bluuebunny/crossref_metadata_2025 huggingface dataset:
SERUM URIC ACID LEVELS APPEAR TO PREDICT IN-HOSPITAL MORTALITY IN PATIENTS ADMITTED WITH ACUTE ISCHEMIC STROKE
Authors: Tsankof Alexandra , Valanikas Evripidis , Papathanasiou Erofili , Polychronopoulos Georgios , Papadopoulos Anastasios , Tzavelas Marios , Satsoglou Sarantis , Veneti Stavroula , Ztriva Eleftheria , Tziomalos Konstantinos
Published: June 2022

Objective:

Previous studies reported discrepant results regarding the association between serum uric acid levels and the outcome of acute ischemic stroke. We aimed to evaluate this association.

Design and method:

We prospectively studied 1,107 consecutive patients who were admitted for acute ischemic stroke (42.1% males, age 79.8 ± 7.2 years). Stroke outcome was evaluated with dependency at discharge (modified Rankin scale (mRS) at discharge 2–5) and with in-hospital mortality. Stroke severity was evaluated at admission with the National Institutes of Health Stroke Scale (NIHSS). Serum uric acid levels were measured at the second day after admission in the fasting state.

Results:

Serum uric acid levels did not correlate with the mRS at discharge (r = 0.003, p = NS) and did not differ between patients who were dependent at discharge and those who were independent (5.7 ± 1.9 and 5.8 ± 1.7 mg/dl, respectively; p = NS). Independent predictors of dependency were age (relative risk (RR) 1.075, 95% confidence interval (CI) 1.043–1.107, p < 0.001), history of ischemic stroke (RR 2.201, 95% CI 1.482–3.270, p < 0.001), family history of cardiovascular disease (RR 1.978, 95% CI 1.166–3.358, p < 0.05) and NIHSS at admission (RR 1.421, 95% CI 1.334–1.514, p < 0.001). Serum uric acid levels were higher in patients who died during hospitalization than in those who were discharged (6.2 ± 2.0 and 5.7 ± 1.9 mg/dl, respectively; p < 0.05). Independent predictors of in-hospital mortality were atrial fibrillation (RR 2.015, 95% CI 1.083–3.747, p < 0.05), diastolic blood pressure at admission (RR 1.046, 95% CI 1.024–1.068, p < 0.001) and NIHSS at admission (RR 1.188, 95% CI 1.148–1.231, p < 0.001).

Conclusions:

Elevated serum uric acid levels might be associated with higher in-hospital mortality in patients admitted with acute ischemic stroke.
CLINICAL CHARACTERISTICS OF PATIENTS WITH SPONTANEOUS CERVICAL ARTERY DISSECTION - THE POLISH REGISTRY FOR FIBROMUSCULAR DYSPLASIA (ARCADIA-POL STUDY)
Authors: Sasin Dawid , Talarowska Paulina , Januszewicz Magdalena , Jozwik-Plebanek Katarzyna , Dobrowolski Piotr , Prejbisz Aleksandrer , Florczak Elzbieta , Gasecki Dariusz , Zylkowski Jaroslaw , Michalowska Ilona , Kabat Marek , Persu Alexandre , Januszewicz Andrzej
Published: June 2022

Objective:

To assess the clinical characteristics of patients with spontaneous cervical artery dissection enrolled into ARCADIA-POL study.

Design and method:

Out of 435 patients enrolled into ARCADIA-POL study since January 2015 (instituted on the basis of Polish-French collaboration) we present 77 consecutive patients with confirmed spontaneous cervical artery dissection (SCeAD) which was one of the inclusion criteria to the study. A standardized fibromuscular dysplasia (FMD) data form was used for data collection. All patients underwent detailed clinical evaluation including ABPM, biochemical evaluation, biobanking and imaging, duplex Doppler of carotid and abdominal arteries and whole body angio-CT.

Results:

In our analysis we included 77 patients with confirmed SCeAD (50F [64.9%], 27 M [35.1%], mean age: 43.9 +/- 9.6). Dissection involved internal carotid artery in 53 (68.8%) patients, vertebral artery in 19 (24.7%) patients and 5 (6.5%) patients presented coexisting vertebral and carotid artery dissection. FMD was confirmed in 27 (35.1%) patients – 22 of patients in one and in 5 patients in two or more vascular beds. Among patients with cervical artery dissection coexisting with FMD, the most frequent localization of FMD lesions were carotid arteries (66.7%) and renal arteries (44.4%) and subclavian artery in one patient. Hypertension was diagnosed in 59.7% of patients. 27 female patients (54%) confirmed usage of hormonal contraception agents in the medical history. The most frequent clinical symptoms associated with the occurrence of cervical artery dissection in the analyzed group were headaches (70.1%), vision disturbances (39%), dizziness (39%), eye pain (40%) and neck pain (37.7%). In 31 patients (40.3%) cervical artery dissection was associated with ischemic stroke and in 9 patients (11.7%) with transient ischemic attack.

Conclusions:

Systematic evaluation by means of whole-body angio-CT of patients with SCeAD confirmed FMD in 1 out of 3 patients. Our data confirms that FMD should be considered as systematic disease with clinical presentation ranging from asymptompatic changes to life-threatening conditions such as SCeAD.
THE EFFECTS OF INDUCED BLOOD PRESSURE INCREASE AND DECREASE ON CEREBRAL SMALL VESSELS: THE HYPERINTENSE STUDY
Authors: Janssen Esther , Ter Telgte Annemieke , Verburgt Esmée , De Jong Joost , Marques José , Kessels Roy , Backes Walter , Maas Marnix , Meijer Anton , Deinum Jaap , Riksen Niels , Tuladhar Anil , De Leeuw Frank-Erik
Published: June 2022

Objective:

Cerebral Small vessel disease (SVD) is a disorder of the cerebral microvessels and is the commonest vascular cause of stroke and dementia. Hypertension is the most established risk factor for SVD, but the pathophysiological mechanisms following hypertension that cause SVD remain poorly understood. We aim to examine the effects of changes in blood pressure on cerebral microvasculature in young- and middle-aged adults with hypertension to detect the earliest microvascular changes associated with SVD.

Design and method:

The Hyperintense study is an ongoing observational cohort study aiming to include 50 hypertensive adults (18–55 years). These patients temporarily discontinue antihypertensive medication for diagnostic purposes, often leading to a temporary increase in blood pressure. Data are collected before medication withdrawal (T = 0), once antihypertensives are withdrawn (T = 1), when patients have restarted medication and reached target blood pressure (T = 2) and 1 year later (T = 3). At each time-point, high-resolution 3T MRI scans are performed with conventional structural sequences and advanced techniques to assess various aspects of microvascular integrity, including integrity of the blood-brain barrier, microperfusion and microstructural integrity. Clinical data includes motor and cognitive examinations and blood sampling.

Results:

Between July-December 2021, 7 patients (86% male, mean age 47.4 ± 4.4 years) were enrolled. Baseline characteristics and SVD burden are shown in Table. In 3/4 participants who completed T = 1, systolic blood pressure increased after medication withdrawal (median increase systolic blood pressure: 13.7 [3.3 – 15.3] mmHg), demonstrating proof of principle of our approach.

Conclusions:

First data show increased blood pressure after medication withdrawal in most participants and demonstrate feasibility of our design. Analysis of the effect of blood pressure increase and decrease on MRI outcomes will improve understanding of the pathological mechanisms following hypertension that may lead to MRI markers of SVD. This knowledge can help identify new targets for treatment of SVD, aimed at preventing or limiting disease progression.
ARTERIAL STIFFNESS GRADIENT PREDICTS INDEPENDENTLY FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE
Authors: Gasecki Dariusz , Kwarciany Mariusz , Kowalczyk Kamil , Rojek Agnieszka , Narkiewicz Krzysztof , Karaszewski Bartosz
Published: June 2022

Objective:

Arterial stiffness is a strong predictor of morbidity in various clinical conditions, including ischemic stroke. However, the prognostic significance of the newly emerged aortic–brachial arterial stiffness gradient, defined as carotid–femoral/radial -carotid pulse wave velocity (PWV ratio) for functional outcome in ischemic stroke remains unknown.

Design and method:

We enrolled 144 patients (114 males, age 63.1 ± 12.4 years, mean ± SD) with acute ischemic stroke (NIHSS score at admission 6.6 ± 5.3 points). Carotid-femoral pulse wave velocity (PWV), radial –carotid PWV and peripheral blood pressure (BP) were measured (SphygmoCorâ) within several (6 ± 2) days after stroke onset. Functional outcome was evaluated 90 days after stroke using the modified Rankin Scale (mRS) with an mRS score of 3 to 6 (dependency or death) considered as a poor outcome.

Results:

PWV ratio was higher in patients with a poor stroke outcome than in patients of the reference group (1.34 ± 0.58 vs 1.17 ± 0.30; p = 0.017). In a multivariate analysis, the predictive value of PWV ratio remained significant (OR, 3.62; 95% CI, 1.04–12.75; p = 0.044) after adjustment for covariates. In contrast, CF PWV had no significant predictive value for stroke poor outcome.

Conclusions:

We found that the higher PWV ratio in patients in the subacute phase of ischemic stroke is independently associated with a poor outcome. This PWV index might be useful in clinical practice, including therapeutic decisions, but needs broader studies in patient populations of stroke subtypes.
OFFICE VERSUS HOME BLOOD PRESSURE VARIABILITY IN YOUNG INDIVIDUALS: COMPARISON AND ASSOCIATION WITH PRECLINICAL ORGAN DAMAGE
Authors: Zeniodi Maria-Elena , Ntineri Angeliki , Kollias Anastasios , Servos George , Moysakis Ioannis , Destounis Antonios , Vazeou Andriani , Stergiou George S.
Published: June 2022

Objective:

Studies in adults showed that blood pressure (BP) variability has independent prognostic value for cardiovascular outcome. This study investigated the relationship between office and home BP variability with indices of preclinical target organ damage in young individuals.

Design and method:

Healthy individuals aged 6–25 years referred for elevated BP and healthy volunteers were subjected to BP measurements in the office (2–3 visits, triplicate measurements, mercury sphygmomanometer) and at home (6–7 school/work days, duplicate morning and evening measurements, validated oscillometric arm-cuff devices) within 4 weeks. BP variability was quantified as the standard deviation and coefficient of variation of visit-to-visit office BP and day-to day home BP. Preclinical organ damage was assessed with ultrasonographic evaluation of left ventricular mass index (LVMI), determination of common carotid intima-media thickness (cIMT) and pulse wave velocity (PWV, piezoelectronic principle).

Results:

233 individuals were analyzed (age 14.1 ± 4.0 years, 72% males, 32% children, 53% adolescents, 15% young adults, 4.3% healthy volunteers, 29.6% with office and 25.3% with home hypertension). All participants had office and home BP measurements and evaluation of at least one index of target organ damage (LVMI 189, cIMT 123, PWV 73). The variability of systolic office BP was higher than home (p < 0.05) whereas there was not such a difference for diastolic BP variability (Table). None of the office and home BP variability indexes exhibited a statistically significant association with LVMI, cIMT or PWV.

Conclusions:

This study in healthy children, adolescents and young adults showed higher systolic office than home BP variability, but none of them was associated with preclinical organ damage. The clinical relevance of BP variability, and the optimal index and method for its evaluation remain undefined and require further investigation.
ROLE OF SEROTONIN AND ITS METABOLITE 5-HIAA IN THE DEVELOPMENT OF PULMONARY HYPERTENSION. NEW APPROACHES TO TREATMENT AND NON-INVASIVE DIAGNOSTICS?
Authors: Bilalova Diana , Nigmatullina Razina , Mustafin Alvar
Published: June 2022

Objective:

Development of new methods for diagnostics and new approaches to treatment of PAH from the standpoint of serotonergic regulation.

The obtained data points out that a potential marker of PAH is an increase in the concentration of 5-HIAA in urine which is shown by a positive correlation with the stage of PAH.

Design and method:

I.The patients (n = 43, 20 days - 16 y.o.):

Patients with congenital heart disease (CHD) and severe PAH;

Patients with CHD with mild to moderate PAH;

Healthy children (controls).

II.PAH was induced in immature rats by subcutaneous injection of monocrotaline (MCT) (60 mg / kg) at the age of 4 weeks. The studies were carried out 1, 2, 4 weeks after the administration of MCT, namely:

- study of 5-HIAA in urine in ELISA

- invasive study of pressure in the right heart and pulmonary artery

- immunohistochemical and morphological examination of the right and left ventricle, pulmonary artery and aorta.

Results:

A statistically significant increase in pressure in the right ventricle was found in MIPHM, which indicates the adequacy of the selected model of PAH;

- Patients with PH have significantly increased plasma 5-HIAA levels compared to other groups;

- There were statistically significant intergroup differences in amount of 5-HIAA in urine;

- Direct positive dependence of amount of 5-HIAA in urine on the stage of PAH was revealed.

Conclusions:

Comparing the data of our studies, it can be concluded that 5-HIAA levels characterize the activity of pathogenetic processes in PAH. Thus, the possibility of plasma or urine 5-HIAA levels measurement in order to assess the severity of PAH and the effectiveness of its therapy is assumed.

The hypothesis based on our results give us the opportunity to continue working in direction with the aim of introducing drugs of 5-HT receptor antagonists class for the PAH therapy. Simplicity, availability and non-invasiveness of the assessment method of PAH process activity makes it promising to introduce the determining of 5-HIAA levels in urine in the clinical pathology of the PAH stage and the effectiveness of its therapy.
THE EFFECT OF A DIGITAL HEALTH INTERVENTION ON THE CONTROL OF HYPERTENSION AMONG PEOPLE LIVING WITH CANCER
Authors: Okpara Chinelo , Mobisson Nneka , Moosa Maria , Rahman Km Jawadur , Akpakli Jonas , Ogboye Ayoposi , Raji Blessing
Published: June 2022

Objective:

To examine the effectiveness of a digital health intervention on the control of hypertension among people living with cancer.

Design and method:

This was a retrospective study of 101 participants (average age of 67 years old) living with cancer and hypertension enrolled on mDoc’s digital CompleteHealthô platform between February 2020 to November 2021.

The people were connected with a coach-led multidisciplinary team that provided self-care support and encouragement via CompleteHealthô. The multidisciplinary team engaged the people with regular digital nudges on monitoring their blood pressure, health education, nutritional advice, virtual exercise classes and co-created personalised action plans with them. Specialised support for their cancer diagnosis included ensuring adherence to their oncology treatment regimens. The change in blood pressure was calculated as the difference between their initial blood pressure value and the average of all subsequent blood pressure values entered on CompleteHealthô.

Results:

Of the 101 people with cancer and hypertension enrolled on the CompleteHealthô, 98 (97.0%) had at least one interaction with a health coach and 84 (83.2%) entered at least 1 subsequent blood pressure value after their baseline while 57 (56.4%) of them had entered at least 5 subsequent values. Of those with at least 1 value, 63 (75%) had a controlled BP while 48 (84.2%) of those with at least 5 values had controlled BP at the end-line. People with at least 1 subsequent value saw a change of 0.3 mmHg and 1.3 mmHg in their systolic and diastolic blood pressure respectively while people with at least 5 values saw a 2 mmHg and 1.7mmHg reduction in their systolic and diastolic blood pressures respectively.

Conclusions:

Our findings show that a digital health intervention was able to help people living with cancer and hypertension reduce their blood pressure via the use of a web platform, digital nudges, encouragement on the need to check blood pressure at home, exercise, and modification of lifestyles. It also showed that a greater number of interactions with the health coaches led to a greater reduction in blood pressure.
SIMILARITIES IN DEPRESSION AND ANXIETY BETWEEN WHITE-COAT AND RESISTANT HYPERTENSION
Authors: Nemcsik János , Korosi Beata , Gyongyosi Helga , Batta Dora , Laszlo Andrea , Kovacs Illes , Nemcsik-Bencze Zsofia , Rihmer Zoltan , Gonda Xenia
Published: June 2022

Objective:

Hypertension is a major risk factor of cardiovascular mortality. Mood disorders represent a growing public health problem worldwide. A complex relationship is present between mood disorders and cardiovascular diseases. However, less data is available about the level of depression and anxiety in different hypertension phenotypes. The aim of our study was to evaluate psychometric parameters in healthy subjects (Cont), in patients with white-coat hypertension (WhHT), with chronic, non-resistant hypertension (non-ResHT), and with chronic, treatment-resistant hypertension (ResHT).

Design and method:

In this cross-sectional study, 363 patients were included: 82 Cont, 44 WhHT, 200 non-ResHT and 37 ResHT. The patients completed the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A).

Results:

BDI points were higher in WhHT (7 (3–11)) and ResHT (6 (3–11.5)) compared with Cont (3 (1–6), p < 0.05). Similarly, HAM-A points were higher in WhHT (8 (5–15)) and ResHT (10.5 (5.25–18.75)) compared with Cont (4 (1–7), p < 0.05) and also compared with non-ResHT (5 (2–10), p < 0.05). ResHT was independently associated with HAM-A scale above 3 points (Beta = 3.804, 95%CI: 1.204–12.015). WhHT was independently associated with HAM-A scale above 2 (Beta = 7.701, 95%CI: 1.165–18.973) and BDI scale above 5 (Beta = 2.888, 95%CI: 1.170–7.126) points.

Conclusions:

The evaluation of depression and anxiety in hypertensive patients could be useful to identify subjects with risk of white-coat effect and resistant hypertension. Our results suggest the possibility of the progression of white-coat hypertension to resistant hypertension in longer term, however, the proof of this concept requires prospective studies.
THE RELATIONSHIPS BETWEEN ANXIETY AND BLOOD PRESSURE DYNAMICS UNDER THE ANTIHYPERTENSIVE TREATMENT
Authors: Fedorishina Olga , Protasov Konstantin , Torunova Anna
Published: June 2022

Objective:

To study the dynamics of the relationship between anxiety and blood pressure (BP) in patients with hypertension (HTN).

Design and method:

The 24-hour BP monitoring was performed and the presence and severity of anxiety using the Hospital Anxiety and Depression Scale questionnaire were investigated in 171 patients (89 man and 82 woman aged 51.1 ± 8.2) with untreated HTN. Then the patients were assigned to standard antihypertensive therapy. The studies were repeated after 6 months. The dynamics of BP and anxiety during the follow up period were evaluated. Were used comparative, Spearman’s correlation and regression analysis for this purpose.

Results:

The mean anxiety score in the whole group of patients initially was within the normal range (6.2 ± 3.4), but anxiety disorders were detected (>7 points) in 61 patients (35.7%).

According to the anxiety dynamics the patients were divided into 4 groups. The 1st one consisted of patients in whom the anxiety persistent throughout 6 month (n = 29). In the 2nd group initially increased level of anxiety normalized by the observation (n = 32). The 3rd group included patients with no anxiety syndrome at baseline and after 6 months (n = 101) and 4th – normal level of anxiety at baseline and elevated after 24 weeks (n = 9).

The office and 24-hour BP significantly decreased in all groups during the treatment. The degree of systolic BP decrease in the groups did not differ, at the same time the degree of decrease in diastolic BP was less pronounced in the second group (-8.9 mmHg) compared with the first (-13.9 mmHg, p = 0.014) and the third (-12 .7 mm Hg, p = 0.011).

The achievement of 24-hour BP < 130/80 mmHg was associated with the of anxiety reduction degree using both by Spearman’s correlation (r = + 0.16, p = 0.031) and by logistic analysis (OR 1.188; 95% CI 1.049–1.346; p = 0.007) adjusted for gender and age. No relationship was found between achieving the target office BP and anxiety dynamics.

Conclusions:

The least effective of antihypertensive therapy was noted in patients with normalization of the initially elevated anxiety levels. The probability of achieving the target of the 24-hour BP pressure increases as anxiety level grows over time.
INCIDENCE AND PROGNOSTIC IMPACT OF TYPE 1 CARDIO-RENAL SYNDROME IN PATIENTS ADMITTED FOR ACUTE CORONARY SYNDROME
Authors: Cherif Abdelghani Bachir , Bennouar Salam
Published: June 2022

Objective:

To assess the incidence and prognostic impact of cardio-renal syndrome (CRS) in a population of patients admitted for an acute coronary syndrome (ACS),

Design and method:

This was a retrospective cohort study of 952 patients with ACS. An information sheet was established for data collection. Cumulative survival rates were obtained by the Kaplan Meier method, survival curves were compared by the Log-Rank test, the ROC curve was used to define the cut-offs of the markers of renal function to predict mortality

Results:

The incidence of cardio-renal syndrome was 54.8%, and it was more frequent in women, elderly subjects, hypertensives and diabetics. The cut-offs of creatinine and uremia to predict mortality were 15.7 mg/l and 0.65 g/l respectively. Cumulative survival rates were lower in the group of patients with CRS-1.

Conclusions:

The cardio-renal syndrome is a frequent complication in patients admitted for ACS. Creatinine levels, as well as uremia, are easy to measure, accessible, and very inexpensive parameters that have very satisfactory predictive capacities in the context of CRS-1
PHYSICAL ACTIVITY AND LIFESTYLE CHANGES IN ITALY DURING THE COVID-19 LOCKDOWN: GENDER DIFFERENCES
Authors: Pellegrino Alessio , Rosselli Martina , Orlandi Melissa , Boddi Maria , Stefani Laura , Toncelli Loira , Modesti Pietro Amedeo
Published: June 2022

Objective:

Italy responded to the Covid-19 pandemic early by forcing the entire population into a 2-month domestic confinement. The aim of this study was to assess gender differences in the impact of lockdown on physical activity and lifestyle habits.

Design and method:

A cross-sectional web-based survey was conducted in April 2020 on a general population sample residing in Italy. Participants completed validated questionnaires. Gender differences were assessed using a multivariable adjusted logistic regression model using gender as independent and exposures as dependent variables. Metabolic equivalents-hour/week was used to evaluate physical activity.

Results:

A total of 2218 participants (761 men and 1457 women) agreed to participate in the study and completed the questionnaire. The survey found that women compared to men showed 1) a lower level of physical activity before the institution of lockdown, 2) a lower tendency to reduce physical activity levels during the lockdown, when gender differences in compliance with guideline recommendations for physical activity disappeared, 3) and a worsening of sleep and tool passage; men experienced an increase in alcohol consumption.

Conclusions:

Women, who previously had a lower level of physical activity than men, showed a lower tendency to reduce it during lockdown, revealing greater resilience than men. However, the worsening in sleep, in stool passage, and a trend to weight increase revealed signs of psychological suffering after a protracted lockdown period.
CONTINUES REMOTE CARDIAC MONITORING IN CRITICALLY ILL COVID-19 PATIENTS (C3 STUDY)
Authors: Rajanna Avinash Hanbe , Kumar Jeetendra
Published: June 2022

Objective:

To evaluate the use of remote cardiac monitoring of critically ill COVID-19 patients.

To correlate DOZEE early warning score(DEWS) with severity and outcome

Design and method:

Ballistocardiography (BCG)Ballistocardiography is a non-invasive method based on the measurement of the body motion generated by the ejection of the blood at each cardiac cycle. It also contains motion arising from breathing, snoring and body movements.

Dozee Early Warning System (DEWS): DEWS is an overall score for risk assessment of the physiological status of a person. It is a cumulative score of risk levels of physiological parameters like HR,RR and SPo2, which acts as an early predictor for possible physiological decline. Assessment of severity of of Acute-illness Detection of clinical deterioration Initiation of a timely and competent clinical response

Total 39 subjects were observed where 24 of the subjects were Male and 15 Female and the average duration of stay at the hospital was 5 days. There were 20 patients who had comorbid conditions like HYPOTHYROID, NHL,ASTHMA etc. 19 patients did not present with any co morbidities. The outcome of 10 patients was death and 29 patients were discharged after recovery, as reported by the healthcare professionals at the ward. The vitals of the subjects were continuously monitored by Dozee, a contactless remote patient monitoring system enabled with Dozee Early Warning System (DEWS) which reflects the overall patient condition based on the Respiration, Heart Rate and Spo2 of the patients.

Results:

The data from the continuous monitoring of the respiration rate, heart rate and oxygen saturation of the 39 patients were analysed for their duration of stay at the hospital. The DEWS score of the patients were also analysed

Conclusions:

It was concluded that continuous vitals monitoring of the patients and the resulting Dews scores were an indicator of the improving or deteriorating condition of the patients. The discharged patients showed a decrease in the DEWS score, especially Breathing DEWS before they recovered. However, the expired patients showed steady increase or a stagnant high Breathing dews until time of death
CARDIOVASCULAR RISK SCORE MAY BE USEFUL IN STRATIFY DEATH RISK IN HOSPITALIZED COVID19 PATIENTS
Authors: Cicco Sebastiano , Mozzini Chiara , Marozzi Marialuisa , De Fazio Giuditta , Carella Rossella , Vacca Antonio , Cariddi Christel , Pappagallo Fabrizio , Solimando Antonio G. , Ria Roberto
Published: June 2022

Objective:

COVID–19 induce a robust systemic inflammation. Patients with cardiovascular disease (CVD) present an increased death risk. Many efforts are spent to identify possible predictors of negative outcomes. CVD score are useful tools in evaluation of risk of cardiovascular events Aim: We evaluated oxygenation and characteristics in COVID–19 according to cardiovascular risk stratification performed using Framingham (FRS) and Atherosclerotic cardiovascular disease (ASCVD) risk scores.

Design and method:

We evaluated retrospectively 155 COVID–19 patients (110 males, aged 67.43 ± 14.72 yrs). All patients underwent to a complete physical examination, chest imaging, laboratory tests, and blood gas analysis at the time of diagnosis. Seventeen patients died (10 males and 7 females, aged 74.71 ± 7.23 yrs) while the remaining 138 patients (100 males, aged 66.07 ± 15.16 yrs) were alive at discharge.

Results:

No differences there were in Hb, C–reactive protein nor in d–dimers between the two groups. Compared to alive, died group presents a significant increase in white blood cells (p < 0.05) and d–dimers (p < 0.05). No difference there were in pCO2, SO2, and in alveolar arteriolar oxygen difference (A–aDO2). On the contrary, in died patients there is an increased pO2 (p < 0.05) and a decreased ratio between oxygen inspired and pO2 (P/F; p < 0.05). Died patients have increased both in FRS (27.37 ± 5.03 vs 21.33 ± 9.49, p < 0.05) and ASCVD (40.18 ± 20.36 vs 21.47 ± 17.23, p < 0.05). FRS, but not ASCVD, presents a negative correlation to P/F (r–0.42, p < 0.05) in died while no correlation was found in alive. No other correlation has been found with blood gas parameters or in the phlogosis parameters evaluated in the two groups. ROC curve analysis showed a good performance in prediction of death for both scores (AUC FRS 0.71, ASCVD 0.77) with a good sensitivity (FRS 76.92%, ASVCD 75.00%) and specificity (FRS 65.00%, ASCVD 81.13%).

Conclusions:

CVD is a major risk factor for death in COVID–19 patients. The increase risk relates to a reduced lung capacity but it is not related to alteration in gas exchange. CV risk results independent from inflammatory state we found. CVD risk score may be useful to stratify patients at admittance for a better treatment.
COVID-19 IMPACT ON THE PREVALENCE OF SUBCLINICAL HYPERTENSION AMONG PRACTICALLY HEALTHY MEDICAL STUDENTS
Authors: Yufereva Yulia , Shevchenko Oleg , Ginzburg Leonid , Zakirzyanov Artem , Shevchenko Alex
Published: June 2022

Objective:

Silent arterial hypertension is not rare among young adults suffering chronic distress like medical students. COVID-19 pandemic with increased fears and anxiety, social isolation, distant learning, and decreased ACE2 receptor activity could boost hypertension and other cardiovascular risk factors.

The study was aimed to compare the frequency of subclinical hypertension in cohorts of ‘apparently healthy’ young adults revealed before the COVID-19 pandemic and two years after its onset.

Design and method:

Medical students without any known diseases or apparent signs of ‘health problems’ enrolled. 24-hour BP monitoring and test questioning with “International Physical Activity Questionnaire” and “The Perceived Stress Scale-10” were performed in ‘pre-COVID’ November and December of 2019 (Group 1) and the same months of ‘peak-COVID’ of 2021 (Group 2).

Results:

A total of 160 students aged 19 to 26 years were enrolled (group 1, n = 74; group 2, n = 86). The groups did not differ with respect to gender, age, body mass index (BMI) or physical activity (table). The proportion of participants with high perceived stress level (24 and more points) was higher in group 2 vs group 1 (58.1% vs 11.2%, p < 0.001). Masked hypertension prevalence and average values of systolic and diastolic blood pressure (SBP and DBP) did not differ between groups, however daytime and nighttime BP load index was significantly higher in group 2 vs group 1 for both SBP and DBP.

Conclusions:

Despite the absence of significant differences in the mean BP variables, when compared with similar group from ‘pre-COVID’ period, ‘apparently healthy’ students examined after two years of the COVID-19 pandemic had significantly worsened day and night BP load indexes. These changes correlated with the increase of perceived stress levels.
CARDIOPULMONARY EXERCISE TEST AND ECHOCARDIOGAPHIC FINDINGS IN HOSPITALISED POST SARS-COV-2 PATIENTS: THE EFFECT OF ARTERIAL HYPERTENSION
Authors: Kariori Maria , Fragoulis Christos , Chrysochoou Christina , Leontsinis Ioannis , Mantzouranis Emmanoyil , Iliakis Panagiotis , Konstantinidis Dimitrios , Konstantinou Konstantinos , Andrikou Ioannis , Kalos Theodoros , Grigoriou Kalliopi , Tsioufis Konstantinos
Published: June 2022

Objective:

There is little data concerning the impact of arterial hypertension (HTN) on the cardiopulmonary status and right ventricle (RV) function of patients with SARS-Cov-2 infection. The purpose of our study was to investigate whether HTN affects the functional status of hospitalized for SARS-Cov-2 patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the first day of infection.

Design and method:

Subjects who were hospitalized and survived Covid-19 infection were divided into two groups according to history of HTN. All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol evaluating all parameters. Echocardiographic findings including right ventricle strain were analyzed using an offline program.

Results:

A total population of 52 hospitalized Sars-Cov-2 patients with a mean age of 57 ± 11.5 years were evaluated 3 months after the symptoms onset. Males amounted to 51.9 %. History of coronary artery disease was recorded in 15.4% of them. In hypertensive subjects, age (63 ± 8 vs. 52 ± 11 years, p < 0.001), BMI (29.9 ± 4.6 vs. 27.1 ± 5.8 kg/m2, p:0.03) and BSA (2.1 ± 0.25 vs. 2 ± 0.9 m2, p:0.04) were significantly higher. When analyzing cardiopulmonary test parameters, only maximum systolic blood pressure ((SBP, mmHg), 190 ± 21 vs.171 ± 26, p: 0.02) at peak and during the 1st minute of recovery (180 ± 23 vs. 157 ± 27 mmHg, p: 0.005) were higher comparing to normotensive subjects. Furthermore, diameter of left atrium ((LA, mm), 42 ± 6 vs.38 ± 6 p: 0.009), left ventricle ejection fraction ((LVEF,%), 48 ± 11 vs. 57 ± 6, p:0.004) and the absolute mean value of right ventricle strain ((RVLS, %), 9.1 ± 4 vs. 12.7 ± 5.4, p:0.04) differed significantly between two groups. Using linear regression analysis adjusted for age, gender, HTN, coronary heart disease and LVEF, HTN

Conclusions:

Our study highlighted negative impact of HTN both in right and left ventricle functionality, implying HTN as a negative independent predictive factor for right ventricle strain in patients hospitalized for SARS-Cov-2.
IMPACT OF HYPERTENSION AS AN ADDITIONAL RISK FACTOR IN CARDIORESPIRATORY STATUS OF POST SARS-COV-2 INFECTED SUBJECTS
Authors: Kariori Maria , Fragoulis Christos , Polyzos Dimitrios , Leontsinis Ioannis , Grigoriou Kalliopi , Drogkaris Sotirios , Manta Eleni , Tatakis Fotis , Zammanis Ioannis , Kouremeti Maria , Siafi Eirini , Konstantinidis Dimitrios , Dimitriadis Kyriakos , Thomopoulos Costas , Tsioufis Konstantinos
Published: June 2022

Objective:

Few data have been published regarding the holistic approach of post-Covid patients, examining physical health. The purpose of our study was to examine the impact of arterial hypertension in the cardiopulmonary status of post-covid patients 3 months after the first day of infection.

Design and method:

All participants who recovered Covid-19 infection underwent cardiorespiratory exercise using either Bruce or modified Bruce protocol where all parameters were evaluated and transthoracic echocardiogram. The population was separated into two groups based on history of hypertension. Group I (n = 29) included hypertensive subjects and Group II (n = 75) included normotensive subjects.

Results:

A total of 104 patients were assessed 3 months after the onset of COVID-19 symptoms. We recorded a mean age of 49 ± 15 years, 50.5% of them were males, 8.7% had a history of coronary heart disease. Hypertensives had higher BMI (29.24 ± 24 vs 26.64 kg/m2, p < 0.01) and BSA (2.09 ± 0.25 vs. 1.95 ± 0.58, p = 0.001). They were hospitalized in higher percentage comparing to normotensives (72.4% vs. 41.3%, p < 0.01). Left atrial diameter (41 ± 6 vs. 35 ± 5.5 mm, p < 0.001) was significantly larger in hypertensives. Furthermore, A wave (79 ± 21 vs. 58 ± 18 cm/s, p < 0.001) and ratios of E/A (1.01 ± 0.42 vs. 1.28 ± 0.44, p < 0.01) and E/E’ (7.3 ± 3.7 vs. 5.9 ± 4.3, p < 0.01) differed between two groups. Finally, LVEF (%) was significantly impaired in hypertensive comparing to normotesive subjects (53 ± 13% vs. 59 ± 7%). This finding was depicted in lower maximum oxygen consumption (VO2 22 ± 4.5 vs.28 ± 8 ml/kg/min, p < 0.001), metabolic equivalents (METS) at peak, 9.1 ± 3 vs. 14 ± 20, p < 0.001), maximum heart rate (maxHR 147 ± 17 vs. 165 ± 21 bpm, p < 0.001) and HR1st minute recovery (123 ± 28 vs. 138 ± 21 bpm, p: 0.02) comparing to normotensive. Systolic blood pressure (SBP, 180 ± 29 vs. 165 ± 25mmHg, p: 0.02) during the 1st minute of recovery was higher in hypertensives. Finally, the duration of exercise was significantly lower in patients with hypertension (7.3 ± 2.7 vs. 9 ± 4 min, p:0.02)

Conclusions:

the current study highlighted the negative impact of hypertension in the ability to exercise. Regardless of the disease severity, post-covid patients need a comprehensive approach for rehabilitation including the modification of risk factors like hypertension and obesity.
ASSOCIATION BETWEEN DEPRESSION DISORDER AND INCIDENTAL HYPERTENSION IN COVID 19 POSITIVE PATIENTS
Authors: Koh Jong Hoon , Kang Min Jong
Published: June 2022

Objective:

Although the association between depression disorder and cardiovascular diseases has been well recognized. but an effect of depression for incident hypertension are scarce.

Design and method:

300 men and 390 women aged over 40 without hypertension or cardiovascular diseases. Depressive disorder was assessed using Beck’s depression inventory (BDI) ranged 0 to 63 and was considered if BDI score over 16. Hypertension was defined as SBP over 140 and/or DBP over 90 mmHg or the use of antihypertensive medication. We calculated incidence rates (IRs) per 100 person-year for incident hypertension were calculated and incidence rate ratios (IRRs) and its 95% CIs.

Results:

COVID 19 positive patients with depressive symptoms had a significantly higher incidence of hypertension in women compared to men with depressive symptoms. In the logistic regression analysis, the presence of depressive symptom was significantly associated with incident hypertension with COVID 19 positive independently of age, body mass index, education level, and current smoking and drinking status.

Conclusions:

COVID 19 positive patients with Depressive symptoms were highly associated with the incidence of hypertension among middle aged women.
ARTERIAL HYPERTENSION FOLLOWING COVID-19
Authors: Delalic Didi , Jug Juraj , Varahabhatla Vamsi , Prkacin Ingrid
Published: June 2022

Objective:

The aim of this study was to determine the frequency of newly verified or worsened existing hypertension in patients who had COVID-19.

Design and method:

In this case-control study which lasted from May 2021 to December 2021, 108 patients (49 males, 59 females) who have had COVID-19 were analyzed at the Emergency department in Clinical Hospital Merkur, a tertiary care center in Zagreb, Croatia. In order to be categorized as a COVID patient, a positive PCR test at a single point in time was required. According to the accepted definitions of COVID-19 and its manifestations in respect to time from a positive PCR test, the patients were divided into two groups: acute COVID patients (PCR test positive < 30 days ago) and post-acute COVID patients (PCR test positive > 30 days ago). Additionally, the post-acute group was subdivided into the following groups: sub-acute (30–90 days from positive PCR test), chronic (90–180 days from positive PCR test), and “long COVID” (>180 days from positive PCR test). Patients’ age, history, BMI, laboratory values, and antihypertensive therapy were recorded.

Results:

Out of 108 patients studied, 13 (12.04 %) had either newly verified (8) or worsened existing (5) arterial hypertension. Among those, the median time from a verified SARS-CoV-2 infection to onset of symptoms was 90 days. When divided into groups, 5 were in the acute, 3 in the sub-acute, 4 in the chronic, and 1 in the “long COVID” group. Compared to the rest of the study population, patients presenting with arterial hypertension had significantly higher systolic (median 155 vs. 126 mmHg, p = 0.004) and diastolic (median 90 vs 80 mmHg, p = 0.02) blood pressure and were non-significantly younger (median 48 vs 58 years, p = 0.067).

Conclusions:

Arterial hypertension following COVID-19, either newly verified or worsened existing, is a relatively common (12.04% of our patient pool) occurrence and more effort should be directed into evaluating patients’ blood pressure values following COVID-19 in order to make a timely diagnosis and start proper treatment early.
THE FEATURE OF ATRIAL FIBRILLATION OCCURRENCE AND PROGRESSION IN PATIENTS WITH ARTERIAL HYPERTENSION, WHO HAVE UNDERGONE COVID-19
Authors: Hazarapetyan Lusine , Grigoryan Svetlana , Zeveian Parunak
Published: June 2022

Objective:

COVID-19 pandemic has a rather negative effect on patients with cardiovascular pathology. AH is one of the main reasons for the remodeling process in AF patients and makes a significant contribution to the development of heart structural changes.

The aim of this study is to identify the feature of AF occurrence and progression in patients with AH, who have undergone COVID-19.

Design and method:

In this study where enrolled 91 patients with AH and non-valvular paroxysmal/persistent AF, who have undergone COVID-19 (first group). As a control group 109 patients with AH and AF, but without have undergone COVID-19 were also examined (second group). The database consisting of indices that characterize the clinical, hemodynamic and structural-functional state of the heart, were analyzed by SPSS 13.

Results:

The obtained results showed that in the first group patients were significantly older than in the second group (mean age 71.6 ± 7.4 vs. 61.6 ± 6.4 years, p < 0.001). Resting heart rate was significantly higher in patients from first group in comparison with second group (86.6 ± 6.2 vs. 76.9 ± 7.8 beat/min, p < 0.01). In first group body mass index of patients was significantly more than in second group (33.9 ± 1.5 vs. 31.6 ± 1.8 kg/m2, p < 0.05). In the first group the prevalence of patients with uncontrolled AH were statistically significantly higher, than in the second group (54% vs. 23%, p < 0.001). In those patients the doses of antihypertensive medications taken were either increased or the antihypertensive treatment were revised. Moreover, in the first group the frequency of hypertensive crises was nearly twofold higher (31% vs. 17%, p < 0.001). It was revealed that the left atrium diameter in patients of the first group was significantly greater than in the second (44.3 ± 1.4 vs.41.2 ± 1.1 mm, p < 0.05); but systolic and diastolic dysfunction did not significantly differ in both groups.

Conclusions:

The obtained results indicate that in patients with AH who have undergone COVID-19, the onset of AF has some features, namely; uncontrolled AH, frequent hypertensive crises, tachycardia, overweight and older age. As well as left atrium more large dilation compared with second group that did not undergo a viral infection.
ARTERIAL HYPERTENSION IN PATIENTS WITH LONG DURATION TYPE 1 DIABETES MELLITUS
Authors: Chalakova Tatiana , Tsochev Kaloyan , Yotov Yoto , Bocheva Yana , Valchev Georgi , Usheva Natalya , Iotova Violeta
Published: June 2022

Objective:

Prognosis in Type 1 diabetes mellitus (T1DM) patients is constantly improving and the role of other cardiovascular risk factors, e.g. hypertension is gradually increasing. The effective management of both conditions is important for the prevention of cardio-vascular diseases (CVD).

Aim: to assess the blood pressure (BP) in patients with long-duration T1DM compared to controls and to evaluate arterial hypertension (AH) management in them.

Design and method:

A study of 124 patients of T1DM at a mean age 42.68 ± 10.4 years, 53% males, with a median duration of T1DM 24 years and mean HbA1c 8.42 ± 1.75% and 59 age- and sex matched controls. BP was measured twice with a calibrated sphygmomanometer and the mean of both measurements was used. AH was defined as BP> 140/90 mm Hg or history of AH or on antihypertensive treatment.

Results:

The mean systolic BP (SBP) in T1DM patients was significantly higher than in controls – 128.17 ± 18.87 vs 121.13 ± 1.26, p = 0.008, with no interaction with gender. Diastolic BP was not significantly higher – 80.28 ± 10.02 vs 77.98 ± 10.72, p = 0.16. AH was twice more prevalent in T1DM patients than in controls – 67 (54%) and 17 (27%), resp. (p = 0.001). It was due to already known hypertension - 51 (41%) vs 12 (20%), p = 0.001 while incident AH cases were equally found in T1DM and controls – 15 (25.4%) vs 4 (25%). Control of AH < 140/90 mmHg was achieved in only 35.8% of the patients with T1DM and in 37.5% of the controls, while BP< 130/80 mm Hg was even less frequent in both categories – 13.4% vs 12.5% (p = NS). Untreated were 24 (29%) of all hypertensive participants, combination treatment was prescribed in 32 (39%) and monotherapy – in 26 (32%). ACE-inhibitors were the preferred antihypertensive class, followed by beta-blockers, ARBs, diuretics, and CCBs.

Conclusions:

SBP is significantly higher in T1DM patients than in their healthy peers, irrespective of gender. The prevalence of AH is higher in diabetic patients with long duration even at still relatively younger age. The BP control is far from optimal in the studied population which requires more aggressive management to prevent CVD occurrence.
ASSOCIATION BETWEEN SERUM LEVELS OF CYSTATIN C AND NATRIURETIC PEPTIDES
Authors: Vasilkova Volha , Mokhort Tatsiana , Yarets Yulia , Korotaeva Ludmila
Published: June 2022

Objective:

Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease, independent of creatinine-based renal function measurements. The aim of our study was to evaluate the association between the levels of natriuretic peptides (BNP and NTproBNP) and serum cystatin C in patients with diabetes.

Design and method:

A total of 449 patients with type 1 and type 2 diabetes, aged 34 to 84 years, were examined. All patients underwent standard clinical and laboratory examination, with an assessment of the levels of BNP and NTproBNP. Renal function was assessed based on the levels of serum creatinine, glomerular filtration rate, which was calculated according to the CKD-EPI formula, and albuminuria, which was assessed as albumin/creatinine ratio (A/C). An echocardiographic examination was conducted according to the standard protocol with the calculation of dimensional, volume and speed characteristics.

Results:

57% DM patients had BNP and NTproBNP levels exceeding the diagnostic values of BNP > 35 pg/ml and/or NTproBNP > 125 pg/ml. The levels of BNP and NTproBNP positively correlated with the levels of homocysteine, uric acid, IL-6, C-reactive protein, high-sensitivity C-reactive protein, A/C, creatinine, cystatin C, TNF-alpha, chemokines (MIG, RANTES), growth factors (FGF-23, VEGF-A) (p < 0.05). According to logistic regression analysis, predictor for increased proBNP was cystatin C, rather than creatinine (ß = 7,216, p = 0,042). ROC analysis determined the diagnostic significance of cystatin C for the prediction of increased NTproBNP. Thus, when the level of cystatin C (AUC-0.798) was 0.96 mg/l, the sensitivity and specificity for increased NT-proBNP concentration were 81% and 69%, respectively.

Conclusions:

Cystatin C might be an independent predictor of increased levels of natriuretic peptide in patients with diabetes.