J Physiol Biochem 2021 Feb 17. Epub 2021 Feb 17.

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Redox balance and methylation are crucial to homeostasis and are linked by the methionine-homocysteine cycle. We examined whether differences in methylation potential, measured as plasma levels of S-adenosyl methionine (SAM) and S-adenosyl homocysteine (SAH), occur at baseline and during anti-oxidant therapy with the xanthine oxidase inhibitor allopurinol in patients with heart failure with reduced ejection fraction. We analyzed plasma samples collected at baseline and 24 weeks in the Xanthine Oxidase Inhibition for Hyperuricemic Heart Failure Patients (EXACT-HF) study, which randomized patients with heart failure with reduced ejection fraction to allopurinol or placebo. Associations between plasma levels of SAM, SAH, SAM/SAH ratio, and outcomes, including laboratory markers and clinical events, were assessed. Despite randomization, median SAM levels were significantly lower at baseline in the allopurinol group. SAH levels at 24 weeks, and change in SAM from baseline to week 24, were significantly higher in the group of patients randomized to allopurinol compared to the placebo group. A significant correlation was observed between change in SAH levels and change in plasma uric acid (baseline to 24-week changes) in the allopurinol group. There were no significant associations between levels of SAM, SAH, and SAM/SAH ratio and clinical outcomes. Our results demonstrate significant biological variability in SAM and SAH levels at baseline and during treatment with an anti-oxidant and suggest a potential mechanism for the lack of efficacy observed in trials of anti-oxidant therapy. These data also highlight the need to explore personalized therapy for heart failure.
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http://dx.doi.org/10.1007/s13105-021-00797-xDOI Listing
February 2021

Predictive Value of Cardiopulmonary Exercise Testing Parameters in Ambulatory Advanced Heart Failure.

JACC Heart Fail 2021 Mar 3;9(3):226-236. Epub 2021 Feb 3.

Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address:

Objectives: This study sought to determine cardiopulmonary exercise (CPX) predictors of the combined outcome of durable mechanical circulatory support (MCS), transplantation, or death at 1 year among patients with ambulatory advanced heart failure (HF).

Background: Optimal CPX predictors of outcomes in contemporary ambulatory advanced HF patients are unclear.

Methods: REVIVAL (Registry Evaluation of Vital Information for ventricular assist devices [VADs] in Ambulatory Life) enrolled 400 systolic HF patients, INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profiles 4-7. CPX was performed by 273 subjects 2 ± 1 months after study enrollment. Discriminative power of maximal (peak oxygen consumption [peak VO]; VO pulse, circulatory power [CP]; peak systolic blood pressure • peak VO], peak end-tidal pressure CO [PEtCO], and peak Borg scale score) and submaximal CPX parameters (ventilatory efficiency [VE/VCO slope]; VO at anaerobic threshold [VOAT]; and oxygen uptake efficiency slope [OUES]) to predict the composite outcome were assessed by univariate and multivariate Cox regression and Harrell's concordance statistic.

Results: At 1 year, there were 39 events (6 transplants, 15 deaths, 18 MCS implantations). Peak VO, VOAT, OUES, peak PEtCO, and CP were higher in the no-event group (all p < 0.001), whereas VE/VCO slope was lower (p < 0.0001); respiratory exchange ratio was not different. CP (hazard ratio [HR]: 0.89; p = 0.001), VE/VCO slope (HR: 1.05; p = 0.001), and peak Borg scale score (HR: 1.20; p = 0.005) were significant predictors on multivariate analysis (model C-statistic: 0.80).

Conclusions: Among patients with ambulatory advanced HF, the strongest maximal and submaximal CPX predictor of MCS implantation, transplantation, or death at 1 year were CP and VE/VCO respectively. The patient-reported measure of exercise effort (Borg scale score) contributed substantially to the prediction of outcomes, a surprising and novel finding that warrants further investigation. (Registry Evaluation of Vital Information for VADs in Ambulatory Life [REVIVAL]; NCT01369407).
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http://dx.doi.org/10.1016/j.jchf.2020.11.008DOI Listing
March 2021

Will COVID-19 Transform Translational Medicine?

Authors:
Douglas L Mann

JACC Basic Transl Sci 2020 Dec 28;5(12):1261-1263. Epub 2020 Dec 28.

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http://dx.doi.org/10.1016/j.jacbts.2020.11.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775954PMC
December 2020

RNA Vaccines for COVID-19: 5 Things Every Cardiologist Should Know.

JACC Basic Transl Sci 2020 Dec 23;5(12):1240-1243. Epub 2020 Nov 23.

Center for Cardiovascular Research, Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.

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http://dx.doi.org/10.1016/j.jacbts.2020.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682931PMC
December 2020

Remembering Dr. James T. Willerson.

JACC Basic Transl Sci 2020 Oct 26;5(10):1054-1055. Epub 2020 Oct 26.

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http://dx.doi.org/10.1016/j.jacbts.2020.09.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591926PMC
October 2020

Proteomic Signatures of Heart Failure in Relation to Left Ventricular Ejection Fraction.

J Am Coll Cardiol 2020 10;76(17):1982-1994

Center for Cardiovascular Research, Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri. Electronic address:

Background: There is a growing recognition of the inherent limitations of the use of the left ventricular ejection fraction (LVEF) to accurately phenotype patients with heart failure (HF).

Objectives: The authors sought to identify unique proteomic signatures for patients with HF with reduced ejection fraction (HFrEF), HF with a midrange LVEF (HFmrEF), and HF with preserved ejection fraction (HFpEF), as well as to identify molecular differences between patients with ischemic and nonischemic HF.

Methods: We used high-content aptamer-based proteomics technology (SOMAscan) to interrogate the blood proteome of age- and sex-matched patients with HF within different LVEF groups.

Results: Within the Washington University Heart Failure Registry, we identified age/sex-matched patients within 3 LVEF categories: HFrEF (LVEF <40%), HFmrEF (LVEF 40% to 50%), and HFpEF (LVEF >50%). We found that patients with HFrEF, HFmrEF, and HFpEF had unique variations in circulating proteins that reflected distinct biological pathophysiologies. Bioinformatics analysis revealed that there were biological themes that were unique to patients with HFrEF, HFpEF, or HFmrEF. Comparative analyses of patients with HFmrEF with improved LVEF and patients with HFmrEF with unchanged LVEF revealed marked differences between these 2 patient populations and indicated that patients with recovered LVEF are more similar to patients with HFpEF than to patients with HFrEF. Moreover, there were marked differences in the proteomic signatures of patients with ischemic and nonischemic HF.

Conclusions: Viewed together, these findings suggest that it may be possible to use high-content multiplexed proteomics assays in combination with the clinical assessment of LVEF to more accurately identify clinical phenotypes of patients with HF.
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http://dx.doi.org/10.1016/j.jacc.2020.08.061DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584807PMC
October 2020

Device Autonomic Regulation Therapy in Patients with Heart Failure with Reduced Ejection Fraction.

J Atr Fibrillation 2020 Jun-Jul;13(1):2409. Epub 2020 Jun 30.

The University of Iowa Hospitals.

Heart failure with reduced ejection fraction (HFrEF) is a common, incompletely treatable, complex, progressive, and severe medical problem despite guideline-directed medical therapy. HFrEF is associated with sympathetic activation and parasympathetic inhibition; these reflexive processes may ultimately be maladaptive and exacerbate or even perpetuate the problem. Attempts to regulate autonomic tone during HFrEF in animal models and in humans has shown promise with beneficial effects that include improvement in symptoms, mitigation of arrhythmic events, reduction in mortality, and correction in hemodynamics. Several modalities to regulate autonomic tone such as unilateral parasympathetic nerve activation, baroreceptor activation, renal nerve ablation and spinal cord stimulation have been investigated. Although they demonstrated some benefit, the long-term efficacy in HFrEF has not been proven. Considering specific limitations of each modality, to draw definitive conclusions is impossible at this time. Here, we review the present state-of-the-art hiterature? of device of autonomic regulation therapy to affect outcomes in HFrEF.
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http://dx.doi.org/10.4022/jafib.2409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533145PMC
June 2020

Cardiac Sympathetic-Parasympathetic Interaction: The Endless Story of Yin and Yang.

JACC Basic Transl Sci 2020 Aug 24;5(8):811-814. Epub 2020 Aug 24.

Center for Cardiovascular Research, Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.

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http://dx.doi.org/10.1016/j.jacbts.2020.07.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452234PMC
August 2020

Improvement of ejection fraction and mortality in ischaemic heart failure.

Heart 2020 Aug 25. Epub 2020 Aug 25.

Cardiovascular Division, Washington University in St. Louis, St. Louis, Missouri, USA

Objective: The frequency and predictors of improvement in left ventricular ejection fraction (LVEF) in ischaemic cardiomyopathy and its association with mortality is poorly understood. We sought to assess the predictors of LVEF improvement ≥10% and its effect on mortality.

Methods: We compared characteristics of patients enrolled in The Surgical Treatment for Ischaemic Heart Failure (STICH) trial with and without improvement of LVEF ≥10% at 24 months. A logistic regression model was constructed to determine the independent predictors of LVEF improvement. A Cox proportional hazards model was created to assess the independent association of improvement in LVEF ≥10% with mortality.

Results: Of the 1212 patients enrolled in STICH, 618 underwent echocardiographic assessment of LVEF at baseline and 24 months. Of the patients randomised to medical therapy plus coronary artery bypass graft surgery (CABG), 58 (19%) had an improvement in LVEF 10% compared with 51 (16%) patients assigned to medical therapy alone (p=0.30). Independent predictors of LVEF improvement 10% included prior myocardial infarction (OR 0.44, 95% CI: 0.28 to 0.71, p=0.001) and lower baseline LVEF (OR 0.94, 95% CI: 0.91 to 0.97, p<0.001). Improvement in LVEF 10% (HR 0.61, 95% CI: 0.44 to 0.84, p=0.004) and randomisation to CABG (HR 0.72, 95% CI: 0.57 to 0.90, p=0.004) were independently associated with a reduced hazard of mortality.

Conclusions: Improvement of LVEF ≥10% at 24 months was uncommon in patients with ischaemic cardiomyopathy, did not differ between patients assigned to CABG and medical therapy or medical therapy alone and was independently associated with reduced mortality.

Trial Registration Number: NCT00023595.
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http://dx.doi.org/10.1136/heartjnl-2020-316975DOI Listing
August 2020

Ischemia reperfusion injury provokes adverse left ventricular remodeling in dysferlin-deficient hearts through a pathway that involves TIRAP dependent signaling.

Sci Rep 2020 08 24;10(1):14129. Epub 2020 Aug 24.

Center for Cardiovascular Research, Cardiovascular Division, Division of Cardiology, Washington University School of Medicine, 660 S. Euclid Ave,, Campus Box 8086, St. Louis, MO, 63110, USA.

Cardiac myocytes have multiple cell autonomous mechanisms that facilitate stabilization and repair of damaged sarcolemmal membranes following myocardial injury. Dysferlin is a protein which facilitates membrane repair by promoting membrane resealing. Although prior studies have shown that dysferlin-deficient (Dysf) mouse hearts have an impaired recovery from acute ischemia/reperfusion (I/R) injury ex vivo, the role of dysferlin in mediating the recovery from myocardial injury in vivo is unknown. Here we show that Dysf mice develop adverse LV remodeling following I/R injury secondary to the collateral damage from sustained myocardial inflammation within the infarct zone. Backcrossing Dysf mice with mice lacking signaling through the Toll-Interleukin 1 Receptor Domain-Containing Adaptor Protein (Tirap), attenuated inflammation and abrogated adverse LV remodeling following I/R injury. Subsequent studies using Poloxamer 188 (P188), a membrane resealing reagent, demonstrated that P188 did not attenuate inflammation nor prevent adverse LV remodeling in Dysf mice following I/R injury. Viewed together these studies reveal a previously unappreciated role for the importance of membrane sealing and the resolution of inflammation following myocardial injury.
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http://dx.doi.org/10.1038/s41598-020-71079-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445276PMC
August 2020

Heart Failure With Recovered Left Ventricular Ejection Fraction: JACC Scientific Expert Panel.

J Am Coll Cardiol 2020 08;76(6):719-734

Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri. Electronic address:

Reverse left ventricular (LV) remodeling and recovery of LV function are associated with improved clinical outcomes in patients with heart failure with reduced ejection fraction. A growing body of evidence suggests that even among patients who experience a complete normalization of LV ejection fraction, a significant proportion will develop recurrent LV dysfunction accompanied by recurrent heart failure events. This has led to intense interest in understanding how to manage patients with heart failure with recovered ejection fraction (HFrecEF). Because of the lack of a standard definition for HFrecEF, and the paucity of clinical data with respect to the natural history of HFrecEF patients, there are no current guidelines on how these patients should be followed up and managed. Accordingly, this JACC Scientific Expert Panel reviews the biology of reverse LV remodeling and the clinical course of patients with HFrecEF, as well as provides guidelines for defining, diagnosing, and managing patients with HFrecEF.
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http://dx.doi.org/10.1016/j.jacc.2020.05.075DOI Listing
August 2020

Developmental changes in myocardial B cells mirror changes in B cells associated with different organs.

JCI Insight 2020 08 20;5(16). Epub 2020 Aug 20.

Center for Cardiovascular Research, Cardiovascular Division, Department of Medicine.

The naive heart harbors a population of intravascular B cells that make close contact with the cardiac microvasculature. However, the timing of their appearance and their organ specificity remain unknown. To address this knowledge gap, we performed a systematic analysis of B cells isolated from the myocardium and other organs, from embryonic life to adulthood. We found that the phenotype of myocardial B cells changed dynamically during development. While neonatal heart B cells were mostly CD11b+ and CD11b- CD21-CD23-, adult B cells were predominantly CD11b-CD21+CD23+. Histological analysis and intravital microscopy of lung and liver showed that organ-associated B cells in contact with the microvascular endothelium were not specific to the heart. Flow cytometric analysis of perfused hearts, livers, lungs, and spleen showed that the dynamic changes in B cell subpopulations observed in the heart during development mirrored changes observed in the other organs. Single cell RNA sequencing (scRNAseq) analysis of B cells showed that myocardial B cells were part of a larger population of organ-associated B cells that had a distinct transcriptional profile. These findings broaden our understanding of the biology of myocardial-associated B cells and suggest that current models of the dynamics of naive B cells during development are incomplete.
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http://dx.doi.org/10.1172/jci.insight.139377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455131PMC
August 2020

Sacubitril/Valsartan in Advanced Heart Failure With Reduced Ejection Fraction: Rationale and Design of the LIFE Trial.

JACC Heart Fail 2020 10 10;8(10):789-799. Epub 2020 Jun 10.

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

The PARADIGM-HF (Prospective Comparison of Angiotensin II Receptor Blocker Neprilysin Inhibitor With Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial reported that sacubitril/valsartan (S/V), an angiotensin receptor-neprilysin inhibitor, significantly reduced mortality and heart failure (HF) hospitalization in HF patients with a reduced ejection fraction (HFrEF). However, fewer than 1% of patients in the PARADIGM-HF study had New York Heart Association (NYHA) functional class IV symptoms. Accordingly, data that informed the use of S/V among patients with advanced HF were limited. The LIFE (LCZ696 in Hospitalized Advanced Heart Failure) study was a 24-week prospective, multicenter, double-blinded, double-dummy, active comparator trial that compared the safety, efficacy, and tolerability of S/V with those of valsartan in patients with advanced HFrEF. The trial planned to randomize 400 patients ≥18 years of age with advanced HF, defined as an EF ≤35%, New York Heart Association functional class IV symptoms, elevated natriuretic peptide concentration (B-type natriuretic peptide [BNP] ≥250 pg/ml or N-terminal pro-B-type natriuretic peptide [NT-proBNP] ≥800 pg/ml), and ≥1 objective finding of advanced HF. Following a 3- to 7-day open label run-in period with S/V (24 mg/26 mg twice daily), patients were randomized 1:1 to S/V titrated to 97 mg/103 mg twice daily versus 160 mg of V twice daily. The primary endpoint was the proportional change from baseline in the area under the curve for NT-proBNP levels measured through week 24. Secondary and tertiary endpoints included clinical outcomes and safety and tolerability. Because of the COVID-19 pandemic, enrollment in the LIFE trial was stopped prematurely to ensure patient safety and data integrity. The primary analysis consists of the first 335 randomized patients whose clinical follow-up examination results were not severely impacted by COVID-19. (Entresto [LCZ696] in Advanced Heart Failure [LIFE STUDY] [HFN-LIFE]; NCT02816736).
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http://dx.doi.org/10.1016/j.jchf.2020.05.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286640PMC
October 2020

The National Institute of Allergy and Infectious Diseases Decision to Stop the Adaptive COVID-19 Trial: On Solid Ethical and Scientific Grounds.

JACC Basic Transl Sci 2020 Jun 26;5(6):645-647. Epub 2020 May 26.

Bioethics Research Center, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri.

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http://dx.doi.org/10.1016/j.jacbts.2020.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250548PMC
June 2020

Comorbid Conditions and Health-Related Quality of Life in Ambulatory Heart Failure Patients: REVIVAL (Registry Evaluation of Vital Information for VADs in Ambulatory Life REVIVAL).

Circ Heart Fail 2020 05 18;13(5):e006858. Epub 2020 May 18.

Division of Cardiovascular Disease, University of Michigan, Ann Arbor (T.M.C., M.P., K.D.A.).

Background: Patients with heart failure (HF) often have multiple chronic conditions that may impact health-related quality of life (HRQOL) despite HF therapy. We sought to determine the association between noncardiac comorbidities and HRQOL in ambulatory patients with advanced HF.

Methods: Baseline data from 373 subjects in REVIVAL (Registry Evaluation of Vital Information for Ventricular Assist Devices in Ambulatory Life) were analyzed using multivariable general linear models to evaluate the relationship between comorbidities and HRQOL (EuroQol Visual Analogue Scale, EQ-5D-3L Index Score, and Kansas City Cardiomyopathy Questionnaire). The primary independent variables were a comorbidity index (sum of 14 noncardiac conditions), a residual comorbidity index (without depression), and depression alone. The median (25th to 75th percentile) number of comorbidities was 3 (2-4).

Results: Increasing comorbidity burden was associated with a reduction in generic (EQ-5D Index, =0.005) and HF-specific (Kansas City Cardiomyopathy Questionnaire, =0.001) HRQOL. The residual comorbidity index was not associated with HRQOL when depression included in the model independently, while depression was associated with HRQOL across all measures. Participants with depression (versus without) scored on average 13 points (95% CI, 8-17) lower on the EuroQol Visual Analogue Scale, 0.15 points (95% CI, 0.12-0.18) lower on the EQ-5D Index, and 24.9 points (95% CI, 21.2-28.5) lower on the Kansas City Cardiomyopathy Questionnaire overall summary score.

Conclusions: While noncardiac comorbidities were prevalent in ambulatory advanced HF patients, only depression was associated with decreased generic and HF-specific HRQOL. Other than depression, the presence of noncardiac comorbidities should not impact expected gains in HRQOL following ventricular assist device implantation, provided the conditions are not a contraindication to implant. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01369407.
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http://dx.doi.org/10.1161/CIRCHEARTFAILURE.119.006858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458108PMC
May 2020

2019 Young Author Award Winner.

Authors:
Douglas L Mann

JACC Basic Transl Sci 2020 Apr 27;5(4):414. Epub 2020 Apr 27.

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http://dx.doi.org/10.1016/j.jacbts.2020.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188871PMC
April 2020

2019 Young Author Award Winner.

Authors:
Douglas L Mann

JACC Basic Transl Sci 2020 Apr 27;5(4):413. Epub 2020 Apr 27.

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http://dx.doi.org/10.1016/j.jacbts.2020.03.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188866PMC
April 2020

The Emerging Role of B Lymphocytes in Cardiovascular Disease.

Annu Rev Immunol 2020 04;38:99-121

Center for Cardiovascular Research, Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA; email:

B cells are traditionally known for their ability to produce antibodies in the context of adaptive immune responses. However, over the last decade B cells have been increasingly recognized as modulators of both adaptive and innate immune responses, as well as players in an important role in the pathogenesis of a variety of human diseases. Here, after briefly summarizing our current understanding of B cell biology, we present a systematic review of the literature from both animal models and human studies that highlight the important role that B lymphocytes play in cardiac and vascular disease. While many aspects of B cell biology in the vasculature and, to an even greater extent, in the heart remain unclear, B cells are emerging as key regulators of cardiovascular adaptation to injury.
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http://dx.doi.org/10.1146/annurev-immunol-042617-053104DOI Listing
April 2020

COVID-19 Clinical Trials: A Primer for the Cardiovascular and Cardio-Oncology Communities.

JACC CardioOncol 2020 Jun 17;2(2):254-269. Epub 2020 Apr 17.

Department of Medicine, Division of Cardiology, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, Missouri.

The coronavirus disease-2019 (COVID-19) pandemic has resulted in a proliferation of clinical trials designed to slow the spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Many therapeutic agents that are being used to treat patients with COVID-19 are repurposed treatments for influenza, Ebola, or for malaria that were developed decades ago and are unlikely to be familiar to the cardiovascular and cardio-oncology communities. Here, we provide a foundation for cardiovascular and cardio-oncology physicians on the front line providing care to patients with COVID-19, so that they may better understand the emerging cardiovascular epidemiology and the biological rationale for the clinical trials that are ongoing for the treatment of patients with COVID-19.
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http://dx.doi.org/10.1016/j.jaccao.2020.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164888PMC
June 2020

COVID-19 Clinical Trials: A Primer for the Cardiovascular and Cardio-Oncology Communities.

JACC Basic Transl Sci 2020 May 16;5(5):501-517. Epub 2020 Apr 16.

Department of Medicine, Division of Cardiology, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, Missouri.

The coronavirus disease-2019 (COVID-19) pandemic has resulted in a proliferation of clinical trials designed to slow the spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Many therapeutic agents that are being used to treat patients with COVID-19 are repurposed treatments for influenza, Ebola, or for malaria that were developed decades ago and are unlikely to be familiar to the cardiovascular and cardio-oncology communities. Here, the authors provide a foundation for cardiovascular and cardio-oncology physicians on the front line providing care to patients with COVID-19, so that they may better understand the emerging cardiovascular epidemiology and the biological rationale for the clinical trials that are ongoing for the treatment of patients with COVID-19.
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http://dx.doi.org/10.1016/j.jacbts.2020.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162643PMC
May 2020

Incident Heart Failure in Chronic Inflammatory Diseases: Is it Time to Rethink Stage A Heart Failure?

Authors:
Douglas L Mann

JACC Heart Fail 2020 06 8;8(6):499-500. Epub 2020 Apr 8.

Center for Cardiovascular Research, Washington University, St. Louis, Missouri. Electronic address:

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http://dx.doi.org/10.1016/j.jchf.2020.02.006DOI Listing
June 2020