bluuebunny/crossref_metadata_2025 huggingface dataset:
RAG-MENA-2: CV RISK PROFILE AND LIFESTYLE PATTERN IN THE MENA
Authors: Najem Robert N , Bahous Sola Aoun
Published: January 2023

There are large and widening global disparities in hypertension prevalence and control in the Mena region.

Almost 40% of adults in the region are either overweight or obese with high rates of childhood obesity. More than a third of the adult population in these countries having either hypertension or diabetes or both. Age at onset of CVD is lower and HTN prevalence is increasing.The prevalence of hypertension in Lebanon increased from 23.1% as reported in 2005 to 35% in 2015 and 37% in 2019. 64.1% of them were aware of it, and only 62.6% of treated participants had a controlled BP.

Since only around half of patients with hypertension in Lebanon are aware of their disease as reported previously, screening for HTN and increasing awareness are of tremendous importance for the population in Lebanon.

Collaborative efforts from national and international stakeholders are urgently needed to combat the emerging hypertension burden in low- and middle-income countries.

Stakeholders should promote blood pressure screening, access to affordable healthcare and antihypertensive medications, and adherence to antihypertensive treatment to improve hypertension control in low- and middle-income countries.

Implementation of innovative, cost-effective, and sustainable programs for hypertension prevention and control should be a public health priority for these countries.
RAG-SACA-1: NUTRITIONAL RISK FACTORS IN SACA REGION
Authors: Patil Mansi
Published: January 2023

One of the key factors influencing the development of hypertension is diet. As a result of its continuing rise in prevalence, HIV is the leading cause of mortality and the burden of disease worldwide. The prevalence of hypertension has rapidly increased in Iran, Pakistan, Thailand, Sri Lanka, the Philippines, China, India, and Nepal. Aging populations and negative changes in risk variables, such as tobacco use, low physical activity, and bad food, notably high salt consumption in this region, are risk factors for hypertension. It is well known that certain nutrients and foods, such as salt, potassium, fibre, and certain fruits and vegetables, have an impact on blood pressure (BP), but less is known about the impact of other nutrients and foods, particularly magnesium, calcium, dairy products, and nuts. Epidemiological data on the connections between nutrition and hypertension are plentiful, but frequently come from cross-sectional rather than prospective analyses, the latter of which have been carried out in particular populations that are likely to be comparable in terms of socioeconomic status and health consciousness. Various eating trends labelled “traditional,” “meat,” “Western,” and “prudent” have been found in studies of Asian communities. Despite the fact that the individuals who live in these countries are remarkably diverse, there are parallels in their societal structure.

In China, dietary patterns with high meat and dairy intakes have been linked to obesity, but in Thailand, a more conventional diet high in carbohydrates has been linked to metabolic syndrome. In that situation, primary dietary prevention has advanced to combat the hypertension epidemic and preventive interventions from a public health perspective are urgently needed.
PS-B01-4: ANGIOTENSIN II TYPE1 RECEPTOR INHIBITION IMPROVES VASCULAR SENESCENCE THROUGH IMPROVEMENT OF MITOCHONDRIAL QUALITY CONTROL VIA CRAF/MEK/ERK PATHWAY
Authors: Uchikado Yoshihiro , Ikeda Yoshiyuki , Uebo Shota , Sasaki Yuichi , Akasaki Yuichi , Ohishi Mitsuru
Published: January 2023

Introduction:

Prevention of atherosclerotic cardiovascular disease has a problem of residual risk that is insufficient even if lipids are properly lowered by drugs such as statin. It has been reported that lectin-like oxidized low-density lipoprotein scavenger receptor-1 (LOX-1) associated with Angiotensin II Type 1 Receptor (AT1R). Mitochondria play crucial role in vascular senescence and atherosclerosis. We hypothesized receptor association with LOX-1 and AT1R might be a breakthrough to solve residual risk in terms of mitochondrial quality control.

Methods:

We performed in vitro and in vivo experiments using vascular smooth muscle cell (VSMC), C57BL6 (WT) and apolipoprotein E deficient (ApoE KO) mice.

Results:

Administration of ox-LDL to VSMC induced mitochondrial dysfunction and cellular senescence accompanied by excessive mitochondrial fission through Drp1 activation. This Drp1 activation was derived from the activation of CRAF/MEK/ERK pathway, which is a downstream of AT1R. AT1R inhibition inactivated ox-LDL-mediated Drp1 activation and retarded mitochondrial dysfunction, excessive mitochondrial fission and cellular senescence, indicating that LDL receptor LOX-1 associates with AT1R and activates CRAF/MEK/ERK/Drp1, leading to induction of mitochondrial fission and resulting in facilitating cellular senescence. AT1R inhibition also induced mitophagy assessed by electron microscopy and immunohistochemistry of LAMP2 and TOMM20. AT1R inhibition-induced mitophagy was not affected by Atg7 knockdown, whereas it was diminished by Rab9 knockdown. Immunohistochemistry showed TOMM20 dots were co-localized to LAMP2 and Rab9 but not LC3. These results suggest that AT1R signal induces mitophagy derived from Rab9-dependent alternative autophagy. Moreover, inhibition of either CRAF or MEK also decreased excessive mitochondrial fission and induced mitophagy, suggesting that AT1R signal followed by CRAF/MEK pathway modulates both mitochondrial dynamics and mitophagy. Taken together, inhibition of AT1R induces dual modification of mitochondrial dynamics and mitophagy through inactivation of CRAF/MEK/ERK axis. Finally, we confirmed that the degree of vascular senescence and the number of fragmented mitochondria were higher in ApoE KO than those of WT mice, and treatment with Candesartan to ApoE KO inhibited vascular senescence through induction of mitophagy and imbalance of mitochondrial dynamics.

Conclusion:

Receptor association of LOX-1 with AT1R plays a crucial role in cellular/vascular senescence induced by ox-LDL, and AT1R inhibition improves mitochondrial quality control through regulation of mitochondrial dynamics and mitophagy derived from Rab9-dependent alternative autophagy.
PS-B01-7: VASCULAR SMOOTH MUSCLE CELL NOX5 REGULATES FIBROBLAST PHENOTYPIC SWITCH AND CARDIOVASCULAR FIBROSIS
Authors: Montezano Augusto , Rios Francisco J , Blaikie Zachariel , Saad Tomador EK , Camargo Livia , Ramirez Roberto Palacios , Tarjus Antoine , Sagan Agnieszka , Beattie Wendy , Guzik Thomasz J , Jaisser Frederic , Graham Delyth , Touyz Rhian M
Published: January 2023

Objective:

We previously observed that mice expressing human Nox5 (hNox5) in VSMC exhibit vascular dysfunction and cardio-renal fibrosis, where mechanisms are unknown. Here we postulated that VSMC-Nox5 promotes fibroblast phenotypic changes leading to myofibroblast differentiation and pro-fibrotic responses.

Design and Methods:

Fibroblasts were cultured from wildtype (WT) and hNOX5 mice (Nox5 + SM22 +). Mice (20 weeks old) were infused with Ang II (600 ng/Kg/day) for 28 days and renal fibrosis/inflammation studied. Markers of myofibroblasts, pro-fibrotic and inflammatory phenotypes were assessed by qPCR and immunoblotting.

Results:

Fibroblasts from Nox5 + SM22 + mice exhibited increased mRNA of pro-fibrotic markers, such as Col1A1 (2-ddC:1.74 ± 0.16 vs. WT 0.67 ± 0.11), Col3A1 (2-ddC:1.74 ± 0.18 vs. WT 0.96 ± 0.24) and TIMP3 (2-ddC:2.65 ± 0.25 vs. WT 0.38 ± 0.07), p < 0.05. Myofibroblast phenotype (SMC) markers mRNA, aSMA (2-ddC:1.54 ± 0.05 vs. WT 0.78 ± 0.17) and Myocd (2-ddC:1.36 ± 0.17 vs. WT 0.39 ± 0.22) were also increased, p < 0.05. mRNA expression of CD36 (2-ddC:1.37 ± 0.07 vs. WT 86 ± 0.24), TNFa (2-ddC:1.32 ± 0.2 vs. WT 0.71 ± 0.17) and TNFR1 (2-ddC:1.26 ± 0.04 vs. WT 1.02 ± 0.10) were increased, while CD68 expression was decreased (2-ddC:0.82 ± 0.11 vs. WT 1.36 ± 0.18) in fibroblasts from Nox5+SM22+ mice (p < 0.05). In Nox5 mice fibroblasts, ROS production and TGFb protein expression (AU:1.8 ± 0.05 vs. WT 1.4 ± 0.06), as well as TGFbR2 gene expression (2-ddC:2.04 ± 0.17 vs. WT 0.57 ± 0.12), were increased (p < 0.05). Kidneys from Ang II-infused Nox5+SM22+ mice exhibited significant perivascular fibrosis and inflammatory cell infiltration compared to WT. Kidney expression of vimentin (AU:1.01 ± 0.05 vs WT 0.85 ± 0.03) and aSMA (AU:0.44 ± 0.03 vs WT 0.33 ± 0.01), markers of myofibroblast differentiation, were increased in Nox5 mice (p < 0.05). Gene expression of DNMT3a and TET2, DNA methylation regulatory enzymes, were also increased in fibroblasts from Nox5+SM22+ mice, p < 0.05.

Conclusion:

VSMC-Nox5 regulates fibroblast phenotypic switch leading to fibrosis; a process that may involve increased production of ROS and TGFb, and activation of DNA methylation pathways.
PS-B01-12: SEXUAL DIMORPHISM OF CEREBROVASCULAR NOX5-NOTCH3 SIGNALLING IN ANGIOTENSIN II-INDUCED HYPERTENSION
Authors: Blaikie Zachariel S L , Montezano Augusto C , Miller Alyson A , Touyz Rhian M , Work Lorraine M
Published: January 2023

Objectives:

NOX5 is a pro-contractile NOX isoform associated with vascular dysfunction. We demonstrated that vascular NOX5 expression is increased in cerebral autosomal dominant arteriopathy with sub-cortical infarcts and leukoencephalopathy (CADASIL), a small vessel disease of the brain. CADASIL is caused by mutations in NOTCH3 and abnormal NOTCH3 signalling. Here we questioned whether cerebrovascular NOX5 influences NOTCH3 in male and female hypertensive mice.

Design and method:

Brain tissues from angiotensin II (Ang II) male and female 20-week wild-type (WT) ice and mice expressing human Nox5 (hNOX5) specifically in VSMCs studied. Ang II was administered by mini-pump (600ng/Kg/per day) for 28 days to induce a hypertension. Protein and mRNA expression of NOX isoforms and NOTCH3 (full-length and intracellular domain (ICD)) and downstream signalling of NOTCH3-specific genes were assessed using qPCR and immunoblotting respectively. Markers of oxidative stress were measured by Amplex-red and TBARS-MDA.

Results:

Ang II induced a significant increase in blood pressure in WT and hNOX5 mice. Expression of full length NOTCH3 expression was significantly increased in male Ang II-treated hNOX5 mice (AU: 0.15 ± 0.01 vs. un-treated hNOX5 0.07 ± 0.02) and unchanged in females. NOTCH3-ICD was significantly increased in male Ang II-treated WT versus WT controls (0.1 ± 0.01 untreated WT vs. 0.25 ± 0.05 Ang II WT), but unchanged in male hNOX5 mice. NOTCH3-ICD expression was unaltered in female untreated versus Ang II treated WT and hNOX5 mice. Downstream NOTCH3 gene HEY1 mRNA expression was significantly reduced in male Ang II-treated hNOX5 mice compared to untreated hNOX5 males (3.91 ± 0.3 vs. male hNOX5 untreated 2.78 ± 0.13). Irreversible protein tyrosine phosphatases (PTP-ox) were significantly increased in Ang II-treated hNOX5 mice (AU: 4.91 ± 0.6 vs. 2.18 ± 0.14) and was unchanged in hNOX5 female mice. MDA lipid peroxidation markers were decreased in female hNOX5 Ang II-treated mice (umol/protein: 1.28 ± 0.26 vs. hNOX5 3.25 ± 0.43), but not males. NOX5 induced no changes in NOX1-4 protein expression, or ROS measures in males or females.

Conclusions:

Ang II-induced hypertension in VSMC-specific NOX5 mice leads abnormal NOTCH3 signalling, downstream HEY1 transcription, and increased PTP-ox in a sex-dependent manner. In conclusion, in brains from VSMC-specific hNOX5 mice under a hypertensive phenotype, NOTCH3 expression is increased with associated attenuation of NOTCH3 downstream gene expression and increased PTP signalling. These findings were only evident in male mice. Our data suggest a possible relationship between NOTCH3 signalling and NOX5 that seems to be sex-specific. Implications of this sexual dimorphism await further clarification in the context of hypertension and vascular dysfunction.
PS-B02-5: NICORANDIL SUPPRESSES ISCHEMIA-INDUCED CARDIAC NOREPINEPHRINE ENHANCEMENT AND VENTRICULAR ARRHYTHMIAS IN PRESSURE OVERLOAD-INDUCED HYPERTROPHIC HEARTS.
Authors: Kobara Miyuki , Amano Toshihiro , Toba Hiroe , Nakata Tetsuo
Published: January 2023

Objective:

Ventricular arrhythmias are a common cause of sudden death in acute myocardial infarction (MI) and hypertension is a major risk factor of MI. Nicorandil, an ATP sensitive potassium channel (KATP) opener, is usually used in the treatment of acute MI. KATP expresses in nerve terminals as well as cardiomyocytes and KATP in nerve terminals regulates norepinephrine release. The effects of nicorandil on ischemic myocyte are fully defined. On the other hand, the roles of nicorandil on ischemic norepinephrine release in hypertrophic cardiac tissue has remained unexplored. We examined whether nicorandil suppressed interstitial norepinephrine level and ventricular arrhythmia during acute ischemia in chronic pressure overload-induced hypertrophic hearts.

Design and Methods:

Rats were divided into two groups: abdominal aortic constriction (AAC) group and sham-operated (Sham) group. Four weeks after constriction, cardiac geometry and function were examined using echocardiography and hemodynamic measurements, and cardiac tissues were stained with hematoxylin and eosin and Sirius Red for histological examinations. In other rats, 4 weeks after constriction myocardial ischemia was induced by the left anterior descending artery occlusion for 100 minutes in the presence or absence of intravenous infusion of nicorandil. Cardiac interstitial norepinephrine concentration in ischemic region was measured using the microdialysis method. Ventricular arrhythmias were monitered by ECG during whole ischemic period.

Results:

Four weeks after constriction, remarkable left ventricular wall thickening and diastolic dysfunction were observed in AAC group. In histological examination, remarkable myocyte hypertrophy and interstitial fibrosis were observed in AAC group. Before ischemia, ventricular arrhythmia was not found in both groups. Number of ventricular arrhythmias, including ventricular tachycardia and ventricular fibrillation, was increased in early ischemic period (−20 min) in both groups, and was grater in AAC group. Before ischemia, interstitial norepinephrine concentration in cardiac tissue was higher level in AAC group than in Sham group, and ischemia increased norepinephrine concentration in both groups. Nicorandil administration in ischemic period significantly suppressed the number of ventricular arrhythmias and abolished the ventricular tachycardia and fibrillation without hemodynamic alterations in hypertrophic hearts. Nicorandil also attenuated epinephrine enhancement in acute ischemic period in hypertrophic hearts.

Conclusion:

Ischemia-induced ventricular arrhythmias were more frequent and severe in hypertrophic hearts and associated with high interstitial norepinephrine concentration. Nicorandil suppressed ischemia-induced interstitial norepinephrine release by neuronal KATP opening, which attenuated ventricular arrhythmias in pressure overload-induced hypertrophic hearts.
PS-B02-10: MTOR INHIBITOR IMPROVES TESTOSTERONE-INDUCED MYOCARDIAL HYPERTROPHY IN HYPERTENSIVE RATS
Authors: Chen Jianshu , Yu Jing
Published: January 2023

Compelling evidence have described the incidence of hypertension and left ventricular hypertrophy in postmenopausal women is significantly increased worldwide. Our team previous research identified that androgen was an underlying factor contributing to increased blood pressure and LVH in postmenopausal women. However, little is known about how androgens affect LVH in postmenopausal hypertensive women. The purpose of this study was to evaluate the role of mTOR signaling pathway in myocardial hypertrophy in androgen-induced postmenopausal hypertension and whether mTOR inhibitors can protect the myocardium from androgen-induced interference to prevent and treat cardiac hypertrophy. For that, ovariectomized spontaneously hypertensive rats aged 12 weeks were used to study the effects of testosterone T 2.85 mg/kg/weekly im on blood pressure and myocardial tissue. On the basis of antihypertensive therapy chlorthalidone 8 mg/kg/day ig, the improvement of blood pressure and myocardial hypertrophy in rats treated with different dose gradients of rapamycin 0.8 mg/kg/day Vs 1.5 mg/kg/day Vs 2 mg/kg/day ip in OVX+ estrogens E 9.6 mg/Kg/day, ig+T group was further evaluated. After T intervention, the OVX female rats exhibited significant increments in the heart weight / tibial length, cross-sectional area of cardiomyocytes and the mRNA expressions of atrial natriuretic peptide, myosin heavy chain and matrix metalloproteinase 9 accompanied by a significant reduction in the uterine weight/TL and issue inhibitor of metalloproteinase 1. Mammalian rapamycin receptor mTOR, ribosomal protein S6 kinase S6K1, 4E-bindiong protein 1 4EBP1 and eukaryotic translation initiation factor 4E in myocardial tissue of OVX+E+T group were expressed at higher levels than those of the other four groups. On the other hand, rapamycin abolished the effects of T-induced cardiac hypertrophy, decreased the systolic and diastolic blood pressure of SHR, and inhibited the activation of mTOR/ S6K1/4EBP1 signaling pathway in a concentration-dependent manner. Collectively, these data suggest that the mTOR/S6K1/4EBP1 pathway is an important therapeutic target for the prevention of LVH in postmenopausal hypertensive women with high T levels. Our findings also support the standpoint that the mTOR inhibitor, rapamycin, can eliminate T-induced cardiomyocyte hypertrophy.
PS-B02-12: EFFECTS OF ULTRAVIOLET LIGHT ON BLOOD PRESSURE AND LEFT VENTRICULAR FUNCTION
Authors: Noda Akiko , Niwa Haruka , Ito Atsuki , Shibata Hiroki , Takeda Kozue , Wu Shiyong
Published: January 2023

Ultraviolet light (UV), induces the activation of constitutive nitric oxide synthases, which produces nitric oxide (NO) of vascular relaxation factor. We hypothesize that UV-induced production of NO could have beneficial effect on hypertension. Twelve 6-week-old salt-sensitive hypertensive rats (Dahl-Iwai salt-sensitive DIS/Eis, Japan Society for the Study of Hypertension, Shizuoka, Japan) were used in this study. These rats were fed a high-salt diet containing 8%NaCl until 10 weeks of age and were then randomly divided into three groups i.e. baseline group (group non-UV), 0 h post UV (group UV 0 h), and 6 h post UV (group UV 6 h). The rats were irradiated with UVA and UVB lamps at an intensity of 100 mJ/cm2. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by using tail-cuff method (BP-98A; Softron Co., Ltd., Tokyo, Japan). We evaluated left ventricular (LV) systolic and diastolic function using echocardiography with a 12 MHz transducer connected to a Xario ultrasound system (Toshiba Medical Systems Co., Tochigi, Japan). Interventricular septal thickness, LV posterior wall thickness, and LV end-diastolic and end-systolic diameters (LVDd and LVDs) were obtained from a short-axis view. Percent LV fractional shortening (%LVFS) was calculated as an index of LV systolic function. Peak flow velocities at the mitral level during rapid filling (E) and deceleration time (Dct), and peak early diastolic mitral annular velocity which indicate LV diastolic function, were measured using pulsed and tissue Doppler echocardiography. Histological skin tissue sections were fixed with 4% paraformaldehyde phosphate buffer solution for 24 h at room temperature, embedded in paraffin, sectioned transversely (thickness, 3 μm), and stained with hematoxylin-eosin to evaluate the impairments of skin. The SBP and DBP were lower in group UV 6 h than group non-UV and group UV 0 h. In contrast, there were no significant differences in heart rate and body weight among the three groups. The peak early diastolic mitral annular velocity was greater in group UV 6 h than group non-UV and group UV 0 h. LVDd, LVDs, and %LVFS were not significantly different among the three groups. We did not find the impairments in skin after UV irradiation. UVA and UVB may play an important role in regulating not only blood pressure but also LV function.
PS-C01-1: CARDIOVASCULAR EVENTS PREDICTION RELATED TO AGE IN PATIENTS WITH HYPERTENSIVE CRISES IN 12-MONTHS FOLLOW-UP GREEK STUDY
Authors: Fragoulis Christos , Dimitriadis Kyriakos , Polyzos Dimitrios , Mavroudis Andreas , Leontsinis Ioannis , Kariori Maria , Kakouri Niki , Kouremeti Maria , Andrikou Ioannis , Grigoriou Kalliopi , Thomopoulos Costas , Konstantinidis Dimitrios , Tsioufis Konstantinos
Published: January 2023

Objective:

Few data have been published regarding the long-term prognosis of patients with hypertensive crises (hC). The aim of our study was to record the prevalence and clinical phenotype of patients with hypertensive urgencies (hU) and emergencies (hE) assessed in the emergency department (ED) and during hospitalization and a 12-month follow-up to record new events in a Greek tertiary hospital.

Design and method:

The registry population consisted of patients admitted to the ED with acute increase in blood pressure (BP) (systolic BP > or = 180mmHg and/or diastolic BP > or = 120mmHg) and depending on the presence or absence of acute hypertension-mediated target organ damage they were divided into the HE and the HU group, respectively. In all patients the demographic and clinical parameters were recorded for 12 months and there was a 12-month follow-up for new end points.

Results:

Out of 38,589 patients assessed in the ED during a period of 12 months, 353(0.91%) had hC, out of whom 256(72.5%) had HU and 97(27.5%) had hE. The mean age of all patients was 67.4 ± 12.9 years, 49% were males and 80% had a history of hypertension. During the study period 81 patients were excluded for not completing the follow-up. We stratified the total population of hC by age separating patients into two groups, e.g. > or = 65 and < 65 years old, and analyzed the composite end point consisting of deaths or hospitalizations caused by cardiovascular disease. Patients > or = 65years old presented more composite events (36 vs 8 events, p = 0.019, hR for patients > or = 65years 2.68, 95% CI 1.18–6.12). Cox regression models were adjusted for age, gender, cardiovascular disease, chronic kidney disease and diabetes mellitus.

Conclusions:

Our study implies that age > or = 65years is an independent risk factor for deaths or hospitalizations caused by cardiovascular disease in patients with hC. There is an arising necessity for more intensive follow-up of these patients and the need for further research in this setting.
PS-C01-12: EARLY DETECTION OF DEMENTIA USING AI-BASED EYE-TRACKING TECHNOLOGY
Authors: Takeda Shuko , Oyama Akane , Nakajima Tsuneo , Ito Yuki , Takami Yoichi , Takeya Yasushi , Yamamoto Koichi , Sugimoto Ken , Rakugi Hiromi , Morishita Ryuichi
Published: January 2023

Responding to the rapid rise in the number of dementia cases is becoming increasingly urgent. A great deal of evidence indicates that early diagnosis and timely intervention lead to beneficial outcomes. Vascular risk factors such as hypertension can be a potential target for dementia prevention as controlling blood pressure can reduce the risk of developing dementia later in life. A diagnostic method for the easy and accurate detection of mild symptoms of dementia is necessary to provide early intervention. Neuropsychological tests, such as the Mini-Mental State Examination (MMSE), are commonly used as a screening tool to detect cognitive impairment. These traditional neuropsychological tests are valid and reliable; however, they are not sufficiently simple and rapid as routine screening tools.

Here, we developed a newly developed eye tracking-based cognitive assessment tool to detect cognitive impairment. The gaze points of the subjects were recorded by the eye-tracking device while a series of short (178 s) task movies are displayed on the monitor, and the cognitive scores are determined from the gaze plots data. Eighty participants, including 27 cognitively healthy controls (HC), 26 patients with mild cognitive impairment (MCI), and 27 patients with dementia, were assessed by both an eye tracking-based and neuropsychological tests. A strong positive correlation was observed between the MMSE and eye tracking-based cognitive scores (r = 0.74, p < 0.00001, Spearman rank test). The eye tracking-based cognitive scores also correlated well with other neuropsychological tests such as FAB and ADAS-cog, and they also demonstrated a good diagnostic performance in detecting MCI.

Eye tracking-based cognitive assessment provides a new platform for a quantitative scoring and sensitive detection of cognitive impairment. Furthermore, we developed an easy-to-administer cognitive assessment application for smart devices such as iPad. This will facilitate early intervention, leading to the prevention of dementia. We are currently conducting a medical device clinical trial in Japan and preparing for the global extension of this service.
PS-C02-3: GREATER BLOOD PRESSURE VARIABILITY MEASURED BY 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING PREDICTS THE RECURRENCE AFTER ATRIAL FIBRILLATION CATHETER ABLATION
Authors: Hayashi Hiroya , Ito Asahiro , Toyoda Natsumi , Yanagishita Tomoya , Ito Ayaka , T Kim Andrew , Nakatsuji Kenichi , Ogawa Mana , Ishikawa Sera , Yoshiyama Tomotaka , Iwata Shinichi , Izumiya Yasuhiro , Fukuda Daiju
Published: January 2023

Objective:

Atrial fibrillation (AF) is an important prognostic factor even in the general population, and its clinical importance is increasing with the aging of the population. In recent years, catheter ablation (CA) of AF has become a common treatment modality, but recurrence of AF is observed in some patients. Especially, hypertension is an important risk factor for recurrence of AF after CA. Regarding blood pressure measurement, ambulatory blood pressure monitoring (ABPM) is known to provide a better prediction of cardiovascular events compared to conventional clinical BP measurement. However, the association between ambulatory BP variables (BPV) and AF recurrence after CA remains unclear. The purpose pf this study is to identify the association between BPV measured by 24-Hour ABPM device and recurrence after CA for AF.

Design and method:

All patients were admitted in Osaka metropolitan university hospital to undergo CA of AF, and were measured 24-hour BP monitoring using an ambulatory BP device (Mobil-O-Graph) after CA between August 2017 and April 2021. Twenty four-hour mean peripheral and central systolic/diastolic BP were separately calculated. BPV was calculated as coefficient of variation (standard deviation/mean BP).

Results:

A total of 107 patients were included in this study. After a median follow-up period of 563 days, AF recurrence was documented in 23 of 107 patients (21.5%). In univariate analysis, patients with AF recurrence tended to have higher age (OR = 1.08, 95%CI = 1.02–1.14, p < 0.01), serum BNP (OR = 1.00, 95%CI = 1.00–1.01, p = 0.01), CHADs2 VASc score (OR = 1.67, 95%CI = 1.22–2.29, p < 0.01), left atrial volume index (OR = 1.07, 95%CI = 1.04–1.10, p < 0.01), E/e’ (OR = 1.11, 95%CI = 1.02–1.21, p = 0.02) than those of non-AF recurrence. In ABPM variables, greater 24-hour mean peripheral and central systolic/diastolic BPV were associated with AF recurrence after CA, whereas any indices of 24-hour mean BP variables were not (Table 1.). Multivariate cox regression analysis after adjustment for relevant variables, 24-hour mean peripheral and central systolic/diastolic BPV were independently associated with AF recurrence after CA (Table 1.).

Conclusions:

Greater BPV measured by ABPM, either in peripheral or central, were indicated to be predictors of AF recurrence after CA. Our data suggest that BP control to aim at minimizing BPV attenuates the risk of AF recurrence after CA.
PS-C03-8: NOVEL STUDY TO SEE ARTERIAL STIFFNESS CHANGES WITH POSTURE IN HYPERTENSIVE SUBJECTS IN ASIAN POPULATION
Authors: Sule Ashish Anil , Cesar Benedict A , Cangco Noe M
Published: January 2023

Aim:

To see the effect of postural variation on parameters of arterial stiffness, in Asian population especially in Singapore.

Methods:

Postural variations and their effects on measures of arterial stiffness were analysed in 2 groups of patients consisting of hypertensive subjects (57 patients) and normotensive subjects (54 patients). Operator index (OI), central pressures such as aortic systolic pressure (ASP), aortic pulse pressure (APP), Aortic Pulse Augmentation (APA), Augmentation Index (AI) and brachial blood pressures (BP) such as brachial systolic pressure (SP) and brachial diastolic pressure (DP) were measured in supine and sitting positions. Differences between BP characteristics in supine and sitting were compared using non parametric paired test of Wilcoxon Signed-rank test. A p-value of p < 0.05 was accepted as statistically significant

Results:

A statistically significant increase in APP (45(35–54) vs 42(31–48) = 0.0058 and a significant decrease in DP (75(69–83) vs 78(69–87), p = 0.023) was seen in the supine position as compared to in the sitting position. A similar trend of significant increase in APP and decrease in DP (33(28.3–36) vs 30(23.3–33.8), p = 0.00158 and 62(55–67) vs 65(59–71), p = 0.0006 respectively was seen in normotensive subjects.

Conclusion:

Postural changes has an effect on arterial stiffness. Normotensive subjects and hypertensive patients on treatment behave similarly on postural changes. On the other hand, hypertensive subjects who are not on medications, behave differently with posture. Central aortic pulse pressure is a sensitive marker for postural variation response of arterial stiffness.
PS-C03-13: THE POTENTIAL AND EXPECTATIONS OF CONSUMER-DRIVEN MARKETING FOR TELEMEDICINE IN HYPERTENSION FINDINGS FROM A CONCEPT SURVEY AND DEPTH INTERVIEWS
Authors: Shioya Saori , Yatabe Junichi , Ishida Kazuya , Yatabe Midori , Terai Taro
Published: January 2023

We provide telemedicine services to manage hypertension, utilizing our consumer-driven marketing knowledge. We have established a system jointly with TelemedEASE, a general incorporated association, and launched the service “Hypertension e-medical” in 2021.

We performed quantitative and qualitative surveys to analyze consumer psychology and examined the essence of the value provided by telemedicine services for hypertension.

Survey Methods:

Findings

(1) Depth interviews

The primary intention of new users of telemedicine was “convenience,” such as no need for visiting hospital and reduced waiting time, while the next largest potential value was “a sense of reassurance”. Many patients have concerns that they are unable to discuss with their doctors regarding hospital visits and medication. In some cases, patients felt that they didn’t receive sufficient explanations from their doctors after only a short consultation, and in other cases, even if they did receive explanations, their concerns were not fully resolved. The ability to monitor one's own symptoms by measuring one's blood pressure at home and the “a sense of reassurance” provided by medical staff watching over the smartphone Apps can be of great value to patients.

(2) Concept survey

Of all subjects including treated and untreated patients, 76.1% had blood pressure of 130/85 mmHg or higher, and 62.5% was on regular blood pressure medication. Majority (56.4%) regularly measured their home blood pressure. At the time of the survey, 56.4% knew about online visits but only 2.4% had used it. Currently, only 13.2% of the respondents were willing to use telemedicine.

Patients in their 30 s and 40 s seemed to value “peace of mind”, as the intention to use the service was about 1.7 times higher when the focus concept was “peace of mind” compared to when it was “convenience” in this age group.

Conclusion:

In Japan, telemedicine from the first visit recently became permanently available. The number of users is expected to increase.

Providing value based on an accurate understanding of such consumer insights is important. The findings may help lead to designing services to encourage the initiation and continuation of treatment in patients with hypertension.
PS-C04-1: COMPARISON OF THE CARDIO-ANKLE VASCULAR INDEX AND AUGMENTATION INDEX AS AN INDEX OF ARTERIOSCLEROSIS IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Morimoto Satoshi , Horiuchi Sayuri , Kimura Miwa , Kimura Shihori , Yamashita Kaoru , Takano Noriyoshi , Seki Yasufumi , Bokuda Kanako , Watanabe Daisuke , Ichihara Atsuhiro
Published: January 2023

Objective:

Arteriosclerosis leads to various serious diseases that substantially reduce quality of life. When treating hypertension, it is important to evaluate the degree of arteriosclerosis. In recent years, the cardio-ankle vascular index and augmentation index have been frequently used as indicators of arterial wall sclerosis. However, the superiority of either the cardio-ankle vascular index or the augmentation index as an index of arteriosclerosis remains unclear. Therefore, the present study compared the usefulness of these two indices as an index of arteriosclerosis.

Design and method:

Associations between the cardio-ankle vascular index or augmentation index and risk factors for arteriosclerosis and other indices of arteriosclerosis in 535 consecutive patients with essential hypertension were evaluated.

Results:

The cardio-ankle vascular index was significantly correlated with age, hemoglobin A1c, brain natriuretic peptide, and estimated glomerular filtration rate. In contrast, the augmentation index showed significant correlations only with age, brain natriuretic peptide, and estimated glomerular filtration rate. In addition, these correlations with the augmentation index were generally weaker than those with the cardio-ankle vascular index. The cardio-ankle vascular index, but not the augmentation index, was significantly correlated with flow-mediated dilation, an index of vascular endothelial function, and carotid intima-media thickness, an index of carotid atherosclerosis. Similar results were observed in subgroups stratified by sex and age.

Conclusions:

These data indicate that the cardio-ankle vascular index is more closely associated with risk factors for arteriosclerosis and other indices of arteriosclerosis than the augmentation index, suggesting that the cardio-ankle vascular index may be superior to the augmentation index as an index of arteriosclerosis.
PS-C04-3: DIFFERENTIAL EFFECT OF A XANTHINE OXIDASE INHIBITOR ON ARTERIAL STIFFNESS AND CAROTID ATHEROSCLEROSIS: A SUBANALYSIS OF THE PRIZE STUDY
Authors: Shiina Kazuki , Tomiyama Hirofumi , Tanaka Atsushi , Node Koichi
Published: January 2023

Atherosclerosis and arterial stiffness are phenotypes of atherosclerotic vascular damage. Atherosclerosis originates from endothelial vascular damage and forms focal morphological lesions; arterial stiffness originates from diffuse medial-layer damage in the arterial tree. Thus, the two phenomena reflect different facets of atherosclerotic vascular damage, and they both gradually progress. We conducted a subanalysis to compare the long-term effects of febuxostat on atherosclerosis and arterial stiffness in the PRIZE study (a multicenter, prospective, randomized, open-label, blinded-endpoint clinical trial to examine the effect of febuxostat on carotid atherosclerosis). Among 514 study participants, arterial stiffness parameters (brachial-ankle pulse wave velocity or cardio-ankle vascular index) were obtained at baseline, 12 months, and 24 months in 100 subjects. Among them, 48 subjects were allocated to the control group (i.e., nonpharmacological lifestyle modification for hyperuricemia), and 52 subjects were allocated to the febuxostat treatment group. While the decrease in serum uric acid was greater in the febuxostat group than in the control group, the adjusted percentage decrease in arterial stiffness parameters at month 24 was greater in the febuxostat group than in the control group, with a mean between-group difference (febuxostat - control) of -5.099% (95% confidence interval (CI) -10.009% to -0.188%, p = 0.042). Thus, long-term treatment with febuxostat may exert beneficial effects on arterial stiffness without improving carotid atherosclerosis. A long-term study to examine the effect of febuxostat on cardiovascular outcomes related to increased arterial stiffness is warranted.
PS-C05-2: COMPARISON OF NON-INVASIVE VASCULAR LOAD ESTIMATION OF THE SYSTEMIC AND PULMONARY ARTERIAL CIRCULATION IN PATIENTS UNDERGOING INVESTIGATION FOR PULMONARY HYPERTENSION
Authors: Adji Audrey , Kearney Katherine , Hungerford Sara , Song Ning , Kotlyar Eugene , Lau Edmund , Jabbour Andrew , Haywrd Christopher
Published: January 2023

Objective:

Quantification of characteristic impedance (Zc) as an estimate of pulsatile load is now feasible using a hybrid non-invasive and invasive technique in any specific vascular bed. Vascular resistance (mean pressure ÷ mean flow) in a system may ignore the pulsatile component of ventricular hydraulic work incorporating the dynamic interaction between vascular resistance, compliance and wave reflection. This interaction is represented by vascular impedance which offers a comprehensive assessment of hydraulic load. This study aims to compare systemic (Ao-Zc) and pulmonary (PA-Zc) Zc in a cohort of patients with suspected pulmonary hypertension (PH) referred for routine right heart catheterisation (RHC) followed by cardiac magnetic resonance (CMR).

Design and Methods:

Thirty participants (77% females, mean 56 ± 18 years) were recruited, and had routine right heart catheterisation (RHC) to measure systolic (sPAP), diastolic (dPAP), mean (mPAP), and PA wedge pressures (PAWP), cardiac output (CO) and PVR. The remaining patients were assigned to the control group. Ao pressures were calibrated to brachial cuff pressures and derived from radial tonometric pressure acquisition (systolic, AoSP; diastolic, AoDP; mean, MP) before/ after CMR. Ao and PA volumetric flows were recorded using 3T cardiac magnetic resonance (CMR) using phase-contrast velocity quantification. Zc was expressed as the relationship of PA pulsatile pressure to PA pulsatile flow in the frequency domain.

Results:

80% of patients had evidence of PH on RHC and classified as pre-capillary PH (n = 11, PrecPH), isolated post-capillary PH (n = 8, IpcPH) and combined PH (n = 5, CpcPH). In patients without PH, Ao-Zc was 83.0 ± 38.4 dynes.s.cm-5 and PA-Zc was 48.8 ± 13.7 dynes.s.cm-5, with PA-Zc being 33% lower than those with PH (72.9 ± 28.0 dynes.s.cm-5, p = 0.005) and Ao-Zc non-significantly lower (77.3 ± 29.6 dynes.s.cm-5, p = 0.575). In patients with PH, different hemodynamic relationships were observed. In those with PrecPH, PA-Zc was 9% higher than Ao-Zc (p = 0.74).

An inverse relationship between PA-Zc and Ao-Zc was found in those with IpcPH (p = 0.11). This relationship approached 1:1 (p = 0.27) in patients with CpcPH. PA-Zc spectra in CpcPH subjects were qualitatively similar to Ao-Zc spectra, although the ratio of PVR to Zc was smaller.

Conclusion:

We describe a straightforward method to measure and compare pulsatile vascular load of the systemic and pulmonary circulations simultaneously, allowing further quantification of systemic/pulmonary vascular interactions. Further research is required to evaluate small-vessel contributions to the arterial circulation, especially in the pulmonary system.
PS-C05-4: EFFECT OF EVOLOCUMAB ON CAROTID MAXIMUM INTIMA-MEDIA THICKNESS IN PATIENTS UNDERGOING STATIN THERAPY
Authors: Hirai Keiji , Hirai Aizan , Morishita Yoshiyuki
Published: January 2023

Background:

This study investigated the effect of evolocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, on carotid maximum intima media thickness (IMT), an established surrogate marker of atherosclerosis, in patients taking statins with and without renal impairment (estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2).

Methods:

The annual change in carotid maximum IMT before and after administration of evolocumab was retrospectively analyzed in 229 statin treated patients (148 men and 81 women; mean age: 72.6 ± 8.6 years). The annual change in carotid maximum IMT was compared between patients with and without renal impairment (n = 73; mean eGFR 48.8 ± 8.3 ml/min/1.73 m2 vs. n = 156; mean eGFR 77.1 ± 11.9 ml/min/1.73 m2). The changes in lipid parameters were also evaluated.

Results:

Evolocumab significantly reduced the progression rate of carotid maximum IMT in whole patients (0.17 ± 0.38 mm/year to 0.08 ± 0.47 mm/year, p < 0.005). Evolocumab significantly reduced the progression rate of carotid maximum IMT in patients without renal impairment (0.18 ± 0.39 mm/year to 0.08 ± 0.46 mm/year, p < 0.05) but did not in patients with renal impairment (0.15 ± 0.36 mm/year to 0.06 ± 0.50 mm/year, p = 0.12). However, it significantly reduced total cholesterol, low density lipoprotein cholesterol, triglyceride, and lipoprotein (a), and increased high density lipoprotein cholesterol in both patients with and without renal impairment.

Conclusion:

Evolocumab attenuated the progression of carotid maximum IMT in patients undergoing statin therapy without renal impairment but not in patients with renal impairment. However, it improved lipid parameters in both patients with and without renal impairment. These results suggest that evolocumab protects against carotid atherosclerosis in only patients undergoing statin therapy without renal impairment.
PS-C05-6: EFFECT OF CORONARY RISK FACTORS AND PRESENCE OF CORONARY ARTERY DISEASE ON DIURNAL VARIATION IN VASCULAR ENDOTHELIAL FUNCTION
Authors: Yamashita Sumiyo , Tamai Nozomu , Sugiura Tomonori , Takase Hiroyuki , Murai Shunsuke , Saeki Tomoaki , Murakami Yoshimasa , Ohte Nobuyuki , Dohi Yasuaki , Seo Yoshihiro
Published: January 2023

Purpose:

Vascular endothelial dysfunction, an early change in atherosclerosis, is an independent risk factor for cardiovascular disease and is known to be reversible; RH-PAT (Reactive Hyperemia Peripheral Arterial Tonometry) can noninvasively measure vascular endothelial function. However, it is difficult to interpret the pathological significance of a single measurement because of many modifying factors such as diet, temperature, and medications. In this study, we aimed to investigate the effects of coronary risk factors and the presence of coronary artery disease on the diurnal variation of vascular endothelial function.

Methods:

Between May 2013 and May 2015, 498 patients (31% female, 19–94 years old, mean 66.7 ± 12.5 years) who were admitted to our hospital for cardiac catheterization, percutaneous coronary angioplasty, catheter ablation, or lower extremity peripheral angioplasty underwent RH-PAT examination (The Endo PAT 2000 system, Itamar Medical Ltd, Caesarea, Israel). The correlation between coronary risk factors and RH-PAT results was investigated. Correlations between coronary risk factors and RH-PAT results were also examined in patients who underwent coronary angiography.

Results:

The Reactive Hyperemia Index (RHI) was significantly lower in the group with smoking habit than in the nonsmoking group. Neither the number of coronary artery branches involved, the presence or absence of atrial fibrillation, nor the responsiveness to coronary spasm induction tests correlated significantly with the RHI. On the other hand, there was a significant difference between the morning and afternoon measurements in the group without coronary artery lesions, but no significant difference between the morning and afternoon measurements in the group with coronary artery lesions, regardless of the number of lesioned branches.

Conclusions:

Patients with a history of smoking, coronary artery lesions, and coronary spasms may have impaired diurnal variation in vascular endothelial function, suggesting that RH-PAT may be useful as an early indicator of coronary artery disease when measured at different time points.
PS-C06-4: RELATIONSHIP BETWEEN URINARY MICROALBUMIN AND LIPID ACCUMULATION PRODUCT AND VISCERAL ADIPOSITY INDEX IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Shu Meiqi , Hu Guangmei , Paermanjiang Naderemu , Xu Xinjuan
Published: January 2023

Objective:

To explore the relationship between urinary microalbumin and lipid accumulation product and visceral adiposity index in patients with essential hypertension.

Design and method:

A total of 463 essential hypertension patients admitted to the Department of Hypertension of the First Affiliated Hospital of Xinjiang Medical University from April 2020 to October 2021 were selected. Patients were grouped according to 24-hours urinary microalbumin and divided into normal 24-hours urinary microalbumin group and elevated 24-hours urinary microalbumin group to compare the clinical data of the two groups and analyze the risk factors of elevated urinary microalbumin.

Results:

The 24-hours urinary microalbumin was positively associated with lipid accumulation product and visceral adiposity index in patients with essential hypertension(all P < 0.01). The risk of elevated 24-hours urinary microalbumin may increase with increasing lipid accumulation product,visceral adiposity index. After adjusting for age,sex,admission systolic blood pressure,admission diastolic blood pressure,body mass index,triglycerides,high density lipoprotein cholesterol,serum creatinine,the OR (95%CI) of lipid accumulation product in the fourth quantile group was 4.770 (1.680∼13.545) compared with the first quantile of lipid accumulation product. The OR (95%CI) values of visceral adiposity index in the second,third and fourth quartile groups were 3.364 (1.330∼8.512),3.440 (1.249∼9.472),and 5.213 (1.556∼17.461),compared with the first quartile group of visceral adiposity index. Analysis of the receiver operating characteristic curve suggested that the risk of elevated urinary microalbumin increases when the lipid accumulation product is greater than 32.236 and the visceral adiposity index is greater than 2.031.

Conclusion:

When the lipid accumulation product and visceral adiposity index increase in patients with essential hypertension, they may lead to an increased risk of increased urinary microalbumin.
PS-C06-6: LONG-CHAIN FATTY ACIDS IN SARCOPENIA PATIENTS WITH CARDIOVASCULAR DISEASES IMPORTANCE OF N-9 MONOUNSATURATED FATTY ACIDS
Authors: Katoh Atsushi , Morita Kohsuke , Sasaki Motoki , Okina Norihito , Niiyama Hiroshi , Kai Hisashi
Published: January 2023

Background:

Long chain fatty acids are essential components of energy supply, cellular membranes and autacoid synthesis. It was suggested that long chain fatty acids might be involved in pathophysiology underlying sarcopenia. Therefore, we investigated the association between sarcopenia and serum long chain fatty acid profile in patients with cardiovascular diseases.

Methods:

We retrospectively investigated 308 cardiovascular patients (age: 72 ± 12, 174 males) admitted in our hospital. All patients were examined sarcopenia diagnostic tests and serum free fatty acids analysis.

Results:

Seventy-seven patients (25%) were diagnosed as sarcopenia. Serum fatty acid weight percentages of nervonic acid and erucic acid (n-9 long chain monounsaturated fatty acids) increased in sarcopenia patients than non-sarcopenia patients, while most of other long chain fatty acids weight percentages decreased in sarcopenia patients. Nervonic acid, which was an independent factor for sarcopenia on binary logistics regression analysis (B = 2.559, p < 0.001), correlated negatively with skeletal muscle index (r = -0.331, p < 0.001), gait speed (r = -0.387, p < 0.001), and handgrip strength (r = -0.372, p < 0.001). These significant relationships were certified in the groups of men, women, younger (≦ 73 years old), and elder (≧ 74 years old). On ROC curve analysis, the cut-off of nervonic acid weight percentage for diagnosis of sarcopenia was 1.37% with a sensitivity and specificity of 76.6% and 65.1%, respectively.

Conclusions:

Nervonic acid, a n-9 monounsaturated fatty acid, could be a new marker for sarcopenia in patients with cardiovascular diseases. Further study with large patient number is necessary to determine the roles of long chain fatty acids in sarcopenia.