bluuebunny/crossref_metadata_2025 huggingface dataset:
RIGHT VENTRICULAR OUTFLOW FUNCTION IN ARTERIAL HYPERTENSION
Authors: Tsverava Mikheil , Tsverava Dimitri , Ungiadze Sophio
Published: May 2024

Objective:

Anatomically and functionally the Right Ventricle (RV) differs from Left. Its structure is complex, and consists of 2 anatomically and functionally different parts, inflow, and outflow tract. The aim of the research was to study the changes of RV Outflow Tract (RVOT) in patients with Arterial Hypertension (AH)

Design and method:

We studied 163 patients with AH. RV outflow tract (RVout) was examined by M-mode from parasternal short axis and PW TDI from subcostal position (RWoutTDI). On RVout M-mode we measured diastolic (Dd) systolic diameters (Ds), fractional shortening (RWoutFS= RVoutDiastD-RVoutSystD)/RVoutDiastD%.) and RW wall systolic excursion (RWexc); The shape of RWoutTDI was different from the Tricuspid anulus TDI (TrTDI). It consists of positive isometric contraction(s1), isotonic contraction (s), negative early diastolic (e) late (a) diastolic waves velocities and two (negative-e1, positive-e2) isometric relaxation waves. We measured the pick velocities of waves in cm/sec and duration of isometric contraction (ICT), ejection (RVET) and isometric relaxation time (IRT) intervals in msec. Control group consist from 192 normal persons.

Results:

In AH RV wall thickness was significantly greater (3.47±0.7 vs 4.56±0.8), RVoutFS% shorter (55.0±6.0 vs 57.4±5.9%) and outflow Dd and Ds greater than in control. On RWoutTDI the velocities of s1, s2, e and e1 valves vas significantly lesser in hypertensives (5.3±1.9;8.7±1.5;5.6±1.6;versus 6.6±2;9.4±0.1;6.2±1.6;7.6±1.9;6.2±1.7) the duration of ICT and IRT longer and RVER shorter (55.8±12.9; 92.1±19.3; 287.1±29.3 versus 62.0±20.1; 107.4±26.8; 273.2±37.2 msec) than in controls.

Conclusions:

Despite no difference in RV inflow and cavity parameters, there are prominent changes in RV outflow tract in AH, which may be an early sign of structural and functional remodeling of the right heart.
COMMUNITY PHARMACY-BASED HYPERTENSION SCREENING: MAY MEASUREMENT MONTH 2023 IN 3 CANADIAN PROVINCES
Authors: Tsuyuki Ross , Gysel Stephanie , Lee Tiffany
Published: May 2024

Objective:

Elevated blood pressure (BP) is the largest contributing risk factor for premature death and disability. Approximately 50% of individuals with hypertension are unaware they have the condition; therefore, BP screening is essential. Canadian health professionals have previously participated in the annual global BP screening campaign, May Measurement Month (MMM); however this has never been completed in community pharmacies, which have the advantage of being highly accessible to the public.

Our objective was to examine the prevalence of elevated (BP) in Alberta (AB), British Columbia (BC), Newfoundland and Labrador (NL) during MMM 2023.

Design and method:

This cross-sectional study enrolled consenting members of the general public 18 years of age, recruited through signage, media and social media. Data collection took place between May 1 and July 31, 2023 in 52 community pharmacies across AB, BC, and NL. Participants completed a questionnaire that included demographic information, medical history, and use of antihypertensives. Pharmacy personnel completed 3 blood pressure readings, with readings 2 and 3 used to estimate BP. We used an automated blood pressure device recommended by Hypertension Canada's Device Recommendation Program. Elevated BP was defined as >140/90mmHg or >130/80mmHg for individuals with diabetes.

Results:

We enrolled 736 participants. The mean age of participants was 52 (SD 18.6) years, 66% were female, 34% had a history of hypertension, and 14% had diabetes. Overall, 21% (152/733) had elevated BP. In subgroups of interest, elevated BP was found in 20% (96/480) of females, 35% (88/251) of those with a history of hypertension (13% (64/482) in those with no history of hypertension), and 52% (53/103) in those with diabetes.

Conclusions:

Identifying individuals with elevated BP is the starting point for better BP management. Community pharmacy screening of BP was effective in identifying individuals with elevated BP warranting further assessment. Our experiences from MMM 2023 will guide the future scale-up of a national community pharmacy-based screening program for MMM 2024.
IMPACT OF ADMISSION HYPERGLYCEMIA ON IN-HOSPITAL MORTALITY IN ACUTE AORTIC DISSECTION
Authors: Mutailifu Saimire
Published: May 2024

Objective:

report suggests that admission hyperglycemia is associated with cardiovascular and cerebrovascular disease. However, there are limited studies on admission hyperglycaemia and in-hospital mortality in patients with acute aortic dissection (AAD) hypertension. Therefore, our study aimed to investigate these associations.

Design and method:

In this survey, we obtained data from an electronic database for analysis from January 1, 2010 to January 1, 2023, 1239. Patients were divided into two groups based on their blood glucose level (BGA) at the time of admission. The outcome was all-cause mortality during hospitalization. Multivariate regression analysis was performed to explore the relationship between hyperglycemia and inpatient mortality.

Results:

The study analyzed 1239 patients, of whom 77.1% were male, with a mean age of 53.0 years and a mean BGA of 6.1 mmol/L. The logistic regression analysis revealed that the in-hospital mortality for individuals with hyperglycemia was 2.53 times greater compared to those with the normoglycemia group (95% CI:1.68-3.80, P < 0.001), which remained statistically significant even after adjusting. However, significant interactions were not found in subgroup analyses. The sensitivity analysis did not alter the association between the two variables. Furthermore, it was observed that patients who were using insulin experienced a decrease in in-hospital mortality.

Conclusions:

Admission hyperglycemia has been found to have a positive correlation with an elevated risk of hospital mortality in hypertensive patients with AAD. It has been observed that using insulin to manage admission hyperglycemia can help reduce the risk of in-hospital mortality.
PRECLINICAL AND CLINICAL EFFICACY AND SAFETY OF A NOVEL MULTI-TARGET SMALL MOLECULE MT-1207 FOR HYPERTENSION
Authors: Li Yutai , Jia Dechao , Miao Chaoyu , Wang Jiguang , Zhang Jin , Wang Peng
Published: May 2024

Objective:

To develop a novel multi-target small molecule agent for the treatment of hypertension with potential renal protection.

Design and method:

Part I (preclinical): MT-1207 was tested in the in vitro and in vivo preclinical models to evaluate mechanisms of action, hypertension efficacy, and renal protection. The in vitro activity of MT-1207 was evaluated in enzyme and radioligand binding assays. In vivo Spontaneously Hypertensive Rats (SHR) and two-kidney two-clip (2K2C) rat models were used to evaluate antihypertensive effects and renal protection of MT-1207. Preclinical safety evaluation of MT-1207 was conducted in rats and dogs following ICH guidelines.

Part II (clinical): MT-1207 in clinical phases I and II were completed based on the clinical protocols. Phase Ia was a single center, randomized, double-blind, placebo-controlled, dose escalation study to evaluate safety, tolerability, pharmacokinetic of single oral dose of MT-1207 in healthy adult subjects. Phase Ia doses were 5, 10, 20, 40, 60, 90 mg. Similarly, Phase Ib study was conducted in patients with hypertension at 10 and 20 mg (BID) for 10 days. Clinical phase II was a multi-center, randomized, double-blind, placebo- and active-controlled, multiple-dose study to evaluate safety and pharmacodynamics of MT-1207 in patients with hypertension for 8 weeks.

Results:

Preclinical (part I): MT-1207 showed potent selective inhibitions of Adrenergic 1alpha and Serotonin (5-HT2A) receptors with IC50 < 1 nM. The efficacy of antihypertension of MT-1207 in SHR model was evident with a well-defined dose-response relationship at 2.5, 5, and 10 mpk. In 2K2C rat model, both blood pressure and serum uric acid decreased post-dose at 4-week and 9-week, indicating antihypertensive effects and potential kidney protection, respectively.

Clinical (part II): in Phase I, healthy volunteers had good tolerability at 40 mg and below. Rapid blood pressure decreases were observed 1-2 hr post dose in patients with 10 and 20 mg doses. Results from Phase II (10 and 20 mg (BID)) with placebo and active drug (amlodipine) study will be presented including summary of adverse effects (AE) and efficacy data.

Conclusions:

Clinical data (phases I and II) demonstrated antihypertensive effects of MT-1207 with mild adverse effects.
ZILEBESIRAN AS ADD-ON THERAPY IN PATIENTS WITH HYPERTENSION INADEQUATELY CONTROLLED WITH A STANDARD ANTIHYPERTENSIVE MEDICATION: EFFICACY AND SAFETY RESULTS FROM THE KARDIA-2 STUDY
Authors: Saxena Manish , Aswad Ahmad , Badariene Jolita , Kazi Farhana , Karns Adam D , Neutel Joel M , Park Wansu , Stiglitz Daniel , Makarova Nune , Havasi Andrea , Zappe Dion , Bakris George
Published: May 2024

Objective:

Zilebesiran is an investigational RNA interference therapeutic that targets hepatic angiotensinogen, the most upstream precursor of the renin-angiotensin system. In the Phase 2 KARDIA-1 study, single subcutaneous (SC) doses of zilebesiran monotherapy significantly reduced 24-hr mean ambulatory and office systolic blood pressure (SBP) from baseline to Months 3 and 6 versus placebo. The objective of KARDIA-2, a Phase 2 randomized, double-blind, placebo-controlled study, was to assess efficacy, safety, and pharmacodynamics of zilebesiran in combination with a standard-of-care antihypertensive medication class in patients with uncontrolled hypertension.

Design and method:

KARDIA-2 enrolled adults with mild-to-moderate hypertension who were untreated or receiving stable therapy with up to two antihypertensives. Patients entered a run-in period, where previous antihypertensives were discontinued, and were subsequently randomized to open-label, once-daily oral olmesartan 20 or 40 mg, amlodipine 5 mg, or indapamide 2.5 mg as background antihypertensive therapy. After at least 4 weeks of run-in, patients with 24-hr mean ambulatory SBP of 130–160 mmHg were randomized 1:1 to single-dose SC zilebesiran 600 mg or placebo as add-on therapy. Escape antihypertensives could be initiated after Month 3 if a patient's SBP met pre-specified escape criteria. However, assessments while patients were on or within two weeks of stopping any escape medication were excluded in analyses. The primary endpoint was change in 24-hr mean ambulatory SBP from baseline to Month 3, assessed as the least-square mean difference between zilebesiran and placebo. Key secondary endpoints were change from baseline to Month 3 in office SBP, time-adjusted change from baseline to Month 6 in 24-hr mean ambulatory and office SBP, and proportion of patients with 24-hr mean ambulatory SBP less than 130 mmHg and/or a reduction of at least 20 mmHg without escape medication at Month 6.

Results:

KARDIA-2 enrolled 672 patients and is currently ongoing. Primary, secondary, safety, and pharmacodynamic endpoints will be presented at the meeting.

Conclusions:

KARDIA-2 will provide insights into the potential benefit of adding zilebesiran to patients with hypertension inadequately controlled with standard-of-care antihypertensive monotherapy, building on efficacy and safety learnings from previous Phase 1 and 2 studies of this novel therapeutic strategy.
EPLERENONE VS IRBESARTAN AS FIRST LINE THERAPY IN OBESE HYPERTENSIVE PATIENTS: PRELIMINARY RESULTS OF HEBRO TRIAL IN ECHOCARDIOGRAPHIC DIASTOLIC FUNCTION INDEXES
Authors: Kouremeti Maria , Iliakis Panagiotis , Drogkaris Sotirios , Stathoulopoulou Maria , Andrikou Ioannis , Kariori Maria , Siafi Eirini , Sakalidis Athanasios , Tatakis Fotis , Manta Eleni , Fragkoulis Christos , Vossos Ioannis , Konstantinidis Dimitrios , Thomopoulos Costas , Kasiakogias Alexandros , Dimitriadis Kyriakos , Tsioufis Konstantinos
Published: May 2024

Objective:

Obesity is significantly associated with hypertension and cardiovascular outcomes. However, little is known about the impact of aldosterone blockade using eplerenone on hypertensive obese patients as first line therapy. The aim of this study is to compare the efficacy between eplerenone-based strategy and irbesartan-based strategy in obese hypertensive individuals, regarding blood pressure reduction and change of echocardiographic diastolic function parameters.

Design and method:

HEBRO (antiHypertensive treatment with Eplerenone vs. irBesartan in hypeRtensive Obese patients) is a prospective, randomized, open-labeled, multicenter trial enrolled 112 obese hypertensive patients aged 30-75 years old, evaluated by office and out-of-office BP measurements. Patients were randomized to either 25 mg eplerenone twice (59) or 150 mg irbesartan (53) once daily. The primary endpoint is the difference in ambulatory BP measurements after 6 months follow-up period and secondary endpoint is difference in diastolic function parameters.

Results:

We enrolled 112 patients, 54.6 years old, 53% female, mean BMI 34.4 kg/m2 and mean eGFR 82.5 ml/min/1.73m2. Diastolic function was assessed at baseline and 6 months, by calculating left ventricular mass index (LVMI) and left atrial volume index (LAVI). At baseline, mean LVMI was 102.9 g/m2 ± 18.1 in the irbesartan group vs. 110.1 g/m2 ± 30.5 in the eplerenone group, p=0.237. The change of LVMI was – 5.6 ± 17.8 vs. -4.5 ± 22.6, p=0.843. At baseline, mean LAVI was 30.6 ml/m2 ± 16.9 in the irbesartan group vs. 30.7 ml/m2 ± 11.1 in the eplerenone group, p=0.979. The change of LAVI in the two study arms was +0.9 ± 6.7 vs. -3.6 ± 11.5, p=0.063, respectively. Although, the result was not statistically significant, there was a numerical trend towards the eplerenone arm.

Conclusions:

There were no statistically significant differences at baseline and follow-up evaluation of changes in left ventricular and left atrial geometry, though there is a numerical trend towards eplerenone arm, regarding reduction of LAVI after 6 months follow-up period. Patients are currently still enrolled and data on larger pool are anticipated.
ANTI-ISCHEMIC EFFECTIVENESS OF TRIMETAZIDINE 80 MG ONCE DAILY IN PATIENTS WITH STABLE ANGINA AND A HISTORY OF MYOCARDIAL INFARCTION. RESULTS OF THE METHOD STUDY
Authors: Elyubaeva Irina , Barbarash O L , Polikutina O M , Khomitskaya Y V , Kvasnikov B B , Burtsev Y P
Published: May 2024

Objective:

To describe the anti-ischemic effectiveness of trimetazidine 80 mg once daily (TMZ OD) in outpatients with symptomatic stable coronary artery disease (CAD) and a history of myocardial infarction (MI) in real clinical practice.

Design and method:

The METHOD (NCT05210465) was a 6-month single-center observational study. Adult outpatients with symptomatic stable CAD and a history of MI who had been recommended to initiate TMZ OD in addition to the standard antianginal therapy were included. Myocardial ischemia was assessed by stress echocardiography (STE) in speackle tracking mode (STM). Primary outcome was the mean change in left ventricular global longitudinal strain (LV GLS) at visit 2 (∼ 6 months) compared to baseline (BL). Main secondary outcomes were mean changes in regional peak systolic deformation (RPSD), global post systolic index (PSI) and the number of anginal attacks per week. Data from patients who completed the study were analyzed.

Results:

Of 36 included patients, 41.7% (15/36) were female, mean age was 62.3 (±7.6) years. Mean time since CAD diagnosis and occurrence of MI was 4.5 (±5.3) and 2.9 (±3.4) years, respectively. Proportions of patients with diabetes, coronary percutaneous revascularization or hypertension were 30.6% (11/36), 88.9% (32/36) and 88,9 (32/36), respectively. Before initiation of TMZ OD, all patients had been taking beta-blockers (36/36), and 33.3% (12/36) calcium channel blockers. LV GLS was significantly improved by -2% (p <0,001) from -13.3% (3.6) at BL to -15.3% (3.7) at V2. There was a significant improvement in RPSD of apex (-1.2., p = 0,042), apical anterior (-2.6% p <0,001) and lateral (-1.5%, p= 0,032) segments of LV myocardium. Compared to BL, mean PSI was significantly changed from 33.3% to 28.9% (-4.3%, p=0,004) at V2. Angina frequency significantly decreased from 1.0 (1.4) to 0.1 (0.4) attacks per week (p<0.001). No adverse events were reported.

Conclusions:

Treatment with TMZ OD demonstrated significant decrease in myocardial ischemia and improvement in angina control in patients with CAD and a history of MI and was well tolerated.
THE PRONOSTIC VALUE OF NOCTURNAL BLOOD PRESSURE IN UNTREATED ADULT HYPERTENSIVES FROM ALGERIAN POPULATION
Authors: Bounab Lyamine , Gacemi Sofiane , Chemli Mourad , Bouamra Abderezak
Published: May 2024

Objective:

The aim of our work is to study the prevalence of nocturnal blood pressure patterns in our Algerian population of untreated adult hypertensives and its impact on target organ damages.

Design and method:

We recruited 304 untreated adult hypertensives. All our patients underwent 24-hour ABPM, and the following target organe damages assessment: ACR (urinary albumin/creatinine), echocardiography, fundoscopy, and carotid ultrasound. Our patients were classified according to nocturnal blood pressure into two groups: nocturnal hypertensive (NH: BP> or = 120/70) and nocturnal normotensive (NN: BP<120/70). We carried a descriptive study of hypertension prototypes, followed by an analytic study in search of predictors of target organ damages (cardiac, renal and vascular).

Results:

The mean age was 46±12 years, with 82% males. The prevalence of patterns according to nocturnal blood pressure were: NH (n=250; 82.2%) vs NN (n=54; 17.3%). In the bivariate analysis, there was a significant difference between two groups for the following damages: cardiac (HN=52% vs NN=34.6; P=0.01), renal (HN=27.5% vs NN=12.8%; P=0.02) and vascular (HN=25% vs NN=2%; P<0.001). On multivariate analysis, indexed LV mass was correlated with waist circumference (B=0.34, P=0.01) and diurnal systolic BP (SBP) (B=1.37; P<0.001). ACR was correlated with glycemia (B=0.33; P=0.002) and nocturnal SBP (B=0.64; P=0.01). Intima-media thickness was correlated with age (B=0.009, P<0.001) and nocturnal SBP (B=0.004, P<0.001). On logistic regression, cardiac damage was correlated with age (OR=1.05; P=0.02), BMI (OR=1.21; P=0.02) and diurnal SBP (OR=1.08; P=0.003). Renal damage was correlated with glycated hemoglobin (OR=1.6; P=0.04). Vascular damage was correlated with age (OR=1.3; P<0.001) and nocturnal diastolic BP (DBP) (OR=1.07; P=0.002).

Conclusions:

The nocturnal hypertension are prevalent in our population. nocturnal hypertension is a predictor of renal and vascular damages. In contrast, diurnal hypertension is a predictor of cardiac damage. These results confirm the literature data on the prognostic value of nocturnal blood pressure. We suggest an active screening for nocturnal hypertension by using ABPM in the hypertensive population with high cardiovascular risk.
CLINICAL FEATURES OF MANAGEMENT OF PATIENTS WITH HYPERURICEMIA IN COMBINATION WITH ARTERIAL HYPERTENSION AND CHRONIC HEART FAILURE
Authors: Zalem Irina
Published: May 2024

Objective:

To evaluate clinical and diagnostic features of patients with AH and CHF combined with hyperuricemia.

Design and method:

The study included 49 patients divided into two groups: Group 1 - 32 patients with AH and CHF on the background of elevated uric acid (UA) 24(75%) men, 8 (25%) women, median age 66.0 (59.0;75.0) years and Group 2 - 20 patients with AH and CHF without hyperuricemia: 13 (65%) men, 7 (35%) women, median age 69.0 (63.0;73.5) years). Clinical data, laboratory and instrumental investigations were analyzed.

Results:

Comparative analysis showed that patients in the group with normal MC levels compared to patients in the hyperuricemia group had higher SCF (62 and 57 ml/min/1.73 m2 (p=0.04) respectively). A negative correlation of medium strength between blood MC level and LVEF was also observed, with lower values in group 1 patients (52.4 and 59.5, respectively). Differences were also observed when NTproBNP level was determined (385.5-2500.4) (R=-0.64 p<0.01). Separately it should be noted that out of 32 patients included in the study, 6 patients showed resistance to standard doses of diuretics, which required intensification of therapy in the form of increasing their dose. In a comparative analysis, MC levels were significantly higher in patients who subsequently underwent intensified therapy compared with patients with a satisfactory response to standard diuretic doses [543.8 (459.4-719.9) and 485(422.4-605.4), respectively; p=0.011].

Conclusions:

The performance of this study further confirmed the high prevalence of hyperuricemia in AH and CHF. Moreover, the severity of hyperuricemia increased in parallel with the increase in the severity of CHF (according to NYHA FC and NUP concentration). Therefore, the patient management strategy should include screening and correction of purine metabolism. One of the main tasks in the algorithm of management of patients with hyperuricemia is rationalization of therapy with the main focus on cardiovascular risk factors and metabolic safety of drugs.
PULSE WAVE ANALYSIS VARIABLES CAN PREDICT ATRIAL FIBRILLATION, HYPERTENSION, HEART FAILURE AND BUNDLE BRANCH BLOCKS
Authors: Mozos Ioana , Baba Mirela , Moroz Simina , Bucur Adina , Jianu Daniela , Maris Mihaela , Gug Cristina , Luca Constantin Tudor
Published: May 2024

Objective:

Pulse wave velocity is a known surrogate marker of cardiovascular events. The present study aimed to find variables of pulse wave analysis able to predict cardiovascular disorders.

Design and method:

A total of 76 patients, aged 63±10 years, with cardiovascular disorders, underwent pulse wave analysis using a Mobil-O-Graph. The following variables were assessed: augmentation index (AI), pulse wave velocity (PWV), mean arterial pressure (MAP) and pulse pressure (PP).

Results:

Hypertension, atrial fibrillation, heart failure and bundle branch blocks were diagnosed in 65 (85.53%), 6(7.89%), 5(6.58%) and 5(6.58%) patients, respectively. PWV, AI, MAP and PP were, as follows: 9.29±1.46 m/s, 24.71±16.2%, 105.57±17.71 mmHg and 49.78±13.17 mmHg, respectively. AI was a significant predictor of atrial fibrillation (AUC=0.74, 95%CI: 0.627 to 0.834, p= 0.0332). PWV significantly predicted hypertension (AUC=0.738, 95% CI: 0.624 to 0.832, p=0.0001), while MAP and PP significantly predicted bundle branch blocks (AUC=0.763 and 0.663, 95% CI was 0.652 to 0.853 and 0.546 to 0.768, p was 0.0046 and 0.0489, respectively.

Conclusions:

Pulse wave velocity, augmentation index, pulse pressure and mean arterial pressure are valuable predictors of hypertension, atrial fibrillation and bundle branch blocks, respectively.
DOPAMINE-DEPENDENT FORM OF ARTERIAL HYPERTENSION IN PATIENTS WITH A HIGH DEGREE OF NUTRITIONAL-CONSTITUTIONAL OBESITY
Authors: Lizogub Viktor , Dolynna Olga , Sobol Viktoria , Kupchynska Olena , Motsak Tetiana
Published: May 2024

Objective:

Despite significant advances in the study of the pathogenesis, clinical picture and treatment of arterial hypertension (AH), the role of the dopaminergic system in obese patients remains insufficiently studied.

Aim: To evaluate the effectiveness of the use of D2 receptor agonists in patients with arterial hypertension (AH) and nutritional-constitutional obesity (NCO) of the 3rd degree.

Design and method:

We examined 151 patients aged 30-60 years (65 men, 86 women) with AH and NCO. The control group (CG) consisted of 78 hypertensive patients. Daily monitoring of blood pressure (BP), body mass index (BMI), daily excretion of dopamine, plasma levels of aldosterone, prolactin, leptin, adrenaline, creatinine, lipid spectrum - obese patients were divided into two groups. In addition to basic antihypertensive therapy, patients 1 group (n=74) were prescribed bromocriptine (0.08 mg/kg in three doses), patients 2 group (n=71) – pramipexole (0.125 mg 3 times/day).

Results:

During the baseline examination, daily dopamine excretion in obese patients was 1.6 times lower (p<0.001) than in control group patients. A negative correlation was found between dopamine excretion and BMI (r=-0.6; p<0.001). In patients with hypertension and NCO, a basic examination revealed a significant (p<0.001) increase in the plasma concentrations of prolactin (2.5 times), aldosterone (1.5 times), leptin (3.4 times) and adrenaline (by 1.3 times) compared to CG. Taking bromocriptine for 8 weeks in patients 1 group led to a decrease in blood pressure, BMI and plasma levels of prolactin and aldosterone. In 41.9% of patients 1 group with dopamine excretion levels less than 300 nmol/day, normalization of blood pressure was observed. In patients 2 group pramipexole was discontinued due to side effects.

Conclusions:

In the majority of patients with hypertension and NCO (58.1%), the main pathogenetic factor in increasing blood pressure is a low level of dopamine and a compensatory increase in prolactin, aldosterone, and adrenaline in plasma. The use of the D2-dopamine receptor agonist bromocriptine helps to normalize the daily excretion of dopamine, reduce the levels of prolactin, aldosterone and adrenaline, blood pressure and BMI. The use of pramipexole in patients with hypertension and NCO seems inappropriate
ARE THERE ANY ADVANTAGES TO USING A POLYPILL OR FREE PILL COMBINATION TO PROTECT PATIENTS WITH ARTERIAL HYPERTENSION AND DYSLIPIDEMIA?
Authors: Vachulova Anna , Simkova Adriana , Sidlo Rastislav , Filipova Slavomira
Published: May 2024

Objective:

Arterial hypertension (AH) has been acknowledged as a leading cause of death. Treating AH alone may provide only limited benefits while it is recommendable to manage the total cardiovascular risk.

The aim was to assess the treatment of AH and dyslipidemia (DLP) in patients in specialists’ offices.

Design and method:

This project was conducted from April to June 2023 in 51 specialists’ offices (SPO) (33% cardiology, and 67% internal medicine) in Slovakia. We have enrolled all 18-year-old pts who are willing to complete a short questionnaire and take office BP.

Results:

We enrolled 514 pts with AH (42% women), mean age 61,5 ± 17,2 years from SPOs. The mean OBP was 134,9 ± 10,9/ 80,3 ± 7,2 mmHg. The average total cholesterol (TC) was 5,7 mmol/l, LDL-C 3,0 mmol/l. TC (6,12 vs 5,15 mmol/l, p<0,01) was higher in male patients, and LDL-C was higher in female patients (3,05 vs 2,91 mmol/l). 76% pts experienced both AH and DLP simultaneously. In comparison to those without HLP, AH patients with HLP were given 0.5 active substances and 0.8 pills more. In total 79% pts with AH and HLP were treated with a free pill combination with a statin, while only 16% were treated with polypill. The use of polypill was more frequent in female pts (18%) vs male pts (14%). Target BP lower than 140/90 mmHg was reached in 68% pts with polypill, and in 53% pts without polypill. Non-HDL- C was lower in pts with polypill (3,6 vs 4,03 mmol/l). The current BP and non-HDL targets were reached more frequently in pts with polypill 56% vs 44% pts.

Conclusions:

Adherence to medications is important to achieve the full effect of antihypertensive and lipid-lowering drugs. We demonstrated that the use of polypill compared to a free pill combination of statin and AH therapy is more effective. 27% of patients reached BP and LDL targets when were treated by polypill. Using polypill in our pts we aim to reach a higher rate of BP and cholesterol control in Slovakia to meet the objectives of the Charter 70/2023 initiative.
RELATIONSHIP BETWEEN NEUTROPHILTO HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND THE SEVERITY OF CORONARY STENOSIS IN PATIENT WITH CORONARY ARTERY DISEASE
Authors: Doan Long , Nguyen Thi Ngoc Quynh , Nguyen Thi Binh Minh , Tran Thi Nguyen Hieu , Vo Thi Phuong Trinh , Le Thanh Thien , Truong Tuan Khanh
Published: May 2024

Objective:

Coronary artery disease (CAD) is a common cardiovascular disease related to atherosclerotic plaque formation. The Neutrophil to HDL-C ratio (NHR) reflects the inflammation process and dyslipidemia, affecting the atherosclerosis pathophysiology. This study aims to evaluate the relationship between NHR and the severity of coronary stenosis in CAD patients.

Design and method:

A prospective study with in-hospital follow-up in all patients admitted to Cardiology Center - Hue Central Hospital, whose were diagnosed with coronary artery disease between April 2023 and February 2024 were enrolled. The diagnostic criteria of CAD according to the recommendation of the Vietnam National Heart Association 2022. All patients received a comprehensive clinical examination and laboratory tests: complete blood count, high-sensitive Troponin-T, Total Cholesterol, HDL-Cholesterol, 12-leads EKG, transthoracic echocardiogram. All patients were undergone coronary angiography with doctor recommendation or self-requirement. Patients with history of coronary artery interventions, either balloon or stenting, or patient with history of coronary artery bypass graft were excluded from the study. Patients with acute or chronic infection state, end-stage kidney failure, end-stage renal disease, severe heart failure, severe valvular diseases and hematology diseases, patients being used corticosteroid therapy were also excluded.

Results:

Mean age was 67.12 ± 11.39 years, 58.5% male. The mean NHR increased according to Gensini score subgroups (p < 0,01). Compared to the group with unincreased hs-Troponin (4.38 ± 1.56), the group with increased hs-Troponin showed a significantly higher mean NHR (6.14 ± 3.17) (p < 0.01). There was a moderate correlation between NHR and Gensini score with r = 0.343, p<0.01. NHR demonstrated moderate ability to predict patients with significant narrowing of coronary branches with the AUC= 0.727. With the NHR at 5.324, NHR has 54.2% in sensitivity and 83.3% of specificity in predicting of the significant coronary artery stenosis.

Conclusions:

Our study demonstrated there was a moderate correlation between Neutrophil to HDL-C ratio (NHR) and Gensini score. Neutrophil to HDL-C ratio (NHR) demonstrated moderate ability to predict patients with significant narrowing of coronary branches.
SEVERITY OF NEUROLOGICAL LONG-COVID SYMPTOMS CORRELATES WITH INCREASED LEVEL OF AUTOANTIBODIES TARGETING VASOREGULATORY AND AUTONOMIC NERVOUS SYSTEM RECEPTORS
Authors: Seibert Felix , Stervbo Ulrik , Wiemers Lea , Skrzypczyk Sarah , Hogeweg Maximilian , Bertram Sebastian , Kurek Julia , Anft Moritz , Westhoff Timm , Babel Nina
Published: May 2024

Objective:

The Long-COVID syndrome is characterized by a variety of physical, cognitive and psychological symptoms. Worldwide, at least 65 million people are thought to be affected, nevertheless there is still insufficient knowledge about the pathogenesis of long-COVID. Studies on the Long-COVID related myalgicencephalomyelitis/chronic fatigue syndrome (ME/CFS) suggest autoimmune-related changes, for example the formation of autoantibodies against G protein-coupled receptors.

Design and method:

This monocentric, cross-sectional study included patients who suffered a mild to moderate SARS-CoV-2 infection up to 12 months prior to enrollment with (n = 72) or without (n = 58) Long-COVID diagnosis according to the German S1 guideline or with no known history of SARS-CoV-2 infection (n = 70). Autoantibodies towards the vasoregulation associated Adrenergic Receptor (ADR) B1 and B2 and the CNS and vasoregulation associated muscarinic acetylcholine receptor (CHR) M3 and M4 were measured by ELISA. Neurological disorders and fatigue were quantified by internationally standardized questionnaires including Chalder Fatigue Scale, Short-Form-36 Questionnaire and the CERAD Neurophysiological Assessment Battery.

Results:

The prevalence and concentrations of evaluated autoantibodies were significantly higher in Long-COVID compared to the 2 other groups (p = 2.1∗10-9) with a significantly higher number of patients with simultaneous detection of more than one autoantibody in Long-COVID group (p = 0.0419). Importantly, the overall inflammatory state was low in all 3 groups. ARB1 and ARB2 correlated negatively CERAD Trail Marking A and B (R <= -0.26, p <= 0.043), while CHRM3 correlated positively with Chadler Fatigue Scale (R = 0.37, p = 0.0087).

Conclusions:

The present study shows that autoantibodies to GPCR are highly prevalent in patients with Long-COVID. These autoantibodies occur in healthy controls as well, but the prevalence is substantially lower.

Concentrations of autoantibodies correlates to intensity of neurological disorders including psychomotor speed, visual search, attention, and fatigue.
LOW HIGH-DENSITY LIPOPROTEIN LEVEL PROMOTES INFLAMMATORY RESPONSE IN LONG COVID PATIENTS UNDERGOING HEMODIALYSIS ONE YEAR AFTER INFECTION
Authors: Stepanova Natalia , Driianska Victoria , Rysyev Andriy , Snisar Lyudmyla , Chernianu Daria
Published: May 2024

Objective:

Long COVID, a syndrome characterized by persistent symptoms post-acute SARS-CoV-2 infection, poses unique challenges for patients undergoing hemodialysis (HD). Low levels of high-density lipoprotein (HDL) (<1.2 mmol/L) have been implicated in heightened COVID-19 risk and associated cardiovascular complications in this patient population. This study aimed to explore the potential association between low HDL and inflammatory responses in long COVID among HD patients.

Design and method:

A total of 80 hemodialysis (HD) patients, aged 55 (44-62.5) years, with a dialysis vintage of 45 (21-78.6) months and a history of COVID-19, were enrolled in this cross-sectional cohort study. Among them, 45 (56.2%) were diagnosed with long COVID, while 35 (43.8%) had fully recovered. Lipid profiles and inflammatory markers, such as serum interleukin (IL)-6, IL-17, and C-reactive protein (CRP), were assessed one year post-infection. The cytokines were measured using ELISA. Data were presented as median and interquartile interval [Me (Q25-Q75)] and compared using the Mann-Whitney test.

Results:

Patients experiencing long COVID exhibited significantly lower HDL levels compared to fully recovered individuals: 1.19 (1.06-1.76) vs 1.66 (1.32-1.92) mmol/L (p = 0.02). Among those with low HDL levels (<1.2 mmol/L), elevated concentrations of CRP, IL-6, and IL-17 were evident in comparison to patients with HDL concentrations exceeding 1.2 mmol/L (Fig. 1). Subsequent subgroup analysis revealed a more pronounced inflammatory profile in patients concurrently experiencing long COVID and exhibiting low HDL levels (Fig. 2).

Conclusions:

Our findings indicate that low HDL levels may enhance the inflammatory response in patients with long COVID undergoing HD one year post-infection, potentially promoting cardiovascular complications. Future research should focus on elucidating the pathways underlying this association and exploring novel strategies to mitigate inflammation and improve outcomes in long COVID among HD patients.
PROLONGED ENDOTHELIAL DYSFUNCTION IN POST-COVID-19 HYPERTENSIVE PATIENTS
Authors: Matova Olena , Mishchenko Larysa , Talaeva Tatiana
Published: May 2024

Objective:

to investigate the endothelial function in hypertensive patients after 1.5 ± 0.4 years after COVID-19 recovery.

Design and method:

We studied 64 treated hypertensive patients divided into 2 groups: 39 patients recovered from mild to moderate COVID-19 in 2020-2022 years (1st group) and 25 patients were not ill with COVID-19 (2nd group). All patients were vaccinated against COVID-19. The clinical characteristics and laboratory finding measurements were evaluated.

Results:

There were no significant differences in sex, duration of hypertension, frequency of family history of premature CVD, smoking, alcohol consumption, BMI, and presence of concomitant DM, CAD, stroke/TIA, atrial fibrillation, heart failure, office BP between the 2 groups. The patients in 1st group were younger and had higher GFR than patients in 2nd group (respectively, 57.9 ± 1.0 vs 61.1 ± 1.5 years, P = 0.03 and 83.2 ± 3.4 vs 71.9 ± 3.7 ml/ min/1.73m2, P = 0.03). The levels of anti-spike IgG antibodies by 21.3% were higher in vaccinated patients with prior COVID-19 than in patients without prior COVID-19. Serum IL-10 and TNF- α concentrations did not differ between groups. However, serum levels of asymmetric dimethylarginine (ADMA) (0.64 ± 0.02 vs 0.53 ± 0.02 μmol/l, P = 0.047), CRP (8.6 ± 2.5 vs 4.3 ± 0.6 mg/l, P = 0.049), 24-h albuminuria (28.1 ± 3.8 vs 14.1 ± 2.3 mg/day, P = 0.048) were higher in post-COVID-19 patients than in patients of 2nd group.

Conclusions:

After 1.5 ± 0.4 years of recovery from COVID-19, the hypertensive patients who received the vaccine were found to have greater activation of systemic inflammation, higher levels of albuminuria, and higher blood ADMA concentrations compared to vaccinated individuals who did not have COVID-19. This fact may indicate a long-lasting dysfunction of the endothelium after suffering from COVID-19 and the absence of such an effect after vaccination without a history of COVID-19.
IMPACT OF SARS-COV-2 INFECTION IN NEUROCOGNITIVE AND CARDIOPULMONARY FUNCTIONALITY OF HYPERTENSIVE PATIENTS
Authors: Kariori Maria , Fragoulis Christos , Chrysohoou Christina , Tsioufis Panagiotis , Grigoriou Kalliopi , Papakonstantinou Panteleimon , Tatakis Fotios , Stathoulopoulou Maria , Siafi Eirini , Nikolopoulou Lefki , Mantzouranis Emmanouel , Manta Eleni , Konstantinidis Dimitrios , Thomopoulos Costas , Tsioufis Konstantinos
Published: May 2024

Objective:

Few data have been published regarding the holistic approach of post-Covid patients with a history of hypertension, examining both physical and mental health. The purpose of our prospective study was to follow up cardiorespiratory status, and mental and psychological health of hypertensive patients 3 months after the first day of infection.

Design and method:

All patients with a history of Sars-Cov-2 infection and good functional status were assessed using cardiorespiratory test, transthoracic echocardiogram, and standardized questionnaires by a comprehensive team of experts (cardiologists, psychiatrists, and psychologists). The population was divided into two groups according to hypertension status.

Results:

Out of total population of 198 patients (51±15 years, 44.4% males, 6.6% history of coronary heart disease) with COVID-19 infection were assessed. Hypertensives had higher BMI (p<0.001) and BSA (p<0.001) and they were hospitalized in higher percentage (p<0.01). Out of echocardiographic parameters, diastolic dysfunction parameters including left atrial diameter (p<0.001) and E/A ratio (p<0.001) differed significantly between the two groups. LVEF (%) was significantly impaired (56±10% vs. 58±9%, p:0.04) in hypertensives that was depicted in lower values of oxygen consumption (VO2 (ml/kg/min)) both maximum (p<0.001) and during the 1st minute of recovery (p<0.006), metabolic equivalents (METS) at peak, (p<0.001) and HR1st minute recovery (p< 0.001) comparing to normotensives. Systolic blood pressure (mmHg) at rest (p: 0.002), at peak (p: 0.01), and during the 1st minute of recovery (p: 0.001) as well as Borg scale score for dyspnea (p:0.02) were higher while the exercise duration was significantly lower (p<0.001) in hypertensives comparing to normotensives. Similarly, their psychometric tests (DASI METS (p:0.008), Functionality (p:0.036)) were also affected. Finally, using linear regression analysis adjusted for age, gender, hypertension status, and hospitalization, age (p: 0.001) proved to be an independent predictive factor for VO2, VO2_AT, and VO21st minute of recovery in hypertensive patients.

Conclusions:

To conclude, the current study highlighted the reduced ability to exercise and fragility of patients with a history of hypertension. Age proved to be an independent negative predictor of functionality. Therefore, the need for a more comprehensive approach to the rehabilitation of post-covid patients is mandatory.
BIOMARKERS OF ENDOTHELIAL DYSFUNCTION AND CLOTTING DYSREGULATION POST COVID-19- A SUBSTUDY OF CARTESIAN
Authors: Fortier Catherine , Agharazii Mohsen , Lakomy Cécile , Lacolley Patrick , Regnault Véronique
Published: May 2024

Objective:

Multiple mechanisms may contribute to a hypercoagulation state in patients with COVID-19. Endothelial cells play a key role in cellular adhesion, coagulation, smooth muscle cell proliferation, and vascular wall inflammation. We aimed to describe the activation of the coagulation system, specifically thrombin generation, plasma release of endothelial factors and NETosis, and their association with kidney function following the resolution of the acute phase of SARS-CoV-2 infection.

Design and method:

Plasma samples were collected from adults 3 to 9 months after a confirmed episode of COVID-19 (COVID+, hospitalized or not, n=22) or after negative testing for COVID-19 in individuals who remained free of COVID-19 (COVID-, n-22). The coagulation system was assessed using in-vivo markers such as D-dimers (ng/ml). Thrombin generation assay estimated the thrombin-generating capacity in platelet-rich and platelet-poor plasma to provide information on soluble coagulation factors and the role of platelets in this process. Plasma release of endothelial factors was assessed by the levels of procoagulant factor VIII (FVIII) and Von Willebrand factor (VWF), and NETosis was determined using DNA-histone complexes levels. Spearman and linear regressions were used, when appropriate, to assess relationships between coagulation biomarkers and clinical and demographic characteristics of the population, such as kidney function (eGFR) calculated with the CKD-EPI equation (ml/min/1.73m2).

Results:

The COVID+ group was older (mean age 53.8± 17.6 years vs 40.6 ± 17.2 years, p=0.031). Compared to the controls, the COVID+ group had higher DNA-histone levels (Spearman ρ =0.311, p=0.040) and lower platelet counts (Spearman ρ = -0.334, p=0.033), but these differences were no longer significant after adjustment for age. However, we observed a significant association between eGFR and D-dimers, VWF and FVIII. Among them, only the association of D-dimers with eGFR was independent of age (β=4.59, p=0.030).

Conclusions:

These findings do not support a persistent long-term dysregulation of coagulation and endothelial dysfunction following the resolution of COVID-19. However, they show a significant increase in D-dimers associated with renal function, independent of both age and COVID-19.
INFLUENCE OF COVID-19 ON VASCULAR REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Abdullaeva Guzal , Atoeva Munisa , Yusupova Khafiza , Masharipov Shukhrat , Khamidullaeva Gulnoz
Published: May 2024

Objective:

evaluate the effect of COVID-19 on arterial stiffness and microalbuminuria (MAU) against the background of antihypertensive therapy (AHT) in patients with arterial hypertension (AH).

Design and method:

74 male and female patients with I-III degree of AH(ESH/ESC, 2018)were studied. The mean age of patients was 53.54±1.92 years, the duration of AH was 8.61 years. 2 groups of patients were identified: group I – patients with AH who had suffered COVID19, (n=42) and 2nd group – patients with AH who had not suffered COVID-19 (n=32). Vascular stiffness was determined SphygmoCor device; central systolic BP (cSBP), central diastolic BP (cDBP), central pulse pressure (cPP), aortic augmentation (AA), augmentation index (AIx), pulse wave velocity (PWV) were studied. The study was conducted before and after 6 months of AHT. significant. The results are presented as μ±SD.

Results:

Level of MAU in 2nd group of patients was 25,5±20,3 mg/l, whereas in 1st group was 32,8±27,9 mg/l. There was a significant decrease of MAU level in 1st group: 32,8±27,9 mg/l initially versus 20,1±19,2,4 mg/l in dynamics (p<0,02). In 1st group cSBP initially- 154.86±24.11 mmHg versus 134.38±13.9 mmHg (p<0.001) in dynamics and in 2 nd group -decreased from 163.84±19.87 m/s to 139.47±19.41 mmHg (p<0.001); cPP in 1st group decreased from 74.79±22.02 mmHg to 53.67±13.32 mmHg (p<0.001) and in group II of patients - from 78.84±14.48 m/s to 54.71±12.46 mmHg (p<0.001)and in group II of patients - from 78.84±14.48 m/s to 54.71±12.46 mmHg (p<0.001), having reached normative values; PWV in 1 st group of patients decreased from 10.6±2.3 m/s to 9.32±2.21 m/s (p<0.05) and in 2 nd group of patients - from 11.21±3.02 m/s to 9.89±2.12 m/s (p<0.001). However, AA was significantly reduced in 2nd group of patients: 19.24±7.67 mmHg before and 14.31±7.57 mmHg after treatment (p<0.02).

Conclusions:

In both groups there was a significant positive dynamics of such indices as cSBP, cPP and PWV, but AA index significantly decreased only in the2nd group of AH patients. At the same time, the level of MAU initially exceeded normal values in the group of AH patients who suffered COVID19.
ASSESSMENT OF RIGHT VENTRICULAR FUNCTION FOLLOWING PERMANENT PACEMAKER IMPLANTATION BY ECHOCARDIOGRAPHY (INCLUDING 3D ECHOCARDIOGRAPHY)
Authors: Kumar Dinesh , Dutta Bornali , Iqbal Farhin
Published: May 2024

Objective:

Several studies have shown that unfavorable ventricular remodelling & mechanical dyssynchrony caused by Right ventricular (RV) pacing leading to development of Left Ventricular dysfunction. Nevertheless, impact of RV pacing on Right Ventricle function has not been thoroughly assessed. Hence, prospective study was done to assess RV dimensions & function by 2D and three-dimensional (3D) echocardiography at 3 months & 6 months after pacemaker implantation

Design and method:

This study was a prospective single-centre study. All patients who underwent pacemaker implantation were assessed for RV function by 2D and 3D Echocardiography at baseline (pre-procedure), 3 months & 6 months after pacemaker implantation. The change in follow-up period was evaluated by using single factor analysis of variance ANOVA with repeated measures in normally distributed data & Bonferroni post-hoc test. A p value of <0.05 is considered to be statistically significant

Results:

From January 2022 to December 2022, a total of 66 patients with permanent pacemaker were enrolled in the study. There was statistically non-significant changes in mean LVEF (%) during follow up (62.13±3.92(Baseline) vs. 62.21±4.15(3-month) vs 62.03+3.83 (6-months), p value>0.05).However, there was statistically significant changes in mean PASP (mm Hg) during follow up (18.45±3.45 (Baseline) vs. 22.18±3.76 (3-month) vs 26.45+3.97, p value <0.05). Also, there was statistically significant changes in mean RIMP during follow up (0.48±0.04(Baseline) vs. 0.50±0.04(3-month) vs 0.50+0.03(6-month),p value<0.05).Likewise, there was statistically significant changes in mean RV E/E’ during follow up (4.47±0.57(Baseline) vs. 4.70±0.74(3-month) vs 4.95+0.82(6-month),p value <0.05).In addition, there was statistically significant changes in mean TR Jet Area (cm2) during follow up (1.68±0.26(Baseline) vs. 2.22±0.43(3-month) vs 2.56+0.53(6-month), p value <0.05). But, there was statistically non-significant changes in mean RVEF % (3D Echo) during follow up (53.51± 2.75(Baseline) vs. 53.02±2.64 (3-month) vs 53.48+2.34 (6-month), p value >0.05).Other echocardiographic parameters of RV function did not show any change in 3-months & 6-months follow-up.

Conclusions:

There is change in Right Ventricular function after Pacemaker implantation which can be documented as early as 6 months post implantation. Permanent pacemaker was associated with changes in RIMP, RV E/E’, PASP, TR JET AREA during 6 months after Right ventricular pacing