bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial regularity of the young stellar population in spiral arms of late-type galaxies NGC 895, NGC 5474, and NGC 6946
Authors: Gusev A S , Shimanovskaya E V , Zaitseva N A
Published: June 2022

We investigate the spatial regularity in the distribution of the young stellar population along spiral arms of three late-type spiral galaxies: NGC 895, NGC 5474, and NGC 6946. This study is based on an analysis of photometric properties of spiral arms using Galaxy Evolution Explorer ultraviolet, optical UBVRI, H α, and 8 μm IRAC infrared surface photometry data. Using the Fourier analysis approach, we found features of spatial regularity or quasi-regularity in the distribution of the young stellar population or (and) regular chains of star formation regions in all arms of NGC 895, NGC 5474, and NGC 6946 with characteristic scales of spacing from 350 to 500 pc in different arms, and (or) scales that are multiples of them. These characteristic scales are close to those found earlier in NGC 628, NGC 6217, and M100.
First characterization of a new high-mass X-ray binary in LMC eRASSU J050810.4−660653 with SRG/ART-XC, NuSTAR, and Swift
Authors: Salganik Alexander , Tsygankov Sergey S , Lutovinov Alexander A , Mushtukov Alexander A , Mereminskiy Ilya A , Molkov Sergey V , Semena Andrei N
Published: June 2022

We report results of the first detailed spectral and temporal studies of the recently discovered Be/X-ray binary eRASSU J050810.4−660653 in Large Magellanic Cloud based on the data from the SRG/ART-XC, NuSTAR and Swift/XRT instruments obtained in 2021 December–2022 May in a wide energy range of 0.5–79 keV. Pulsations with the period of 40.5781 ± 0.0004 s were found in the source light curve with the pulsed fraction monotonically increasing with the energy. An estimate of the orbital period of ∼38 d was obtained based on the long-term monitoring of the system. The source spectrum can be well approximated with a power-law model modified by an exponential cutoff at high energies. The pulse phase-resolved spectroscopy shows a strong variation of spectral parameters depending on the phase of a neutron star rotation. We have not found any features connected with the cyclotron absorption line both in the phase-averaged and phase-resolved spectra of eRASSU J050810.4−660653. However, the neutron star magnetic field was estimated around several 1013 G using different indirect methods. Discovered variations of the hardness ratio over the pulse phase is discussed in terms of physical and geometrical properties of the emitting region.
Estimating atmospheric parameters from LAMOST low-resolution spectra with low SNR
Authors: Li Xiangru , Zeng Si , Wang Zhu , Du Bing , Kong Xiao , Liao Caixiu
Published: June 2022

Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST) acquired tens of millions of low-resolution stellar spectra. The large amount of the spectra result in the urgency to explore automatic atmospheric parameter estimation methods. There are lots of LAMOST spectra with low signal-to-noise ratios (SNR), which result in a sharp degradation on the accuracy of their estimations. Therefore, it is necessary to explore better estimation methods for low-SNR spectra. This paper proposed a neural network-based scheme to deliver atmospheric parameters, LASSO-MLPNet. Firstly, we adopt a polynomial fitting method to obtain pseudo-continuum and remove it. Then, some parameter-sensitive features in the existence of high noises were detected using Least Absolute Shrinkage and Selection Operator (LASSO). Finally, LASSO-MLPNet used a Multilayer Perceptron network (MLPNet) to estimate atmospheric parameters Teff, log g, and [Fe/H]. The effectiveness of the LASSO-MLPNet was evaluated on some LAMOST stellar spectra of the common star between the Apache Point Observatory Galactic Evolution Experiment (APOGEE) and LAMOST. It is shown that the estimation accuracy is significantly improved on the stellar spectra with 10 < SNR ≤ 80. Especially, LASSO-MLPNet reduces the mean absolute error (MAE) of the estimation of Teff, log g, and [Fe/H] from [144.59 K, 0.236 dex, 0.108 dex; LAMOST Stellar Parameter Pipeline (LASP)] to (90.29 K, 0.152 dex, 0.064 dex; LASSO-MLPNet) on the stellar spectra with 10 < SNR ≤ 20. To facilitate reference, we release the estimates of the LASSO-MLPNet from more than 4.82 million stellar spectra with 10 < SNR ≤ 80 and 3500 < SNRg ≤ 6500 as a value-added output.
Pulsar emission patterns seen as evidence for magnetospheric interactions
Authors: Wright Geoff
Published: June 2022

This paper seeks to understand the origin of the multiple complex patterns present in the emission of many pulsars. Previous attempts have often required the observed signal to be aliased, especially in pulsars exhibiting stationary subpulses or drift-mode changes. However, such mathematics places the observer in an improbably special position. It is therefore proposed that patterns are intrinsic to the magnetosphere and arise through beats between the magnetospheric drift and the time-delayed interaction of widely separated regions of the magnetosphere. The beat equation is modelled geometrically by two turning carousels of ‘footprints’ linked by a time-delay of approximately a pulse period, with the carousels adopting different speeds according to the number of footprints. Comparison with observed drift-changing modes suggests that footprints are separated at a minimum distance of about 95m on polar caps wider than those conventionally defined by the last closed fieldline touching the light cylinder. Applying this picture to a pulsar lifetime defines three stages: (1) young pulsars whose magnetosphere drift is only slightly slower than the pulsar but generating footprints rotating slowly in space; (2) a Nyquist stage where the magnetosphere and footprints rotate in tandem, observed as on-off pulses; and (3) older pulsars with relatively wide polar caps on which footprints are near-stationary. Explanations for chaotic mode-switching, nulling, and pulsar death are offered in the same context. A physical interpretation of the model is kept to a minimum, although it clearly suggests that pulsar emission is driven by magnetospheric rather than polar cap effects.
Interstitial lung disease in ANCA-associated vasculitis: associated factors, radiographic features and mortality
Authors: Doliner Brett , Rodriguez Karen , Montesi Sydney B , Fu Xiaoqing , Sharma Amita , Wallace Zachary S
Published: June 2022

Objective

To evaluate the prevalence, clinical and radiographic features, and long-term outcomes of interstitial lung disease (ILD) in a United States-based ANCA-associated vasculitis (AAV) cohort.

Methods

In this retrospective cohort study, we identified cases of ILD within the 2002–2019 Mass General Brigham AAV Cohort, a consecutive inception cohort of PR3- or MPO-ANCA+ AAV patients. ILD diagnosis and classification as fibrotic or non-fibrotic were confirmed by review of available chest imaging by two board-certified radiologists. Cox proportional hazard models, with age as the time scale, were used to estimate the association of AAV-ILD with all-cause mortality.

Results

Of 684 patients in the MGB AAV Cohort, 91 (13%) had ILD which preceded the diagnosis of AAV by a mean of 2.2 years. AAV-ILD patients were older (67 vs 60 years, P < 0.001) than patients without ILD but the distribution of sex and race was similar. AAV-ILD patients were more often MPO-ANCA+ (93% vs 65%, P < 0.001); among MPO-ANCA+ patients (n = 470), 85 (18%) had ILD. The majority of ILD was fibrotic (76%) and UIP was the most common ILD pattern (42%). The baseline forced vital capacity (FVC) % predicted among ILD patients was 81 ± 20%. Fibrotic AAV-ILD was associated with a 58% higher risk of death (aHR 1.58, 95% CI 1.06, 2.37) compared with AAV patients without ILD.

Conclusion

ILD is a frequent complication of AAV, especially MPO-ANCA+ AAV, often preceding recognition of AAV. Fibrotic AAV-ILD is associated with a higher risk of death than AAV without ILD.
Resting state functional connectivity in SLE patients and association with cognitive impairment and blood–brain barrier permeability
Authors: Hanly John G , Robertson Jason W , Legge Alexandra , Kamintsky Lyna , Aristi Guillermo , Friedman Alon , Beyea Steven D , Fisk John D , Omisade Antonina , Calkin Cynthia , Bardouille Tim , Bowen Chris , Matheson Kara , Hashmi Javeria A
Published: June 2022

Objective

Extensive blood–brain barrier (BBB) leakage has been linked to cognitive impairment in SLE. This study aimed to examine the associations of brain functional connectivity (FC) with cognitive impairment and BBB dysfunction among patients with SLE.

Methods

Cognitive function was assessed by neuropsychological testing (n = 77). Resting-state FC (rsFC) between brain regions, measured by functional MRI (n = 78), assessed coordinated neural activation in 131 regions across five canonical brain networks. BBB permeability was measured by dynamic contrast-enhanced MRI (n = 61). Differences in rsFC were compared between SLE patients with cognitive impairment (SLE-CI) and those with normal cognition (SLE-NC), between SLE patients with and without extensive BBB leakage, and with healthy controls.

Results

A whole-brain rsFC comparison found significant differences in intra-network and inter-network FC in SLE-CI vs SLE-NC patients. The affected connections showed a reduced negative rsFC in SLE-CI compared with SLE-NC and healthy controls. Similarly, a reduced number of brain-wide connections was found in SLE-CI patients compared with SLE-NC (P = 0.030) and healthy controls (P = 0.006). Specific brain regions had a lower total number of brain-wide connections in association with extensive BBB leakage (P = 0.011). Causal mediation analysis revealed that 64% of the association between BBB leakage and cognitive impairment in SLE patients was mediated by alterations in FC.

Conclusion

SLE patients with cognitive impairment had abnormalities in brain rsFC which accounted for most of the association between extensive BBB leakage and cognitive impairment.
Protracted Speciation under the State-Dependent Speciation and Extinction Approach
Authors: Hua Xia , Herdha Tyara , Burden Conrad J
Published: June 2022

How long does speciation take? The answer to this important question in evolutionary biology lies in the genetic difference not only among species, but also among lineages within each species. With the advance of genome sequencing in non-model organisms and the statistical tools to improve accuracy in inferring evolutionary histories among recently diverged lineages, we now have the lineage-level trees to answer these questions. However, we do not yet have an analytical tool for inferring speciation processes from these trees. What is needed is a model of speciation processes that generates both the trees and species identities of extant lineages. The model should allow calculation of the probability that certain lineages belong to certain species and have an evolutionary history consistent with the tree. Here, we propose such a model and test the model performance on both simulated data and real data. We show that maximum-likelihood estimates of the model are highly accurate and give estimates from real data that generate patterns consistent with observations. We discuss how to extend the model to account for different rates and types of speciation processes across lineages in a species group. By linking evolutionary processes on lineage level to species level, the model provides a new phylogenetic approach to study not just when speciation happened, but how speciation happened. [Micro–macro evolution; Protracted birth–death process; speciation completion rate; SSE approach.]
Evaluation of dietary mycotoxin control strategies on nursery pig growth performance and blood measures
Authors: Becker Larissa L , DeRouchey Joel M , Woodworth Jason C , Tokach Mike D , Goodband Robert D , Vidal Arnau , Gougoulias Christos , Gebhardt Jordan T
Published: June 2022

A total of 4,318 pigs (337 × 1,050, PIC; initially 6.5 ± 0.08 kg) were used in a 35-day study to evaluate dietary mycotoxin control strategies on nursery pig performance and blood measures. Pigs were weaned at approximately 21 d of age and randomly allotted to 1 of 5 dietary treatments in a randomized complete block design with blocking structure including sow farm origin, date of entry into facility, and average pen BW. A total of 160 pens were used with 80 double-sided 5-hole stainless steel fence line feeders, with feeder serving as the experimental unit. For each feeder, 1 pen contained 27 gilts and 1 pen contained 27 barrows. There were 16 replications per dietary treatment. A common phase 1 diet was fed to all pigs in pelleted form for 7 day prior to treatment diets. Experimental treatments were fed from days 7 to 42 after weaning (days 0 to 35 of the study) and included a low deoxynivalenol (DON) diet (1.12 ± 0.623 mg/kg), high DON diet (2.34 ± 1.809 mg/kg), high DON+ 0.50% sodium metabisulfite (SMB), high DON+ one of two mitigating products; 0.30% Technology1, or 0.30% Technology1+. Technology1 and 1+ are comprised of clays, yeast cell wall components, and a blend of plant extracts. Technology1+ also contains SMB. Overall (days 0 to 35), pigs fed high DON had decreased (P < 0.05) final BW, ADG, and ADFI compared with low DON. Additionally, pigs fed high DON+SMB had increased (P < 0.05) ADG compared with all other treatments. An improvement (P < 0.05) in G:F was observed in pigs fed high DON + SMB or high DON + Technology1+ compared with the low DON or high DON + Technology1 diets with high DON diets intermediate. Pigs fed high DON + SMB or high DON + Technology1 diets had reduced (P < 0.05) total removals and mortality compared with pigs fed low DON diets with high DON and high DON + Technology1+ intermediate. Liquid chromatography/mass spectrometry analysis of circulating blood collected on day 35 revealed that pigs fed high DON or high DON + Technology1 had increased (P < 0.05) DON concentrations compared to low DON with high DON + SMB and high DON + Technology1+ intermediate. In summary, pigs fed high DON diets had reduced performance compared with pigs fed low DON. Sodium metabisulfite in high DON diets provided a benefit in growth performance with ADG and G:F exceeding growth performance in the low DON diet while, the improved G:F ratio combined with other immunometabolic changes (gamma glutamyltransferase and creatine kinase) associated with Technology1+ warrant further investigation.
Conserved recombination patterns across coronavirus subgenera
Authors: de Klerk Arné , Swanepoel Phillip , Lourens Rentia , Zondo Mpumelelo , Abodunran Isaac , Lytras Spyros , MacLean Oscar A , Robertson David , Kosakovsky Pond Sergei L , Zehr Jordan D , Kumar Venkatesh , Stanhope Michael J , Harkins Gordon , Murrell Ben , Martin Darren P
Published: June 2022

Recombination contributes to the genetic diversity found in coronaviruses and is known to be a prominent mechanism whereby they evolve. It is apparent, both from controlled experiments and in genome sequences sampled from nature, that patterns of recombination in coronaviruses are non-random and that this is likely attributable to a combination of sequence features that favour the occurrence of recombination break points at specific genomic sites, and selection disfavouring the survival of recombinants within which favourable intra-genome interactions have been disrupted. Here we leverage available whole-genome sequence data for six coronavirus subgenera to identify specific patterns of recombination that are conserved between multiple subgenera and then identify the likely factors that underlie these conserved patterns. Specifically, we confirm the non-randomness of recombination break points across all six tested coronavirus subgenera, locate conserved recombination hot- and cold-spots, and determine that the locations of transcriptional regulatory sequences are likely major determinants of conserved recombination break-point hotspot locations. We find that while the locations of recombination break points are not uniformly associated with degrees of nucleotide sequence conservation, they display significant tendencies in multiple coronavirus subgenera to occur in low guanine-cytosine content genome regions, in non-coding regions, at the edges of genes, and at sites within the Spike gene that are predicted to be minimally disruptive of Spike protein folding. While it is apparent that sequence features such as transcriptional regulatory sequences are likely major determinants of where the template-switching events that yield recombination break points most commonly occur, it is evident that selection against misfolded recombinant proteins also strongly impacts observable recombination break-point distributions in coronavirus genomes sampled from nature.
Meta-Analysis of Yield Response to Applications of Fungicides Made at Different Crop Growth Stages in Michigan Winter Wheat
Authors: Breunig Mikaela , Nagelkirk Martin , Byrne Adam M. , Wilbur Jaime F. , Steinke Kurt , Chilvers Martin I.
Published: June 2022

Various foliar fungal diseases, as well as Fusarium head blight, are a reoccurring threat to Michigan wheat production. Fungicides are a key management tool for these diseases, and many products are efficacious. However, the timing of application is thought to be a key determinant of yield response and disease prevention. A meta-analysis of data from previously conducted small-plot fungicide trials from Michigan was performed to evaluate which fungicide application timings individually or in combination resulted in the greatest yield response across multiple years. Data from 46 trials (2007 to 2020) were utilized to examine six fungicide regimes. All regimes analyzed resulted in a statistically significant yield response, and at least an 87% probability of a positive response in future applications. The combination treatment of a Feekes 5 to 7 plus a Feekes 10.5.1 application had the highest mean yield response of 10.5 bu./ac. increase relative to the mean of the nontreated control, and the Feekes 10.5.1 application alone resulted in 7.4 bu./ac. yield response. Early season applications (Feekes 5 to 7) resulted in the lowest response, with a mean yield increase of 4.1 bu./ac. Probabilities of positive yield response and prediction intervals were calculated for all regimes to aid growers in making future fungicide application decisions.
TIME-VARYING SERUM URIC ACID PREDICTS NEW-ONSET ATRIAL FIBRILLATION IN TREATED HYPERTENSIVE PATIENTS
Authors: Kjeldsen Sverre E. , Zachs Eran S. , Stokke Ildri M. , Wachtell Kristian , Hille Darcy A. , H⊘ieggen Aud , Julius Stevo , Gerdts Eva , Okin Peter M. , Devereux Richard B.
Published: June 2022

Objective:

The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study was the first clinical outcome trial to suggest that lowering of serum uric acid by a uricosuric drug such as losartan has a beneficial effect on cardiovascular outcome independently of changes in renal function or blood pressure. LIFE also showed less new-onset atrial fibrillation in hypertensive patients receiving losartan vs. atenolol based treatment. Because losartan reduces serum uric acid levels, we investigated relations of serum uric acid with new-onset atrial fibrillation in the study.

Design and method:

Hypertensive patients with electrocardiographic left ventricular hypertrophy and no prior atrial fibrillation (n = 8243) were treated for 5.0 ± 0.4 years with losartan or atenolol based therapy. Associations of serum uric acid with new-onset atrial fibrillation documented by Minnesota coding were assessed by Cox models using serum uric acid and systolic blood pressure as time-varying covariates to take into account changes of serum uric acid related to losartan or diuretic treatment, changes in renal function, and aging.

Results:

Time-varying serum uric acid was associated with new atrial fibrillation defined by Minnesota code (HR = 1.19 per 16.8 umol/L [1 mg/dL] [95% CIs, 1.12–1.26], P < 0.0001), independent of losartan treatment (HR = 0.75 [95% CIs, 0.61–0.93], P = 0.007), older age (HR = 1.95 per 7.0 years [95% CIs, 1.73–2.20], P < 0.0001), male sex (HR = 1.46 [95% CIs, 1.09–1.94], P = 0.010) and higher Cornell voltage duration product (HR = 1.10 per 1023 msec x mm [95% CIs, 1.01–1.21], P = 0.034). Similar results were obtained in Cox models with serum uric acid levels partitioned according to baseline quartiles and in which atrial fibrillation was defined by physician reports or by both Minnesota coding and physician reports.

Conclusions:

Thus, we found a strong relationship between time-varying serum uric acid levels during antihypertensive treatment and new-onset atrial fibrillation in elderly patients with left ventricular hypertrophy. Our data suggest that in-treatment serum uric acid is a strong predictor for new onset atrial fibrillation in hypertensive patients, independent of effects of antihypertensive treatment, age, sex, and electrocardiographic left ventricular hypertrophy. Further research is needed to clarify how serum uric acid may provoke atrial fibrillation.
PREDICTING THE RISK OF SYNCOPE IN PATIENTS WITH AN INDICATION FOR ANTIHYPERTENSIVE TREATMENT: DEVELOPMENT OF THE STRATIFY-SYNCOPE PREDICTION MODEL
Authors: Constantinos Koshiaris , Stevens Richard , Hobbs F.D. Richard , McManus Richard J. , Sheppard James P.
Published: June 2022

Objective:

Syncope is one of the most common side effects associated with antihypertensive medication. In patients at increased of syncope, the additional risk of harm from antihypertensive medication may outweigh the potential benefits of treatment in terms of cardiovascular risk reduction. However, it is unclear how to identify patients at most risk of syncope events. This study aimed to develop a clinical prediction model for risk of hospitalisation or death from syncope.

Design and method:

This was a cohort study using data from the Clinical Practice Research Datalink (CPRD) in the UK. The electronic health records of patients aged greater than 40, with at least one blood pressure measurement between 130–179 mmHg were included. Outcomes were defined as a syncope event resulting in hospitalisation or death within 10 years of baseline. Predictors of syncope were based on the literature and expert opinion and included patient characteristics, past medical history and prescribed treatment (including antihypertensive prescription). A Fine-Gray model was used to adjust for competing risk of mortality and results are reported as subdistribution hazard ratios (SHR).

Results:

A total of 1,772,617 patients were eligible for the study, with mean age of 59 and 48% males. Median follow up was 6.2 years with 39898 syncope events (2.3%). The antihypertensive medications most strongly associated with syncope were alpha blockers (SHR: 1.21, 95%CI 1.15 to 1.28) and ACE inhibitors (SHR: 1.19, 95%CI 1.16 to 1.22). Other important predictors included age (Figure 1), male sex, high social deprivation, heavy alcohol consumption, previous syncope, diabetes, dementia, structural cardiac problems, arrhythmias, spinal cord injuries, parkinsonism, cardiopulmonary disease and prescription of antidepressants, antipsychotics and opioids (table 1).

Conclusions:

This prediction model identified a number of strong predictors of syncope which are routinely available in an individual's electronic health records. The accuracy of this model will examined in a further ∼3,000,000 patients from a different electronic health record database. If it is found to perform well, such a model could be used to provide personalised estimates of an individual's risk of harm from antihypertensive treatment, thus facilitating more informed treatment choices.
REDUCED NACL COTRANSPORTER ABUNDANCE AND PHOSPHORYLATION IN URINARY EXTRACELLULAR VESICLES IN RESPONSE TO KCL SUPPLEMENTS IN HEALTHY ADULTS MAINTAINED ON A HIGH-NA+ LOW-K+ DIET: A
Authors: Wu Aihua , Wolley Martin , Mayr Hannah , Cowley Diane , Li Bo , Welling Paul , Campbell Katrina , Fenton Robert , Stowasser Michael
Published: June 2022

Objective:

A renal-K switch mechanism has been established in rodent models and demonstrates that a low K+ intake acts as a trigger that links K+ and Na+-dependent blood pressure. This mechanism involves activation (phosphorylation) of the NaCl-cotransporter NCC in the distal convoluted tubule in response to low-K+ intake and suppression (dephosphorylation) after a high-K+ intake. As a first step to establishing a similar mechanism in humans, this study aimed to examine if the abundance of NCC and pNCC in urinary extracellular vesicles (uEVs) of healthy adults on a high-Na+ diet changes in response to alterations in K+ intake.

Design and method:

The study design was a double-blind, randomised and placebo-controlled trial. Healthy adults maintained on a high-Na+ (∼200mmol/day), low-K+ (∼60mmol/day) diet underwent a run-in period of 1-week followed by a cross-over study, with 5 days supplementary KCl (active phase, Span K, 24mmol thrice daily) or 5 days placebo administered in random order and separated by 2 days washout. NCC and pNCC were measured in uEVs after each phase. Participants who met dietary compliance (no less than 80%) and increased urinary K+ in the active phase were included in analyses.

Results:

Among the 18 (out of 28) participants who met inclusion criteria, supplementary KCl administration (versus placebo) in the active phase was associated with higher levels of plasma K+ (p < 0.001) and 24-Hour urine levels of K+ (p < 0.001), Cl- (p < 0.001) and aldosterone (p < 0.001), and lower levels of 24-Hour urinary Na+/K+ (p < 0.001), NCC (p < 0.01) and pNCC (p < 0.05); whilst the ratio of pNCC/NCC remained unchanged. Correlation analyses revealed an inverse correlation of plasma K+ with NCC (R2 = 0.11, p = 0.05) and δurinary K+ with δpNCC (R2 = 0.23, p = 0.04). Ambulatory systolic blood pressure positively correlated with timed urinary Na+/K+ (R2 = 0.08, p = 0.04) during interventions.δ

Conclusions:

KCl supplementation in healthy adult subjects maintained on a high-Na+ low-K+ diet was associated with a fall in NCC and pNCC, consistent with the renal-K switch mechanism, and offers a useful target for dietary intervention.
ARTERIAL STIFFNESS FROM MONITORING OF QKD INTERVALL PREDICTS OVERALL MORTALITY
Authors: Gosse Philippe , Boulestreau Romain , Doublet Julien , Cremer Antoine
Published: June 2022

Objective:

Markers of subclinical target organ damage increase cardiovascular risk prediction beyond traditional risk factors. Arterial stiffness is one of these parameters, and QKD intervall a marker of arterial stiffness.

We aimed to precise if arterial stiffness through QKD intervall measurement could predict overall mortality.

Design and method:

The patients included in this study belong to the Bordeaux cohort of hypertensive started in 1984.

It includes patients with essential hypertension and no cardiovascular complications or pathology likely to affect the prognosis. All the patients benefited from an ambulatory measurement of blood pressure coupled with the measurement of QKD interval (Diasys 200RK then Diasys integra and from 2020 Diasys 3 plus, Novacor, France). QKD interval is the time between the QRS wave on the ECG and the detection of the last Korotkoff sound on deflation of the cuff. The stiffer the arteries, the shorter the QKD intervall. The value obtained is expressed as a percentage of a theoretical normal value based on the height predicted value of a population of normal young subjects. In 2021, we made a systematic search of all cause deaths for all the patients in the registry from national institut INSEE.

Results:

We included 913 patients whose main characteristics are summarized in table 1. The average follow up period for the population was 11.88 ± 7.5 years. Cardiovascular prediction calcultated by the score SCORE, 24 h SBP and QKDh as a continuous or discontinuous variable were significantly and independently linked to the occurrence of cardiovascular complications or all cause deaths in multivariate Cox model.

Conclusions:

Arterial stiffness evaluated by the ambulatory measurement of QKD interval has an independent prognostic value in the hypertensive and add significant predictive information to the risk SCORE.
SYMPATHETIC NERVOUS SYSTEM ACTIVITY IN ATTENDED AND UNATTENDED BP MEASUREMENTS: NAVIGATING THE UNCHARTED
Authors: Manta Eleni , Andrikou Ioannis , Thomopoulos Costas , Konstantinidis Dimitrios , Zammanis Ioannis , Polyzos Dimitrios , Drogkaris Sotrios , Iliakis Panagiotis , Mantzouranis Emmanouil , Dimitriadis Kyriakos , Tsioufis Konstantinos
Published: June 2022

Objective:

It has been hypothesized that unattended blood pressure (BP) measurement may provide complementary clinical information to conventionally attended BP measurement. The role of sympathetic nervous system activation during attended and unattended BP measurements is largely undetermined.

Design and method:

We studied 161 untreated hypertensive patients undergoing attended and unattended office BP measurements. Patients were divided into two groups - group A, unattended systolic BP greater than the attended systolic BP (n = 79), and group B, unattended systolic BP equal or lower than the attended (n = 82). All participants underwent muscle sympathetic nerve activity (MSNA) estimation by microneurography. Unattended and attended BP measurements were performed with the same device in a random order for each patient on the day of MSNA recording. MSNA levels were compared between the two groups

Results:

We examined 161 hypertensive patients [54% men, mean age 56 ± 12 years, BMI 29 ± 5 kg/m2, mean attended BP 140 ± 17 / 87 ± 13 mmHg, mean unattended BP 141 ± 20 / 85 ± 12 mmHg]. Group A and group B had statistically significant differences between attended systolic BP (136.7 ± 17.8 vs 143.7 ± 15.7 mmHg respectively, p = 0.009), attended diastolic BP (85.5 ± 14.7 vs 89.7 ± 11.4 mmHg respectively, p = 0.04), unattended systolic BP (145.5 ± 19 vs 135.7 ± 19.9 mmHg respectively, p = 0.002) and unattended diastolic BP (86.9 ± 13 vs 83.2 ± 11.2 mmHg respectively, p = 0.05). However, the two groups did not differ as regards MSNA levels (41.6 ± 8.9 vs. 42.1 ± 8.1 bursts per minute respectively, p = 0.7). MSNA levels did not correlate to attended and unattended systolic/diastolic BP in both groups.

Conclusions:

sympathetic nervous system activity may not contribute significantly to the differential BP levels during attended or unattended BP measurements.
INFLUENCE OF SEX, BODY MASS INDEX, AND SKIN COLOR ON THE ACCURACY OF NON-INVASIVE CUFFLESS PHOTOPLETHYSMOGRAPHY-BASED BLOOD PRESSURE MEASUREMENTS
Authors: Eisenkraft Arik
Published: June 2022

Objective:

It is suggested that vital signs obtained by photoplethysmography-based devices might be influenced by subcutaneous fat and skin color. This study aimed to test the accuracy of blood pressure (BP) measurements taken using a photoplethysmography-based device by stratifying participants based on sex, body mass index (BMI), and skin color.

Design and method:

Ambulatory individuals coming for a routine BP checkup were recruited for an observational, comparative study. Systolic BP (SBP) and diastolic BP (DBP) measurements compared between the photoplethysmography-based and the cuff-based devices were stratified based on sex, BMI, and skin color (types 1–3 and 4–6 by the Fitzpatrick scale).

Results:

A total of 1548 measurements were nalysed. Correlations of SBP and DBP between the devices among males and females were between 0.914 to 0.987 (p < 0.001), Bland-Altman analysis of SBP and DBP showed a bias of less than 0.5 mmHg for both sexes. Correlations of SBP and DBP between the devices among BMI groups were between 0.931 to 0.991 (p < 0.001), Bland-Altman analysis of SBP and DBP showed a bias of less than 1 mmHg for all. Correlations of SBP and DBP between the devices among the skin color groups were between 0.936 to 0.983 (p < 0.001), Bland-Altman analysis of SBP and DBP showed a bias of less than 1 mmHg for all.

Conclusions:

This study shows similar and high agreement rates between BP measurements obtained using a PPG-based non-invasive cuffless BP device and a cuff-based BP device across sex, BMI groups, and skin color.
RISK STRATIFICATION BY CROSS-CLASSIFICATION OF CENTRAL AND BRACHIAL SYSTOLIC BLOOD PRESSURE
Authors: Cheng Yi-Bang , Thijs Lutgarde , Aparicio Lucas S. , Huang Qi-Fang , Wei Fang-Fei , Yu Yu-Ling , Barochiner Jessica , Sheng Chang-Sheng , Yang Wen-Yi , Niiranen Teemu J. , Boggia José , Zhang Zhen-Yu , Stolarz-Skrzypek Katarzyna , Gilis-Malinowska Natasza , Tikhonoff Valérie , Wojciechowska Wiktoria , Casiglia Edoardo , Narkiewicz Krzysztof , Filipovský Jan , Kawecka-Jaszcz Kalina , Wang Ji-Guang , Li Yan , Staessen Jan A.
Published: June 2022

Objective:

Whether cardiovascular risk is more tightly associated with central (cSBP) than brachial (bSBP) systolic pressure remains debated, because of their close correlation and uncertain thresholds to differentiate cSBP into normotension vs hypertension.

Design and method:

In a person-level meta-analysis of the International Database of Central Arterial Properties for Risk Stratification (n = 5576; 54.1% women; mean age 54.2 years), outcome-driven thresholds for cSBP were determined and whether the cross-classification of cSBP and bSBP improved risk stratification was explored. cSBP was tonometrically estimated from the radial pulse wave using SphygmoCor software.

Results:

Over 4.1 years (median), 255 composite cardiovascular endpoints occurred. In multivariable bootstrapped analyses, cSBP thresholds (in mm Hg) of 110.5 (95% CI, 109.1–111.8), 120.2 (119.4–121.0), 130.0 (129.6–130.3) and 149.5 (148.4–150.5) generated 5 year cardiovascular risks equivalent to the ACC/AHA bSBP thresholds of 120, 130, 140 and 160. Applying 120/130 mm Hg as cSBP/bSBP thresholds delineated concordant central and brachial normotension (43.1%) and hypertension (48.2%) vs isolated brachial hypertension (5.0%) and isolated central hypertension (3.7%). With concordant normotension as reference, the multivariable hazard ratios for the cardiovascular endpoint were 1.30 (95% CI, 0.58–2.94) for isolated brachial hypertension, 2.28 (1.21–4.30) for isolated central hypertension, and 2.02 (1.41–2.91) for concordant hypertension. The increased cardiovascular risk associated with isolated central and concordant hypertension was paralleled by cerebrovascular endpoints with hazard ratios of 3.71 (1.37–10.06) and 2.60 (1.35–5.00), respectively.

Conclusions:

In conclusion, irrespective of the brachial blood pressure status, central hypertension increased cardiovascular and cerebrovascular risk indicating the importance of controlling central hypertension.
AMBULATORY BLOOD PRESSURE TRAJECTORIES AND BLOOD PRESSURE VARIABILITY IN KIDNEY TRANSPLANT RECIPIENTS: A COMPARATIVE STUDY AGAINST HEMODIALYSIS PATIENTS
Authors: Korogiannou Maria , Sarafidis Pantelis , Alexandrou Maria Eleni , Theodorakopoulou Marieta , Pella Eva , Xagas Efstathios , Argyris Antonis , Protogerou Athanase , Papagianni Aikaterini , Boletis Ioannis N. , Marinaki Smaragdi
Published: June 2022

Objective:

Hypertension is the most prevalent cardiovascular risk factor in kidney transplant recipients (KTRs). Preliminary data suggest similar ambulatory blood pressure (BP) levels in KTRs and hemodialysis (HD) patients. This is the first study evaluating in comparison the full ambulatory BP profile and short-term BP variability (BPV) in KTRs versus HD patients.

Design and method:

Two hundred four KTRs were matched (2:1 ratio) with 102 HD patients for age and gender. BP levels, BP trajectories and BPV indices over a 24-hour ambulatory BP monitoring (ABPM) in KTRs were compared against both the 1st and 2nd 24-hour period of a standard 48-hour ABPM in HD. To evaluate the effect of renal replacement treatment and time on ambulatory BP levels, two-way-ANOVA for repeated-measurements was performed.

Results:

KTRs had significantly lower SBP and pulse pressure (PP) levels compared to HD during all periods studied (24-hour SBP: KTR: 126.5 ± 12.1mmHg; HD 1st 24-hour: 132.0 ± 18.1mmHg, p = 0.006; 2nd 24-hour: 134.3 ± 17.7mmHg, p < 0.001); no significant differences were noted for DBP levels with the exception of 2nd nighttime. Repeated-measurements-ANOVA showed a significant effect of RRT modality and time on ambulatory SBP levels during all periods studied, and a significant interaction between them; the greatest between-group difference in BP (KTRs - HD in mmHg) was observed at the end of the 2nd 24-hour (-13.9mmHg, 95%CI: -21.5 to -6.2, p < 0.001). Ambulatory systolic and diastolic BPV indices were significantly lower in KTRs than in HD during all periods studied (24-hour SBP-ARV: KTRs: 9.6 ± 2.3mmHg; HD 1st 24-hour: 10.3 ± 3.0mmHg, p = 0.032; 2nd 24-hour: 11.5 ± 3.0mmHg, p < 0.001). No differences were noted in dipping pattern between the two groups.

Conclusions:

SBP and PP levels and trajectories, and BPV were significantly lower in KTRs compared to age- and gender-matched HD patients during all periods studied. These findings suggest a more avourable ambulatory BP profile in KTRs, in contrast to previous observations.
THE INFLUENCE OF AMBULATORY BLOOD PRESSURE ON THE ASSOCIATIONS OF INTRADIALYTIC HYPERTENSION WITH FUTURE CARDIOVASCULAR EVENTS AND MORTALITY IN HEMODIALYSIS PATIENTS
Authors: Theodorakopoulou Marieta , Iatridi Fotini , Alexandrou Maria-Eleni , Karpetas Antonios , Bikos Athanasios , Raptis Vasilios , Tsouchnikas Ioannis , Giamalis Panagiotis , Papagianni Aikaterini , Sarafidis Pantelis
Published: June 2022

Objective:

Patients with intradialytic hypertension (IDH) have higher mean 44-hour ambulatory blood pressure (BP) levels than patients without the phenomenon. IDH is associated with an increased risk of cardiovascular and all-cause mortality. Whether the excess risk for mortality in patients with IDH depends on the BP rise during dialysis per se or on elevated 44-h ambulatory BP is not known. This is the first study evaluating the association of IDH with cardiovascular events and all-cause mortality before and after adjustment for ambulatory BP and other cardiovascular risk factors.

Design and method:

A total of 242 hemodialysis patients underwent 48-h ABPM with Mobil-O-Graph-NG and were followed for a median of 45.7 months. IDH was defined as: SBP rise greater than or equal to 10 mmHg from pre- to post-dialysis and post-dialysis SBP greater than or equal to 150 mmHg. The primary end-point was all-cause mortality; the secondary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest, ospitalisation for heart failure, coronary or peripheral revascularization procedure.

Results:

During follow-up, a total of 122 patients died; 69 due to cardiovascular causes. Cumulative freedom from both the primary and secondary endpoint was significantly lower for patients with IDH (logrank-p = 0.048/0.022, respectively). The risk for all-cause mortality was significantly higher for patients with IDH (HR = 1.566 95%CI [1.001, 2.450]); similarly, the risk for the combined cardiovascular endpoint was higher for these individuals (HR = 1.675 95%CI [1.071, 2.620]). The observed associations attenuated after adjustment for 44-h SBP (all-cause mortality: HR = 1.529 95%CI [0.952, 2.457] and combined cardiovascular endpoint: HR = 1.388 95%CI [0.866, 2.225]. After additional adjustment for age, interdialytic weight gain, dialysis vintage, 44-h pulse wave velocity, history of coronary artery disease, diabetes mellitus and heart failure the respective HRs were 1.409 (95%CI [0.851, 2.332]) and 1.435 (95%CI [0.879, 2.343]).

Conclusions:

Patients with IDH presented higher risk for death and cardiovascular outcomes. Sustained high BP levels during the 44-h interdialytic period and not only intradialytic BP rise per se may be participating in the excess risk of this condition.
ARTERIAL ELASTICITY PREDICTS CARDIOVASCULAR MORBIDITY AND MORTALITY- A LONGITUDINAL STUDY IN THE VARA-SKÖVDE COHORT
Authors: Szalo Gabor , Hellgren Margareta , Allison Matthew , Lindblad Ulf , Daka Bledar
Published: June 2022

Objective:

Background: Measures of arterial elasticity are used for early detection of vascular disease and identification of individuals at high risk for cardiovascular disease morbidity (CVD).

Aim: To investigate the association between arterial elasticity and risk for CVD in men and women.

Design and method:

A total of 2816 randomly selected individuals were examined (Men = 1400) between 2002 and 2005. The average follow-up time was 14.8 ± 2.4 years. After excluding participants with known cardiovascular disease, hypertension and diabetes mellitus, 2362 individuals (Men = 1186) were included in this study. Small Arterial Elasticity Index (SAEI) was measured using the HDI/Pulse Wave™ CR2000. Diagnoses of CVD were defined as acute myocardial infarction or stroke and based on Swedish Cause of Death Register and Swedish National Inpatient Register for period 2002–2019. Kaplan – Meijer and Cox- regression analyses were used to investigate the differences between SAEI quartiles and future CVD, adjusting for age, sex, heart rate, systolic blood pressure, LDL- cholesterol, HOMA-IR, C- reactive protein, smoking, alcohol consumption and physical activity. Of note, higher values of SAEI indicate more compliant arteries.

Results:

Mean age at baseline was 46 ± 10.6 years. Overall, 108 events were observed, 38 in women with 11 under 50 years. In the fully adjusted model, a one quartile higher SAEI score was associated with a 26% lower risk of incident CVD among men and women combined; (HR = 0.74, 95% CI: 0.55- 0.99, p = 0.041). Similar results were observed in men in the fully adjusted model (HR = 0.65, 95% CI: 0.45- 0.95, p = 0.024). Analogous, however nonsignificant, results were observed in women older than 50 years (HR = 0.59, 95% CI: 0.24- 1.45). The effect size was significantly lower in women younger than 50 years (HR = 0.93, 95% CI: 0.58- 1.45). However, the number of events in this group was low.

Conclusions:

We showed a strong and independent association between SAEI and CVD in men. Similar tendencies and effect size were observed in postmenopausal women. The diastolic pulse wave appears to provide additional information for cardiovascular risk assessments.
SYNERGISTIC EFFECT OF HIGH HOMOCYSTEINE AND LOW VITAMIN B12 LEVELS ON CARDIOVASCULAR AND STROKE RISK OF HYPERTENSIVE PATIENTS
Authors: Liakos C. , Karpanou E. , Markou M. , Grassos C. , Tousoulis D. , Vyssoulis G. , Tsioufis K.
Published: June 2022

Objective:

Arterial hypertension is a risk factor for cardiovascular (CV) events, including stroke. High blood homocysteine levels (hyperhomocysteinemia) are also considered to increase CV risk and are associated with vitamin B12 deficiency that possibly increase CV and stroke risk, as well. The present study assessed the possible relation of high homocysteine and low vitamin B12 levels with the underlying CV and stroke risk of hypertensive patients.

Design and method:

This retrospective study comprised all hypertensives referred to our institutions and had a blood sample measurement of homocysteine and B12 (n = 32800). The 10-year fatal CV risk and stroke risk were calculated with the HeartScore and the FraminghamStrokeScore, respectively. The population was divided in quartiles according to homocysteine levels (groups 1, 2, 3 and 4 for increasing levels) and B12 levels (groups 1, 2, 3 and 4 for decreasing levels). Cardiovascular and stroke risk were calculated for each homocysteine and B12 quartile group as well as for each of the 16 homocysteine/B12 combination quartile subgroups.

Results:

The mean values for homocysteine were 13.3 ± 7.2 μmol/l and for B12 525 ± 196 pg/ml. For homocysteine quartiles 1, 2, 3, 4, CV risk was 3.4%, 5.5%, 9.0%, 17.9%, respectively (pfor trend 0.05). For B12 quartiles 1, 2, 3, 4, CV risk was 3.0%, 6.2%, 9.5%, 15.1%, respectively (pfor trend 0.01). Correlation coefficient ® between homocysteine and CV risk values was 0.416 (p < 0.0001) while between B12 and CV risk values was -0.369 (p < 0.0001). For homocysteine quartiles 1, 2, 3, 4, stroke risk was 4.2%, 7.3%, 12.9%, 25.0%, respectively (pfor trend 0.04). For B12 quartiles 1, 2, 3, 4, stroke risk was 5.4%, 9.2%, 13.4%, 19.3%, respectively (pfor trend 0.08). Correlation coefficient ® between homocysteine and stroke risk values was 0.474 (p < 0.0001) while between B12 and stroke risk values was -0.348 (p < 0.0001). The synergistic effect of increasing homocysteine and decreasing B12 values on CV and stroke risk increase is presented in Figure.

Conclusions:

High homocysteine levels and low vitamin B12 levels are individually and synergistically associated with the underlying CV and stroke risk of hypertensive individuals. Possible mechanisms merit further examination.
COMMON CAROTID ARTERY ELASTICITY, INTIMA-DIAMETER RATIO, AND TENSILE STRESS IN PEDIATRIC PATIENTS WITH PRIMARY HYPERTENSION
Authors: Szyszka Michal , Skrzypczyk Piotr , Ofiara Anna , Wabik Anna , Panczyk-Tomasz Malgorzata
Published: June 2022

Objective:

Elevated blood pressure (BP) lead to increased thickness of arterial wall and increased diameter of arteries, are risk factors of cardiovascular sequelae in adult populations. Intima-diameter ratio (IDR) and tensile stress (TS) may reflect arterial wall-remodeling to elevated BP. The aim was to evaluate common carotid artery elasticity, IDR, and TS in children with primary hypertension (PH).

Design and method:

50 untreated patients with PH and we evaluated: common carotid artery(CCA) intima-media thickness (cIMT) and elasticity(E-tracking - ET), central BP and aortic elasticity (aPWV,AIx75HR), office BP and ABPM, and clinical, and biochemical data. IDR (cIMT/minimal diameter of CCA[D]) and TS (MAP∗D/cIMT) were calculated in all the subjects.

Results:

Patients with PH compared to CG were characterized by significantly higher peripheral, central office and ambulatory BP, BMI Z-score, uric acid, triglycerides, lower HDL-cholesterol and higher aPWV. PH patients had thicker cIMT and larger CCA D. The groups did not differ in parameters of CCA elasticity: beta stiffness index, CCA pulse wave velocity(PWVbeta) and pressure-strain elasticity modulus(Ep) and in IDR(0.08 ± 0.01vs.0.08 ± 0.02,p = 0.479) and TS(584.9 ± 135.5mmHg vs.529.7 ± 84.2,p = 0.095). We found correlations between cIMT(Z-score) and triglycerides, peripheral SBP Z-score, and ABPM MAP 24 h Z-score. CCA D correlated with BMI Z-score, uric acid and HDL-cholesterol, 24 h systolic blood pressure load(SBPL), Central systolic blood pressure(AoSBP) and peripheral diastolic BP Z-score. We found significant correlations between TS and uric acid, 24 h diastolic blood pressure load, and peripheral systolic and diastolic blood pressure Z-scores. There was no association between IDR and BP except for a weak correlation between IDR and SBPL. In PH patients, there was a strong correlation between cIMT and CCA D(r = 0.790,p < 0.001).

Conclusions:

In children with PH, structural changes and decreased elasticity primarily affect the aorta and to a lesser extent the muscular arteries.

In children with PH, both CCA wall thickness and internal diameter are associated with BP, and are significantly higher in children with PH. The changes observed in the carotid artery are probably adaptive in nature, not associated with impaired arterial function, thus intima-diameter ratio or tensile stress measurement does not appear to contribute additional information in this group of patients.