bluuebunny/crossref_metadata_2025 huggingface dataset:
SEX DIFFERENCES IN SHORT-TERM BP VARIABILITY AMONG PATIENTS UNDERGOING PERITONEAL DIALYSIS
Authors: Vaios Vasilios , Georgianos Panagiotis , Vareta Georgia , Leptokaridou Eirini , Kontogiorgos Ioannis , Geropoulou Evangelia , Zebekakis Pantelis , Liakopoulos Vassilios
Published: June 2023

Objective:

The present study aimed to explore potential differences in short-term blood pressure (BP) variability between men and women with end-stage kidney disease undergoing peritoneal dialysis (PD).

Design and method:

In this comparative study, 48 male PD patients from Northern Greece were matched for age and history of heart failure with 48 female patients in a 1:1 ratio. All patients underwent 24-hour ambulatory BP monitoring with the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). Short-term BP variability was assessed with the calculation of standard deviation (SD), coefficient of variation (CV) and average real variability (ARV) of systolic and diastolic BP during the 24-hour, daytime and nighttime periods.

Results:

Age, the duration of PD therapy and the prevalence of cardiovascular comorbidities were similar in men and women. During the 24-hour period, SD (13.4±3.8 vs. 14.6±3.1 mmHg, P = 0.091), CV (0.10±0.03% vs. 0.12±0.2%, P<0.05) and ARV (10.7±3.1 vs. 11.9±2.6 mmHg, P<0.05) of systolic BP were significantly lower in men than in women. Similarly, the variability of diastolic BP over the 24-hour period was numerically lower in men as compared with women (SD: 10.3±2.4 vs. 10.9±2.2 mmHg, P = 0.218; CV: 0.12±0.03% vs. 0.14±0.03%, P<0.05; ARV: 8.4±2.0 vs. 9.0±1.9 mmHg, P = 0.136). These sex differences in indices of short-term BP variability were consistent during both daytime and nighttime periods.

Conclusions:

The present study shows that among patients undergoing PD, SD, CV and ARV of systolic and diastolic BP are lower in men than in women. Longitudinal studies are needed to explore whether these sex-related differences in short-term BP variability are prognostically informative in the PD population.
ASSOCIATION BETWEEN VARIABILITY IN SYSTOLIC BLOOD PRESSURE AND CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS: DOES GENDER METTER?
Authors: Ilic Marina Deljanin , Stojanovic Sanja , Stojanovic Milovan , Krstic Ivana , Ilic Stevan
Published: June 2023

Objective:

To investigate the association between variability in systolic blood pressure (SBPV) and development of cardiovascular events (CVE): angina pectoris, myocardial infarction, cerebrovascular accident in hypertensive patients (pts) according to gender, and to estimate whether SBPV could be a predictor of CVE.

Design and method:

300 hypertensive pts (148 men and 152 women) were studied. The study comprised 3 visits during a follow-up period of 30 months. Blood pressure values were defined by the arithmetic mean of three measurements at each visit. SBPV for each patient was defined using the standard deviation from 3 values of systolic BP (SBP-SD). In order to estimate distribution SBPV, quartiles of SBP-SD were introduced. High SBPV were defined as SBP-SD above the 4th and 3th quartile.

Results:

During 30 months follow up the incidence of CVE was higher in men than in women (22.3% vs 17.7%). The first quartile included SBPV values < 6.00 mmHg, the second quartile 6.01-10.00 mmHg, the third quartile 10.01-17.00 mmHg, and the fourth quartile >17.00 mmHg. The highest SBPV was recorded in 3rd and 4th quartile in men as well in women who had CVE, and SBPV was higher in men than in women (p<0.01 for both quartile). Logistic regression analysis showed that there was a significant relationship between SBPV and CVE in men (OR = 1.141; 95% CI 1.107-1.183, p<0.001), as well as in women (OR = 1.103; 95% CI 1.071-1.139, p<0.001). A cut-off value of SBPV = 12.48 mmHg predicted the CVE with a sensitivity of 68% and specificity of 64% in men (p<0.01), while cut-off value of SBPV = 12.03 mmHg predicted the CVE in women with a sensitivity of 65% and specificity of 67% (p<0.001).

Conclusions:

Our results showed a significant relationship between SBPV and CVE in hypertensive pts regardless of gender. Higher SBPV was recorded in men than in women. Lower value of SBPV in women >12.03 mmHg than in men >12.48 mmHg predicted future CVE.
CARDIAC MACROPHAGES EXACERBATE DOXORUBICIN-INDUCED CARDIOTOXICITY
Authors: Gambardella Jessica , Santulli Gaetano , Fiordelisi Antonella , Cerasuolo Federica Andrea , Wang Xujun , Prevete Nella , Sommella Eduardo , Avvisato Roberta , Buonaiuto Antonietta , Altobelli Giovanna Giuseppe , Rinaldi Laura , Feliciello Antonio , Piaz Fabrizio Dal , Campiglia Pietro , Ciccarelli Michele , Morisco Carmine , Sadoshima Junichi , Iaccarino Guido , Sorriento Daniela
Published: June 2023

Objective:

The functional contribution of non-myocyte cardiac cells, such as inflammatory cells, in the setup of heart failure in response to doxorubicin (Dox) is recently becoming of growing interest. Objective: The study aims to evaluate the role of macrophages in cardiac damage elicited by Dox treatment.

Design and method:

C57BL/6 mice were treated with one intraperitoneal injection of Dox (20mg/Kg) and followed up for 5 days by cardiac ultrasounds (CUS), histological, and flow cytometry evaluations. We also tested the impact of Dox in macrophage-depleted mice. Murine cardiomyoblasts were directly treated with Dox (D-Dox) or with a conditioned medium from cultured murine macrophages treated with Dox (M-Dox).

Results:

In response to Dox, macrophage infiltration preceded cardiac damage. Macrophage depletion prevents Dox-induced damage, suggesting a key role of these cells in promoting cardiotoxicity. To evaluate the crosstalk between macrophages and cardiac cells in response to DOX, we compared the effects of D-Dox and M-Dox in vitro. In cardiomyoblasts, cell vitality was lower and apoptosis was higher in response to M-Dox compared with D-Dox. These events were linked to p53-induced alterations of mitochondria morphology, function, and autophagy. We identify a mechanistic role of catecholamines released by Dox-activated macrophages that lead to mitochondrial apoptosis of cardiac cells through b-AR stimulation.

Conclusions:

Taken together, our data indicate that crosstalk between macrophages and cardiac cells participates in cardiac damage in response to Dox.
INCREASED RISK OF NEW ONSET OF ARTERIAL HYPERTENSION IN PATIENTS WITH MULTIPLE MYELOMA TREATED WITH CARLFIZOMIB
Authors: Cicco Sebastiano , Fazio Giuditta De , Marozzi Marialuisa Sveva , Melaccio Assunta , Cavallo Michele , Solimando Antonio Giovanni , Vacca Angelo , Ria Roberto
Published: June 2023

Objective:

Several new drugs are used nowadays to treat multiple myeloma (MM). Some drugs are loaded with an increased risk of developing cardiovascular diseases. Carfilzomib (K), a proteasome inhibitor, is well recognized to cause cardiovascular side effects. Also, arterial hypertension is a main factor leading to LV dysfunction. Purpose is to evaluate if patients who underwent the carfilzomib treatment may present an increased incidence of arterial hypertension.

Design and method:

We evaluated 34 patients (group K, 20M, 14F, aged 65.87±5.98) treated with carfilzomib: 25 patients were given 56 mg/m2 (group 1, 14M, 9F, aged 67.30±5.98) while 9 27 mg/m2 (group 2, 6M, 3F, aged 63.00±5.39). As controls, we recruited 34 patients (16M, 18F, aged 69.80±9.13) who underwent in the same period the MM treatment without carfilzomib. Hypertension was identified as new onset of disease or worsening of disease (need double the dose used, add a new drug, or no pressure control in at least 3 drugs treatments).

Results:

At baseline, the controls presented an increased arterial hypertension rate (76.47% vs group K 47.06%, p = 0.07). There was no difference in any other CVD risk factor. There was no difference in LV mass, volumes and ejection fraction. The group K experienced an increased incidence of arterial hypertension compared to controls (controls 0% vs group K 41.17 %, p = 0.001). This result was not related to the drug dose. Finally, there was no difference in mortality between the two groups also by analysing the CV death.

Conclusions:

Carfilzomib is a potent and effective drug in MM. Its cardiovascular toxicity relates to a vascular and endothelial damage leading to a new onset of arterial hypertension. This observation may be useful in preventing evolution of the CV dysfunction in survivors and long survivors MM patients. Also, it may be important for studies of vascular damage in arterial hypertension pathophysiology.
ARTERIAL HYPERTENSION AND ATHEROGENIC DYSLIPIDEMIA ARE LEADING RISK FACTORS FOR CORONARY ATHEROSCLEROSIS IN YOUNG AND MIDDLE-AGED IN DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROME
Authors: Wang Zheming , Zbyshevskaya Elizaveta , Makeeva Tatiana
Published: June 2023

Objective:

To study the incidence of coronary atherosclerosis in young and middle-aged diabetic (DM) patients with acute coronary syndrome (ACS) against the background of arterial hypertension (AH).

Design and method:

Seventy-six DM patients admitted with a diagnosis of ACS (59 men,17 women) were included, ages from 36 to 59 years (mean 55.5 years). History of DM less than 1 year in 16 patients; 1-5 years in 24 patients and 5-12 years in 36 patients. The mean of HbA1c was 8.1% (6.2-10.9%). Diagnosed the grade 1 of AH was in 32 (42%) patients; grades 2-3 in 44 (58%) patients. All patients underwent coronary angiography (CAG) with stent implantation in criminal artery. Blood tests for low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C), NT-proBNP, renin, aldosterone, creatinine were performed. As a control group 115 patients (101 men, 14 women) with ACS without diabetes mellitus included, mean age was 54.5 years (37-59 years). Mean of HbA1c was 5.4% (4.9-5.8%). Grade 1 of AH was diagnosed in 72 (62.6%) patients; grade 2-3 in 43 (37.4%) patients.

Results:

According to CAG, lesions in one vessel of coronary artery (CA) was found in 18 (23.7%) diabetic and in 64 (55.7%) without diabetes patients; lesions in 2 vessels of CA - in 40 (52.6%) diabetic and in 35 (30.4%) without diabetes patients. Lesions in 3 vessels of CA was found in 18 (23.7%) diabetic and in 16 (13.9%) without diabetes patients. The incidence of multivessel CA lesions in diabetic was 76.3% and 44.3% without diabetes patients. LDL-C was 4.14 ± 1.45 mmol/l in diabetes and 3.66 ± 1.26 mmol/l without diabetes (p = 0.0334); HDL-C was 1.30 ± 0.42 mmol/l in diabetes and 1.15 ± 0.32 mmol/l without diabetes (p = 0.0046). In 67.1% diabetic patients and in 52.1% without diabetes renin and aldosterone levels exceeded the norm. NT-proBNP was 880 pg/ml (397-2530 pg/ml) in diabetes had significantly higher than 739 pg/ml (272-1576 pg/ml) without diabetes (p = 0.0001).

Conclusions:

In young and middle-aged DM patients, arterial hypertension and atherogenic dyslipidemia are the leading risk factors for atherosclerotic CA lesions.
CORONARY ARTERY CALCIFICATION AS A MARKER OF SUBCLINICAL ATHEROSCLEROSIS IN PATIENTS OF NON ALCOHOLIC FATTY LIVER DISEASE
Authors: Siddiqi Zeba , Ashfaq Aquib , Wani Irshad , Khanduri Sachin , Sajid Sana , Naqvi Nigar , Srivastava Shikha , Mahdi Farzana , Singh Taruna , Mateen Saboor , Masakputra Vasim
Published: June 2023

Objective:

Non Alcoholic Fatty Liver Disease (NAFLD) has been proposed to have a strong association with coronary artery disease(CAD) and subclinical atherosclerosis . Coronary artery calcification (CAC) is the well-established non-invasive surrogate index of atherosclerotic burden in arterial beds independent of conventional risk factors. Present study was an attempt to assess CAD risk in NAFLD patients by estimating coronary calcification.

Design and method:

cross sectional.

Sonographically confirmed NAFLD patients between 30-60 years of either sex were included after obtaining informed consent and study approval by institutional ethics committee. Those with alcohol intake,acute and chronic infectious diseases, patients on parenteral nutrition, hepatotoxic drug intake, pregnant and lactating women and known CAD were excluded. History, Examination and investigations were recorded. CAC estimation was performed using 384 slice Dual source machine and CAC score was calculated by Agatston method. Statistical analysis by SPSS.

Results:

Out of 152 NAFLD patients, 79 (52.0%) were Grade I, 37 (24.3%) were Grade II and 36 (23.7%) Grade III. Mean age was 49 years with 86 males and 66 females. Considering comorbidities; 47 were diabetic,62 hypertensive, 36 hypothyroid and 6 dyslipidemic.

CACS of patients ranged from zero to 620.80.

Observed CACS and CAD Risk in NAFLD patients

Significantly increased CACS were observed in Grade III NAFLD cases (208.08±193.92) followed by Grade II (53.90±82.67) and minimum in Grade I (9.84±52.93).

Conclusions:

Accelerated atherosclerosis in NAFLD maybe due to high oxidative stress,inflammatory markers like TNF Alpha, interleukin-6, oxidized LDL, insulin resistance, and macrophage activation. Present study was conducted to estimate coronary artery calcification in NAFLD by determining coronary artery calcium scores. Higher grades of NAFLD patients had moderate to high risk of CAD as evidenced by high CACS. This study shows that asymptomatic patients of NAFLD may have high atherosclerotic burden thus need to commence preventive measures before occurrence of an adverse CV event.
INFLUENCE OF THE METHYLENE TETRAHYDROFOLATE REDUCTASE (MTHFR) GENE POLYMORPHISMS ON SERUM FOLATE, COBALANIN AND HOMOCYSTEINE LEVELS IN HEALTHY GREEK ADULTS
Authors: Papadakis Ioannis , Papadomanolaki Maria , Vougiouklakis George , Petrakis Emmanouel , Mazokopakis Elias
Published: June 2023

Objective:

Methylene tetrahydrofolate reductase (MTHFR) is a key enzyme of homocysteine metabolism participating in the folate cycle. It is well known that hyperhomocysteinemia is associated with an increased risk for cardiovascular disease. The aim of this study was to investigate the association of MTHFR C677T and MTHFR A1298C gene polymorphisms with serum folate, cobalamin (Cbl) and homocysteine (Hcy) concentrations in healthy Greek adults.

Design and method:

The MTHFR C677T and A1298C gene polymorphisms were genotyped in 383 healthy Greek adults (199 men; mean age±SD: 37.3±8.2 years) using polymerase chain reaction and reverse hybridization. Serum folate, Cbl and total Hcy (tHcy) levels were determined using immunoassays methods.

Results:

Among the 383 individuals, 73 (19.1%) were normal (CC), 202 (52.7%) were heterozygous (CT) and 108 (28.2%) were homozygous (TT) regarding the MTHFR C677T gene polymorphism, while 263 (68.7%) were normal (AA), 105 (27.4%) were heterozygous (AC) and 15 (3.9%) were homozygous (CC) regarding the MTHFR A1298C gene polymorphism. The overall C and T allele frequency for the MTHFR C677T gene polymorphism was 45.4% and 54.6%, respectively, while the overall A and C allele frequency for the MTHFR A1298C gene polymorphism was 82.3% and 17.6%, respectively.

The individuals with 677TT genotype had significantly lower serum folate and significantly higher serum tHcy levels than individuals with 677 CC or CT genotypes.

On the contrary, the A1298C gene polymorphism had no significantly influence on serum folate and tHcy levels.

Conclusions:

Serum folate and tHcy levels are influenced by the existence of the MTHFR C677T gene polymorphism (mainly 677TT genotype). Individuals with low serum folate levels and/or high serum tHcy levels should be further investigated for a possible existence of MTHFR C677T and not A1298C gene polymorphisms, with aim to determine the suitable treatment.
CARDIOVASCULAR DISEASE AFTER PNEUMOCOCCAL PNEUMONIA
Authors: Oliveira Ana Maria , Simões André Vicente , Pereira João Gonçalves
Published: June 2023

Objective:

The purpose of this study was to assess the impact of arterial hypertension (AH) and dyslipidemia on the severity, cardiovascular events and death in patients hospitalized for pneumococcal community acquired pneumonia (CAP).

Design and method:

Retrospective, cohort, multicenter, epidemiologic study. All adult inpatients of 4 different centres in Portugal, with microbiological and clinical documented pneumococcal CAP were included. Demographic data, comorbidities, antibiotic therapy, hospital length of stay, need for ICU admission, invasive mechanical ventilation (IMV) and renal replacement therapy (RRT) were collected. All patients were monitored until death or 1-year of follow up. Risk factors for short- and long-term all-cause mortality, including cardiovascular events, were computed. Patients were divided into 3 groups: H) with isolated AH; HD) with both AH and dyslipidemia; Control) without AH or dyslipidemia. The significance level was defined as p <0.05.

Results:

797 patients were included in this study, 53.6% male, mean age 72.4±16.5 years. Comparing the 3 groups, females were prevalent in H and HD groups (52% and 54.3% vs 40.6% Control; p<0.002). Mean age was higher in H and HD (78.2±12.6 and 78.4±10.7 years; vs Control 67.5±18.2 years, ANOVA p<0.001). 18.8% patients required ICU admission, 6.7% IMV and 13.1% RRT. H required more IMV (7.5%, p = 0,5) and HD more RRT (16.6%, p = 0.2). The overall in-hospital mortality was 17.8%. During the follow up, H and HD groups were more readmitted to the emergency department due to cardiovascular events than Control group (11.7% and 13.4% vs. 6.5%, OR 1,91 p = 0.04 and OR 2.26 p = 0.016, respectively); also required more hospitalization for cardiovascular events than Control group (14.4% e 12.6% vs. 6.2%; OR 2.49, p = 0.002; and OR 1.99, p = 0.02, respectively). One-year all-cause mortality was higher in H group (39.2%; p = 0.026).

Conclusions:

Prevalence of arterial hypertension was 47.4%, higher than the national rate. H group resorted, with or without dyslipidemia, more often to the emergency department, requiring more hospitalization and with higher mortality rates, without difference in hospital mortality. It's crucial to control cardiovascular risk factors, providing greater cardiovascular protection to reduce the risk of long-term mortality.
ASSOCIATION OF N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE AND HIGH-SENSITIVITY TROPONIN WITH MORTALITY IN THE GENERAL POPULATION
Authors: Liu Lin , Cheng Yt , Chan Yap-Hang , Cheung Bernard
Published: June 2023

Objective:

High-sensitivity troponin T (Hs-cTnT) and N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) are clinically useful markers of myocardial injury and ventricular function. Whether their elevation in the general population predicts poor prognosis and increased mortality is unclear.

Design and method:

Serum concentrations of Hs-cTnT and NT-proBNP in participants of the US National Health And Nutrition Examination Survey (NHANES) 1999-2004 were used. Elevated Hs-cTnT and NT-proBNP were defined as 14 ng/L and 125 pg/mL, respectively. Participants were classified according to whether none, one or both of the markers were elevated. The weighted-Cox model was used to estimate the hazard ratios (HRs) for cardiovascular and all-cause mortality.

Results:

13,680 patients (mean age 46.7 years, 52.1% female) with a median follow-up of 17 years were included. Compared to the both-not-elevated group, the adjusted HRs [95% confidence interval (CI)] of one and both elevated groups were 1.57 (1.40-1.76) and 2.70 (2.33-3.11), respectively, for all-cause mortality. The corresponding HRs for cardiovascular mortality were 1.58 (1.31-1.92) and 3.36 (2.63-4.30). There was an interaction with age (P-interaction = 0.006) and diabetes status (P-interaction = 0.03) in the association between Hs-cTnT and NT-proBNP categories and cardiovascular mortality. The HR in the both-elevated group was 7.23 (3.79-13.81) in participants <60 years and 2.89 (2.16-3.88) in older participants. The HRs for cardiovascular mortality in participants with and without diabetes were 2.31 (1.48-3.60) and 4.04 (2.87-5.68), respectively.

Conclusions:

In the general population, elevated Hs-cTnT and NT-proBNP are associated with increased mortality, especially in non-elderly and people without diabetes. These tests may be useful for screening.
CARDIOVASCULAR RISK FACTORS IN NORTHEAST INDIA INDIGENOUS POPULATION
Authors: Lalnuneng Abigail
Published: June 2023

Objective:

To determine the prevalence of cardiovascular risk factors in Northeast India Indigenous Population.

Design and method:

A cross-sectional sample of 615 adults from 5 rural villages of the Churachandpur sub-division was collected. A similar sample size of 592 urban adults (aged 18-70 years) was collected from the Imphal East and Imphal West. Data on behavioural characteristics, height, weight, systolic blood pressure, and diastolic blood pressure were collected using standardized schedules, instruments and techniques.

Results:

The cardiovascular risk factors in the present study are alarming. Hypertension accounts for 21 %. It is significantly higher in urban (24.70%) than in rural areas (17.40%). The prevalence of overweight/obesity is about 24% in rural areas and 40% in urban areas according to the WHO international cut-off points (1995). It is further observed that the proportion of overweight individuals is higher if we use the WHO cut-offs recommended for the Asia Pacific region (WHO, 2000).

About 73% of males and 71.24% of females in urban areas consume junk food. In both sexes, junk food consumption is higher in urban areas compared to rural areas. About 82% of males and 83% of females in rural areas consume tobacco. In urban areas, about 78% of males and 71% of females consume tobacco. About 28.32% of males and 9.80% of females are physically inactive in urban areas. This shows that males are more physically inactive than females in both settings. Also, in both sexes, rural areas have a higher proportion of physically inactive individuals compared to their urban counterparts.

Conclusions:

The cardiovascular disease epidemic is a particular cause of concern in India, including the fast pace of increasing incidence, the early age of disease onset in the population, and the high morbidity and mortality rate. Hypertension and unhealthy behaviour are the major cardiovascular risk factors, which pose a major public health challenge to the individual and population in an epidemiological transition. This is also evident in the present study which will predispose the indigenous Northeast India population to cardiovascular risk factors, both in the urban and rural settings.
AN OVERVIEW OF COGNITIVE TESTS USED IN CARDIOVASCULAR RESEARCH
Authors: Koren Pjero , Podrug Mario , Jeroncic Ana
Published: June 2023

Objective:

Cardiovascular status and risk factors such as hypertension, diabetes, smoking, and composite risk scores have been shown to impact cognitive performance. Yet, despite an abundance of available tests, there is no clear choice of cognitive test(s) to measure this impact, rendering direct comparison between studies difficult. The purpose of this study was to identify cardiovascular studies utilizing cognitive tests to detect mild cognitive impairment, in order to quantify the prevalence of different tests and analyse the authors’ comments regarding their applicability.

Design and method:

This was an overview of eligible cardiovascular studies systematically collected from the literature, which used at least one cognitive test on a sample representing either the general population, or hypertensive or metabolic syndrome population with increased risk for mild cognitive impairment. We excluded studies performed on children or including a significant share of the elderly. A total of 59 studies were collected, with key information extracted, and comments qualitatively analysed.

Results:

We identified 111 different cognitive tests. In 71% of studies 3 or more cognitive tests were used, while only 14% used a single test, mostly Mini-Mental-State-Examination (MMSE). Studies solely using MMSE had larger sample size compared to other studies: median (IQR) of 3282 participants (1326-6274) vs 539 (160-2727), p = 0.050. MMSE was used most frequently (29%), followed by Stroop-Colour-and-Word-Test (25%) and Trail-Making-Test-B (24%). Authors commented on cognitive tests in 48 studies (81%), generating 148 distinct remarks. MMSE had the most- 31 remarks across 16 studies of which 32% remarks were interpreted as negative: mostly due to being either insensitive/unable/unreliable for assessing cognition or certain cognitive domains such as executive function, verbal memory, and visuospatial domain; versus 32% positive: reliable/sensitive, widespread use in cardiovascular research. A large proportion (29%) of remarks focused on MMSE cut-offs as well.

Conclusions:

MMSE is still the most widespread test in the field of cardiovascular research, despite numerous reported shortcomings, and tends to be used in large sample studies. However, most studies use multiple tests simultaneously, allowing authors to compensate for the weaker areas of each individual test.
FECAL CALPROTECTIN IS ASSOCIATED WITH CARDIOVASCULAR RISK MARKERS, AND CAROTID ATHEROSCLEROSIS IN A POPULATION-BASED SAMPLE
Authors: Kolesova Ekaterina , Rotar Oxana , Moguchaya Ekaterina , Boyarinova Maria , Erina Anastasia , Tolkunova Kristina , Kibkalo Sofia , Gurina Marina , Vasilieva Elena , Usoltsev Dmitrii , Artomov Mykyta , Mazing Aleksandra , Maslyanskiy Aleksey , Konradi Aleksandra
Published: June 2023

Objective:

To identify associations of fecal calprotectin with cardiovascular risk factors including vascular damage in population-based sample.

Design and method:

77 patients without cardiovascular diseases from population-based sample were randomly invited and signed informed consent. All patients underwent a questionnaire (eating habits, physical activity, smoking, alcohol consumption, stress, anxiety and depression, quality of life, EFPQ), anthropometry, blood pressure and pulse measurement, laboratory examination (biochemical blood test, lipids, fecal calprotectin), vascular examination (carotid ultrasound, applanation tonometry by SphygmoCor, volume sphygmomanometry by Vasera).

Results:

Results The analysis included 77 patients, 33 (42.8%) males with mean age 52 [43;59] years, and 44 (57.2%) females with mean age 60.5 [47;66] years. The results of the linear regression analysis adjusted for sex and age of the level of calprotectin are presented in Table 1.

Table 1 Results of linear regression analysis of fecal calprotectin levels.

Conclusions:

Fecal calprotectin as intestinal wall inflammation marker has been associated with dietary patterns, metabolic disorders, behavioral habits such as a tendency to depression and increased alcohol consumption, as well as carotid atherosclerosis.
LIPOPROTEIN(A) IN CVR EVALUATION
Authors: Joaquim Meireles-Brandao , Lucia Meireles-Brandao , Rui Coelho , Francisco Rocha-Goncalves
Published: June 2023

Objective:

High values of lipoprotein(a), related to atherosclerosis progression, are often considered a marker of thrombosis. We assessed the lipoprotein(a) profile in a group of patients with high vascular risk and no cardiovascular events, established its correlation with other cardiovascular risk factors (CVRF) and inferred the results for patients with metabolic disorders and, at least, two risk factors.

Design and method:

This longitudinal observational study included 516 patients, who had at least two cardiovascular risk factors and regularly attended, for at least two years, the outpatient consultations at a clinic of metabolism and vascular risk for primary prevention.

Sociodemographic, clinical and anthropometric parameters were obtained at the baseline visit. Hepatic morphology was assessed in 509 patients (98.6%) by ultrasonography.

The 10-year vascular risk was estimated using Framingham risk score (FRS), atherosclerotic cardiovascular disease (ASCVD) and systematic coronary risk evaluation (SCORE) tables.

Results:

Significant correlations were found between lipoprotein(a) levels and the addressed vascular risk factors, as well as between lipoprotein(a), and FRS, ASCVD and SCORE evaluation charts.

Lipoprotein(a) values were also considerably higher in patients with steatosis.

Increased lipoprotein(a) values were directly associated with all markers of cardiovascular risk and with non-alcoholic hepatic steatosis.

Conclusions:

Due to its high availability and low cost, lipoprotein(a) should become part of the routine evaluation of patients at vascular and should be decisive part in the calculation of vascular risk regardeless of age group.
PREDICTIVE FACTORS OF MASKED HYPERTENSION IN TYPE 2 DIABETES
Authors: Ibrir Moufida , Bouali Faycal , Berrah Abdelkrim
Published: June 2023

Objective:

- Primary objective: to identify masked hypertension predictive risk factors in normotensive type 2 diabetic patients in clinical measurement.

Design and method:

This was a case-control study. We performed 24-hour ambulatory BP in 358 type 2 diabetic patients normotensive in clinical measurement. We compared both Masked Hypertension and Normotensive groups according to clinical/laboratory parameters and target organ damage, and identify MH predictor risk factors among diabetic population

Results:

The percentage of participants with masked hypertension was 30,7%, in 54,5% of the cases, it is a noctural hypertension. 38,2% of the masked hypertension patients has normal high blood pressure in routine office measurement, 53,63 % of our MH are obese, 64,5% had metabolic syndrome as classified by NCEP/ATP III.

Predictors of masked hypertension are: Normal high blood pressure in consultation, the presence of left ventricular hypertrophy and a microalbuminuria. In this hypertensive masked population, target organs achievement is frequent: 6,8% have peripheral arterial disease, 64,8% have left ventricular hypertrophy, 48% have microalbuminuria, 72,9% have intima-media thickness > 0,9 and 56,3% have arterial stiffness evidence by a PWV> 10 m/sec.

Conclusions:

Predictive factors assessment for masked hypertension helps to better assess cardiovascular risk in normotensive type 2 diabetic patients in routine practice.
POSSIBLE PREDICTORS CONTRIBUTING TO AF OCCURRENCE IN HYPERTENSIVE PATIENTS
Authors: Grigoryan Svetlana , Zelveian Parunak , Hazarapetyan Lusine
Published: June 2023

Objective:

Arterial hypertension (AH) and atrial fibrillation (AF) are two important public health problems. Their prevalence is increasing worldwide, and often coexist in the same patient. AH and AF are strikingly related to an excess risk of cardiovascular disease and death. AH ultimately increases the risk of AF and several factors underlying the higher risk of AF in hypertensive patients are still incompletely known. AH is one of the main reasons for the remodeling process in these patients and makes a significant contribution to the development of structural changes. The aim of this study is to identify possible predictors of paroxysmal/persistent AF occurrence and progression in hypertensive patients

Design and method:

In this study where enrolled 219 hypertensive patients with non-valvular paroxysmal/persistent AF (mean age 63.6 ±7.4) who were hospitalized at Research Institute of Cardiology between 2016 and 2018 year. As a control group 94 hypertensive patients without AF were also examined. After the enrollment the echocardiography examination and 24-hour ambulatory Holter monitoring ECG were registered in each patient. We measured plasma indexes of inflammation (hsCRP, IL-6) and fibrosis marker TGF-beta1. The database consisting of 19 indicators that characterize the clinical, hemodynamic and structural-functional state of the heart, as well as markers of inflammation and fibrosis was created. All data were analyzed by SPSS 13 and EXCEL - 2013 programs using logistic analysis by odds ratio (OR).

Results:

The obtained results showed that in hypertensive patients with paroxysmal /persistent AF, OR of more episodes of hypertensive crises, deterioration of electrical remodeling and LV diastolic function, as well as a significant increase in the levels of concentrations of inflammatory and fibrosis markers in comported with hypertensive patients without AF were detected (tabl.1).

Conclusions:

The multifactorial analysis revealed significant impact of left atrial and ventricular dysfunction, inflammation and fibrosis as well as hypertensive crises on the possible risk of AF occurrence and progression in hypertensive patients
THE EMERGING ROLE OF IDH2-MEDIATED MITOPHAGY AND MTUPR IN ATHEROSCLEROSIS
Authors: Choi Su-Jeong , Nagar Harsha , Piao Shuyu , Kim Seonhee , Lee Ikjun , Park Jeen-Woo , Jeon Byeong Hwa , Song Hee-Jeong , Kim Cuk-Seong , Choi Su-Jeong
Published: June 2023

Objective:

Mitochondrial dysfunction is a risk factor for vascular disease by overexpressing ROS caused by some stimuli in mitochondria which causes oxidative stress and enhances vascular inflammatory response. Isocitrate dehydrogenase 2 (IDH2) is NADP+ dependent mitochondrial enzyme and an antioxidant enzyme that produces NADPH in the antioxidant system. Mitophagy and mitochondrial Unfolding Protein Response (mtUPR) are internal defense mechanism in mitochondria. In this study, we investigated whether IDH2 knockdown causes mitochondrial dysfunction then Mitophagy and mtUPR in vitro in HUVECs and in vivo in IDH2 knock out mice.

Design and method:

We examined expression of mitophagy and mtUPR-related gene in IDH2-deficient human umbilical vein endothelial cells (HUVECs) and its role in mitophagy and mtUPR in the endothelial cell and IDH2 KO animal tissues. Mitophagy and mtUPR were measured using the western blotting and qPCR.

Results:

We showed that knockdown of IDH2 expression induced depolarization of mitochondrial membrane potential (MMP). Mitochondrial dynamics is mitochondrial fusion and fission. Knockdown of IDH2 increased Drp1 (fission protein) and mfn1 (fusion protein) compared with Tom20 (control). IDH2 deficiency increase Mitophagy related protein PINK-1 and Parkin expression and mRNA level (PINK-1, Parkin, BNIP3, NIX, FUNDC-1). Moreover, knockdown of IDH2 induced mtUPR mRNA level (USP30, Clpp) in vitro. In addition, IDH2 deficiency increases mtUPR mRNA level and decreases PINK-1 and Parkin protein expression in vivo.

Conclusions:

Our data show that IDH2 deficiency induces mitochondrial dysfunction and then Mitophagy and mtUPR expression in endothelial cells. These findings provide novel strategy for the development of therapeutic agents for restoring mitochondrial and endothelial function.
FEATURES OF THE ASSOCIATION OF TYPE 2 DIABETES AND ARTERIAL HYPERTENSION IN ELDERLY IN THE AREA OF BLIDA (ALGERIA)
Authors: Cherif Abdelghani Bachir , Bennouar Salam
Published: June 2023

Objective:

Arterial hypertension is frequent and serious in elderly diabetic patients, responsible for an increase in cardiovascular risk and an acceleration of the degenerative damage of diabetes. The aim of this study was to determine the characteristics of hypertension with dyslipidemia in elderly diabetics and to study its impact.

Design and method:

Cohort study, including 1884 type 2 diabetic patients with hypertension aged 65 years old or over, hospitalized in the internal medicine department in Blida (Algeria), between the year 2019 and the year 2022.

Results:

Most of our patients were female with a sex ratio of 1.62. The mean age was 58±3.2 years. The duration of diabetes was 8.1 ± 2.6 years. The diagnosis of diabetes preceded that of hypertension in 61.4% of cases. Only 10.8% had an HbA1c less than or equal to 7%. The mean BMI was 29.2±3.5 kg/m2. Dyslipidemia was present in 62.2% of our patients with essentially hypoHDLemia (70.5%). Macroangiopathy was observed in 40% of patients with mainly ischemic heart disease (33%). It was significantly more frequent in patients with HbA1c greater than 8.5%, LDL-c greater than or equal to 1.2 g/l and hypoHDLemia. The microangiopathy present in 72% of cases was significantly related to HbA1c, GFR and triglyceride levels. During a 2 years follow-up, we observed 212 deaths. Kaplan-Meier curves demonstrated that total cholesterol level was associated at an increased risk of all-cause and cardiovascular death (p<0.001 for all curves). Then, we performed a multivariate Cox regression analysis adjusted for all cardiovascular risk factors, ECG left ventricular hypertrophy, secondary prevention, MDRD and antihypertensive treatment.

Conclusions:

Our results confirmed the prognostic value of total cholesterol on long-term mortality in elderly patients with diabetes and hypertension. Complete management of cardiovascular risk factors in elderly subjects reduces cardiovascular morbidity and mortality.
HYPERTENSION AND CARDIOVASCULAR RISK AT PRIMARY CARE SETTING
Authors: Oliveira Monica Amorim De , Rey Helena Cramer Veiga
Published: June 2023

Objective:

to assess cardiovascular risk of patients treated at basic health units

Design and method:

Prospective cohort of 1000 patients over 18 years selected in 21 primary care units in the city of Rio de Janeiro. At the initial consultation, the clinical form was filled out, in which medical history, socioeconomic variables, data on life habits and functional assessment were documented. The definition of HTN was bases on data from medical records.

Results:

A total of 1014 patients were included in the study. Of these, 737 patients had a diagnosis of Hypertension, which corresponds to 72.68% of the sample.

The presence of target organ damage and/or clinical cardiovascular disease, characterizing a high cardiovascular risk population, was found in 103 patients (10.2%) of the studied population. Among them, 95 (12.9%) were from the hypertensive group and 08 (2.9%) from the non-hypertensive group.

Cardiovascular risk was calculated according to the number of risk factors and the presence of target organ damage and/or clinical cardiovascular disease, in accordance with the guidelines of the SAH Guidelines of the SBC 1. In the hypertensive population of the study, 40.4% were considered low risk and 42.5% high risk, as can be seen in the attached table.

At the end of 12 months, the presence of hospitalization or death was 8.3% (N = 61) in the hypertensive population and 5.8% (N = 16) in the population without SAH (p = 0.18 ). Among hypertensive patients, there were 20 cardiovascular events (2.7%) and 3 (1.1%) in non-hypertensive patients (p = 0.156), with an odds ratio of 2.54 (95% CI 0.74-13.48).

Deaths occurred in 1.9% (N = 19) of the study population, 2% (N = 15) of hypertensive individuals and 1.4% (N = 4) of non-hypertensive individuals (p = 0.795).

Conclusions:

Cardiovascular events accounted for approximately one third of the total events, characterized by hospitalization or death, in patients with hypertension. Although not significant, the cardiovascular risk was almost three times higher in the hypertensive group when compared to the non-hypertensive group, corresponding to 8.3% of the hypertensive population and 5.8% of the population without hypertension.
SYMPTOMS OF POST-TRAUMATIC STRESS PARTIALLY MEDIATE THE RELATIONSHIP BETWEEN GENDER-BASED VIOLENCE AND ALCOHOL MISUSE AMONG SOUTH AFRICAN WOMEN
Authors: Nguyen Kim , Myers Bronwyn , Abrahams Naeemah , Jewkes Rachel , Mhlongo Shibe , Seedat Soraya , Lombard Carl , Garcia-Moreno Claudia , Chirwa Esnat , Kengne Andre P , Peer Nasheeta
Published: June 2023

Objective:

Alcohol misuse is among modifiable risk factors of hypertension and cardiovascular diseases. Previous studies have described the associations of a range of traumatic experiences with problematic alcohol use, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association between trauma exposure across the lifespan and alcohol misuse.

Design and method:

We analysed cross-sectional data from a pooled sample of rape-exposed and non-rape-exposed women, 18-40 years-old, living in KwaZulu-Natal, with self-reported data on alcohol misuse (Audit-C cut-off = >3) and exposure to childhood maltreatment (CM), intimate partner violence (IPV), non-partner sexual violence (NPSV), other traumatic events, and mental ill-health including depression, post-traumatic stress symptoms (PTSS). Logistic regression and multiple mediation models were used to test the mediation effects of symptoms of depression and PTSS on the association between abuse/trauma and alcohol misuse.

Results:

Of 1615 women, 31% (n = 498) reported alcohol misuse. Exposure to any CM (adjusted odds ratio (OR): 1.59, 95% confidence interval (CI): 1.27-1.99), sexual (OR: 1.24, 95%CI: 1.04-1.94), physical (OR:1.39, 95%CI:1.12-1.72) and emotional CM (CA) (OR: 1.31, 95%CI: 1.04-1.66) were independently associated with alcohol misuse. Lifetime exposures to any IPV (OR:2.01, 95%CI:1.59-2.54), physical (OR:2.15, 95%CI:1.72-2.69), emotional (OR:1.61, 95%CI: 1.30-2.01) and economic IPV (OR: 1.35, 95%CI: 1.03-1.78), NPSV (OR: 1.75, 95%CI: 1.32-2.33) and other trauma (OR:2.08, 95%CI:1.62-2.66) were associated with alcohol misuse. Parental neglect and sexual IPV were not associated with alcohol misuse. Exposure to an increasing number of abuse types, and severity of CM (overall, physical and emotional, and parental neglect), IPV (overall, physical and emotional), NPSV and other traumatic events were independently associated with alcohol misuse. PTSS partially mediated the associations of CM, IPV, NPSV and other trauma exposures with alcohol misuse (p-values< = 0.04 for indirect effects), but depression symptoms did not.

Conclusions:

These findings highlight the need for trauma-informed psychological interventions to prevent and reduce alcohol misuse in women exposed to violence. Women diagnosed with alcohol misuse should be screened for trauma exposures and provided appropriately care, treatment.
OBESITY AND HYPERTENSION AMONG YOUNG ADULTS OF DELHI-NCR
Authors: Mishra Sumit
Published: June 2023

Objective:

Our study aimed to determine the association between overweight and obesity with hypertension among young adults.

Design and method:

This study included a total of 200 adults (85 men and 115 women) aged between 18-30. Anthropometric measurements and blood pressure were measured using standard procedures. Statistical methods such as Chi-square and Binary logistic regression were used.

Results:

The prevalence of BMI (Overweight+ obese) was 48% (52.1% males & 47.9% females) while hypertension was 23% (51.1% males & 48.9% females) in the studied population. The binary logistic regression, in terms of OR and coefficient analysis, revealed that high BMI is significantly associated with a 2-fold increased risk for hypertension (OR 2.044, 95% CI = 1.046-3,933). To understand the relationship between height & weight with blood pressure, the sample was stratified for BMI. In BMI cohorts’ height is inversely associated with BP, but in some BMI cohorts (25-28) height is showing a significant positive association with BP. in some BMI cohorts’ weight is positively associated with blood pressure

Conclusions:

This study shows a high prevalence of obesity and hypertension among young adults, males were more obese and hypertensive as compared to females. The risk of obesity and hypertension in young individuals requires urgent awareness.
POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME DUE TO HIGH BLOOD PRESSURE PEAK AFTER HEART TRANSPLANT
Authors: Zanella Luca , Toscano Giuseppe , Rossi Gian Paolo , Letizia Claudio , Seccia Teresa Maria , Tessari Chiara , Pradegan Nicola , Gerosa Gino
Published: June 2023

Objective:

Posterior reversible encephalopathy syndrome (PRES) is a reversible subcortical vasogenic cerebral oedema involving parieto-occipital regions in patients with acute neurological symptoms. The aim of this study is to analyse an interesting case of PRES after heart transplant.

Design and method:

A heart transplant was performed in a 53-years-old woman affected by arrhythmogenic cardiomyopathy. She had history of atrial fibrillation and ventricular fibrillation requiring an implantable cardioverter defibrillator, chronic renal insufficiency with frequent acute episodes, heart failure and stasis hepatopathy. After the transplantation, the patient required femoral extracorporeal membrane oxygenator for three days, mediastinal revision for bleeding, two runs of continuous veno-venous hemofiltration, and a pericardial drainage for effusion.

After fifty days the patient was stable, but she suddenly experienced a high blood pressure peak of 180 mmHg and tachycardia, followed by limb stiffening, limb colonies resolved with diazepam, verbal blockade, and sphincter release.

Results:

A cerebral computer tomography was immediately performed showing a bilateral parieto-occipital oedema suggestive of PRES (Figure 1).

The patient was treated by brivaracetam and the immunosuppressive therapy was switched from cyclosporine to tacrolimus. Subsequently, she experienced amelioration of symptoms. Ten days later, electroencephalography did not show any epileptic signs and oedema was regularly evolving on cerebral imaging.

PRES usually appears in the setting of blood pressure fluctuations, cytotoxic drugs, and renal failure. In the case presented, the time link between symptoms and typical brain images could show that the high blood pressure peak after heart transplant could have been a trigger for the syndrome in a patient with chronic renal disease treated with cyclosporine, which are both risk factors for PRES.

According to literature, PRES syndrome could be due to endothelial injury related to abrupt blood pressure changes, breaking down blood-brain barrier and generating cerebral oedema.

Conclusions:

This case showed that PRES is a possible complication after heart transplant in patient with predisposing risk factors and blood pressure sudden variations. It is very important to have a good blood pressure control after heart transplant and to choose the property immunosuppressive therapy in these patients.
FEATURES OF COGNITIVE FUNCTIONS IN HYPERTENSIVE PATIENTS WITH THE PRESENCE/ABSENCE OF CHRONIC HEART FAILURE
Authors: Yusupova Khafiza , Abdullaeva Guzal , Khamidullaeva Gulnoz , Radjabova Gulruh
Published: June 2023

Objective:

to evaluate cognitive functions in hypertensive patients with the presence/absence of chronic heart failure (CHF).

Design and method:

100 male and female patients with I-III degree of arterial hypertension (AH) (ESH / ESC, 2018), who are on outpatient treatment at Republican Specialized Scientific and Practical Medical Center of Cardiology, were examined. The stage of CHF was diagnosed according to classification (ESH / ESC, 2020), the exclusion criteria was CHF stage IIB-III. The mean age of patients was 55.8±12.2 years, AH duration was 9.4±6.7 years. All patients initially measured office systolic blood pressure (SBP) and diastolic blood pressure (DBP). Cognitive functions were evaluated using neuro-psychological tests: the Mini-Cog test, Montreal Cognitive Assessment (MoCA). The hospital anxiety and depression scale (HADS) was used to assess levels of anxiety and depression. The results are presented as M ± SD.

Results:

All patients were divided into two groups: 1 - patients with AH without CHF (n = 78) and 2 - patients with AH with CHF stage I-IIA (n = 22). The analysis of cognitive functions in AH patients revealed good indicators of cognitive functions in AH patients without CHF in comparison with AH patients with stage I-IIA CHF. In particular, the overall score on the Mini-Cog test: in 1st group it was 4.05±0.92 points, in 2nd group - 3.45±1.4 points (p<0.05), the drawing function was much better: 1.72±0.55 points versus 1.4±0.85 points (p<0.05). The total score on the MOCA scale was slightly higher in group 1 than in group 2: 24.59±2.65 versus 23.31±3.83 points, p = 0.075. At the same time, self-assessment of attention was better in 1st group than in 2nd group: 8.76±1.51 versus 7.84±2.46 points, p<0.05. Visual-constructive performance skills were also better in group 1 than in group 2: 4.13±1.05 versus 3.5±1.47 points, p<0.05. Coping with work in the 1st group of patients was somewhat better than in the 2nd group: 9.09±1.37 versus 8.31±2.39 points, p = 0.072.

Conclusions:

Thus, in hypertensive patients with CHF stage I-IIA is noted the severity of cognitive impairment, in contrast to patients without CHF.