bluuebunny/crossref_metadata_2025 huggingface dataset:
INFLUENCE OF PRO-INFLAMMATORY ADIPOKINES IN THE VASCULAR PHENOTYPE OF OVERWEIGHT AND OBESE ADOLESCENTS
Authors: De Blas Ana , Álvarez-Pitti Julio , Torro Maribel , Aguilar Francisco , Ponce Francisco , Lurbe Empar
Published: June 2022

Objective:

Obesity is a complex disease that leads to an adipocyte dysfunction favoring a profile characterized by insulin and leptin resistance with low adiponectin values. The objective of the present study is to assess in overweight and obese subjects the impact of the unfavorable profile of adipokines in blood pressure and vascular function.

Design and method:

Overweight and obese adolescents referred for cardiovascular risk assessment were included in a cross-sectional study. Height, body weight, and body composition were measured by bioelectrical impedance analysis. Hemodynamics were assessed by office blood pressure. Pulse wave velocity (PWV) and central blood pressure (cBP) were measured with Sphigmocorâ device. The logarithm of Aortic pulse pressure (AoPP) was calculated. Metabolic profile including fasting glucose and insulin levels, lipids profile and uric acid was assessed. Leptin and adiponectin were measured and the leptin/adiponectin ratio (L/A r) was calculated.

Results:

A total of 60 subjects (mean age 12.5 years, 53% male, and 68% obese) were included. Participants with obesity (mean BMI Z-score 2,3 ± 0.2) had higher levels of daytime SBP (118 Vs 116 mmHg; p = 0.05), and no differences in PWV (5.5 vs 5 m/s; p = 0.06) as compared to overweight. No differences were found in the metabolic profile, in contrast, leptin, was higher in subjects with obesity (43 vs 30 ng/L p = 0.045). Overall, a positive and significant correlation was found between leptin and PWV. Focusing on cBP values, a significant and negative correlation among adiponectin and AoPP was observed. In contrast a positive correlation to L/A r was found (figure). The multiple regression analysis showed that PWV was partially explained by L/A r and AoPP by adiponectin, when age, sex, BMI Zscore, insulin, leptin, and L/A r were included in the model.

Conclusions:

Obesity leads to an adipokines profile that is related to unfavorable vascular phenotypes in youth.
THE RELATIONSHIP BETWEEN THE DISTRIBUTION OF BODY FAT AND THE LEVEL OF OSTEOCALCIN IN CHINESE ADOLESCENTS
Authors: Bai Ling , Zhou Jinyu , Tong Lingling , Ding Wenqing
Published: June 2022

Objective:

Current studies on body fat distribution and bone metabolism in adolescents are very limited. This study aimed to examine the relationship between the body fat distribution and serum osteocalcin levels in adolescents.

Design and method:

A total of 1068 subjects (564 boys,52.8%) aged 12–18 years from Ningxia were randomly selected through a stratified cluster sampling. Serum osteocalcin levels were measured by ELISA. An automatic bioelectric impedance analysis (BIA) was used to measure body compositions, which included body fat mass(BFM),trunk fat mass(TFM),limbs fat mass(LFM),visceral fat level(VFL).

Results:

In the total population, serum osteocalcin levels were negatively correlated with BFM, TFM, LFM, and fat mass percentage (FMP) (r = -0.076, -0.066, -0.094 and -0.117, respectively, all P < 0.05); Serum osteocalcin levels were positively correlated with limb fat mass percentage (LFMP) (r = 0.167, P < 0.001). Logistic regression analysis showed that the odds ratios (ORs) of FMP in the third and second quintiles suggesting high levels of osteocalcin is 0.28 (95% confidence interval [CI],0.13—0.57) and 0.44(95% CI, 0.25—0.76) compared with the lowest quartile level among total population, respectively. Additionally, the corresponding ORs for high levels of osteocalcin were 0.2 (95%CI, 0.05–0.72) in the fourth quantile of FMP,0.21 (95%CI, 0.08–0.55) in the third quantile of FMP and 0.45(95% CI, 0.25–0.82) in the second quantile of FMP in boys, respectively. Compared with the reference subgroup, the fourth quantile level of LFMP could better predict high osteocalcin levels between boys and girls, and the ORs were 7.46 (95%CI, 2.79—19.96) and 2.60(95%CI: 1.36—4.96), respectively.

Conclusions:

FMP have a negative impact on bone resorption in in Chinese adolescents, especially in boys. However, LFMP has a protective effect on bone metabolism between Chinese boys and girls.
RELATIONSHIP BETWEEN SERUM OSTEOCALCIN AND BLOOD PRESSURE IN CHINESE ADOLESCENTS AGED 12–18 YEARS
Authors: Bai Ling , Zhou Jinyu , Tong Lingling , Ding Wenqing
Published: June 2022

Objective:

The relationship between serum osteocalcin level and blood pressure remains unclear. The aim of this study was to determine whether osteocalcin would be associated with blood pressure in Chinese adolescents.

Design and method:

A total of 1686 subjects (1022 boys,60.6%) aged 12–18 years from Ningxia were randomly selected through a stratified cluster sampling. Serum osteocalcin levels were measured by ELISA. Blood pressure (BP) by using a calibrated electronic sphygmomanometer according to the standard method by the American Hypertension Education Project Working Group.

Results:

The proportions of Hypertension was highest in the< = 33th percentile subgroup (39.8%) and lowest in the > 66th percentile subgroup (26.3%) in boys, with statistically significant differences between groups (2 = 10.988, P = 0.027). Compared with the subgroup of the< = 33th percentile, the odds ratios (ORs) for abnormal blood pressure were 0.73(95% confidence interval (CI), 0.55—0.96) in the 34th–66th percentile subgroup, 0.64(95% CI, 0.48—0.84) in the > 66th percentile subgroup, respectively. Additionally, the corresponding ORs for high BP were 0.63(95%CI,0.45–0.89) in the 34th–66th percentile subgroup,0.59(95%CI,0.42–0.84) in the > 66th percentile subgroup, respectively. Similar results were found in boys (P all < 0.05). After Adjusting age, fasting blood glucose and BMI, the ORs for high BP were 0.60(95%CI,0.36–0.99) in the > 66th percentile subgroup compared with the reference subgroup.

Conclusions:

Serum osteocalcin is a protective factor for hypertension in Chinese adolescents, especially in boys.
CARDIOMETABOLIC MULTIMORBIDITY AND ASSOCIATED FACTORS: THE FIRST BRAZILIAN REGISTRY OF PATIENTS WITH HYPERTENSION
Authors: Batista Sandro Rodrigues , Vitorino Priscila V.O. , Silva Renato Rodrigues , Sousa Ana Luiza Lima , Coca Antonio , Barroso Weimar K. Sebba
Published: June 2022

Objective:

Cardiometabolic multimorbidity (CM-MM) is defined by the occurrence of at least two of morbidities (diabetes mellitus, stroke, acute myocardial infarction). The purpose of this study was to analyze the occurrence of CM-MM and associated factors among Brazilian patients with hypertension.

Design and method:

Cross-sectional study with participants of The First Brazilian Registry of Patients with Hypertension (BRH) from 45 sites in all regions of Brazil (n = 2,646). For this study we select the individuals with 65 and more years (n = 1,033) and CM-MM was defined with the presence of 2 or more of the following: diabetes mellitus, stroke, acute myocardial infarction evaluated by self related. CM-MM was analyzed according to sex, age, race, presence of others morbidities (dyslipidemia, myocardial revascularization, heart failure and chronic kidney disease), control of blood pressure, obesity, physical activity, actual smoking and alcohol consumption. The numerical variables were presented by median and interquartile range, the categorical variables by absolute and relative frequency. To verify the variables associated with the outcome, simple logistic regression was performed.

Results:

CM-MM was present in 8.9% of participants. The median age was 71.6 (IQ: 67.9–76.8), female (59.7%), 65–70 years of age (39.6%), and 59.8% were white. Obesity was present in 55.8% and 48.4% of individuals have no blood pressure controlled. The occurrence of diabetes mellitus, stroke, and acute myocardial infarction was, respectively, 32.7%, 14.7% and 6.7%. A higher occurrence of CM-MM was observed in males, aged between 70 and 75 years old and with 75 years old or more, the presence of dyslipidemia; myocardial revascularization (MR); heart failure (HF) and kidney disease. The intersection size among diseases is represented in Figure 1. After multiple analysis, the following variables were associated with the presence of cardiovascular multimorbidity: male gender; age equal to or greater than 75 years and report of dyslipidemia, MR and HF.

Conclusions:

The prevalence of CM-MM was high and an approach based on the clusters of cardiometabolic diseases can be a potent care strategy.
CARDIOVASCULAR, COMORBIDITY AND METABOLIC SCORES AND VASCULAR FUNCTION IN HOSPITALIZED PATIENTS
Authors: Mozos Ioana , Jianu Daniela , Mozos Costin , Baba Mirela , Gug Cristina , Stoian Dana , Caraba Alexandru
Published: June 2022

Objective:

To assess the relationship between cardiovascular, comorbidity, and metabolic scores with arterial stiffness and early vascular aging, respectively, in a cohort of hospitalized patients.

Design and method:

A total of 55 patients, aged 61 ± 16 years, 35% men, hospitalized with several chronic disorders, including hypertension, coronary heart disease, heart failure, dyslipidemia, obesity, chronic hepatitis, and liver cirrhosis, and chronic kidney disease were enrolled in the study. The vascular function was assessed using the Arteriograph, an oscillometric, noninvasive device. The cardiovascular score was calculated considering the presence of hypertension, coronary heart disease, and heart failure, metabolic score included overweight obesity and dyslipidemia, and comorbidity score considered cardiovascular, metabolic, liver, and renal disorders.

Results:

Pulse wave velocity (PWV), arterial age, and brachial augmentation index (AixBrach) were: 10.21 ± 1.9 m/s, 55 ± 11 years, and -8.83 ± 34.37 %, respectively. Significant correlations were obtained between PWV and Comorbidity and Cardiovascular Score, respectively (r = 0.29, p = 0.033 and r = 0.34, p = 0.010, respectively). ROC curve analysis revealed the Cardiovascular Score as a diagnostic test for early vascular aging (AUC = 0.717, p < 0.001).

Conclusions:

Comorbidity and Cardiovascular Scores provide valuable information about arterial stiffness and early vascular aging in hospitalized patients. Further studies are needed to confirm the value of the mentioned scores in patients with chronic disorders.
TRICUSPID VALVE SECONDARY TO OLD BLUNT CHEST TRAUMA
Authors: Jain Rajesh , Hosseini Sj , Shoghli Reza
Published: June 2022

Objective:

The patient was a 42-year-old man who presented to the hospital with chest pain caused by movement.

The patient had no other symptoms and underwent cardiac examination and examination.

Echocardiography is performed. The patient mentions that these pains have been created for 6 months and have increased.

Background: After Trauma tricuspid insufficiency is an uncommon presentation generally caused by not traumatic injury to the chest wall and here the tricuspid valve injury is detected after 15 years of Chest injury by motorbike.

Design and method:

Case presentation

A 42-year-old man non-smoker and non-alcoholic presented with complaints of chest pain on movement with no exertional breathlessness for 3 months. Chest pain was increased with movement. He did not have any history of chronic illness. However, 15 years back he had suffered a non-penetrated chest trauma following a bike traffic accident. He was treated medically and since then he had remained well.

At admission, the pulse rate was 72/min, blood pressure 110/70 mm Hg, and respiratory rate 20/min. Po2 88 mmHg, So2 97%. Physical examination revealed elevated jugular venous pressure with prominent V wave and Y descent, grade II pan systolic murmur best heard at the fifth intercostal space along the left sternal border, which increases on inspiration and bilateral basal pulmonary crepitations.

Results:

The patient was a 42-year-old man who had no history of any specific disease. Except for the history of an accident while riding a motorcycle 15 years ago, he did not have any particular complaints.

During the operation, we noticed a rupture of the cord (tricuspid valve) which was a sign of rupture due to trauma to the valve. After the surgery, the patient had a complete recovery process and was discharged. Due to the gradual process of severities, which was asymptomatic, we came too the conclusion that after the trauma, the patient suffered a partial tear of the tricuspid cord, which increased with age and time.

Conclusions:

The patient had chest pain and systolic sonic, which is a rare case of severe TR
THE EFFECTIVENESS OF ANTIHYPERTENSIVE THERAPY IN COMORBID PATIENTS
Authors: Dunaieva Inna , Bilovol Olexander , Knyazkova Iryna , Kirienko Olexander
Published: June 2022

Objective:

An analysis of antihypertensive drugs in patients with comorbidities, namely, arterial hypertension (AH), type 2 diabetes mellitus, obesity, indicates that the complex treatment of these patients should include drugs that inhibit excessive activation of the renin-angiotensin-aldosterone system, in particular, angiotensin converting enzyme (ACE) and angiotensin II receptor blocker (ARB II). Numerous scientific data have established that angiotensin II is the main effector mediator of the RAAS, and ACE inhibitors do not fully inhibit the synthesis of angiotensin II. ARB II, their advantages over ACE inhibitors should be emphasized by their ability to reduce the effects of angiotensin II, regardless of the ways of its formation, aim of this study was to compare the results of treatment of patients with comorbidities

Design and method:

56 patients of middle age (64.4 ± 1.1) years old, men/women—43%/57% were examined and treated.

Arterial hypertension was diagnosed, according to the recommendations of the International Society of Hypertension (ISH), 2020. The type 2 diabetes mellitus, obesity were diagnosed on the basis of clinical, instrumental, biochemical criteria, in accordance with the recommendations of WHO experts, the European Society of Endocrinologists.

Results:

After treatment for three months, there was a significant decrease in systolic blood pressure (SBP) (by 19.6%), diastolic blood pressure (DBP) (by 15%), and heart rate (HR) (by 9%).

From the side of echocardiographic characteristics, the following levels have decreased: EDV—by 25.5%, ESV—by 17.3%, EDD—by 24.0%, ESD—by 12.6%, LVMM—by 8.3%; LVEF has increased by 6% compared with the indicated indicators before treatment.

There were no significant differences between such indicators as fasting blood glucose, HbA1c, insulin, TChC, TG, HDL cholesterol, AI; however, a significant decrease was found after treatment in the levels of VLDL cholesterol and BMI.

Conclusions:

Treatment of arterial hypertension in patients with type 2 diabetes mellitus and obesity with the inclusion of ramipril or telmisartan in the standard therapy had a positive effect on the structural and functional parameters of the left ventricle and ejection fraction.

At the same time, the neutral effect of these drugs on carbohydrate metabolism in the examined category of patients has been determined.
ASSOCIATION OF SERUM URIC ACID LEVELS AND ATHEROMATOSIS OF CAROTID ARTERIES IN HYPERTENSIVE PATIENTS
Authors: Papavasileiou M.V. , Doumas M. , Karamanou A. , Moustakas G. , Patsianis S. , Aravantinos D. , Pittaras A.
Published: June 2022

Objective:

The aim of this study was to investigate a possible association between the serum uric acid levels with the atheromatosis of the carotid arteries of hypertensive patients and the possible role of fibrinogen in this status.

Design and method:

We studied 1296 hypertensive patients (45,2% female), treated or newly diagnosed untreated, of mean age: 60,2 ± 5,3 years, without any known cardiovascular disease and with mean office systolic/diastolic arterial blood pressure (S/DBPo): 145,9 ± 12.6/89.7 ± 5,3 mmHg, mean office heart rate (HRo): 74,3 ± 9,9 bpm, average body mass index (BMI): 28.3 ± 5,3 kg/m2and average waist circumference (WC) 96.1 ± 12.9 cm. The levels of serum uric acid (SUA), fibrinogen, urea and creatinine, were recorded. eGFR was calculated according Cockcroft-Gault Equation.

All studied patients underwent triplex –Doppler ultrasound of carotids and intima -media thickness was measured (IMT) and the presence or not of atheromatous plaque was investigated.

The study population was separated in two groups, according the IMT value and the existence or not of atheromatous plaque.

Group A: IMT > 0.9 mm or/and existence of atheromatous plaque

Group B: IMT < 0.9 mm and without any atheromatous plaque (t-test between the two groups p < = 0.001).

By using the ANOVA statistic method we registered the SUA levels values in both groups as well as fibrinogen levels.

Using Pearson correlation method we correlated SUA with fibrinogen serum levels

Results:

Table 1: Differences of serum uric acid levels between group A and group B 

Table 2. Correlation between serum uric acid levels with fibrinogen levels 

SUA: serum uric acid

Conclusions:

In hypertensive patients treated or not, the existence of increased thickness or atheromatous plaques in carotids was associated with significantly higher serum uric acid levels and fibrinogen levels, possibly indicating their importance in the atheromatous status of hypertensive patients while a significant positive correlation exists between SUA and fibrinogen levels in this population
PROGNOSTIC VALUE OF THE REMNANT CHOLESTEROL AND OTHER LIPID PARAMETERS TO THE MACE IN HYPERTENSIVE PATIENTS
Authors: Papavasileiou Maria , Karamanou Alexandra , Moustakas Georgios , Aravantinos Dionysios , Patsianis Stylianos , Pittaras Andreas
Published: June 2022

Objective:

Of the study was to investigate the role of remnant cholesterol levels and other lipid parameters levels to the major cardiovascular events (MACE) in hypertensive patients.

Design and method:

This is a prospective analysis including 637 hypertensive patients (52,6% female) of mean age at the entry: 57,2 ± 13,1 years, mean office systolic/diastolic blood pressure (S/DBPo): 152,3 ± 19,1/94,4 ± 11,83 mmHg, mean office heart rate (HRo): 76,0 ± 12 beats/min, treated or newly diagnosed untreated. The median follow-up period was 9 years.

Total cholesterol (TCH), LDL-CH, HDL-CH, Triglycerides (Trg), VLDL-CH were measured at the entry of the study and Remnant cholesterol (RCH) as well as non HDL-CH (nonHDL) were calculated at the entry of the study. Major cardiovascular events (MACE) (myocardial infarction, unstable angina, transient ischemic attack or stroke, peripheral vascular intervention, heart failure events, cardiovascular death) were registered. We estimated the prognostic value of the above mentioned lipids parameters to the MACE.

Cox proportional hazard model were employed to determine the prognostic value of lipid parameters.

Results:

The median follow-up period was 9 years. There were 264 (40,5%) MACE at the end of the study.

Table Cox regression statistical analysis 

TCH = total cholesterol, Trg=triglycerides, RCH= remnant cholesterol

Conclusions:

Remnant cholesterol as well as triglycerides serum levels, were the major predictors of MACE, greater than the prognostic value to MACE of LDL-CH and HDL-CH, while total and non HDL CH did not have any predictor value to MACE in hypertensive patients in a follow up of 9 years.
EFFECT OF MOBILE APPLICATIONS FOR PHYSICAL ACTIVITY TRACKING ON EXERCISE TOLERANCE IN PATIENTS WITH HYPERTENSION AND CORONARY ARTERY DISEASE
Authors: Tsygankova Oxana , Ponkin Serghei , Veretyuk Varvara
Published: June 2022

Objective:

To assess the effect of smartphone applications designed for physical activity tracking on exercise tolerance of patients with arterial hypertension (HTN) and coronary artery disease (CAD) during rehabilitation program.

Design and method:

We examined 464 patients with HTN (men 176, 37.9%) aged 61.7 ± 11.0 who attended rehabilitation programs in 5 days to 6 months after myocardial infarction (median 24 [6; 92] days) in health campus. Most of the patients undergone coronary revascularization: 371 (80.0%) - percutaneous coronary intervention and 75 (16.1%) coronary artery bypass grafting; 18 patients (3.9%) had non-invasive management. Patients were randomized in two groups: I (n = 238, 51.3%) were using mobile apps with activity trackers and II (control, n = 226, 48.7%) without intervention. The six-minute walk test (6MWT) was performed at the time of admission, in the middle of the rehabilitation course (the 6th day) and before discharge (the 12th day) (6MWT1, 6MWT2 and 6MWT3, respectively). We compared groups using Mann-Whitney U test and assessed changes in 6MWT distance as the difference between measurements (6MWT2-1 = 6MWT2 – 6MWT1 and 6MWT3-1 = 6MWT3 – 6MWT1).

Results:

The 6MWT1 distance on admission did not differ between the experimental and control groups (440.1 ± 82.3 m vs 421.3 ± 78.1 m, p = 0.81). The 6MWT distance increased over time in both groups. In the middle and at the end of the course difference between the groups became statistically significant: 6MWT2 in I group 499.3 ± 88.5 m vs 446.0 ± 82.7 in group II, p < 0.001; 6MWT3 was 570.6 ± 89.5 m vs 473.6 ± 88.3 m, respectively, p < 0.001. Experimental group had a more pronounced increase in 6MWT after the 2nd measurement (6MWT2-1 59.1 ± 26.3 m vs 25.6 ± 17.7m, p < 0.001) and the 3rd measurement (6MWT3-1 was 130.5 ± 45.2 m vs 52.5 ± 30.6 m, p < 0.001).

Conclusions:

The use of mobile apps for physical activity tracking in patients with HTN and CAD after MI was associated with an increase in the 6MWT distance on the 6th and 12th day of cardiac rehabilitation program compared with the control group.
HYPERTENSIVE PATIENTS WITH ANGINA AND NON-OBSTRUCTIVE CORONARY ARTERY DISEASE ARE CHARACTERIZED BY INCREASED SYMPATHETIC NERVOUS SYSTEM ACTIVATION
Authors: Sakalidis Athanasios , Dimitriadis Kyriakos , Dri Eirini , Soulaidopoulos Stergios , Mantzouranis Emmanouil , Manta Eleni , Aznaouridis Konstantinos , Vaina Sophia , Leontsinis Ioannis , Konstantinou Konstantinos , Konstantinidis Dimitris , Tsioufis Konstantinos
Published: June 2022

Objective:

There are data supporting that sympathetic nervous system (SNS) is implicated in the regulation of endothelium function and vascular tone in different cardiovascular disease states. Patients with hypertension and angina frequently present non-obstructive coronary artery disease (CAD) in angiography. The aim of our study was to assess the level of SNS activation in hypertensive patients with angina and non-obstructive CAD, in hypertensives without angina and normotensive controls.

Design and method:

Our population consisted of 10 treated hypertensive patients with angina who had non-obstructive CAD in coronary angiography [7 females, mean age: 60.5 ± 9.6 years, office blood pressure (BP): 157/93 ± 13/11 mmHg], 16 treated hypertensive patients without angina (9 females, mean age: 59.5 ± 7.5 years, office BP:142/88 mmHg) and 11 normotensive individuals without angina (8 females, mean age: 51.8 ± 11 years, BP:125/87 mmHg). In all participants, muscle sympathetic nerve activity (MSNA) was assessed.

Results:

Hypertensives with angina and non-obstructive CAD (n = 10) compared to hypertensive patients without angina (n = 16) and normotensives without angina (n = 11) exhibited higher levels of MSNA (57.6 ± 6.1 vs 43 ± 8.4 vs 45 ± 9.5 bursts per minute, respectively; p < 0.01 for all) and 24-h ambulatory BP (144/83 ± 20/14 vs 141/83 ± 7/10 vs to normotensives 125/81 ± 7/6 mmHg, respectively; p < 0.001 for all). There were no differences in renal function between groups and no gender related effects on MSNA values (p = NS).

Conclusions:

Hypertensive patients with angina and non-obstructive CAD are characterized by higher SNS drive compared to hypertensives without angina and normotensive controls, as reflected by MSNA levels. These preliminary results indicate that therapies targeting SNS tone could be of potential clinical benefit in this high-risk hypertension phenotype.
GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS DO NOT DECREASE THE RISK FOR CORONARY REVASCULARIZATION IN PATIENTS WITH TYPE 2 DIABETES: A META-ANALYSIS OF CARDIOVASCULAR OUTCOME TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Imprialos Konstantinos , Stavropoulos Konstantinos , Siskos Fotios , Kassimis George , Petidis Konstantinos , Papadopoulos Christodoulos , Karagiannis Asterios , Doumas Michael
Published: June 2022

Objective:

Cardiovascular disease (CVD) is common among subjects with type 2 diabetes mellitus (T2DM), while it represents the main cause of death, accounting for half of deaths in this population. Prevalence of coronary artery disease (CAD) among diabetic subjects is relatively high, more than 20%. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), a class of antidiabetics with established cardiovascular benefits for patients with T2DM, have been shown to decrease the risk for major adverse cardiovascular events, cardiovascular and all-cause mortality, while they have been shown to decrease the risk for fatal or non-fatal myocardial infarction; therefore they have been suggested as second-line treatment option for patients with T2DM and established atherosclerotic cardiovascular disease.

Design and method:

We searched PubMed from inception to September 1st, 2021, for the relevant cardiovascular outcome trials with GLP-1RAs in patients with T2DM, to pool data concerning coronary revascularization. We searched both published reports and supplementary appendices. We evaluated the surrogate outcome of coronary revascularization with GLP-1RAs versus placebo.

Results:

We pooled data from 5 trials in a total of 41,355 subjects with T2DM. GLP-1RA treatment compared to placebo did not have a significant effect on the risk for coronary revascularization (risk ratio = 0.95, 95% CI; 0.81 – 1.11, I2 = 77%, p = 0.51). No significant differences were observed during various subgroup analyses.

Conclusions:

Despite their established cardioprotective effects in high-risk patients with T2DM, GLP-1RAs do not seem to confer a significant risk reduction in terms of coronary revascularization. Additional analyses according to the type of revascularization procedure might provide interesting insights.
EFFECT OF SGLT-2 INHIBITORS ON THE RISK FOR ANGINA IN PATIENTS WITH OR WITHOUT TYPE 2 DIABETES MELLITUS: A META-ANALYSIS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Toumpourleka Maria , Boulmpou Aristi , Siskos Fotios , Koutsampasopoulos Konstantinos , Petidis Konstantinos , Kassimis George , Papadopoulos Christodoulos , Doumas Michael
Published: June 2022

Objective:

Coronary artery disease represents the main form of cardiovascular disease worldwide, while it is the leading cause of death among subjects with type 2 diabetes mellitus. Unstable angina and angina pectoris constitute major forms of coronary artery disease, associated with significant cardiovascular morbidity and mortality. Herein, we sought to determine the effect of sodium-glucose co-transporter-2 (SGLT-2) inhibitors on the risk for angina in patients with or without type 2 diabetes mellitus.

Design and method:

We pooled relevant data from the hallmark, cardiovascular and renal outcome trials, along with the heart failure trials in patients with or without background type 2 diabetes mellitus, assigned either to a SGLT-2 inhibitor or control. We set as primary outcome the risk for angina pectoris and as secondary outcome the risk for unstable angina.

Results:

We finally pooled data from a total of 9 trials in 59,962 subjects assigned either to a SGLT-2 inhibitor or placebo. SGLT-2 inhibitor treatment did not decrease significantly the risk for angina pectoris (risk ratio = 0.94, 95% CI; 0.81 – 1.08, I2 = 0%); likewise it did not significantly affect the risk for unstable angina (risk ratio = 0.91, 95% CI; 0.81 – 1.03, I2 = 0%). No subgroup differences between various study groups were observed.

Conclusions:

SGLT-2 inhibitors do not affect significantly the risk for unstable angina and angina pectoris among subjects with established or at high risk for cardiovascular disease.
ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN YOUNG PATIENTS: RISK FACTORS AND PROGNOSIS
Authors: Chamtouri Ikram , Souissi Rania , Amdouni Nesrine , Kaddoussi Rania , Abdallah Wajih , Jomaa Walid , Ben Hamda Khaldoun , Maatouk Faouzi
Published: June 2022

Objective:

ST elevation myocardial infarction (STEMI) is a common event in old adult. However, STEMI remains poorly described in young. We aimed to assess risk factors, angiographic results and in-hospital prognosis in young < 45 years presented with STEMI.

Design and method:

All patients hospitalized for STEMI and aged between 18 and 65 years were retrospectively enrolled in this study. Young patients < 45 years were compared to those (less young) aged more than 45 and less than 65 years. Demographic informations, risk factors, angiographic profile and prognosis were collected.

Results:

Among 1210 STEMI patients, 251 (20.7%) patients were young. Two young patients and four less young did not have coronary angiography because of premature death.

No significant difference was demonstrated in term of in-hospital complications such as acute heart failure, cardiogenic shock, ventricular arrhythmia, atrio-ventricular block between the two groups. Compared to less young patients, in-hospital mortality accounted for 3.40% in young versus 4.6% (p = 0.3). Smoking was identified as a significant predictors factors of mortality (p = 0.015) in young patients.

Conclusions:

In contrast to “less young” patients, STEMI in young is characterized by predominance of smoking, cannabis consumption and family history of CAD as risk factors, more MINOCA and diffuse coronary lesions with no difference in term of in-hospital mortality.
THE EFFECT OF COVID-19 VACCINE ON ARTERIAL FUNCTION
Authors: Terentes-Printzios Dimitrios , Gardikioti Vasiliki , Solomou Eirini , Emmanouil Eleni , Gourgouli Ioanna , Xydis Panagiotis , Christopoulou Georgia , Georgakopoulos Christos , Dima Ioanna , Miliou Antigoni , Lazaros George , Pirounaki Maria , Tsioufis Konstantinos , Vlachopoulos Charalambos
Published: June 2022

Objective:

To fight the COVID-19 pandemic, messenger RNA (mRNA) vaccines were the first to be adopted by vaccination programs worldwide. We sought to investigate the short-term effect of mRNA vaccine administration on endothelial function and arterial stiffness.

Design and method:

Thirty-two participants (mean age 37 ± 8 years, 20 men) that received the BNT162b2 mRNA COVID-19 vaccine were studied in 3 sessions in a sequence-randomized, sham-controlled, assessor-blinded, cross-over design. The primary outcome was endothelial function assessed by brachial artery flow-mediated dilatation (FMD), and secondary outcomes were aortic stiffness, evaluated with carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx@75), and inflammation measured by high-sensitivity C-reactive protein (hsCRP) in blood samples. The outcomes were assessed prior to, and at 8 h, 24 h post the 1st dose of vaccination, and 8 h, 24 h, and 48 h post the 2nd.

Results:

There was an increase in hsCRP that was apparent at 24 h after both the 1st dose (-0.60 [95% Confidence intervals [CI]: -1.60 to -0.20], p = 0.013) and the 2nd dose (max median difference at 48 h -6.60 [95% CI: -9.80 to -3.40], p < 0.001) compared to sham. The vaccine did not change PWV or AIx@75. FMD remained unchanged during the 1st dose but decreased significantly by 1.5% (95% CI: 0.1% to 2.9%, p = 0.037) at 24 h post the 2nd dose. FMD values returned towards baseline at 48 h.

Conclusions:

Our study shows that the mRNA vaccine causes a prominent increase in inflammatory markers, especially after the 2nd dose, and a transient deterioration of endothelial function at 24 h that returns towards baseline at 48 h. These results confirm the short-term cardiovascular safety of the vaccine.
CORONAVIRUS DISEASE-2019 IS ASSOCIATED WITH ARTERIAL STIFFNESS IMPAIRMENT: A META-ANALYSIS OF OBSERVATIONAL STUDIES
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Imprialos Konstantinos , Stavropoulos Konstantinos , Sviggou Asimina , Aidinis Asterios , Kordalis Vasilios , Pyrpasopoulou Athina , Papadopoulos Christodoulos , Doumas Michael
Published: June 2022

Objective:

Coronavirus disease-2019 (COVID-19) still represents a global nightmare, associated with significant morbidity and mortality, despite the development of effective vaccines. Cardiovascular complications are frequent among infected subjects. Arterial stiffness is an accurate prognostic marker of cardiovascular disease, with pulse wave velocity (PWV) being the gold-standard for arterial stiffness quantification. Herein we sought to determine whether there is a significant difference in PWV between COVID-19 positive subjects and healthy controls.

Design and method:

We searched two major databases (PubMed and Cochrane Library) from inception to 10th December 2021 for observational studies assessing the effect of SARS-CoV-2 on arterial stiffness. We set as primary efficacy outcome the mean difference in PWV between infected patients and healthy controls.

Results:

We finally pooled data from 4 observational studies in a total of 327 subjects. SARS-CoV-2 positive patients exhibited significantly greater PWV compared to healthy controls (mean difference = 1.32 m/s, 95 CI; 0.46 – 2.18, I2 = 62%, p = 0.0003).

Conclusions:

COVID-19 is associated with significantly increased PWV. However, it remains unclear whether PWV could be a significant prognostic marker of cardiovascular complications among infected subjects.
COLCHICINE FOR THE PREVENTION OF COVID-19 “HARD” OUTCOMES: ALL THAT GLITTERS IS NOT GOLD. AN UPDATED ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Imprialos Konstantinos , Stavropoulos Konstantinos , Papadopoulos Christodoulos , Doumas Michael
Published: June 2022

Objective:

Previous meta-analyses of observational studies and randomized controlled trials demonstrated a mortality benefit with colchicine in patients with COVID-19, leading to the amendment of treatment protocols against the disease worldwide. COVID-19 pandemic still remains a global nightmare, requiring a decisive treatment strategy.

Design and method:

We sought to determine whether colchicine compared to standard of care offers a true benefit, both in the in-hospital and out of hospital setting, for the prevention of surrogate COVID-19 outcomes. We searched PubMed and Cochrane Library databases for relevant published randomized controlled trials up to 12th November 2021. We set as primary efficacy outcome the surrogate endpoint of COVID-19 death and as secondary efficacy outcome that of mechanical ventilation.

Results:

We finally included 6 randomized controlled trials in at total of 15,624 subjects with documented COVID-19 infection. All trials except for one enrolled hospitalized patients. Colchicine was not superior to standard of care in terms of prevention of COVID-19 death (RR = 0.63, 95% CI; 0.33 – 1.20, I2 = 28%). In addition, colchicine did not result in a significant decrease in the risk for mechanical ventilation during disease course (RR = 0.66, 95% CI; 0.36 – 1.20, I2 = 48%).

Conclusions:

The present pooled analysis of relevant, published randomized controlled trials so far does not support the routine use of colchicine for the prevention of surrogate COVID-19 outcomes in daily clinical practice, either in the in-hospital or in the community therapeutic management of patients with COVID-19.
DYNAMICS OF ECHOCARDIOGRAPHY CHARACTERISTICS OF THE MYOCARDIUM IN PATIENTS WITH CONFIRMED DIAGNOSIS OF COVID-19
Authors: Minushkina Larisa , Davydova Tatyana , Chuprik Natalya , Snigirova Anna
Published: June 2022

Objective:

It has now been shown that the SARS-Cov2 virus can be found in myocardial tissue. It is still unknown whether persistence of the virus in cardiomyocytes always leads to clinically significant heart damage. The aim of the study is to assess the dynamics of echocardiography characteristics in patients with COVID-19 in primary care clinic.

Design and method:

Material and methods 210 patients were enrolled into the study between Oct and Dec 2020. The mean age was 51.6 ± 14.61 years, 100 (47, 6%) men. All patients had no cardiovascular disease prior to enrollment. 57 patients (26.1%) underwent COVID-19 without significant lung damage on CT, 114 patients (54.1%) had CT1 lung damage, - 31 patients (14.2%) - CT2, 7 patients (3, 2%) - CT 3, 1 patient (0.5%) - CT-4. All patients were examined by Echo before COVID-19 disease and after the discharge from the hospital using Vivid 9 GE with assessment of standard parameters and global longitudinal strain (GLS).

Results:

In the examined group of patients, 1 case of mild myocarditis and 1 case of pericarditis were recorded. No significant dynamics of the parameters of the LV was revealed by standart Echo. There was a significant increase in the size of the RV from 2.38 ± 0.233 cm to 2.57 ± 0.327 cm (p < 0.001) after the disease. Patients with lung lesions CT2 and higher had lower GLS (17.7 ± 1.06 and 18.7 ± 0.72%, p = 0.032), higher LA size (4.29 ± 0.39 and 3.59 ± 0.49 cm, p = 0,036) and RV size (2.54 ± 0.32 and 2.39 ± 0.23 cm, p = 0.013) compared with patients without lung involvement or with CT1. There was a weak significant correlation between the GLS and the dynamics of the RV diameter (r = 0.288, p < 0.001).

Conclusions:

After the transferred coronavirus infection, changes are detected mainly in the right ventricle, the severity of which correlates with the severity of lung damage

Left ventricular changes can be detected mainly in severe infection and mainly by assessing the global longitudinal deformity of the left ventricle.
IMPAIRED BETA-2ADRENERGIC ENDOTHELIUM-DEPENDENT VASODILATION IS REVERSED BY PHOSPHODIESTERASE INHIBITION IN PATIENTS PREVIOUSLY HOSPITALIZED WITH COVID-19
Authors: Faconti Luca , Farukh Bushra , McNally Ryan , Brett Sally , Chowienczyk Philip
Published: June 2022

Objective:

Endothelial dysfunction is thought to underlie many of the complications of COVID-19 but to what degree this persists after recovery is unknown. Here we examine endothelial function in subjects previously hospitalized with COVID-19, those with mild symptoms who were not hospitalized and negative controls (absence of SARS-CoV-2-antibodies). Endothelial function was measured as pulse wave response to the 2 adrenergic agonist salbutamol (PWRS) which is mediated through the nitric oxide - cyclic guanosine monophosphate pathway (NO-cGMP).

Design and method:

Echocardiography was used to exclude subjects with cardiac abnormalities. Tonometry of the radial artery (SphygmoCor, AtCor Medical, Sydney, Australia) was performed in duplicate by a single operator before and after inhalation of 200 mcg of salbutamol using a spacer device. The PWRS was taken as the change from baseline in augmentation index (Aix) as calculated by the SphygmoCor system. In a sub-sample, PWRS was assessed in the presence and absence of the phosphodiesterase type 5 inhibitor sildenafil which inhibits the breakdown of cGMP.

Results:

We recruited 88 subjects (49 men) aged 47.9 ± 14.3 (mean ± SD) years of whom 32 were previously hospitalized with COVID-19 (~6 months). Subjects previously hospitalized with COVID-19 were all previously assessed in a dedicated pulmonary clinic. Age, gender, BMI, smoking status, diabetes and estimated 10-year cardiovascular risk (Q-RISKâ3) were similar between the groups. Administration of salbutamol reduced AIx in controls and those with mild COVID-19 but produced an increase in AIx in previously hospitalized COVID-19 cases (mean [95% CI]): -2.85 [-5.52, -0.188] %, -2.32 [-5.17,0.54] %, and 3.03 [0.06, 6.00] % respectively, P = 0.017 between the groups. In a sub-sample (11 hospitalized and 11 non-hospitalized) the PWRS was measured again 30 minutes after oral administration of sildenafil 25 mg. This produced a greater reduction in AIx: -5.28 [-9.00, -1.54] % in non-hospitalized and a reduction: -3.90 [-7.60, -0.21] % in hospitalized patients, and an overall improvement in the PWRS (P = 0.006).

Conclusions:

In subjects previously hospitalized with severe COVID-19, endothelial function is impaired for many months after hospital discharge and the impaired NO-cGMP mediated vasodilation may be reversed by sildenafil.
COMPARISON BETWEEN FIRST AND SECOND/THIRD WAVE OF SARS-COV-2 MODERATE TO SEVERE INFECTION IN ELDERLY PATIENTS IN AN NORTH ITALIAN HOSPITAL SETTING
Authors: Boari Gianluca , Leidi Francesca , Accordini Beatrice , Mangili Benedetta , Ghidelli Chiara , Archenti Giulia , Chiarini Giulia , Malerba Paolo , Gorla Giulia , Corbani Andrea , Scarano Ottavio , Napoli Federico , Bonetti Silvia , Braglia-Orlandini Federico , Faustini Cristina , Bianco Gianluca , Ferrari-Toninelli Giulia , Turini Daniele , Guarinoni Vittoria , Saottini Michele , Manzoni Francesca , Marengoni Alessandra , Rosei Claudia Agabiti , De Ciuceis Carolina , Rizzoni Damiano
Published: June 2022

Objective:

Worldwide spread of SARS-CoV-2 caused a pandemic as never were seen in the last fifty years and represented a major clinical problem in Lombardy, one of the most affected Italian Regions, in terms of death toll and long-term sequelae. This is particularly true when elder people are considered; therefore, we conducted a retrospective cohort study in the General Medicine of our Hospital.

Design and method:

In the present study we recorded data of patients older than 65 years, admitted to a COVID-19 unit during 2020 and 2021; we compared the characteristics of in-patients admitted in the first (March-May 2020) and the second/third pandemic waves (October 2020-May 2021)

Results:

A total of 407 patients 65 year-old and older were included, 185 during the first wave and 222 during second/third waves; 63 (34%) of them died during the first and 36 (16%) during the second/third wave. No significant differences were found according to main comorbidities and chronic prescriptions between the two groups of patients, whereas those admitted during the second/third wave were slightly older.

Number of in-hospital adverse events were similar in the two samples. Main differences between the two groups were: a lower mean number of days with symptoms before hospitalization, and a less severe laboratory, respiratory ed radiologic profile.

Further, steroid treatment was highly implemented during the second/third wave.

Conclusions:

Older patients admitted to hospital since the beginning of the pandemic showed diverse clinical severity profile according to different waves; patient admitted during the first wave had worse respiratory, radiological and laboratory parameters than those admitted in the second/third wave; further difference was found in COVID-19 treatment during hospital stay as steroids were largely administered during the latter waves
ACUTE MYOCARDITIS FOLLOWING COVID-19 VACCINATION: A PECULIAR CASE SERIES
Authors: Corradetti Sara , Sclafani Matteo , Mistrulli Raffaella , Gallo Giovanna , Pagannone Erika , Di Girolamo Marco , Autore Camillo , Volpe Massimo , Battistoni Allegra
Published: June 2022

Objective:

Although acute myocarditis has not been observed as an adverse event in landmark trials of COVID-19 vaccines, it has been reported as a rare complication in real-world. The study aims to report a single-center experience on this issue.

Design and method:

We identified five cases of acute myocarditis with consistent temporal association to administration of COVID-19 vaccine and described clinical, serological, echocardiographic and cardiac magnetic resonance findings both in the acute phase and after a median follow up of 6 months.

Results:

All five patients received a COVID-19 vaccination dose within 24 to 96 hours before the onset of symptoms. Four patients received an mRNA vaccine (Comirnaty or Spikevax) and one received the adenovirus vaccine (Janssen). Only one patient had a known prior COVID-19 infection. All patients presented with chest pain and troponin I elevation occurring after the first vaccine dose in four cases. All patients tested negative for acute COVID-19 infection by polymerase chain reaction at admission. Blood tests revealed no or only mild inflammatory serological changes. Only one patient developed an increase in white blood cell count. None had specific changes on electrocardiography and echocardiography demonstrated preserved left ventricular systolic function and no regional wall motion abnormalities in all patients. Three patients underwent coronary angiography since risk factors and troponin trends raised clinical suspicion of acute coronary syndrome, none showed evidence of obstructive coronary artery disease. All patients had a mild to moderate disease not complicated by acute heart failure or arrhythmias. Cardiac Magnetic Resonance was performed in four cases and showed myocardial oedema and late gadolinium enhancement during the acute phase with persistence of areas of late gadolinium enhancement after a median follow-up of 6 months. None had further symptoms or hospitalizations since discharge.

Conclusions:

Acute myocarditis following COVID-19 vaccination is a well-defined clinical entity.

Our findings suggest an immune rather than inflammatory pathogenesis and a benign course without clinical complication after a median follow-up of 6 months, but further studies are needed to define the prognostic significance of persistent findings on cardiac magnetic resonance.
ARTERIAL HYPERTENSION SEVERITY INFLUENCE ON COVID19 SEVERITY AND ICU ADMISSION
Authors: Vintila Ana Maria , Horumba Mihaela , Miron Paul , Balan Razvan , Catrangiu Maria Beatrice , Negoescu Iris Andreea , Trifan Iuliana , Homentcovschi Corina , Siliste Roxana , Savulescu-Fiedler Ilinca
Published: June 2022

Objective:

Our aim was to assess whether COVID19 positive hypertensive patients were more likely to develop severe symptoms resulting in ICU management and mechanical ventilation.

Design and method:

We performed a retrospective study on consecutive patients hospitalised for COVID19 admitted to our department between 1st of September and 1st of December 2021. Collected data included medical history, treatment, echocardiographic data and lab test results. SPSS version 23 was used for descriptive and inferential statistics.

Results:

A total of 139 COVID19 patients were included in the study with a median age of 68 years (range: 18–91), 51.1% males. Up to 85.2% of patients were either unvaccinated or had incomplete vaccination courses.

Of the lot, 64.7% of patients had known arterial hypertension (HTN) - up to 25.9% of patients had grade 3 HTN. Hypertensive patients were generally older (68 vs 62 y, p < 0.001) and with a female predominance (77.9% of women vs. 52.1% of men, p = 0.001). About a third of patients (32.4%) required ICU management. The number of patients requiring ICU treatment (32.2% vs. 32.7%, p = 0.552) or mechanical ventilation (33.3% vs. 28.6%, p = 0.352) were similar irrespective of HTN diagnosis. However, grade 3 HTN patients had a higher relative risk of developing severe COVID19 (RR: 2.021 | 1.49 - 2.71).

Conclusions:

Many of the patients hospitalised for COVID19 in our department were either unvaccinated or had incomplete vaccination courses. Arterial hypertension is the most common finding among patients hospitalised for COVID19 and up to a third of patients had severe hypertension. A third of all patients required ICU management and grade 3 HTN was more likely to be associated with severe COVID19 and respiratory failure.