bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C10-8: ANALYSIS OF OFFICE SYSTOLIC BLOOD PRESSURE MEASURED BY VARIOUS METHODS IN DIFFERENT CONDITIONS
Authors: Muzik Jan , Peleska Jan , Holubova Anna , Camek Rene , Navratil Vojtech , Fiala Dominik , Doksansky Marek , Hana Karel , Kaspar Jan , Vranka Jakub , Hronova Julie , Chrolenko Anna , Jiravova Maria , Dolezil David , Jozifova Marie
Published: January 2023

Objectives:

The aim of the study is to confirm results of our pilot study (presented ESH/ISH Glasgow 2021) and perform a detailed analysis of the larger sample size.

Design and Method:

BP monitors Nissei DM-3000 (both auscultatory and oscillometric), SunTech-40 and Fora P30 Plus, in both conditions, were used for office BP measurements (BPM) in triplets by one physician at the entry and exit phase of the 3 months home BP telemonitoring study. 122 treated patients with essential hypertension, aged 24–85 years, 60% of males, were referred by their physicians as well controlled. Their therapy was not changed during this study. Those starting BPMs in the office at the entry, started BPMs in the quiet room at the exit, and vice versa, approximately at the same time. On the other hand, the order of methods used both in the office and in the quiet room was not changed. Effects of gender, age, BMI, order of BPM (physician/quiet room - P/QR, order of BPM in triplets) and methods of BPM on systolic BP at the entry and exit of the study were evaluated. Linear mixed models with random effect of a patient were used for the statistical analysis of data.

Results:

Systolic BP (SBP) values significantly depended on the morning medication (yes, no, p = 0.005) and the method of BPM used (p < 0.001). SBP values of various methods varied in dependence on the phase of the study (entry, exit, p < 0.001), age (< 60,> = 60, p < 0.001) and BMI (< 30,> = 30, p < 0.001). SBP was not dependent on the measurement order P/QR significantly. If each method of BPM was analyzed independently on other ones, only auscultatory SBP depended significantly on the measurement order in triplets (p < 0.001). Decrease of mean SBP+SD from the first to the third BPM was seen only at the entry phase of the study - 128.8 + 13.0, 126.0 + 13.5 and 124.7 + 12.6 mmHg.

Conclusions:

Significant differences between BPM methods used in systolic BP measurement were found. Fora BP monitor showed especially higher mean SBP values probably due to a stress from the first contact with a telemonitoring equipment in the quiet room only at the entry (132.0 + 12.9) vs. (127.3 + 12.3) mmHg. We did not prove any influence of measurement order P/QR even when Fora was used in both attended and unattended conditions.

If an independent analysis of BPM methods was used, only auscultatory SBP depended significantly on the measurement order in triplets, whereas no significant influence was shown in oscillometric methods.
PS-C11-4: UPPER ARM SBP DECLINE ASSOCIATED WITH REPEATED CUFF-OSCILLOMETRIC INFLATION SIGNIFICANTLY CORRELATED WITH ARTERIAL STIFFNESS INDEX
Authors: Kawaura Noriyuki , Ishigami Tomoaki , Tamura Kouichi
Published: January 2023

Background:

It is unknown how the repeated cuff-oscillometric inflations with blood pressure measurements are related to arterial stiffness and central arterial pressure, and how changes to the novel indexes of arterial stiffness, AVI (arterial velocity pulse index) and API (arterial pressure volume index) will be brought about by the repeated cuff-oscillometric inflations.

Aim:

We evaluated the clinical significance of the new non-invasive vascular indexes AVI and API in outpatients with various clinical backgrounds to explore potential utilities of these two indexes by using repeated cuff-oscillometric inflation in actual clinical settings.

Methods:

In 250 consecutive outpatients, we performed a cross-sectional, retrospective, single center, observational study to investigate arterial stiffness using blood pressure and the AVI and API with three times repeated measurements that used multifunctional blood pressure monitoring device, AVE-1500 (Shisei Datum, Tokyo, Japan).

Results:

Of the 250 enrolled subjects, 236 were analyzed. 62.7% of the patients were male, with an overall mean age of 68.1 ± 12.1. The mean SBP (systolic blood pressure) and DBP (diastolic blood pressure) of first time measurement were 133.07 ± 21.20 mmHg and 73.94 ± 13.56 mmHg, respectively. The mean AVI and API of first time measurement were 23.83 ± 8.30 and 31.12 ± 7.86, respectively. In each measurement with repeated measurements of BP (SBP/DBP), AVI and API, although DBP and AVI did not have the significant changes throughout the measurements, both SBP and API decreased significantly according to the measurement orders.

Conclusions:

In this study, upper arm SBP decline associated with repeated cuff-oscillometric inflation significantly correlated with arterial stiffness index. Furthermore, it would suggest that arterial stiffness could be predicted by the changes in repeated SBP measurements.
PS-C13-7: THE ROLE OF WATER HAMMER PRESSURE IN THE GLOMERULAR PODOCYTE SHEDDING AND RENAL PROGNOSIS
Authors: Abe Makoto , Kaiga Akiko , Ohira Takehiro , Ishimitsu Toshihiko , Tojo Akihiro
Published: January 2023

Objective:

Urinary podocyte excretion is related to a reduction in glomerular podocyte numbers, glomerulosclerosis, and urinary protein selectivity. To elucidate the factors of urinary podocyte shedding and renal prognosis, we examined urinary podocytes in 120 renal biopsy patients.

Design and method:

Podocytes were identified in urinary sediments stained with fluorescent-labelled anti-podocalyxin antibodies in ten high power fields. The amounts of protein bands, separated by SDS-polyacrylamide gel electrophoresis, were calculated using an image software program. The renal prognosis, including induction of hemodialysis or 30% reduction in eGFR, was investigated.

Results:

Urinary podocyte excretion showed a higher positive correlation with albumin excretion compared to IgG, prealbumin, and transferrin, but not with low molecular weight proteins, including beta2-microglobulin and alpha1-microglobulin. The hemodynamic pressure on the glomerular capillary wall, including products of pulse pressure and pulse rate (water hammer pressure), was positively correlated with urinary podocyte excretion. Urinary podocyte excretion and Tamm-Horsfall protein were independent risk factors for renal prognosis.

Conclusions:

Urinary podocytes shed from glomerular capillaries by water hammer and were involved in albuminuria and renal prognosis of renal biopsy patients.
PS-C13-10: A PROFILE OF OUT-OF-HOSPITAL CARDIAC ARREST IN AMANG RODRIGUEZ MEMORIAL MEDICAL CENTER: A PROSPECTIVE COHORT STUDY
Authors: Jesus Donna Erika Evangelista De
Published: January 2023

Objective:

For every minute of cardiac arrest without early intervention, chances of survival drop by 7 to 10%. It is crucial that CPR be initiated within 4 to 6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment are not readily available, resulting to poor victim outcomes. The objective of the study is to present the different patient, responder, and transport factors affecting out-of-hospital cardiac arrest among adult patients brought to Amang Rodriguez Memorial Medical Center.

Design and method:

This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Descriptive statistics was used to summarize the demographic and clinical characteristics of the patients.

Results:

63 participants were included in the study. Majority were male patients at 73.02%. Hypertension was identified as the top co-morbidity. Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival in the form of hands-only CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which had no available equipment necessary to provide proper resuscitation. Average travel time from dispatch to ER arrival is 20 minutes.

Conclusion:

Overall survival of OHCA in our local setting remain dismal, as return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.
PS-C13-13: BLOOD PRESSURE REACTIVITY AGAINST PHYSICAL ACTIVITY “ACTISENSITIVITY” EVALUATED BY MULTISENSOR-ABPM CHANGES BEFORE AND AFTER TREATMENT OF HEART FAILURE
Authors: Narita Keisuke , Hoshide Satoshi , Kario Kazuomi
Published: January 2023

Introduction:

The pathological significance of blood pressure (BP) variability in patients with heart failure (HF) has not been fully elucidated. We propose the term Actisensitivity to describe such BP reactivity in response to physical activity; this new aspect of BP variability can be evaluated using our recently developed device, a multisensor-ambulatory BP monitoring (ABPM) device (TM-2441, A&D Co., Tokyo) equipped with an actigraph that can detect physical movements.

Methods:

In the present study, actisensitivity is defined as the slope of the regression line that is calculated from ambulatory systolic BP (SBP) with the log-transformed value corresponding 5-min average of physical activity just before each BP measurement. We prospectively assessed the changes in actisensitivity and ambulatory BP (ABP) parameters between patients with and without improved cardiac function during the treatment of HF. We assessed 20 patients with diagnosed HF (mean ± SD age, 63.3 ± 14.1 years; male, 65%; ischemic heart disease, 15%; atrial fibrillation, 25%) just after initial or adjusted treatments, and reassessed the multisensor-ABPM data at follow-up from 6–12 months after tailored treatment. Second, we divided these patients into an improved (n = 11 patients) and a not-improved (n = 9) cardiac-function group; an increase in echocardiographic left ventricular ejection fraction of ≧ 10%. We then compared the changes in actisensitivity and ABP parameters between the two groups.

Results:

Parameters of ABP variability, i.e., SD, coefficient of variation, and average real variability of SBP, did not change between baseline and follow-up in either group. However, the actisensitivity value tended to increase from baseline to follow-up in the improved group (1.0 ± 3.5 vs. 4.5 ± 3.5, p = 0.065), but not in the not-improved group. The degree of changes in actisensitivity from baseline to follow-up tended to be higher in the improved group than the not-improved group (3.5 ± 5.6 vs. -1.2 ± 4.8, p = 0.059) (Figure). Moreover, in the overall patient group, the change of actisensitivity from baseline to follow-up was significantly related to the changes of LVEF (r = 0.553, p = 0.011).

Conclusion:

To our knowledge, this is the first study to prospectively observe the changes of novel BP reactivity against physical activity in HF patients using the new multisensor-ABPM device. Our findings should help to elucidate the relationships between BP variability/hemodynamics during physical activity and cardiac function in patients with HF.
PS-C16-7: ASSOCIATION OF ELECTROCARDIOGRAM FINDINGS WITH MORTALITY IN COVID-19 PATIENTS
Authors: Aquino Achilles , Lopez Marian
Published: January 2023

Objective:

The COVID-19 virus has greatly debilitated a lot of patients in the Philippines. Baseline demographic characteristics and other parameters such as baseline electrocardiographic (ECG) findings were investigated to act as predictors for mortality among admitted patients who are RT-PCR positive for COVID. This study aims to determine the association of baseline ECG findings including both normal and abnormal variants such as those suggestive of acute cardiac injury and hypertrophy with mortality of these patients.

Design and method:

This is a retrospective study of patients admitted from March 2020 to May 2021 who were diagnosed to have COVID-19 thru an RT-PCR swab. Inclusion criteria include a recorded baseline ECG. Demographic characteristics were also included. Patients were divided according to their ECG findings as normal and abnormal. Among those with abnormal ECG findings, they were further subdivided into those with ischemic changes, hypertrophy, and miscellaneous (bundle branch blocks).

Results:

A total of one hundred thirty-six (136) patients were included in this study. Among the abnormal ECG findings obtained, the miscellaneous group particularly those with right bundle branch block was noted to be associated with mortality (OR = 4.86, 95% CI 1.04–22.7, p = 0.044). Other ECG findings such as ischemic changes and hypertrophy showed no significant association.

Conclusion:

Among the different classifications of ECG findings, those with baseline ECG findings of right bundle branch block showed a positive association with mortality. Other parameters such as demographic features are also noted to have no association with mortality. Further investigation and a higher population number are suggested to further conclude these findings.
PS-P01-4: PREDICTORS FOR REVERSIBILITY OF MILD COGNITIVE IMPAIRMENT OVER 9 YEARS IN GENERAL POPULATION (TANUSHIMARU COHORT STUDY)
Authors: Morikawa Nagisa , Enomoto Mika , Fukami Ako , Sato Hiromi , Adachi Hisashi , Fukumoto Yoshihiro
Published: January 2023

Backgrounds:

Prevention of dementia by preventing mild cognitive impairment (MCI) is very important, because the treatment for dementia has not been established. It is known that some of MCI convert to normal cognitive function, although its pathophysiology has not been elucidated. Currently, evidences of predictors for the cognitive reversibility are scarce, however, promoting cognitive improvement is necessary to prevent dementia. Therefore, we investigated the predictors of reversible MCI in a general population.

Methods:

We conducted medical interview, physical and blood tests and Mini-Mental State Examination (MMSE, 30 points) to assess cognitive function as a longitudinal cohort study in Tanushimaru in Japan in 2009 and 2018. Our study subject was 376 participants with MCI, which was defined as 24–27 points of MMSE, in 2009. Reversible MCI, which means MMSE score improvement to more than 28 in 2018, was defined as an outcome. Univariate and multivariate logistic regression analyses were used to analyze the association between life style factors in 2009 and reversible MCI. Traditional cardiovascular risk factors including were used as covariates.

Results:

Of the 376 subjects, 211 (56.1%) had reversible MCI. In fully adjusted logistic regression analyses, reversible MCI was significantly associated with higher body mass index (p = 0.003), history of alcohol intake (p = 0.009), taking lipid-lowering medication (p = 0.008), and less domains of impaired cognition in MMSE in 2009 (p = 0.01). The odds ratios (95% confidence interval) were 1.14 (1.05–1.24), 2.2 (1.2–3.8), 2.6 (1.3–5.3), and 0.62 (0.43–0.90).

Conclusion:

This study suggests some features of reversible MCI. Especially, we found that a possibility of a protective effect of lipid-lowering drugs on cognitive function. Further studies are needed to clarify the association.
PS-P02-3: DIETARY RISK FACTORS FOR HYPERTENSION- INSIGHTS FROM THE TESCO 1.0 DATASET
Authors: Pimenta Dominic , Yilmaz Dilsan , Anyim Martin , Taubel Jorg
Published: January 2023

Background:

Tesco published an open-source dataset containing area-aggregated product purchase information from 420m transactions across 16m individual Clubcard users in the Greater London area, at a borough level. This dataset is presented as a typical product purchase for each borough, divided into 220 individual datapoints.

Purpose:

We wanted to explore dietary correlates with the prevalence of hypertension, utilising the London Borough wide Quality and Outcomes Framework (QOF) for GP reported hypertension diagnoses.

Methods:

The Tesco 1.0 dataset (2015) was accessed on 1/11/21 and all data downloaded. Hypertension data was accessed from the QOF reporting database (gpcontract.co.uk) for the last year available presented by Borough (2017). HYP001: the number of established hypertension patients as a total of registered patients, and HYP006: the % of hypertensive patients with a reading < 150/90 mmHg were selected, representing the prevalence and control of hypertension respectively. To explore for relevant associated factors, the average deprivation index (IMD) for each borough was accessed from Public Health England, and demographic data accessed from the Greater London Authority database. Univariable correlation using Spearmans Rho was calculated in using scipy in Python (3.0) and significance value of < = 0.01.

Results:

Highly significant risk factors for hypertension were the consumption of sugar, carbohydrate and sweets. Diabetes mellitus and obesity prevalence were also highly correlated with hypertension. Salt consumption was not a significant risk factor. Highly significant protective factors included consumption of eggs, fish, fruit and vegetables.

Conclusions:

The Big Data approach of utilising supermarket data allows a unique insight into dietary habits at a population level. We have demonstrated here an unexpected finding, the consumption of sugar and carbohydrate are highly significant risk factors for hypertension prevalence, while salt consumption is not. While not the first time the sugar versus salt question has been asked, this is the first time it has been answered in this manner.
PS-P05-6: CAROTID INTIMA-MEDIA THICKNESS IS ASSOCIATED WITH PREVALENCE OF ATRIAL FIBRILLATION
Authors: Yamamoto Maki , Enomoto Mika , Fukami Ako , Morikawa Nagisa , Sato Hiromi , Adachi Hisachi , Fukumoto Yoshihiro
Published: January 2023

Objective:

Carotid intima-media thickness(IMT) is one of the useful marker for atherosclerosis and increased IMT predicts for cardio-vascular disease(CVD). Prevalence of atrial fibrillation(AF) is increasing with age, and the elderly have complications such as CVD and AF. We investigated whether IMT was related with prevalence of AF.

Methods:

We performed a health check-up in Tanushimaru in 2018. A total of 1368 subjects were measured IMT by using ultrasonography, and were examined electrocardiography and echocardiography.

Results:

Mean IMT was 0.72 ± 0.21 mm, 18 subjects (1.3%) had AF. The characteristics of age (p < 0.001), systolic blood pressure (p < 0.001), LDL-cholesterol (p = 0.0026), E/A ratio (p < 0.001), Left ventricular end-diastolic diameter (p = 0.0199), Left Atrial Dimension (p < 0.001) and prevalence of AF (p < 0.001) were significantly associated with the IMT quartiles. After adjustment for age and sex, the significances of factors were remained.

Conclusion:

This study demonstrated that increased IMT was associated with prevalence of AF. A prospective study is needed to examine whether increasing IMT predicts for incidence of AF.
PS-R02-3: MASSIVE TUBERCULOUS PERICARDIAL EFFUSION WITHOUT CARDIAC TAMPONADE OR MEDIASTINAL LYMPHADENOPATHY IN AN 88 YEAR OLD MALE: A CASE REPORT
Authors: Batan Keven Joy Calugan , Hojilla ALina Fatima Macawaris
Published: January 2023

Tuberculosis, although endemic in Asia does not commonly affect the heart and would usually present as constrictive pericarditis. Pericardial involvement heralds an unfavorable prognosis and remains a challenge to clinicians. Cardiac tamponade is common in patients with massive pericardial effusions. In the Philippines, it is the second most common cause of cardiac tamponade as documented in the five-year CAPTIVE Heart Study. Mediastinal lymphadenopathy occurs in all cases and denotes lymphatic spread to the pericardium. We present a rare case of an elderly patient presenting with two month history of dyspnea without fever, weight loss, or chest pain. Echocardiography revealed thickened pericardium with fibrinous strands and massive pericardial effusion of 91 mm without tamponade physiology. CT scan revealed absence of mediastinal or hilar lymphadenopathy. Sputum gene xpert was positive. Anti-tuberculosis regimen was started. Patient also then underwent anterolateral thoracotomy, pleuropericardial window with biopsy. Histopathology revealed chronic inflammatory cells, peripherally located granulomas composed of epitheloid cells and Langhans giant cells confirming tuberculosis as the cause of the pericardial effusion. Large pericardial effusion of more than 20 mm is a predictor to the development of hemodynamic instability and subsequent tamponade. In comparison to 2D Echocardiography findings of the patient with a pericardial effusion measurement of 91 mm, still no tamponade physiology was noted even if the effusion existed for more than a month. Mortality is high even in the absence of cardiac tamponade. Mediastinal lymphadenopathy does not occur in all cases of tuberculous pericardial effusion but is still a possibility as seen in the case. The threshold of chronic massive pericardial effusion in developing into tamponade may be higher than previously noted as documented in the case.
PS-R02-7: PAROXYSMAL ATRIAL FIBRILLATION IN A PATIENT WITH HYPERTENSION: A CASE REPORT
Authors: Kabaklic Amela , Sinigoj Petra , Hitij Jana Brguljan
Published: January 2023

Objective:

To present the association between arterial hypertension and concomitant arrhythmias.

The report examines a case of a 74-year-old female patient with known arterial hypertension. She presented with wide blood pressure (BP) fluctuations, with surges of very high BP during the last three months. She also experienced palpitations, dyspnea and chest pain. BP measurements ranged from 116/67 mmHg in the office to 235/103 mmHg at home. She had been taking telmisartan 40 mg once-daily (OD), lercanidipine 10 mg OD and bisoprolol 5 mg OD regularly for several years and her BP was previously well controlled.

Considering the discrepancy between BP measurements in the office and at home, we decided against changing her regular therapy. Therefore, the patient was advised to continue current antihypertensive treatment and additionally take captopril 25 mg and/or sublingual nitroglycerin when systolic BP was above 150 mmHg.

Further diagnostics was performed. Transthoracic echocardiogram was normal, except for moderately enlarged left atrium. Pulmonary embolism and obstructive coronary artery disease were excluded. 24-hour Holter ECG revealed that the patient had symptomatic paroxysmal AF with rapid ventricular response (Figure 1a). There were also some sinus pauses and short periods of sinus bradycardia immediately after the cessation of AF paroxysm (Figure 1b).

To reduce AF-related symptoms and improve the quality of life, the patient was referred to catheter ablation. Pulmonary vein isolation was successfully achieved with no periprocedural complications. Due to borderline sinus bradycardia, bisoprolol was temporarily discontinued and later reintroduced in a lower dose. After the procedure, she was regularly taking telmisartan 40 mg OD, lercanidipine 10 mg OD, bisoprolol 1.25 mg OD, a direct oral anticoagulant and a statin. 24-hour ambulatory blood pressure monitoring was performed. A 24-hour mean BP was 112/66 mmHg, mean day-time BP was 115/69 and mean night-time BP was 108/62 mm Hg (Figure 1c). There was no excessive fluctuation in BP. Furthermore, no increases in HR were noted that would suggest recurrence of AF paroxysms.

Conclusion:

The patient, who was referred to our outpatient hypertension clinic due to uncontrolled hypertension, was diagnosed with symptomatic paroxysmal AF. By means of a successful AF catheter ablation, we eliminated the excessive BP fluctuations. AF and hypertension are closely related, and the appearance of AF can lead to poor BP control. An appropriate treatment for AF in patients with hypertension contributes to better control of the hypertension itself.
PS-R02-8: RUPTURED SINUS OF VALSALVA ANEURYSMS: A CASE SERIES OF THE 3-YEAR EXPERIENCE IN THE PHILIPPINE GENERAL HOSPITAL
Authors: Cheng Paula Victoria Catherine Young , Bongcawil Roxanne Yen , Manalaysay Amanda Mae Ramos , Laforteza Stephanie Obillos , Uy Celia Catherine , Magno Jose Donato , Punzalan Felix Eduardo
Published: January 2023

Introduction:

Sinus of Valsalva aneurysms (SOVA) are rare conditions in which a portion of the aortic root dilates due to a weakness of the aortic wall, which can eventually lead to rupture, leading to a shunt from the aorta into any one of the cardiac chambers. Some patients can present asymptomatically and are diagnosed incidentally, while others can present with precipitous courses with symptoms of chest pain, palpitations, and heart failure. When left untreated, these patients have poor prognosis.

Case Description:

A total of 6 patients are presented in this case series. These patients were seen in the Philippine General Hospital from 2018–2020. The patients had varied characteristics, with ages ranging from 24–57 years old. Most of the patients were males. Presenting symptoms are also varied, with dyspnea as the most common symptom, and a murmur as the most common sign. The most commonly involved sinus is the right coronary sinus draining into the right ventricle, with half of the patient presenting with concomitant ventricular septal defects. Five out of the six patients underwent successful open repair of their ruptured SOVAs and were eventually discharged.

Discussion:

Early identification of the cardiac lesion is important to clinch the diagnosis and plan for eventual definitive management. Imaging studies such as transthoracic echocardiogram are needed to visualize the defect, which is classically described as a windsock deformity. Transesophageal echocardiography may present clearer images to assess the anatomy better preoperatively. Medical management is usually done to bridge the patient to more definitive therapy, either through endovascular closure if the anatomy permits it, or through surgical repair. Urgent and timely repair is needed to ensure improved survival in these patients.
PS-BPB01-8: IMPACT OF DIFFERENT DIURETIC TYPES ON ARTERIAL STIFFNESS AND CALCIFICATION IN A RAT MODEL OF CHRONIC KIDNEY DISEASE
Authors: Agharazii Mohsen , Larivière Richard , Ung Roth-Visal , Picard Sylvain , de Souza Dailson N , Richard Darren E , Mac-Way Fabrice
Published: January 2023

Introduction:

We reported that antihypertensive therapy with a hydrochlorothiazide (HCTZ)-based regimen aggravates arterial stiffness and vascular calcification in a rat model of chronic kidney disease (CKD) with mineral and bone disorder (MBD). In this study, we investigated whether the aggravation of arterial stiffness and vascular calcification in CKD-MBD rats is induced by HCTZ and whether these abnormalities could also occur with other types of diuretic currently used in clinic.

Methods:

In rats with renal mass ablation-induced CKD, MBD was generated by a Ca/P-rich diet and calcitriol supplementation. The animals were divided into 4 groups; 1) CKD-MBD control; 2) CKD-MBD + HCTZ (thiazide diuretic, 5 mg/kg/d); 3) CKD-MBD + Chlorthalidone (thiazide-like diuretic, 5 mg/kg/d), and; 4) CKD-MBD + Furosemide (loop diuretics, 10 mg/kg/d). At week 6, hemodynamic parameters including systolic and mean blood pressure (SBP and MBP), pulse pressure (PP) and pulse wave velocity (PWV) were determined. The thoracic aorta was harvested to assess vascular calcification.

Results:

SBP was reduced by all types of diuretic in CKD-MBD rats. Contrary to chlortalidone nor furosemide, HCTZ treatment led to a reduction of MBP, but an increase in PP and PWV in CKD-MBD rats (p < 0.05). As expected from these hemodynamic changes, medial calcification in the thoracic aorta was significantly greater in CKD-MBD rats treated with HCTZ as compared to all the other groups of rats (p < 0.05).

Conclusion:

In rats with CKD-MBD, antihypertensive therapy with the thiazide diuretic HCTZ, but not other types of diuretic, exacerbated arterial stiffness and vascular calcification despite a reduction in SBP. The deleterious effect of HCTZ in CKD-MBD rats may have major clinical impact as this diuretic is widely use in patients with CKD that often develop MBD.
PS-BPB06-7: NOVEL MOLECULAR MECHANISMS OF CARDIO-RENAL INTERACTION MEDIATED BY INCREASED SERUM MODIFIED NUCLEOSIDES ASSOCIATED WITH RENAL FAILURE
Authors: Nagayoshi Yu , Yamamura Ryosuke , Kaneko Hitomi , Kakizoe Yutaka , Nishiguchi Kayo , Nakagawa Terumasa , Adachi Masataka , Miyasato Yoshikazu , Izumi Yuichiro , Kuwabara Takashige , Tomizawa Kazuhito , Mukoyama Masashi
Published: January 2023

Objective:

The number of patients with chronic kidney disease (CKD) continues to rise by population aging. Moreover, CKD patients progress to end-stage renal failure and require renal replacement therapy. Many cohort studies have shown that impaired renal function itself is a risk factor for the development of cardiovascular disease, rather than comorbidities such as diabetes or hypertension. However, the molecular mechanisms are not fully understood. We focused on chemical modifications in RNA and their pathophysiological significance. Previously, we have shown that modified nucleosides, the metabolites of modified RNA, have unique physiological effects. For example, we reported that N6-methyladenosine is a true ligand for the A3 adenosine receptor, and that 1-methylguanosine promotes Zika virus replication in the host. In addition, it was found that a number of modified nucleosides are present in serum and excreted into extracellular spaces like urine. Therefore, we hypothesized that the decreased urinary excretion of modified nucleosides upon renal failure may cause abnormally high levels of modified nucleosides in the blood, which may exert detrimental effects on the heart and vasculature.

Methods and Results:

First, serum samples were collected from 210 CKD patients, and the correlation between serum modified nucleoside levels and eGFR was investigated. The results showed that several modified nucleosides such as 5-methylcytidine and pseudouridine were inversely correlated with renal function (r2 = -0.76, p < 0.0001; r2 = -0.78, p < 0.0001, respectively). Moreover, we found that 1-methylinosine was inversely correlated with renal function and positively correlated with BNP, a typical marker for heart failure (r2 = -0.82, p < 0.0001 vs. eGFR; r2 = 0.41, p = 0.010 vs. BNP). Next, to explore the possibility of cardiovascular injury associated with this elevation of 1-methylinosine, we examined its effect on vascular endothelial cells. We found that the addition of 1-methylinosine significantly increased cell proliferation using cultured human aortic endothelial cells (p = 0.004, n = 6).

Conclusions:

Through this study, we found that multiple modified nucleosides are significantly elevated in serum of CKD patients. Furthermore, the elevation of 1-methylinosine in serum can induce abnormal proliferative signals in vascular endothelial cells, which may thereby lead to endothelial damage. In conclusion, these results suggest that the elevated blood levels of modified nucleosides could be a novel marker for vascular injury, and might become a potential target for drug intervention in the cardio-renal interaction.
PS-BPB09-5: BROWN ADIPOSE TISSUE DYSFUNCTION PROMOTES METABOLIC DISORDER IN A FAILING HEART.
Authors: Yoshida Yohko , Shimizu Ippei , Minamino Tohru
Published: January 2023

Objective:

Low body temperature predicts poor clinical outcomes in patients with heart failure, however, underlying mechanisms and pathological implications are largely unknown. Brown adipose tissue (BAT) was initially characterized as a heat generating organ, and studies suggest it has crucial roles for maintaining systemic metabolic health. The purpose of this study was to determine whether alteration of BAT function contributes to development of heart failure.

Design and method:

We generated two murine heart failure models, thoracic aortic constriction (TAC) and myocardial infarction (MI). We analyzed cardiac function, thermogenic response, and pathological findings in the hearts of these mice. We also performed comprehensive metabolomic analyses in the heart, BAT, and plasma samples from sham- and TAC-operated mice.

Results:

We found murine models with TAC or MI induced BAT dysfunction, and this led to a significant reduction in body temperature. Chronic activation of adrenergic signaling induced apoptosis in brown adipocytes, and surgical denervation of sympathetic nerves innervating BAT improved thermogenic response and cardiac systolic dysfunction. Gain of BAT function model, generated with BAT implantation into peritoneal cavity, improved thermogenesis and ameliorated cardiac dysfunction in TAC. In contrast, systolic function was reduced in genetically BAT dysfunctional model, and this associated with poor survival rate in this model. Metabolomic analyses showed that BAT dysfunction led to an increase of choline and its downstream metabolite, trimethylamine N-oxide (TMAO) that promoted metabolic dysfunction in the failing heart. TMAO administration resulted in a significant reduction in phosphocreatine or ATP level in cardiac tissues, and this was mediated by the suppression of complex IV activity in mitochondria. Genetic or pharmacological inhibition of TMAO production ameliorated cardiac dysfunction during left ventricular pressure overload. Dilated cardiomyopathy patients had lower body temperature, and this associated with an increase in circulating choline and TMAO level.

Conclusions:

Alteration of BAT function contributes to the development of heart failure via increased TMAO. Our findings suggest that maintenance of BAT homeostasis and reducing TMAO production could be potential next-generation therapies for heart failure.
PS-BPB10-3: MOLECULAR INSIGHT INTO SALT-SENSITIVITY; THE ROLE OF ATF3 AND THE GENERATION OF TUBULAR SPECIFIC KO MICE. (2)
Authors: Mouri Satoshi , Machida Kosho , Maeda Kazuki , Matsumoto Kento , Kino Tabito , Saigo Sae , Minegishi Shintaro , Sugawara Takuya , Uchida Kotaro , Arakawa Kentaro , Chen Lin , Sugiyama Michiko , Tamura Koichi , Ishigami Tomoaki
Published: January 2023

Objective:

Atf3 is transcriptionally activated according to intracellular Na concentrations. We found about 1.6 fold to 2.5 fold gene expression enhancements in kidney of Nedd4 2 C2 KO mice due to oral salt intakes and diuretics treatments. Aim of this study is to elucidate significance of Atf3 gene for salt-sensitivity by dietary salt loading and furosemide treatment for tubular specific Atf3 KO mice examining blood pressure, body weight, urine volume, water intake with genetic analyses.

Methods:

We performed metabolic cage experiments for male Ksp-cre (minus) Atf3 flox/flox mice (N = 5) and male Ksp-cre (+) Atf3 flox/flox mice (N = 10) with 7–8 wks old for subsequent protocol. After 1 week habituation period, experiments were done for 3 days normal salt intake, 5 days high salt intake, and 5 days high salt intake with furosemide treatment (40 mg/kg, ip), respectively. We measured blood pressure by tail cuff methods at day 0, day 8, and day 12. During experimental periods, body weight, water intake and urine volumes are measured daily.

Results:

We could not find significant differences among body weight, water intake and urine volume between two groups. After high oral salt intake and intra-peritoneal furosemide injection, we found blood pressure of cre (+) Atf3 flox/flox mice were significantly higher than cre (minus) Atf 3 flox/flox mice. (p < 0.001, 119.6 ± 1.4 mmHg vs 112.8 mmHg) Additionally, we found significant expression change of both classic renin and alternative renin in tubules between two groups by quantitative RT PCR and immunohisto chemistry imaging for kidney.

Conclusions:

Tubular-specific Atf3 KO mice have elevated blood pressure sensitive to salt and furosemide treatment. Because furosemide treatment might induce enhancement of intra-cellular Na ion concentration, Atf3 gene is responsible for adaptations for intra-cellular Na concentration change through tubular renin expressions.
PS-BPB10-5: POSSIBLE INVOLVEMENT OF RENAL TUBULAR NFAT5 IN AGING-ASSOCIATED RENAL DYSFUNCTION AND SALT-SENSITIVE HYPERTENSION
Authors: Maruyama Kosuke , Izumi Yuichiro , Ono Makoto , Kakizoe Yutaka , Morinaga Jun , Kuwabara Takashige , Mukoyama Masashi
Published: January 2023

Objective:

Japan is currently facing a super-aging society, where an incidence of lifestyle-related diseases has become a greater social burden. The number of patients with chronic kidney disease (CKD) and hypertension is being increased with age; however, it is not clearly defined why and how aging causes renal dysfunction and hypertension. Nuclear factor of activated T-cells 5 (NFAT5) is a transcription factor that is activated upon hypertonic conditions as observed in the renal medulla. We have shown that the renal tubular cell-specific NFAT5 conditional knockout (KO) mice exhibit salt-sensitive hypertension, while the mice exhibit impaired urine concentrating ability and are susceptible to renal fibrosis. These phenotypes resemble aging-associated renal dysfunction, i.e., urine concentrating disorder, salt-sensitive hypertension, and renal fibrosis. We therefore investigated the possible involvement of NFAT5 in aging-related changes of the kidney.

Methods:

Male wild-type (WT) and KO mice (12 weeks old) were subjected to unilateral ureteral obstruction (UUO) or sham operation. After 7 days, mice were sacrificed and kidneys were removed for analysis. Renal fibrosis was evaluated by AZAN staining. Senescence-associated beta-galactosidase (SA-β;-Gal) activity was examined by fluorescence study in the whole kidney slices. mRNA expression for senescence-associated secretory phenotype (SASP)-related factors (TGF-β;1, COL1A1, ICAM1, PAI-1, p21, p16, and p53) in the whole kidney tissue was examined by real-time PCR.

Results:

AZAN staining showed that UUO induced renal fibrosis both in WT and KO mice. The UUO-induced fibrotic area was significantly larger in KO mice than in WT mice in the medulla. In sham-operated mice, overall SA-β;-Gal activity was larger in KO mice, in which the activity was dominant in the corticomedullary region. In UUO groups, overall SA-β;-Gal activity was low compared to sham-operated groups. The mRNA expression of SASP-related factors was not different between WT and KO mice in sham-operated groups. UUO upregulated the mRNA expression of all SASP-related factors both in WT and KO mice. In UUO groups, the expression of TGF-β;1, COL1A1, ICAM1, and PAI-1 was significantly larger in KO mice than in WT mice. The expression of p21, p16, and p53 tended to be larger in KO mice than in WT mice.

Conclusions:

Renal tubular NFAT5 deficiency showed senescence-related phenotypes at baseline. Deficit of renal tubular NFAT5 may further induce cell senescence upon insult, which might accelerate aging-associated renal inflammation and dysfunction in CKD.
PS-BPC02-4: RELATIONSHIP BETWEEN EXERCISE CAPACITY AND CHANGES OF PULSE WAVE VELOCITY AFTER CARDIAC REHABILITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Yoon Homin , An Soyeon , Kang Bomin , Beom Jongwook , Boo Kiyoung , Lee Jaegeun , Choi Joonhyouk , Kim Songyi , Joo Seungjae
Published: January 2023

Objective:

Guidelines strongly recommend exercise-based cardiac rehabilitation (CR) to reduce cardiovascular mortality in patients with acute myocardial infarction (AMI). Reduction of central aortic systolic pressure, augmentation index, and pulse wave velocity (PWV) after aerobic exercise may be associated with better clinical outcomes after CR. However, the change of pulse wave velocity after CR in patients with AMI has been rarely investigated.

Design and Method:

Sixty-five patients (age 55.3 ± 10.1 years, 63 men) with AMI who completed the 6-month CR and evaluation program were included in this study. Maximal oxygen uptake (VO2max) during cardiopulmonary exercise (CPX) testing and brachial-ankle PWV (baPWV) were measured before exercise program and after 6 months. Based on the results of baseline CPX testing, each exercise program which included target metabolic equivalent, target heart rate, and exercise duration, was prescribed. Patients were recommended to attend the outpatient CR program which composed of 8 to 12 visits during 4 to 6 weeks. Self-exercise program was educated for each patient who finished or denied the outpatient CR program.

Results:

After 6 months, VO2max was increased from 28.9 ± 5.79 to 31.7 ± 6.5 mL/kg/min (p < 0.001) and baPWV was decreased from 14.68 ± 2.66 to 13.54 ± 2.92 m/sec (p < 0.001). Changes of baPWV (Delta-baPWV) showed a significant negative correlation with 6-month VO2max (r = -0.339, p = 0.006). Patient were divided into group 1 (n = 32, Delta-baPWV <-1.13 m/sec) and group 2 (n = 33, Delta-baPWV > = -1.13 m/sec). Group 1 showed higher 6-month VO2max (33.5 ± 6.7 vs. 29.9 ± 5.9 mL/kg/min; p = 0.023). On logistic regression analysis, 6-month VO2max was a significant determining factor for Delta-baPWV (OR 1.159, 95% CI 1.030–1.305, p = 0.014) after adjustment of age, sex, height and baseline baPWV.

Conclusions:

Patients with better exercise capacity after CR program showed more decreased PWV.
PS-BPC02-6: ASSOCIATION BETWEEN MAJOR ADVERSE CARDIOVASCULAR EVENTS AND GENSINI SCORE IN HYPERTENSIVE PATIENTS WHO UNDERWENT CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY
Authors: Miura Shinichiro , Miura Erika , Higashi Sara , Tashiro Kohei , Kawahira Yuto , Shiga Yuhei
Published: January 2023

Objective:

From the Fukuoka University coronary computed tomography angiography (FU-CCTA) registry, we present major cardiovascular events (MACEs) in hypertensive patients who underwent CCTA, and the association between MACE and Gensini score of coronary arteries.

Design and method:

Of the patients who underwent CCTA for the purpose of screening for CAD at Fukuoka University Hospital (FU-CCTA registry), 318 hypertensive patients with suspected CAD or at least one cardiovascular risk factor were enrolled. A severity of atherosclerosis of coronary arteries was assessed by the Gensini score. The coronary artery calcification score (CACS) was defined as the presence of two or more contiguous pixels with more than 130 Hounsfield Units on CT images at the time of CCTA. MACEs (all-cause death, ischemic stroke, acute myocardial infarction, coronary revascularization) was a primary endpoint for the follow-up of patients for up to 5 years. The patients were divided into two groups according to the presence (MACEs group) or absence (non-MACEs group) of MACEs.

Results:

The average age was 68 ± 10 years and 50 % were males. The percentages of smoking, dyslipidemia, diabetes and chronic kidney disease were 37 %, 70 %, 26 % and 35 %, respectively. The %males, %smoking, CACS and Gensini score in the MACEs group were significantly higher than that in the non-MACEs group, whereas there were no differences in age, dyslipidemia, diabetes and chronic kidney disease between the groups. Regarding the relationships between MACEs and various coronary risk factors, CACS or Gensini score by a Cox regression analysis, significant relationships were observed for the CACS (p = 0.019) and the Gensini score (p = 0.002).

Conclusions:

CACS or Gensini score could be a predictor of MACEs in hypertensive patients who underwent CCTA.
PS-BPC04-2: ASSOCIATION OF SHORT-TERM BLOOD PRESSURE VARIABILITY AND MICROALBUMINURIA IN ESSENTIAL HYPERTENSION: DIFFERENCES ACCORDING TO CLASSIFICATIONS OF BLOOD PRESSURE ABSOLUTE VALUE
Authors: Koike Tsutomu , Tomoda Fumihiro , Ohara Maiko , Yamazaki Hidenori , Kinugawa Koichiro
Published: January 2023

Objective:

Increased short-term blood pressure (BP) variability has been highlighted as a novel risk for cardiovascular diseases. The influence of short-term BP variability on cardiovascular mortality is also accelerated together with increase in BP. In essential hypertension, short-term BP variability is independently associated with early renal abnormalities. In this study, the associations of short-term BP variability with microalbuminuria were analyzed according to classifications of BP absolute value in essential hypertensive patients.

Design and method:

In 222 untreated essential hypertensive patients (127 males, average age 55 ± 11 years) without chronic kidney disease (urinary albumin excretion less than 300 mg/g of creatinine and estimated glomerular filtration rate 60 mL/min/1.73m2 or more), ambulatory BP monitoring was performed to estimate BP and the standard deviation of systolic BP (SBP-SD) during 24 hours. The 24-hour urine collection was also done to evaluate urinary albumin excretion. According to 24-hour BP level, patients were divided into 4 groups: 33 patients with BP < 130/80 mmHg (N), 71 patients with BP of 130–149/80–89 mmHg (G1), 84 patients with BP of 150–169/90–99 mmHg (G2) and 34 patients with BP 170/100 mmHg (G3).

Results:

24-hour systolic BP correlated positively with urinary albumin excretion in G1, G2 and G3 groups (r = 0.25 in G1 group; r = 0.22 in G2 group; r = 0.30 in G3 group, p < 0.05, respectively), whereas there was no relation between them in N group. SBP-SD correlated positively with UAE in both G2 and G3 group (r = 0.20 in G2 group; r = 0.30 in G3 group, p < 0.05, respectively), but did not so in either N or G1 group. Thus, the correlation between SBP-SD and urinary albumin excretion was confined to patients with 24-hour BP ≧ 150/90 mmHg. Furthermore, in patients with 24-hour BP ≧ 150/90 mmHg, multiple regression analysis revealed that SBP-SD was an independent determinant for urinary albumin excretion together with 24-hour systolic BP.

Conclusions:

These data indicate in essential hypertensive patients, that the risk of increased short-term BP variability for microalbuminuria could be potentiated along with the elevation in BP absolute value.
PS-BPC05-10: DIASTOLIC DYSFUNCTION, HYPERTROPHY AND HYPERTENSION VENTRICULAR-ARTERIAL UNCOUPLING TREATMENT
Authors: Piskorz Daniel , Keller Luis , Tissera Gabriel , Mata Lucrecia , Citta Luciano , Citta Paula , Bongarzoni Laureano
Published: January 2023

Objective:

the aim of this study was to evaluate the effects of hypertension ventricular-arterial uncoupling treatment on left ventricular hypertrophy and diastolic dysfunction regression.

Design and method:

observational prospective study, consecutive hypertension patients. Left ventricle mass index measured by Devereux 2D echocardiography method and diastolic function by conventional and tissue Doppler following the Guidelines from Echocardiography from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Left ventricular end systolic elastance (Ees) was measured by Guarracino calculator, the effective arterial elastance (Ea) and ventricular-arterial coupling (VAC) measured by Sunagawa et al single beat method adapted by Chen et al in human ventricles. The sample was analyzed in quartiles (Q) according to VAC (Q1 worst VAC to Q4 best VAC). Follow-up 2 years.

Results:

288 patients, mean age 56.3 + 12.5 years and 168 patients (58.3%) males. VAC increased from 0.303 + 0.07 to 0.54 + 0.25 (p < 0.005) in Q1 mainly due to a reduction in Ees from 5.25 + 2.3 to 3.68 + 0.25 mm Hg/ml (p < 0.01) while Ea increased from 1.5 + 0.53 to 1.64 + 0.56 mm Hg/ml (p = NS); on the other side VAC was reduced from 0.87 + 0.15 to 0.68 + 0.26 (p < 0.05) in Q 4 with an increase in Ees from 2.28 + 0.6 to 2.67 + 1.07 mm Hg/ml (p = NS) and a reduction of Ea from 1.94 + 0.41 to 1.69 + 0.67 mm Hg/ml (p = NS) (Figure). The frequency of LVH was reduced from 31.9% to 10.8% in Q1 (p < 0.025) while moved from 14.7 to 17.9% (p = NS) in Q2, 22.9% to 13.9% (p = NS) in Q3 and 11.3 % to 23.7% (p = NS) in Q4. The frequency of normal diastolic function increased from 75% to 94.6% (p < 0.01) in Q1, from 78.7% to 100% in Q2 (p < 0.005), from 87.1% to 100% (p < 0.025) in Q3 and from 88.7% to 100% (0,025) in Q4.

Conclusions:

1) patients with the worst ventricular-arterial uncoupling (Q1) are the most VAC benefited from hypertension treatment; 2) regression of left ventricular hypertrophy was observed only in the group of patients with the worst ventricular-arterial uncoupling (Q1); 3) improvement in diastolic function was demonstrated in all Q of ventricular-arterial coupling. This study shows that achieving an optimal mechanical efficiency measured as ventricular-arterial coupling by hypertension treatment is essential for left ventricular hypertrophy and diastolic dysfunction regression.