bluuebunny/crossref_metadata_2025 huggingface dataset:
S-38-5: IDENTIFICATION OF FERROPTOSIS-RELATED GENES IN CAROTID ATHEROSCLEROSIS ON BIOINFORMATIC ANALYSIS
Authors: Cai Qiujing
Published: January 2023

Background:

Carotid atherosclerosis (CAS) is a common chronic vascular inflammatory disease and one of the main causes of cardiovascular and cerebrovascular diseases (CVDs). Ferroptosis related genes (FRGs) may play a crucial part in pathophysiological processes of CAS. However, the expression profile of FRGs have rarely been adopted to explore the relationship between ferroptosis and CAS.

Objects:

Therefore, using the expression profile of FRGs to explore the relationship between ferroptosis and CAS may provide new insights for the prevention and treatment of CVD.

Methods:

The differentially expressed genes (DEGs) of the GSE432192 dataset were obtained from the Gene Expression Omnibus (GEO) database. Ferroptosis related genes (FRGs) were identified by downloading data from the FerrDb database. The GSE432192 dataset contains 32 carotid atheroma plaque samples and 32 macroscopically intact carotid tissue samples adjacent to the atheroma plaque. The differentially expressed FRGs (DE FRGs) of the GSE432192 dataset were screened and analyzed by gene ontology analysis (GO), Kyoto Encyclopedia of Genes and Genomes analysis (KEGG), protein protein interaction network (PPI), and were chosen to explore related miRNAs.

Results:

The GSE432192 dataset had a total of 41 DE FRGs. The GO analysis results revealed that DE FRGs were mainly enriched in response to oxidative stress, oxidoreductase activity acting on NAD(P)H, and apical part of cell. KEGG analysis results showed that DE FRGs were mainly enriched in ferroptosis and chemical carcinogenesis reactive oxygen species relating pathways. Expressions of top 5 hub genes, as HIF1A, HMOX1, TFRC, CYBB, EGFR, were regarded as focus in the PPI regulatory networks.

Conclusions:

In this study, Ferroptosis and FRGs may play a vital role in regulating the pathophysiology of CAS.
S-38-10: THE NON-CODING GENOME IN HYPERTENSION
Authors: Charchar Fadi
Published: January 2023

The Non-coding genome is an expanding repertoire of regulatory and non-regulatory RNA. Some of the latest research in the SHR and humans point to contribution of this RNA to hypertension and cardiovascular disease. I will discuss some of our findings including evidence for renal circular RNA in hypertension.
S-39-5: FACTORS AFFECTING DEVELOPMENT OF AKI AMONG COVID-19 HYPERTENSIVE PATIENTS
Authors: Omer Intisar Abdelrahim Bashir , Elamin Maha Esmail , Hasan Dina Ahmed
Published: January 2023

Objective:

To determine risk factors associated with development of AKI with regards to mortality rate among covid-19 patients taking in consideration risk factors such as age, sex and chronic diseases like diabetics considering renal function to outcome.

Design and method:

This is a retrospective cohort study using de-identified data retrieved from clinical records of patients from two COVID 19 isolation centers. Medical history, demographic data, symptoms, disease complications and laboratory investigations were extracted from clinical records of 406 confirmed COVID 19 hospitalized patients in the period between Feb 2020 and July 2021. Continuous variables were presented as means ± standard deviation (SD) while categorical variables were presented as percent proportions. Logistic regression was used to determine risk factors associated with development of AKI with regards to mortality factors rate among covid 19 hypertensive patients.

Result:

Out of 406 hospitalized COVID-19 patients, 59.6% had a history of hypertension. Logistic regression was used to analyze risk factors associated with AKI among hypertensive and non hypertensive patients of covid-19.

Age factor is highly significant factor for development of AKI for hypertensive (odd ratio [OR]: 4.89, 95% confidence interval [CI]: (1.93–1.36, P = 0.001) and non-hypertensive patients (odd ratio [OR]: 4.73, 95% confidence interval [CI]: (1.58–4.18, P = 0.001).

Urea (odd ratio [OR]: 3.06, 95% confidence interval [CI]: (1.63–5.76, P = 0.001), creatinine (odd ratio [OR]: 3.39, 95% confidence interval [CI]: (1.82–6.32, P > 0.001) and potassium[K] (odd ratio [OR]: 2.17, 95% confidence interval [CI]: (2.23–3.83, P = 0.035) are highly significantly increased for hypertensive covid-19 patients, whereas urea, creatinine and K are not significantly changed for non-hypertensive covid-19 patients

Gender and morbidity factor (diabetes mellitus) has no significant effect for AKI development for hypertensive and non-hypertensive covid-19 patients.

AKI is considered as a risk factor death among COVID-19 patients (OR:284, CI:1.56–5.15, p = 0.001).

Conclusion:

The present study indicates that 71% of patients with AKI are hypertensive. The results also highlight the alarming high incidents of hypertension in the studied population. On conclusion hypertension is considered as highly morbidity factor for development of AKI
S-40-4: ANGIOTENSIN II-INDUCED BLOOD PRESSURE ELEVATION WAS POTENTIATED TOGETHER WITH INCREASES IN INTERFERON-GAMMA PRODUCING T CELLS IN INTERLEUKIN-23 RECEPTOR-DEFICIENT MICE
Authors: Paradis Pierre , Shokoples Brandon , Comeau Kevin , Higaki Akinori , Ferreira Nathanne S , Caillon Antoine , Berillo Olga , Oukka Mohamed , Schiffrin Ernesto L
Published: January 2023

Objectives:

We previously demonstrated a role for γδ T cells in hypertension and vascular injury. In inflammatory conditions γδT17 are a prominent producer of IL-17A, which has been shown to contribute to hypertension. The development and expansion of γδT17 cells is regulated in part through IL-23 receptors (IL-23R). We hypothesized that angiotensin (Ang) II-induced blood pressure (BP) elevation and vascular injury would be blunted in mice with dysfunctional IL-23R.

Design and method:

Wild-type (WT) and Il23r knock-in (Il23r
gfp/gfp) mice were infused or not with Ang II (490ng/kg/min, SC) for 7 or 14 days. BP was monitored via telemetry, mesenteric artery function and remodeling using pressurized myography, and T cell profiling in mesenteric artery perivascular adipose tissue (PVAT) by flow cytometry.

Results:

Il23r
gfp/gfp mice exhibited a greater BP elevation in response to Ang II than WT by day 3 (152 ± 5 vs 144 ± 7 mm Hg, P < 0.05), which was sustained through day 9 (169 ± 2 vs 155 ± 5 mm Hg, P < 0.05), but eventually similar to that of WT mice by the end of the Ang II infusion (167 ± 2 vs 167 ± 4 mm Hg). Il23r
gfp/gfp mice were not protected from vascular dysfunction and remodeling after 14 days of Ang II. Il23r
gfp/gfp mice had less γδT17 cells in PVAT than WT mice (40 ± 8 vs 108 ± 15 cells/PVAT, P < 0.05). Ang II increased interferon-γ producing γδ T cells in WT (13 ± 3 vs 5 ± 1 cells/PVAT, P < 0.05) and Il23r
gfp/gfp mice (14 ± 3 vs 3 ± 1 cells/PVAT, P < 0.05), and interferon-γ producing CD4+ (125 ± 27 vs 38 ± 13 cells/PVA, P < 0.05) and CD8+ T cells (76 ± 13 vs 33 ± 8 cells/PVA, P < 0.05) only in Il23r
gfp/gfp mice.

Conclusion:

Functional IL-23R deficiency exaggerated BP elevation during the initiation of Ang II-induced hypertension, potentially due to the increased number of interferon-γ producing T cells.
S-41-1: PAST, PRESENT AND FUTURE OF CKD IN JAPAN
Authors: Kashihara Naoki
Published: January 2023

CKD is increasing in many countries around the world, especially in Asian countries. It is expected that the number will more than double in Asia by the end of 2030 compared to 2010. In North and East Asian countries, the prevalence of CKD is generally above 10%. In Japan, 12% of adults are regarded as CKD. As a result, the number of patients who are treated with chronic hemodialysis is increasing in Japan, and currently 340,000 patients are receiving dialysis treatment. Approximately 40,000 patients are newly introduced to dialysis treatment every year, and the medical expenses required for dialysis treatment exceed 1.5 trillion yen annually. 42% of kidney failure is caused by diabetic kidney disease. At the same time, aging is also a cause of increment of kidney failure. More than half of the patients are 65 years or older at the time of introduction of dialysis. Thus, Japan has the second highest prevalence of patients with long-term hemodialysis after Taiwan.
S-41-3: HYPERTENSION AND KIDNEY DISEASE IN SINGAPORE
Authors: Teo Boon Wee
Published: January 2023

The inter-related lifestyle non-communicable diseases of hypertension and diabetes accounts for 70 to 80% of all end-stage kidney disease (ESKD) in Singapore. Singapore is a multi-ethnic Asian society where the Chinese are the majority (76%), Malay (15%), Indian (9%), and other. The National Population Health Survey 2020 reported that the age-standardized prevalence of hypertension had increased from 21.9% in 2017 to 31.7% in 2019–2020, and more men (41.0%) were affected than women (30.2%). The prevalence of hypertension increased with age; starting at around 10% for those aged 18 to 29 years to 74.9% among those aged 70 to 74 years. Almost half (52.4%) of residents had not been previously diagnosed with hypertension. In adults with known hypertension, 35.7% had good control of their blood pressure (BP). Men (66.0%) had poorer BP control compared to women (62.2%). Among the ethnic groups, Malays (69.4%) had the highest proportion with poor BP control followed by Chinese (64.0%) and Indians (58.6%).

The National Nutrition Survey 2018/9 reported that more than 90% exceeded the recommended amount of 5 g per day (average intake 9 g in 2018). This was due mostly to seasonings, salt, and sauces added during food preparation, which accounted for 75% of salt in the diet.

We studied the usual clinical practice of hypertension management in chronic kidney disease (CKD) patients in the Nephrology clinics of an academic medical center. Despite intensive follow-up and access to medical care, many patients were unable to achieve the BP goals. We also compared the 24-hour urinary sodium excretion of healthy controls and CKD. Dietary habits vary by ethnicity, and the Indian population take more sodium than other groups. We developed a prediction equation in our population to determine the likelihood of exceeding 100 mmol of sodium in a 24-hour urine from an early morning spot urine sodium test.

The age-standardized incidence rate (ASIR) of CKD5 was relatively stable at between 266.7 pmp and 295.3 pmp in 2011 to 2019. ASIR of CKD5 were higher among Malays than other ethnicities. ASIR of definitive dialysis increased from 169.6 pmp in 2011 to 187.3 pmp in 2020. About 39.6% of deaths in dialysis patients were due to cardiac causes. Overall, hypertension was a contributory factor to the main causes of death in the population of Singapore, being ischemic heart disease, cerebrovascular disease, CKD, and hypertensive disease.
S-42-4: ISOLATED NOCTURNAL HYPERTENSION IN PATIENTS LIVING WITH HUMAN INMUNODEFICIENCY VIRUS (HIV)
Authors: Zanuzzi Matias G , Lopez Silvina M , Cattaneo Maximo J , Maure Maria A Perez , Lahiri Cecile D , Romero Cesar A
Published: January 2023

Introduction:

People living with HIV (PLHIV) have higher rates of cardiovascular events compared to the general population; however mechanisms behind this discrepancy are poorly understood. High prevalence of hypertension has been proposed as a mechanism underlying cardiovascular events with contradictory results when office blood pressure (BP) is considered. Ambulatory blood pressure measurements (ABPM) have the advantage to measure BP during sleep, a cause of masked hypertension. Additionally, body weight and electrolytes disturbances are common in PLHIV under antiretroviral and antibiotic therapy. We aim to describe the prevalence of isolated nocturnal hypertension (INH) and it characteristics in PLHIV.

Material and methods:

A random sample of PLHIV from the provincial HIV program in Cordoba, Argentina, underwent clinical and laboratory examination, and 24 h ABPM. Nocturnal hypertension (NH) was defined as nocturnal systolic BP ≥ 120 mmHg and or nocturnal diastolic BP≥70 mmHg. INH was defined in those patients with NH with daytime systolic and diastolic BP< 135/85 mmHg respectively.

Results:

PLHIV were included in the study: 60% male, mean age was 44.6 (27–69) years old, 87% were receiving antiretroviral therapy. BMI was 25.8 ± 4.8, mean CD4 count was 404.4 ± 289, cells/ml and 86.2% were virologically suppressed. The prevalence of NH was 48.5% [95%CI:36–60%], the vast majority having INH 29/32 (90%), thus the population prevalence of INH was 43.9% [95%CI:32–55,%]. INH patients have an excess of 10.4 and 8 mmHg in 24 hr systolic BP and diastolic BP respectively compared to no INH patients (both p < 0.001). No differences were found regards age, sex, viral load, CD4+ cells and years of HIV history between patients with and without INH. Multiple linear regression (adj-R2 = 0.27, p < 0.001) adjusted by sex and age determined that BMI (β = 0.79, p = 0.02]), plasma uric acid (β = 0.33, p = 0.01) and plasma potassium (β = -9.5, p = 0.03]) independently predicted nocturnal systolic BP in PLHIV. In a multiple logistic regression model adjusted by age and sex, BMI≥30 was associated with INH (OR 4.04 [95%CI: 1.25–13)

Conclusion:

INH is highly prevalent in PLHIV conferring an excessive hypertension load that may explain the associated high CVS risk. Obesity, increased uric acid, and low plasma potassium are associated with nocturnal systolic BP. Our work suggests the routine use of ABPM and explore metabolic disturbances in obese PLHIV.
S-43-4: CENTRAL ADIPOSITY IN CHILDHOOD INCREASES THE LIKELIHOOD OF EARLY VASCULAR AGING
Authors: Kruger Ruan , Masike Kebiditswe Lesego , Uys Aletta Sophia , Breet Yolandi
Published: January 2023

Objective:

Arterial stiffness, measured by pulse wave velocity (PWV), is a central component of early vascular aging (EVA) and has been associated with obesity and hypertension. However, the association between overweight/obesity and arterial stiffness is controversial in the general population, with less known in children from South Africa. We aimed to determine whether overweight/obesity increases the likelihood of EVA in South African school-aged children.

Design and method:

A total of 994 children (aged 5–9 years) were included in this study. Groups were stratified according to body composition (low-normal weight, overweight and obesity) and EVA (lower 75th (n = 725) and upper 25th (n = 269) percentiles of PWV) categories. We collected anthropometric data and conducted arterial pulse wave analysis.

Results:

Body mass index z-score (BMI-z) was higher in the upper versus the lower PWV group (p < 0.001). A higher percentage of overweight (23.8% vs 11.2%; p < 0.001) and obese (7.8% vs 3.0%; p < 0.001) participants were in the upper compared to the lower PWV group. In stepwise regression analysis, PWV showed a modest association with waist circumference (β=0.02; p = 0.044) in the upper PWV group only, but not with BMI-z (β=0.02; p = 0.065) and waist/height ratio (β=0.01; p = 0.085). In the lower PWV group, white ethnicity (β=0.07; p < 0.001) and higher age (β=0.02; p≦0.009) were contributors of PWV.

Conclusions:

In conclusion, higher adiposity (BMI-z and waist circumference) increased the odds of being in the upper PWV group, but only waist circumference remained the predictor of increased PWV in independent analysis. These findings suggest that central adiposity especially contributes to the development of increased arterial stiffness in South African school-aged children.
S-43-6: HYPERTENSION FROM CHILDHOOD TO ADULTHOOD: THE BT20+ STUDY
Authors: Kagura Juliana , Meer Romain , Boateng Daniel , Klipstein-Grobusch Kerstin , Norris Shane Anthony
Published: January 2023

Background:

Hypertension is a major risk factor for cardiovascular diseases and its prevalence among the Sub-Saharan African population has risen extremely in the last decades. Moreover, there is growing evidence that suggest that hypertension has its roots in childhood and adolescence and persist into adulthood. However, the epidemiology of hypertension in the young in a Low to Middle Income Country (LMIC) setting is not fully understood due to paucity of longitudinal data. Thus, we sought to investigate prevalence and new cases of hypertension and to identify risk factors that predict the incidence of hypertension from early childhood in urban black South-African children.

Methods:

We used data from the Birth to Twenty (BT20+) cohort in Johannesburg, South Africa. This cohort comprised of children born in 1990 and who had their growth, development and blood pressure measured at six follow-up periods over the course of 13 years. Hypertension status was classified using the fourth report of the National High Blood Pressure Education Program. Hypertension incidence rate was calculated using staggered entry survival analysis. We identified risk factors for incident hypertension using multivariable cox proportional hazard regressions.

Results:

Over a follow-up period of 13 years, the overall point prevalence of hypertension ranged from 8.4 to 24.4 % and cumulative incidence of hypertension was 54.3% (95% CI: 51.8 to 56.8). The overall hypertension incidence rate was 57.0 cases per 1000 person-years (95% CI: 53.2 to 61.1). Furthermore, the risk for incident hypertension increased with a rapid relative weight gain in early childhood (aHR = 1.11, 95% CI: 1.00 to 1.22), in mid childhood (aHR = 1.13, 95% CI: 1.03 to 1.24) and in adolescence (aHR = 1.21, 95% CI: 0.99 to 1.47). An increase in maternal parity significantly increased the risk for incident hypertension (aHR = 1.08, 95% CI: 1.01 to 1.15).

Conclusion:

Rapid weight gain relative to height and higher parity are prominent risk factors for incident hypertension in urban black South African children and adolescents. In order to reduce the high incidence and the disease burden of hypertension, national health programs should focus on promoting healthy lifestyle in early stages of life to curb rapid weight gain. Further research is required to check whether incident hypertension in childhood predict clinical outcomes in adulthood.
S-43-7: HYPERTENSION IN ADOLESCENTS AND YOUNG PEOPLE: OPPORTUNITIES FOR INTERVENTION IN SOUTH AFRICA
Authors: Jones Erika S. W.
Published: January 2023

Hypertension in adolescents and young people is a rising concern across the world. In South Africa the cardiovascular epidemic is simultaneous to the HIV and TB epidemics. Sub-Saharan Africa has a large proportion of young people compared to many developed regions but poor access to healthcare. This presentation will discuss the epidemiology of hypertension in young people, the causes of hypertension and the approach to diagnosis and causes. There will be discussion about how this age group is the optimal age in which to introduce screening and lifestyle changes and how to address this age group.
S-44-4: POST-STROKE SUPPLEMENTATION WITH SHORT-CHAIN FATTY ACIDS ACCELERATES RECOVERY IN MICE VIA THE G-PROTEIN COUPLED RECEPTORS
Authors: Peh Alex , Dinakis Evany , Mackay Charles R , Broughton Brad RS , Marques Francine Z
Published: January 2023

Objective:

Dietary fibre intake is negatively associated with stroke and overall mortality. A plausible hypothesis is that this happens via the gut microbiota, producing metabolites known as short-chain fatty acids (SCFAs) during fibre fermentation. Indeed, our unpublished data showed that low-fibre (LF) intake worsens stroke outcomes while high-fibre (HF) intake ameliorates it. Thus, we aimed to investigate whether switching from a LF diet pre-stroke to either a HF diet or supplementation with SCFAs post-stroke can improve functional and histological outcomes. We also aimed to determine if this effect is dependent on SCFAs-sensing G-protein coupled receptors GPR41, GPR43, and GPR109A.

Design and methods:

Male C57BL/6J mice (8–9 weeks, n = 8/group) were randomized and treated with a LF diet for 4-weeks prior to photothrombotic stroke surgery. Post-stroke, the mice were either fed with LF, HF or SCFAs for 7-days.

Results:

Using MRI, we observed no difference in the infarct volume at day 1 (D1) post-stroke. However, a HF diet and SCFAs supplementation reduced infarct volume at day 7 (D7) (mean brain infarct volume ± SEM; LF:13.52 ± 2.43 mm3 vs HF:7.71 ± 1.12 mm3 vs SCFAs:5.25 ± 1.18 mm3, P = 0.007), and improved brain recovery rate (LF:64.93 ± 2.94% vs HF:78.06 ± 1.98% vs SCFAs:85.05 ± 2.45%, P < 0.001). High-fibre and SCFAs supplementation improved wire-hanging grip strength and coordination at D7, which measures motor function (mean % improvement ± SEM; LF:12.59 ± 2.66% vs HF:69.77 ± 8.44% vs SCFAs:97.42 ± 1.54%, P < 0.001). Immunofluorescence was performed to access gut barrier integrity, immune cell infiltration and neurogenesis in the brain at D7. HF and SCFAs improved gut barrier integrity (ZO-1, P < 0.001). Moreover, SCFAs-treated mice had fewer neutrophils (MPO+, P = 0.017) and more neuroblasts (DCX+/Tuj1+, P < 0.001) in the infarct core, with a positive correlation between DCX+/Tuj1+ and recovery rate post-stroke (R2 = 0.50, P < 0.001).

To identify the receptors by which SCFAs improve stroke recovery, wild-type (WT) and GPR41/43/109a-/- mice (8–9 weeks, n = 8/group) were fed a HF diet pre- and post-stroke. GPR41/43/109a-/- mice showed worse stroke outcomes with larger brain infarct volume at D1 (P = 0.048) and D7 (P = 0.008), and worse recovery rate (P = 0.002). Consistent with this, wire-hanging grip strength was reduced (P < 0.001) at D7. In addition, compared to WT mice, GPR41/43/109a-/- mice had a leaky gut (P < 0.001), more neutrophils (P = 0.007) and very few neuroblasts (P = 0.011) in the infarct core.

Conclusions:

A high-fibre diet, resulting in the production of SCFAs, targets GPR41/43/109a signalling to reduce stroke-induced brain injury and improve functional recovery post-stroke. This improvement is likely to occur via neurogenesis and the suppression of the inflammatory response in the ischaemic brain.
S-45-1: ONCO-HYPERTENSION: CONCEPT AND FUTURE PERSPECTIVES
Authors: Kidoguchi Satoshi
Published: January 2023

In these decades, the morbidity of cancer has been increasing worldwide. On the other hand, the development of cancer treatment, such as small-molecule inhibitors, had improved the prognosis of patients with cancer. Consequently, cardiovascular diseases in cancer-survivors have become a matter of global concern. As a matter of fact, the mortality from cardiovascular events surpasses the mortality from cancers themselves in several types of cancer. Hypertension is reported to be the most frequent comorbidity and a significant risk factor for cardiovascular diseases among cancer-survivors. Besides, many types of newly discovered small-molecule inhibitors, including vascular endothelial growth factor signaling pathway inhibitors, proteasome inhibitors and Bruton-type tyrosine kinase inhibitors have been reported to be associated with blood pressure elevation. On the other hand, there have been reports that hypertension itself is associated with the occurrence of certain types of cancer, such as kidney or colon cancer, and some researchers have raised the possibility that antihypertensive drugs, such as thiazide diuretics, could elevate the risk of skin cancer from cancer registry database. From these, there is a close relationship between hypertension and cancers. However, many issues have remained to be solved regarding this field. For example, few guidelines mentioned the optimal target blood pressure and appropriate types of antihypertensive drugs during and after cancer therapy. Indeed, cancer patients are excluded from major large-scale trials evaluating the effects of antihypertensive drugs, and the patients with cardiovascular diseases are excluded from trials studying the effect of anticancer therapy, which makes it difficult to draw a definite conclusion regarding these issues. Additionally, it has not been clarified whether hypertension itself or the use of antihypertensive drugs are real risk factors for certain types of cancer and the screening for cancer occurrence is necessary for patients with hypertension or antihypertensive drugs. From these, we have been proposed a new concept, Onco-Hypertension, to better understand the complex association between hypertension and cancer. The concept, Onco-Hypertension, not only covers experimental and clinical studies exploring the bidirectional association between hypertension and cancer but also pursues comprehensive management of hypertensive cancer patients to improve their prognosis and quality of life. We think that multidisciplinary team approach including experts in hypertension, oncology, cardiology, nursing and so on, is necessary to clarify the unsolved issues regarding this, Onco-Hypertension, field.
S-45-4: THE EFFECTS OF HANDGRIP STRESS TEST ON HEMODYNAMIC PARAMETERS IN PATIENTS WITH HYPERTENSION AND DIASTOLIC HEART FAILURE
Authors: Hristova Krasimira , Tselov Nikolay , Tsonev Svetlin , Marinov Rumen , Slavchev Boris , Zlatancheva Galina , Velikov Toni , Stoyanovski Vasil
Published: January 2023

Aim:

The effectiveness of isometric handgrip exercise on changes of cardiovascular hemodynamic parameters in patients with diastolic heart failure is unknown. We assess the effect of several hemodynamic parameters and it changes during handgrip maneuvers in patients with arterial hypertension and diastolic heart failure during different stages of chemotherapy.

Methods:

The study population included 245 patients females /120 pts with HFpEF and 100 pts with HFmrEF and 25 pts with HFnEF / mean age of 45 years/. The effects of handgrip maneuver on hemodynamic parameters were studied by speckle tracking echocardiography. Following maximal squeeze until 100%, during the next 3 minutes patients were instructed to apply pressure at 50 %. The global longitudinal strain were extracted by 3, 4 and 2 CV images 70 fr/s and MAP and HR were performed at basal level, 1st, 2nd and 3rd minutes during handgrip stress test.

Results:

Heart rate (HR) and mean arterial pressures (MAP) increased significantly after handgrip maneuver (from 95 beats/min to 101 beats/min; from 109 mm Hg to 118 mm Hg, p < 0.05 respectively). Pulmonary capillary wedge pressure (PCWP), pulmonary artery systolic (s) and diastolic (d) pressures (PAP), cardiac index (CI), left ventricular ejection fraction (LVEF), did not change after handgrip maneuvers (p > 0.05). On the other hand, PAPs and PAPd, MAP and HR (p < 0.05) decreased significantly during handgrip maneuvers in group with HFmrEF. In same group were found significantly decreases of GLVLS at 2nd and 3rd minutes during stress test comparable with other 2 groups / p < 0.01/

Conclusion:

Cardiovascular response to handgrip maneuver may be a marker of failure to respond to compensatory mechanisms. Patients with good LV reserve had a rise in stroke /work with little or no change in LVEDP. Patients with poor reserve had a fall in stroke/ work together with a substantial rise in LVEDP. It is concluded that the stress imposed by sustained handgrip provides a simple test for the evaluation of left ventricular reserve in patients, who will develop cardiotoxicity during chemotherapy treatment.
S-46-2: DAYTIME MAXIMUM AMBULATORY BLOOD PRESSURE AND RISK OF STROKE IN INDIVIDUALS WITH INCREASED AMBULATORY ARTERIAL STIFFNESS INDEX: THE JAMP STUDY
Authors: Hoshide Satoshi , Tomitani Naoko , Kario Kazuomi
Published: January 2023

Objective:

The hypothesis of this study is that maximum ambulatory BP during daytime is a risk of cardiovascular events. We further hypothesize that this association may be remarkable in the population with increased arterial stiffness, because BP variability is linked to increased arterial stiffness.

Methods:

A total of 6294 Japan Ambulatory Blood Pressure Monitoring Prospective study participants (mean age, 68.6 ± 11.7 years; 78% treated hypertensive patients) with at least 1 cardiovascular risk factors performing ambulatory BP monitoring were followed for 4.5 years. Daytime maximum BP was calculated as the highest 1 hour moving average of 2 consecutive systolic BP readings during daytime defined by referring to the diary. Ambulatory arterial stiffness index (AASI) was calculated as 1 minus the regression of diastolic BP plotted against systolic BP obtained from individual 24-hour BP.

Results:

During a follow-up, there were 217 atherosclerotic cardiovascular events (119 stroke, 98 coronary artery disease). Divided into quartiles of daytime maximum BP, the top quartile (≧179.4 mmHg) was a risk of stroke events compared to other quartiles after adjustment for covariates (Hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.02–2.27), but not a risk of coronary artery disease. In the higher AASI group (≧0.5783), this association was observed (HR, 1.89; 95%CI, 1.13–3.15) but not in the lower ASSI group. The highest risk of stroke among BP groups was observed the individuals with 24-hour systolic BP of at least 130 mmHg and the top quartile of daytime maximum BP with a HR (95%CI) of 2.44 (1.27–4.68), compared with those with 24-hour systolic BP of less than 130 mmHg and other quartiles of daytime maximum BP in the higher AASI group, but this association was not found in the lower AASI group.

Conclusion:

Maximum ambulatory BP during daytime was a risk of cardiovascular events, especially in increases arterial stiffness represented as AASI.
S-47-3: APPLICATION OF AI FOR SCREENING CARDIOVASCULAR DISEASE
Authors: Kagiyama Nobuyuki
Published: January 2023

Recent advancements in information technologies and computer science brought dramatic changes not only in the field of business but also in the field of medicine. By analyzing big data using artificial intelligence techniques, especially deep learning, computers now have similar or even better diagnostic performance than trained physicians in medical image interpretation. In addition to their speed, reproducibility, and tirelessness, these artificial intelligence programs are starting to reveal their possibility to find hidden information from medical images. For example, studies have shown that not only present arrhythmias but also the presence of myocardial dysfunction and latent arrhythmias can be found in a body-surface ECG. Given the extremely high prevalence of hypertension worldwide, screening the cardiovascular risk in all patients with hypertension has not been realistic so far. However, such artificial intelligence may become a wider and more ubiquitous tool for the general screening of cardiovascular risk. Furthermore, big data generated from digital tools surrounding our daily life, such as laptops, smartphones, and smartwatches may provide further information regarding healthy or risky lifestyles, with which the risk stratification can be personalized. Thus, the current achievement in the application of artificial intelligence technologies in medicine and future perspective in regard to cardiovascular risk screening in patients with hypertension will be summarized in the talk.
S-48-1: EXERCISE TRAINING CONSIDERING THE CHARACTERISTICS OF SARCOPENIA AND FRAILTY
Authors: Takahashi Tetsuya , Yokoyama Miho , Morisawa Tomoyuki , Saitoh Masakazu , Minamino Tihru , Daida Hiroyuki
Published: January 2023

As Japan's population ages, the number of people with cardiovascular disease is also aging, and the frequency of frailty is increasing. Hypertension is another frequent finding in older patients. Hypertension in older patients is associated with frailty, and hypertension can be a risk factor for frailty. Studies have shown that frailty correlates with systolic blood pressure and that frailty is strongly associated with white matter lesions on brain MRI in hypertensive older patients. Thus, flail prevention is extremely important because of the potential impact of hypertension on the development of organ damage. Hypertension is also recognized as a major risk factor for cardiovascular diseases such as heart failure, atrial fibrillation, and stroke, and the development of these diseases can cause a decline in health status and/or exacerbate the degree of frailty. As people age, more people also experience blood pressure drops on standing (orthostatic hypotension), particularly as they become frail. This increases the likelihood of falls. Hypertension in older patients is also associated with sarcopenia.

We, the Juntendo University Cardiac Rehabilitation Team, provide exercise training for older patients with cardiovascular disease based on the characteristics of frailty and sarcopenia. Specifically, we conduct regular frailty assessments, and in addition to aerobic exercise, we have a program that specifically focuses on improving muscle strength, muscle power, and slowness. In addition, older cardiac patients with frailty and sarcopenia may have difficulty participating in outpatient cardiac rehabilitation program due to their own low physical fitness and low physical function, distance to the hospital, and lack of caregivers who can accompany them. To overcome the extremely low participation rate in outpatient cardiac rehabilitation program in Japan, the feasibility studies of tele-cardiac rehabilitation with real-time communication are also being conducted.
S-48-5: VASCULAR AGEING AND EXERCISE
Authors: Climie Rachel
Published: January 2023

Cardiovascular disease (CVD) remains the leading cause of death worldwide. Thus, we desperately need tools and approaches that can identify individuals at the asymptomatic, subclinical stage. Numerous studies have demonstrated a progressive decline of arterial function with age, even in the absence of traditional cardiovascular risk factors and overt CVD, which has given rise to the theory that arterial dysfunction (or accelerated vascular ageing) is a primary effect of advancing age and may represent a link between ageing and CVD. Markers of vascular ageing may be such tools, useful for identify those at risk of CVD.

Vascular ageing involves the deterioration in vascular structure and function over time, which ultimately leads to end organ damage in the heart, brain and kidney. Markers of vascular ageing are independent predictors of CVD events and mortality. Importantly, it must be recognised that vascular ageing occurs on a continuum across the life course, with its roots in foetal development and thus the importance of promoting healthy vascular ageing starts early in life.

Lifestyle interventions such as increasing exercise levels have been shown to have beneficial effects on various markers of vascular ageing. This presentation will summarise the evidence on the association between a physically active lifestyle and vascular ageing and how exercise can be used to delay early vascular ageing it at risk populations.
S-49-1: NUTRITION, CARDIO-METABOLIC RISK AND THE METABOLOME
Authors: Elliott Paul
Published: January 2023

Dietary and nutritional factors are known to be important in the emergence and progression of cardiometabolic disease risk factors including high blood pressure and obesity. At population level, large variations in cardiometabolic and cardiovascular disease risk across populations and temporal variations within populations point to the key importance of lifestyle factors including diet in the occurrence of these diseases. For example, epidemiological studies (including INTERSALT and INTERMAP studies), animal models and randomised controlled clinical trials (including the recent Salt Substitute and Stroke Study (SSaSS) in rural China [1]) have demonstrated the importance of salt intake in raised blood pressure and the rise of blood pressure with age, with interventions to lower salt intake resulting in lower risk of stroke, heart disease and all-cause mortality.

The “exposome“ concept has been proposed as a means to encapsulate the effects of environmental and lifestyle exposures (including diet) on the individual’s metabolism and risk of disease. The concept is that these factors interact at a cellular and systems level (against a background of genetic susceptibility) to determine the trajectory of health or disease. Their associated molecular signatures can be captured using omic technologies -- with the measurement of small molecule metabolites in blood or urine (metabolomics) being the most proximal to the phenotype. Metabolomics captures at high-resolution the biological signatures from the totality of internal (biochemical) and external exposures, including nutritional exposures and interactions between diet and the gut microbiome. These represent the end products of metabolic pathways associated with a wide range of physiological and pathophysiological processes, as well as direct signatures of lifestyle exposures including dietary intakes [2]. Agnostic (untargeted) analyses through the metabolome-wide association study (MWAS) applied to large-scale epidemiological data, coupled with targeted measurement of specific metabolites, can reveal novel signatures of perturbations in metabolic and disease pathways associated with nutritional exposures, including those related to blood pressure and adiposity. Development of nutritional biomarkers using such approaches could lead to objective markers of dietary intakes and diet quality which may be important for developing and monitoring dietary goals for long-term health.
S-50-3: MICROSAMPLING BASED MASS SPECTROMETRY FOR QUANTIFICATION OF ANGIOTENSIN PEPTIDES IN THE RENIN ANGIOTENSIN ALDOSTERONE SYSTEM
Authors: Bernieh Dennis , Lane Dan , Gill Henry , Jones Don , Gupta Pankaj
Published: January 2023

Objective:

Hypertension is the leading risk factor of premature death globally, affecting around 1.3 billion people. The canonical renin angiotensin aldosterone system (RAAS) has been extensively studied and methods are available for use clinically to assess hypertension. The non-canonical axis of the RAAS (consists of angiotensin 1Ξ7, angiotensin 1Ξ9, angiotensin converting enzyme 2 and alamandine) counteract the effects of the canonical pathway. This reveals their role as potential therapeutic targets for cardiovascular disease, but it has not been studied in detail in the clinical or research setting due to the difficulty in measuring its components owing to instability. Furthermore, the functional balance between the two arms of RAAS has not been fully understood. These limitations can be overcome by using dried microsampling, which provides better sample stability. Microsampling requires just a micro blood volume (<30 μL) from a finger prick collected on a card. It is minimally invasive, cheap, and easy to collect by patients.

Design:

A microsampling based liquid chromatography coupled with triple quadrupole mass spectrometry (LCMS/MS assay) was developed and optimised to simultaneously quantify 10 peptides (angiotensin II, Ang III, Ang IV, ACE2, Ang 1Ξ5, Ang 1Ξ7, Ang 1Ξ9, Ang 1Ξ12, Alamandine and Ang A) in the RAAS pathway.

Methods:

For the preparation of calibration samples, 30 μL of bovine serum albumin (BSA) was spiked with the 10 peptides standards, spotted on a card, dried and extracted by solid phase extraction using their respective internal standards. Chromatographic analyses were performed on an Acquity C18 Premier peptide column using gradient elution with a run time of 8 min. Identification was carried out using electrospray ionisation (positive) on a Waters Xevo TQXS triple quadrupole mass spectrometer. The developed assay is currently undergoing validation in line with international guidelines.

Results:

The method shows good linearity. The accuracy (relative error) and precision (coefficient of variation) values were within the pre-defined limits of ≧15% at all tested concentrations for the peptides. The assay sensitivity was sufficient to detect the peptides in dried blood spot samples.

Conclusion:

The microsampling based LCMS/MS assay development was successful and following completion of validation has the potential to quantify the circulating levels of these vasoactive peptides in patients with hypertension. This has been achieved, for the first time to the best of our knowledge on the entire RAAS pathway. This microsampling based proteomics assay could be used to study patients with hypertension in both research and clinical settings.
S-50-4: INCREASED PLASMA NEUROFILAMENT LIGHT AND CEREBRAL ATROPHY IN PATIENTS WITH TYPE 2 DIABETES AND LEFT VENTRICULAR HYPERTROPHY
Authors: Patel Sheila K , Restrepo Carolina , Khlif Mohamed , Werden Emilio , Ramchand Jay , Srivastava Piyush M , MacIsaac Richard J , Ekinci Elif I , Burrell Louise M , Brodtmann Amy
Published: January 2023

Objective:

Left ventricular hypertrophy (LVH) is common in people with type 2 diabetes mellitus (T2DM), and both are independently associated with increased dementia risk. Neurofilament light chain protein (NfL) is exclusively expressed in neurons and is an emerging plasma marker of neurodegeneration. We investigated the relationship between LVH, plasma NfL levels and brain atrophy in people with T2DM.

Design and method:

Participants with T2DM aged ≧ 50 years (n = 137) from the Diabetes and Dementia study (ACTRN126160005464590) in Melbourne, Australia completed detailed assessments including 3T brain MRI, transthoracic echocardiograms, and 24-hour ambulatory blood pressure. FreeSurfer estimated brain volume measures; plasma NfL assayed on Simoa® Quanterix HD-X Analyzer. Differences in the mean cortical thickness and average cortical gray matter volume were examined using multivariate general linear models. Multiple linear regression models examined the relationship between NfL and LVH. Comparisons were made between those with and without LVH.

Results:

Participant details: age = 65 ± 7 (mean ± SD) years, BMI = 30 ± 6 kg/m2, 44% women, HbA1c = 60 ± 14 mmol/mol, median diabetes duration = 15 [25th, 75th quartiles 7, 22] years, 21% APOE ε4 carriers; 25% educated < 12 years; 28% LVH. LVH was significantly associated with older age, female sex, obesity (BMI 33 ± 6 vs. 29 ± 5 kg/m2), hypertension history (95% vs. 67%), less education (37% vs. 20%), greater cortical thinning and lower cortical gray matter volume. Plasma NfL was correlated positively with age, HbA1c, and LV mass and negatively with cortical thickness. Median plasma NfL levels were significantly higher in LVH participants (21 [14, 28] vs. 15 [11, 22] pg/mL). Differences with LVH remained significant after adjustment for age, BMI, sex, education, and total intracranial volume for cortical thickness and average cortical gray matter volume, but not after adjustment for hypertension. LVH was an independent predictor of NfL levels (coefficient 0.19, p = 0.04).

Conclusion:

Accelerated structural brain aging is seen in people with LVH and T2DM. LVH and hypertension appear conflated as risk factors for brain atrophy. Plasma NfL levels are associated with LVH and cortical thickness. LVH and plasma NfL are potential early biomarkers of neurodegeneration in T2DM.
S-51-2: ROLE OF THE SYMPATHETIC NERVOUS SYSTEM IN HYPERTENSION: FOCUSED ON THE CENTRAL NERVOUS SYSTEM
Authors: Hirooka Yoshitaka
Published: January 2023

Activation of the sympathetic nervous system plays a critical role in the pathogenesis of hypertension. In particular, the central nervous system (CNS) organizes the sympathetic outflow and various inputs from the periphery. These include afferent neural inputs, circulating hormone, cellular factors, and inflammatory and immune responses. Also, within the brain, several factors affect and determine the central sympathetic outflow. Interestingly, these factors are activated particularly in the autonomic nuclei such as the paraventricular nucleus of the hypothalamus and rostral ventrolateral medulla of the brainstem. I will review what and how these factors are altered in various stages of hypertension from the results of basic studies using animal models of hypertension including our own and other investigators. I will address topics such as imbalance of nitric oxide and reactive oxygen species, activation of the brain renin-angiotensin pathway, and altered immunity including Toll-like receptor activation, regulatory T cell inhibition, and perivascular macrophages. In addition, activation of the mineral corticoid receptors in the CNS could be responsible for salt-sensitive hypertension. Finally, I will introduce some new aspects of neural mechanisms of hypertension in the recent progress in the field of research. These experimental studies regarding CNS mechanisms of hypertension can be translated to clinical practice and novel therapies.
S-51-6: RENOVASCULAR HYPERTENSION AND BRAIN: ROLE OF THE RENIN-ANGIOTENSIN SYSTEM AND SODIUM
Authors: Colombari Debora Simoes Almeida
Published: January 2023

Renovascular hypertension is a type of secondary hypertension. Renovascular hypertensive 2-kidney, 1-clip (2K1C) rats have an increased activity of the renin-angiotensin system, and it is an experimental model to study renovascular hypertension. Renovascular hypertensive 2K1C rats have an imbalance of RAS components in the brain, an impairment of the baroreflex and they present an increase in daily intake of hypertonic NaCl solution. Therefore, we focused on studying: 1) the effects of overexpression of RAS components in the in the nucleus of the solitary tract (NTS), a brainstem area involved with cardiovascular control, 2) the brain mechanisms involved with the sodium appetite (operationally defined as an ingestion of hypertonic NaCl solution) in 2K1C rats. In adult Holtzman rats, the left renal artery was partially occluded by a silver clip with an opening of 0.2 mm to induce 2K1C. The experiments started after 6 weeks (hypertension plateau). We observed that increasing angiotensin type 2 receptor (AT2R) expression in the NTS attenuated the development of renovascular hypertension and also reversed the impairment of the baroreflex observed in 2K1C rats. Furthermore, an observed decrease in mRNA levels of angiotensin-converting enzyme 2 in the NTS of 2K1C rats was restored to control levels after viral-mediated increases in AT2R at this site. Virally mediated blockade of an intracellular pathway activated by angiotensin II (ANG II) acting in type 1 receptor (AT1R) in the NTS attenuated the development of renovascular hypertension and also reversed the impairment of the baroreflex. Daily 0.3 M NaCl intake transiently increased from the 2nd to the 5th week after 2K1C surgery. On the 6th week, in spite of comparable daily 0.3 M NaCl intake between 2K1C and sham rats, water deprivation (used to induce sodium appetite) produced a greater increase 0.3 M NaCl intake in 2K1C rats. Moreover, this intake is totally blocked by central AT1R and mineralocorticoid receptor antagonism. These data demonstrated that ANG II acting in the AT1R in the NTS is involved with the development of hypertension and baroreflex impairment in 2K1C and that AT2 overexpression at the same site can counteract these effects. In addition, the results demonstrated the participation of ANG II and aldosterone acting centrally in the enhanced sodium intake in water deprived 2K1C rats.