bluuebunny/crossref_metadata_2025 huggingface dataset:
DETAILED ANALYSIS OF VASCULAR STIFFNESS IN PATIENTS WITH CHRONIC HEART FAILURE
Authors: Pietschner Robert , Kolwelter Julie , Bosch Agnes , Striepe Kristina , Kannenkeril Dennis , Ott Christan , Schiffer Mario , Achenbach Stephan , Schmieder Roland E.
Published: June 2022

Objective:

Risk factors for chronic heart failure (CHF) lead as well to vascular stiffness of the large arteries, increasing thereby the afterload imposed on the left ventricle and deteriorating the clinical condition of CHF. The aim of this project was twofold: to compare vascular stiffness of patients with CHF (CHF+) to those without CHF (CHF-) and to analyse whether vascular stiffness is related to the severity of CHF.

Design and method:

In this cross-sectional project a total of 223 patients were included (CHF+: n = 105, CHF-: n = 118). Patients in an euvolaemic state with a reduced left ventricular ejection fraction (LVEF) were included in the CHF+ group. The measurement of the pulse wave velocity (PWV), the most accepted vascular stiffness parameter, and the recording of the arterial pulse wave were performed using the SphygmoCor TM XCEL System under resting conditions. Under ambulatory conditions, blood pressure (BP) and vascular stiffness parameters were assessed by a validated device (Mobil-O-Graph, I.E.M.) over 24 hours. Additionally, blood and spot urine samples were used to measure laboratory markers, in particular NT-pro-BNP.

Results:

Vascular stiffness parameters between the CHF+ and the CHF- group differed for resting central SBP (CHF+: 116.66 ± 15.18 mmHg, CHF-: 122.83 ± 15.87 mmHg, p = 0.004) and central augmentation index (CHF+: 21.24 ± 11.76 %, CHF-: 13.69 ± 11.49 %, p = <0.001) as well as for ambulatory central SBP (CHF+: 114.46 ± 15.35 mmHg, CHF-: 120.69 ± 13.97 mmHg, p = 0.007) and PWV (CHF+: 9.39 ± 1.56 m/s, CHF-: 8.19 ± 1.65 m/s, p = <0.001). In patients with CHF, greater levels of NT-pro-BNP were related to a higher central SBP (r = 0.292, p = 0.005), higher PWV (r = 0.340, p = <0.001) and a trend to higher central PP (r = 0.198, p = 0.058), after full adjustment for CHF risk factors and gender. In accordance, higher levels of NT-pro-BNP were related to a higher ambulatory peripheral PP (r = 0.322, p = 0.002) and total peripheral resistance (r = 0.227, p = 0.041).

Conclusions:

In patients with stable CHF we observed a worse vascular stiffness and function, compared to patients with no CHF. The extent of vascular stiffness and dysfunction was related to the severity of CHF.
SERUM CHOLESTEROL, LDL-C, TG/HDL-C WERE HIGHER IN APOE-/- MICE WITH BOTH ARTERIAL STIFFNESS INCREASE AND PLAQUE FORMATION THAN IN THOSE WITH ARTERIAL STIFFNESS INCREASE ALONE
Authors: Ma Jun , Chen Xiaoping
Published: June 2022

Objective:

Atherosclerosis is currently thought to be strongly associated with arterial stiffness. However, several clinical studies have shown no significant correlation between serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and arterial stiffness. This is in contradiction with that TC and LDL-C lead to atherosclerosis. Here, we explored and discussed the effect of blood lipid levels on arterial stiffness in ApoE-/- mice with or without atherosclerotic plaque formation.

Design and method:

ApoE-/- mice were fed with a normal chow diet (4.5 % fat, control group), a high-fat, high-cholesterol diet (40% fat, 1.25% cholesterol, HFHC group) and a high-fat diet (60 % fat, HF group) respectively. Body weight changes were recorded. Serum TC, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) levels were detected by automatic biochemical analyzer. PWV was measured by ultrasound, Russell-Movat’s pentachrome stain was used to detect structural arterial stiffening and oil red O stain was used to detect atherosclerotic plaque formation. Cell death was detected by flow cytometry and protein expression was measured by western blot.

Results:

After 14 weeks of feeding, a significant increase in PWV and a decrease in diastolic capacity and elastic fibers were observed in both HF and HFHC group. When the HFHC group atherosclerotic plaques appeared, no plaques were formed in the HF group. Serum TC, LDL-C, TG/HDL-C were significantly higher in the HFHC group than in the HF group, but TG, HDL-C, non-HDL-C, TC/HDL-C, non-HDL-C/HDL-C were not significantly different between the HFHC and HF group. In vitro, cholesterol crystals induced increase of death in mouse arterial endothelial cells, while knockdown of caspase-1 expression partially alleviated the cell death.

Conclusions:

Serum cholesterol, LDL-C, TG/HDL-C were higher in ApoE-/- mice with arterial stiffness increase and atherosclerotic plaques formation than in ApoE-/- mice with an equal increase in arterial stiffness but no plaque formation. Caspase-1-mediated pyroptosis of artery endothelial cell activated by cholesterol crystals may be an important mechanism leading to atherosclerotic plaque formation.
INCREASE ARTERIAL STIFFNESS IN MOYAMOYA DISEASE PRESENTING WITH HYPERTENSION AND STROKE: A NOVEL FINDING IN A VERY RARE CASE IN SINGAPORE
Authors: Chinnaaiah Kausalia , Lo Francis Albert , Sule Ashish Anil , Chin Tay Jam
Published: June 2022

Objective:

Arterial stiffness in Moyamoya disease (MMD) has not been described before in literature. We describe a young 42 year-old lady who initially presented as hypertensive urgency and recurrent stroke and was later diagnosed with MMD. We would like to highlight increased arterial stiffness as a cause of hypertension in patients with MMD.

Design and method:

This is a case report of a 42 year old lady 42 year Singaporean lady presented in 2015 with headache and transient ischemic attack(TIA) and systolic blood pressure was 200mmHg. She was diagnosed with hypertension at the age 28 years and started on telmisartan 40 mg OD.

There was no end organ damage and secondary hypertension work up was negative. She has recurrent TIAs and was started on T. atorvastatin 40 mg ON and T clopidogrel 75 mg OD in Feb 2017.

She presented with stroke in March 2019, and MRI revealed left posterior temporal-parietal infarct, MRA revealed severe stenosis of left terminal internal carotid artery(ICA).

She presented with recurrent stroke in April 2019 and MRI/MRA revealed scattered acute infarcts in left MCA and ACA territories and severe steno-occlusive disease involving left ICA. She underwent left external carotid –internal carotid bypass in June 2019. In light of these findings, MMD was diagnosed.

Results:

She was started on T spironolactone and her blood pressure was kept in stable range of 130–150/80–95mmHg. An arterial stiffness study by SphygmoCor in June 2020 showed markedly increased arterial stiffness with markedly increased augmentation index, aortic augmentation pressure, aortic systolic pressure and aortic pulse pressure for the patient’s age.

Conclusions:

We present an interesting and rare case of hypertension in a young patient with MMD associated with increased arterial stiffness, with no renovascular disease. This is one of the first cases reported in MMD with increased arterial stiffness. We also highlighted genetic studies and case reports that have suggested that the histopathological process underlying Moyamoya vessels may also affect systemic vessels. We hope that this article will inspire more research on the relationship between MMD and hypertension, particularly in terms of how systemic vasculature is affected.
ADVANCED GLYCATION END PRODUCTS(AGES) AND DIETARY METABOLITES RESULTED IN NEUTROPHIL EXTRACELLULAR TRAPS (NETS) AND VASCULAR CHRONIC INFLAMMATION AND STIFFNESS
Authors: Chen I Chun , Chen Szu Ting , Cheng Hao Min , Chen Chen Huan
Published: June 2022

Objective:

Inflammaging is a risk factor for cardiovascular diseases. Advanced glycation end products (AGEs) are proteins or lipids that become glycated as a result of exposure to sugars, they are thought to be a detrimental metabolite involving in inflammation and some age-related chronic diseases. To explore the effects of vascular aging via the immune pathway.

Design and method:

To investigate the role of AGEs in inducing neutrophil activation and cause neutrophil extracellular traps (NET), Neutrophil cell line treated with AGEs analyzed the reactive oxygen species (ROS) production and proinflammatory cytokines expression. Whether AGEs cause the morphological and functional change in endothelial cells by using a human cell line HMEC-1. Next, we investigate if older people bear spontaneous NET in the circulation that may bring detrimental impact in the vasculature system. We enrolled volunteers > 65 years-old, the serum was measured with MPO-DNA complex by ELISA. In vivo, we established an animal model by feeding mice with a high-fat diet (HFD) for long period to induce chronic intestinal inflammation. The aortic stiffness was assessed in vivo by the pulse wave velocity (PWV) after HFD feeding and normal diet (ND) feeding for 20 weeks.

Results:

AGE not only caused neutrophil cell line cellular ROS generation in time-dependent manners but also significantly increased expression of TNF and il-1, and AGE increased expression of inflammation markers including ICAM-1, VCAM-1, DLC-1 and reduced tube formation by HMEC-1. AGEs induced the NETs formation in primary neutrophils in a time-dependent manner. Volunteer serum MPO-DNA complex is higher than younger donors, HFD-feeding mice had increased and PWV and decreased colon of length, compared with ND-feeding mice, suggesting PWV tends to increase with higher arterial stiffness.

Conclusions:

In conclusion, AGEs, a metabolite from HFD is able to induce neutrophil activation and NET formation. Volunteers > 65 years old have high MPO-DNA complex, suggesting the “Netting” neutrophil in the circulation would be one of the potential factors causing the inflammation in the vessel and leading to vessel stiffness. The HFD-feeding mice with intestinal inflammation display vascular stiffness.
FAMINE EXPOSURE IN EARLY-LIFE AND HIGH CARDIOVASCULAR RISK IN ADULTHOOD: FINDINGS FROM THE CHINA PATIENT-CENTERED EVALUATIVE ASSESSMENT OF CARDIAC EVENTS MILLION PERSONS PROJECT
Authors: Chaolei Chen , Zhiqiang Nie , Yanqiu Ou , Yuqing Huang , Yingqing Feng
Published: June 2022

Objective:

Previous studies reported that early-life exposure to undernutrition play key roles in the development of metabolic diseases, but the association with high cardiovascular disease (CVD) risk in later life remains unclear. We aimed to investigate whether exposure to famine in early life is associated with high cardiovascular disease (CVD) risk in adulthood.

Design and method:

This study included 85,473 participants from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project in southern China who were born around the time of the Chinese Great Famine. They were divided into four famine exposure groups according to the birth year, including nonexposed (1963–1974), fetal exposed (1959–1962), childhood exposed (1949–1958), and adolescent exposed (1941–1948). High CVD risk was defined as having previous heart disease or a predicted 10-year risk of CVD greater than 20% based on the WHO/ISH criteria. Logistic regression models were used to examine the association between famine exposure and high CVD risk.

Results:

Among the participants included, 4.6% (3893) participants had high risk for CVD, including 2543 (3.0%) participants had a predicted 10-year risk of CVD greater than 20%. Compared with the nonexposed group, childhood-exposed and adolescent exposed but not fetal-exposed participants had increased risk of having high CVD risk in adulthood, with odd ratios (ORs) (95% CIs) of 1.40 (1.15–1.70), 1.43 (1.07–1.90) and 1.14 (0.97–1.33), respectively, after adjusting for age and other covariates. For individuals without previous heart disease, fetal, childhood, and adolescent famine exposure were associated with higher likelihood of predicted 10-year risk of CVD greater than 20%, with multivariable-adjusted ORs (95%CI) of 1.34 (1.08–1.66), 2.17 (1.69–2.78), and 2.84 (1.98–4.07). Sensitivity analysis showed similar results by combining the relatively older and younger age group as the reference, which neutralized the age gap between the nonexposed group and the exposed groups in the main analysis.

Conclusions:

Early-life exposure to famine is significantly associated with higher risk of developing CVD in later life. These findings have important epidemiological and clinical implications on the understanding and prevention of CVD.
IMPACT OF ADAPTED PHYSICAL ACTIVITY ON BLOOD PRESSURE AND HYPERTENSION CONTROL IN MILITARY OF THE KINSHASA GARNISON
Authors: Buila Nathan , Kabanda Gilbert , Nkodila Aliocha , Mundu Gustave , Beya Felix Espoir , Kiana Nicaise , Mety Rawell , Buila Nathan , Kayembe Jean-Marie , Longo-Mbenza Benjamin , Mbuyamba-Kabanga Jean-René
Published: June 2022

Objective:

To evaluate the impact of adapted physical activity (APA) on blood pressure (BP) and hypertension control among soldiers in the Kinshasa garrison.

Design and method:

We assessed variation in BP level and hypertension control in 229 soldiers randomly allocated to endurance training (active group n = 119) or maintained at rest (control group n = 110) for 8 weeks. Both study groups comprised of 58 % drug treated hypertensive patients.

Results:

At the last available visit after randomization BP was 5.1/3.0 mmHg lower in the active than in the control group for all randomized participants and 4.3/2.0 mmHg lower for the cohort of participants who completed the protocol. Exercise induced BP reduction was greater in participants < 50y, in high graded officers and in hypertensive individuals. The control of hypertension, unchanged in the control group, increased from 43.8% at randomization to 85.3% in the active group (p < 0.001). The probability to control hypertension was greater for the active group (RR: 3.38 [95% CI: 1.48–4.84]; p < 0.0001).

Conclusions:

Our results support the recommendation that endurance physical activity constitutes a cornerstone not only for the prevention but also for the treatment and control of arterial hypertension.
NATIONWIDE COMPREHENSIVE HEALTH PROTECTION SCREENING PROGRAM IN HUNGARY, 2010 2020 2030
Authors: Barna István , Daiki Tenno , Dankovics Gergely , Kékes Ede
Published: June 2022

Objective:

From 2010 a new, complex screening program started in Hungary, named NATIONWIDE COMPREHENSIVE HEALTH PROTECTION SCREENING PROGRAM in HUNGARY MAESZ 2010 2020 2030.

Design and method:

Within the framework of the Program in the largest mobile diagnostics center in Hungary, the adult population has the opportunity to obtain 40 comprehensive surveys in free form. In the past nine years, the special screening lorry visited 1886 places

Results:

228076 inhabitants had a complex screen and 561873 individuals received information packages about the right lifestyle, the prevention of illnesses, and preservation of health and we have received 14 million lifestyle question answers on sites. From 2018 2019 academic year officially started the child prevention program of the nationwide health prevention screening program of Hungary named Travel to Empire of the Health MAESZ provides free participation for about 75,000 children annually and assists in the development of children’s health knowledge. The nationwide comprehensive health protection screening program greatly contributes to improving students’ health knowledge. Within the framework of the program, students can gain insight into the program from the first grade of primary school to the university level. Based on data from 2010, the age of participants was 42 years for women and 40 years for men. 22% in women, 23% in men was the rate of known hypertension, and 5.1% and 4.5% was the proportion of known diabetics irrespectively. Myocardial infarction 26–22%, hype,rte,nsion disease 62–55%, stroke 19–14%, cancer 47–38%, and metabolic disease 42–34% occurred in the family history. BMI was increased in both genders, 45% in women and 59% in men. In both sexes, the proportion of smokers was over 24%.

Conclusions:

Based on the results, it has been repeatedly found that the Hungarian population has high risk.
CHARACTERIZATION OF EATING HABITS IN UNIVERSITY STUDENTS OF BARRANQUILLA – COLOMBIA
Authors: Rodero Eulalia Maria Amador , Esmeral Leslie Piedad Montealegre , Ayala Zazyl , Charris Martha Arteta , Aguado Carlos De Oro , Rebolledo Roberto
Published: June 2022

Objective:

The objective was to characterize dietary habits in a group of university students from the city of Barranquilla, Colombia

Design and method:

a cross-sectional observational descriptive-analytical study is proposed. A convenience sampling was carried out, students from the private university of Barranquilla district were selected, they were characterized at a sociodemographic and anthropometric level, in addition, the questionnaire Lifestyle in Young University Students (CEVJU-R) was applied.

Results:

13.28% of the participants had unhealthy eating habits. With a P-value < 0.05 and a confidence level of 95%, it is stated that eating habits are associated with socioeconomic status, as well, lifestyle is associated with dietary habits.

Conclusions:

Conclusion: university life can become a risk factor for the development of non-transmissible diseases associated with dietary habits, which is why it is important to work on promoting healthy lifestyles
ARTERIAL HYPERTENSION, THE MOST FREQUENT CARDIOVASCULAR RISK FACTOR, BUT HITHERTO UNRECOGNIZED IN THE NOMADIC POPULATION OF SOUTHERN ALGERIA
Authors: Abdelhalim Taleb , Nadia Dammene Debbih , Abdelghani Bachir Cherif
Published: June 2022

Objective:

evaluate the prevalence of hypertension among former nomads

Design and method:

cross-sectional, descriptive, and analytical study, where we included 605 nomads, 303 nomads, and 302 nomads settled for 03 years aged 40 and over without distinction of sex or skin color.

Results:

nomadic population the average age is 61.2 years ± 13.5 (40–101), 136 women (44.9%), and 167 men (55.1%).

252 (83.2%) had white skin, while 51 (16.8%) had black skin. nomad’s blood pressure status 32% of nomads were hypertensive (95% ci: 26.6–35.2), hypertension was known in 47.4% (95% ci: 44.1–54.9), 73.8% were treated (95 % ci: 63.8–87.4), and 33.1% were controlled (95% ci: 20–39.4). sedentary nomadic population the average age is 58, 4 years ± 13,7 (40–95), 148 women (49%), and 154 men (51%). 156 (65, 6%) had white skin, while 104 (34,4 %) had black skin. blood pressure status of the sedentary nomad 47% (95% ci: 39,1–50,5) were hypertensive, hypertension was known in 35,6 % (95% ci: 28–43,9), 96,9% were treated (95% ci: 92–99), and 25,4% were controlled (95% ci: 15,7–37,2)

Conclusions:

high blood pressure is found in 32% of the nomadic population and in 44.7% in the sedentary group. the statistical difference according to the environment is clearly significant in favor of the sedentary group. this survey allowed us to obtain important data among the nomadic population on the prevalence of other risk factors
OBSTRUCTIVE SLEEP APNEA IS ASSOCIATED WITH INCREASED CORONARY CALCIFICATION AND ARTERIAL STIFFNESS IN PATIENTS WTH DIABETIC NEPHROPATHY
Authors: Nielsen Sebastian , Nyvad Jakob , Christensen Kent Lodberg , Poulsen Per Løgstrup , Laugsen Esben , Grove Erik Lerkevang , Buus Niels Henrik
Published: June 2022

Objective:

To investigate the association between obstructive sleep apnea (OSA), coronary calcification and arterial stiffness in patients with diabetic nephropathy.

Design and method:

We conducted a cross-sectional study in patients with diabetic nephropathy. Subjects with type-2 diabetes, estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 and urine albumin-creatinine (UAC) ratio > 30 mg/g were recruited from the outpatient clinics in renal medicine or diabetes or from the local general primary care. Eligible patients were tested for OSA with ApneaLinkâ and quantified by apnea-hypopnea index (AHI, events/h). Absence of OSA was defined as AHI < 5, mild OSA as 5–14, moderate as 15–29 and severe as > = 30. Subjects with an AHI < 5 or > = 15 had a coronary computed tomography angiography (CTA) with subsequent blinded Agatston-scoring (AS) to quantify coronary calcification. Aortic stiffness was determined as carotid-femoral pulse wave velocity (cf-PWV) using Sphygmocorâ.

Results:

A total of 121 patients were examined by ApneaLinkâ with 114 having complete data. 43 (38%) did not have OSA, 33 (29%) had mild OSA and 38 (33%) had moderate-severe OSA. A total of 74 patients (92%) underwent CTA and 70 cf-PWV measurements. Mean age was 71 years (73% males), mean eGFR 32 mL/min and mean UAC-ratio 533 mg/g. BMI and UAC-ratio were higher in the OSA-group than the non-OSA group, while age, smoking habits, eGFR, diabetes duration, Hb1Ac, blood pressure, lipid levels, and medication were comparable between the two groups. Logarithmic transformed Ln(e) AS was significantly higher in patients with moderate-severe OSA compared to non-OSA (6.59 ± 1.71 vs. 5.56 ± 2.41, p = 0.04) and the same was observed for cf-PWV (11.9 ± 2.7 vs. 10.5 ± 2.2, p = 0.03) (Figure 1). A secondary analysis suggested AS to be especially elevated in those with severe OSA (mean AS 2350, n = 16) as compared to moderate OSA (AS 1031, n = 19) and non-OSA (AS 1011, n = 39).

Conclusions:

OSA is common in patients with diabetic nephropathy and associated with increased coronary calcification and aortic stiffness. These vascular abnormalities are seen despite optimized blood pressure-, lipid- and glycemic control. Our data indicate that screening for OSA adds important cardiovascular risk information in patients with diabetic nephropathy.
ASSOCIATION BETWEEN TRIGLYCERIDE GLUCOSE INDEX AND LEFT VENTRICULAR HYPERTROPHY AMONG CHINESE POPULATION WITH HIGH CARDIOVASCULAR RISK
Authors: Chaolei Chen , Zhiqiang Nie , Jiabin Wang , Yuqin Huang , Yingqing Feng
Published: June 2022

Objective:

The triglyceride glucose (TyG) index has been proposed to be a reliable surrogate of insulin resistance. In the present study, we aimed to examine the relationship between TyG index and left ventricular hypertrophy (LVH) among Chinese population with high cardiovascular risk.

Design and method:

This cross-sectional study included 20,921 participants with measurable echocardiographic parameters from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project in Guangdong Province. Participants with high cardiovascular risk, which was defined as a predicted 10-year risk of cardiovascular disease greater than 20%, according to the 2019 cardiovascular disease risk charts for east Asia by WHO, or those with previous myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, or stroke, were identified. They were divided into four famine exposure groups according to the quartiles of TyG index. The association between TyG index and LVH was examined by Logistic regression and restricted cubic spline regression, and the results were presented in odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses were also conducted to examine potential interactions between demographics and TyG index.

Results:

Among 20,921 participants, 1799 (8.6%) of them had LVH. The multivariate OR for every SD increment in TyG index was 1.22 (95% CI, 1.14–1.31). When comparing to the lowest quartile of TyG index, the multivariate ORs for LVH were 1.22 (0.96–1.54) for Q2, 1.61 (1.28–2.01) for Q3, and 1.73 (1.38–2.16) for Q4 (P for trend < 0.001). The restricted cubic spline regression also showed a linear association. No interaction was found between subgroup variables and the association between TyG index and the LVH.

Conclusions:

Higher TyG index associated with the elevated risk of LVH in Chinese population with high cardiovascular risk. The data suggest that TyG index may serve as a simple and effective tool for LVH risk assessment in daily clinical practice.
ABNORMAL DIPPING PATTERN OF NOCTURNAL BLOOD PRESSURE AS A PREDICTOR OF COGNITIVE IMPAIRMENT AND/OR DEMENTIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Wang Analise , Chong Eric , Gupta Ankur
Published: June 2022

Objective:

Impact of abnormal nocturnal blood pressure (BP) dipping pattern on cognitive impairment and/or dementia is uncertain. The aim is to review the association between abnormal nocturnal BP dipping patterns (extreme dipping, non-dipping, or reverse dipping) and cognitive impairment and/or dementia in adults.

Design and method:

PubMed, MEDLINE, and EMBASE databases were systematically searched. Primary outcome was pooled odds ratios for cognitive impairment/dementia between normal and abnormal dipping patterns. Secondary outcomes were pooled mean Mini-Mental State Exam score among normal and abnormal dipping patterns, and pooled mean nocturnal dipping percentage among study participants with normal and low cognitive function.

Results:

When compared to normal dippers, reverse dippers have the strongest association with cognitive impairment/dementia (OR 5.56, 95%-CI 2.39–13.0, p = 0.0016) followed by non-dippers (OR 2.49, 95%-CI 1.39–4.45, p = 0.006). Association between extreme dippers and cognitive impairment/dementia was not statistically significant (OR 2.70 (95%-CI 0.80–9.12, p = 0.0904). The pooled mean Mini-Mental State Exam score among the non-dippers (26.8, 95%-CI 20.2 – 33.5) were lower than the normal dippers (27.4, 95%-CI 23.1–31.6). The standardized mean difference between the two groups was not significant (SMD -0.0694, 95%-CI -0.4998–0.361, p = 0.677). The pooled mean nocturnal dipping percentage among study participants with low cognitive function was (8.24%, 95%-CI 5.21–11.3) less than study participants with normal cognitive function (11.5%, 95%-CI 8.83–14.1). Similarly, the standard mean difference of mean nocturnal dipping percentage between the two groups was not significant (SMD -0.934, 95%-CI -2.053–0.186, p = 0.0906).

Conclusions:

Abnormal nocturnal dipping pattern may be a risk factor for cognitive impairment/dementia. Multiple included studies with cross-sectional data sets precludes drawing valid causal inference between dipping pattern and cognitive impairment.
FEATURES OF THE PARAMETERS OF RED BLOOD CELLS AND HEMOSTASIS IN PATIENTS WITH STROKES ASSOCIATED WITH CORONAVIRUS INFECTION
Authors: Kruchinina Margarita Vitali , Gromov Andrey Alexandro , Generalov Vladimir Mikhail , Rabko Anna Vladimirovn
Published: June 2022

Objective:

The purpose is to identify the peculiarities of the parameters of red blood cells (RBC) and hemostasis in patients with strokes associated with coronavirus infection.

Design and method:

A total of 124 patients (48.5 + 1.9 years) with impairments of cerebral circulation due to COVID-19 (confirmed by positive PCR test) had been examined. Among them, 74 patients had ischemic stroke, 25– transient ischaemic attack, 17– intracerebral hemorrhage, 8– subarachnoid hemorrhage. The parameters of hemostasis were measured by standard methods, electrical, viscoelastic parameters of RBC - by dielectrophoresis.

Results:

71 patients (the 1st group) showed signs of intravascular coagulation and thrombosis: accelerated platelet-leukocyte aggregation, increased levels of coagulation products, reduced fibrinolysis activity (p = 0.001–0.04). The levels of D-dimer, fibrinogen, ESR, platelet count were higher in this group compared to the second one (p < 0.01). A moderate increase of RBC summarized rigidity, viscosity was noted. The level of RBC hemolysis was associated with platelet count (r = 0.735,p = 0.03), D-dimer (r = 0.482, p < 0.05), fibrinogen level (r = 0.374, p = 0.04).

In 2nd group (53 persons), the markers of thrombosis had moderate deviations. Sharply reduced RBC deformability with increased summarized rigidity, viscosity was dominant coupled with the background of high electrical conductivity of cell membranes compared to the indicators in the 1st group (p < 0.01). There was a decrease of membrane capacity, surface charge, cell dipole moment, polarizability than those in the 1st group (p = 0.0001–0.05). A sharp decrease of RBC deformability creates obstacles to overcoming small-diameter capillaries, leading to violations of microcirculatory blood flow.

RBC deformability was associated with levels of ferritin (r = 0.451, p = 0.02), HbA1c (r = 0.480, p = 0.03), uric acid (r = -0.371, p < 0.05), LDL cholesterol (r = 0.461, p = 0.02).

Incubation of blood samples in vitro for 10 min with riboflavin, nicotinamide, inosine, which ensures RBC energy metabolism, restored the reduced RBC deformability (p < 0.01), altered cell morphology (p = 0.04), decreased RBC aggregation (p < 0.001).

Conclusions:

The revealed features of parameters of RBC hemostasis in stroke patients with coronavirus infection are associated with two independent pathogenetic mechanisms: thrombotic and hemorheologic. The thrombotic variant is due to procoagulant state and an activity of inflammation. The hemorheologic variant is caused by decrease of RBC energy metabolism, activity of enzymes.
RELATIONSHIP BETWEEN BODY FAT DISTRIBUTION AND BONE MINERAL CONTENT IN CHINESE ADOLESCENTS
Authors: Zhou Jinyu , Bai Ling , Tong Lingling , Ding Wenqing
Published: June 2022

Objective:

The aim of this study is to analyze the relationship between body fat distribution and bone mineral content (BMC), and gender difference among Chinese adolescents.

Design and method:

A total of 1575 adolescents aged 12–18 were randomly selected in China by stratified cluster sampling. BMC and body fat distribution indexes, included fat mass (FM), appendicular fat mass (AFM), and trunk fat mass (TFM), were measured by Bioelectrical Impedance Analysis (BIA).

Results:

Except for limb to total fat ratio (LTFR), girls’ FM, AFM, TFM, trunk to total fat ratio (TrTFR) and trunk to limb fat ratio (TrLFR) were higher than boys (P values < 0.05). There was a statistically significant negative correlation between LTFR and BMC (boys: r = -0.630, girls: r = -0.351), while other indexes were positively correlated with BMC (all P values < 0.05). Regression analysis revealed that the higher BMC in the fourth tertile of TrTFR was 34.23 (17.49, 67.00) times versus that of the control group in boys. Similarly, the higher BMC in the fourth tertile of TrLFR was 45.09 (5.84,348.38) times than that in the control group in girls (P value < 0.05).

Conclusions:

There are gender differences in the distribution of body fat in Chinese adolescents. And during this period, higher central fat mass has a positive effect on the accumulation of BMC.
EARLY LIFE BLOOD PRESSURE TRAJECTORIES AND SUBCLINICAL VASCULAR DAMAGE IN MIDLIFE: A 30-YEAR PROSPECTIVE COHORT STUDY
Authors: Wang Yang , Mu Jian-Jun , Chu Chao , Hu Gui-Lin , Liao Yue-Yuan , Yan Rui-Chen , Du Ming-Fei , Zou Ting , Chen Chen , Ma Qiong , Wang Dan , Wang Ke-Ke , Sun Yue
Published: June 2022

Objective:

To describe the trajectory of BP across a 30-year span and evaluate its association with carotid intima–media thickness (CIMT) and brachial-ankle pulse wave velocity (baPWV) by middle age.

Design and method:

4623 participants aged 6–18 years, recruited from the ongoing cohort of Hanzhong Adolescent Hypertension study, a total of 2780 subjects were followed up for 6 visits over 30 years, and 1925 participants with complete CIMT and baPWV data were used for final analyses. Systolic and diastolic BP trajectories were identified by latent mixture modeling.

Results:

We identified 5 distinct systolic BP (SBP) trajectories as: “low-stable” (n = 512, 26.6%), “moderate-stable” (n = 993, 51.6%), “high-stable” (n = 229, 11.9%), “moderate-increasing” (n = 152, 7.9%) and “high-increasing” (n = 39, 2.0%). The levels of CIMT and baPWV were linearly increased from low stable- to high-increasing SBP trajectories. A total of 85 individuals and 425 participants developed high CIMT and high baPWV by 2017, respectively. Compared with the low-stable SBP trajectory group, the high-increasing group had increasingly greater odds of high CIMT by middle age in the full adjustment [OR = 5.04(1.76–14.44)]. Such association was observed in diastolic BP trajectories [OR = 3.61(1.11–11.70)].

Conclusions:

BP trajectories derived from childhood to middle age vary, and higher BP trajectories were associated with an increased risk of subclinical vascular damage in middle age. Monitoring trajectories of BP from childhood may help identify a high cardiovascular risk population in early life.
CENTRAL BLOOD PRESSURE MEASUREMENT IN CHILDREN AND ADOLESCENTS: SYSTEMATIC REVIEW
Authors: Prapa Sofia , Ntineri Angeliki , Kollias Anastasios , Menti Ariadni , Theodosiadi Aikaterini , Stergiou George S.
Published: June 2022

Objective:

Central aortic blood pressure (BP) has attracted the researchers interest due to its potential to improving cardiovascular risk stratification. We reviewed the published data on central BP in children and adolescents excluding those with chronic heart, lung or kidney disease, congenital anomaly or syndrome, malignancy, and acute illness.

Design and method:

A systematic review of literature based on PubMed database was conducted by two independent researchers up to January 2021 in accordance with the PRISMA guidelines. Additional studies were identified from the reference lists of relevant articles.

Results:

A total of 56 eligible articles were identified (Table). The available literature advocates a positive association between male gender, age, height, African-American descent, preterm birth, hypertension and diabetes with central BP, whereas the association of birth weight and physical exercise with central BP was inverse. Regarding the relationship of central BP with indices of preclinical target organ damage, 11 studies showed a positive association with pulse wave velocity, 7 with left ventricular mass index, 5 with carotid intima-media thickness, and 4 with augmentation index. Two studies reported an inverse association with the equivalent of the central retinal artery. The studies testing non-invasive techniques for central BP estimation reported that they approach the invasive technique with adequate accuracy, with crucial impact of the calibration method. Tonometry remains the most studied non-invasive measurement method, followed by oscillometry. Two studies provided normalcy values using the oscillometric method. The evidence on 24-hour ambulatory central BP is limited.

Conclusions:

The evidence on central BP measurement in youth is limited and derived from non-invasive evaluation in static conditions using tonometry. Central BP in children and adolescents seems to be affected by multiple factors and is associated with preclinical target organ damage.
THE IMPORTANCE OF THE SYMPTOMS FOR DIAGNOSING AND TREATING OF HYPERTENSION IN CHILDREN, ADOLESCENTS AND YOUNG-AGED, ASSESSED WITH APPLANATION TONOMETRY
Authors: Paterno Carlos Alberto
Published: June 2022

Objective:

The aim is to know if the presence of symptoms in children, adolescents, and young-aged are important for early diagnosis and therapy of hypertension.

Design and method:

For this cross-sectional study was entered 180 children, adolescents, and young-aged, female 96 -male 84 (F-M), divided into 3 groups of age: from 5 years to 12, from 13 to 18, and from 19 to 22 years. Principally, patients consulted for the presence of symptoms. During the anamnesis, several symptoms were registered, such as headache, palpitations, thoracic pain, breathlessness, sweating, asthenia, and mental confusion. Was entered the anthropomorphic measures, systolic and diastolic blood pressure (S-DBP), heart rate, central hemodynamics parameters (CHP), and difference of augmentation index (Diff AIx) between observed values and normal levels, evaluated with applanation tonometry (Sphygmocor-PVX AtCor-Medical Australia) according to standards methods.

Results:

In F-M, S-DBP increased from 1 group (104.3/66.9–109.1/67.7 mmHg) to 2 group (117.5/71.5–120.4/72.0 mmHg). Into the 3 group (117.9/73.0–126.6/77.8 mmHg) a slight increase was observed (normal values according to JHypertens 2019). Similar changes occur in CHP, but central aortic pressure and pulse pressure were higher than normal, both sexes. The Diff-AIx (surrogate value of arterial stiffness), was measured only in the 3 group and results were higher than normal, both sexes. High prevalence of headache was observed among female 69%-76% and male 53%-47% in the 2-3 groups, respectively, and high percentage of palpitations too, among female 66%-64% and male 47%-41% in the 2-3 groups, respectively. Also, was observed thoracic pain, dyspnoea, sweating, and asthenia whose prevalence increases with age. Few cases of mental confusion were more prevalent in females (7%-7%) in the 2-3 group. Patients in therapy with Angiotensin Receptors Blocker were registered female 31%-38% and male 40%-47% into the 2-3 group, respectively. All the patients treated improved the symptoms since the first month.

Conclusions:

In the diagnosis of Hypertension in children, adolescents, and young-aged it is very important the evaluation of symptoms and assesses them by applanation tonometry to know the optimal time of therapy to more early age with the objective of preventing future complications.
WHAT IS THE MEANING OF FINDING A WANDERING ATRIAL RHYTHM?
Authors: Paterno Carlos Alberto
Published: June 2022

Objective:

To know if the presence of a Wandering Atrial Rhythm (WAR), from childhood, is a pathophysiological condition that should be interpreted as an early sign of hypertension.

Design and method:

For this cross-sectional retrospective study, data were collected from 251 patients with episodes of WAR, registered during 24hs-Holter monitoring. Female-male (F-M) 126–125 mean age (SD) 56 (18.4) - 52 (18.3) from 6 to 89 years. Some patients were unaware of having hypertension, others with and without antihypertensive therapy. Was registered the anthropomorphic measures, systolic and diastolic blood pressure (S-DBP), heart rate, Central Haemodynamics Parameters, and difference of augmentation index (Diff-AIx) between observed values and normal levels, evaluated by applanation tonometry according to established protocols (SphygmoCor System-PVX AtCor-Medical Australia).

Results:

In the sample of males who were overweight from the 30 s, in females overweight/obese from the 40 s. In this study, the average of S-DBP before 20 years was registered in F-M 113.9/69–113.9/67.9 mmHg, and from 20 years to octogenarians in F-M was 140/82.5–136.8/84.2 mmHg. Among the groups of the F-M from 40–20 years, the average BP was higher than 120/80 mmHg. In all groups, the Central Haemodynamics Parameters (principally end-systolic pressure) and Diff-AIx (surrogate value of arterial stiffness) were higher than normal. A minimal mitral regurgitation was found in a female-male 38%-33.6% after 18–11 years, and brief phases of atrial fibrillation were found in 23%-19.2% from 35–48 years, respectively.

Conclusions:

Wandering Atrial Rhythm appearance is more early in life than minimal mitral regurgitation, it was observed during life even in octogenarians, which is correlated with an increase of S-DBP and Central Haemodynamics Parameters, and the frequent presence of atrial fibrillation. It could be interpreted as an early sign of hypertension from childhood.
MAJOR ADVERSE EVENTS WITH THE USE OF FINERENONE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A META-ANALYSIS OF CARDIOVASCULAR OUTCOME TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Sviggou Asimina , Kordalis Vasilios , Aidinis Asterios , Imprialos Konstantinos , Stavropoulos Konstantinos , Karagiannis Asterios , Papadopoulos Christodoulos , Doumas Michael
Published: June 2022

Objective:

Type 2 diabetes mellitus (T2DM) is recognized as the main cause of chronic kidney disease (CKD) and end-stage renal disease worldwide, carrying enormous human and financial costs. Mineralocorticoid receptor antagonists (MRAs) have been shown to decrease proteinuria and albuminuria, posing a favorable effect against the progression of CKD. Recently, we welcomed the publication of two large randomized controlled trials (RCTs), namely FIGARO-DKD and FIDELIO-DKD, addressing the cardio-renal efficacy of finerenone, a newer MRA, in patients with T2DM. Herein we sought to assess major adverse events with the use of finerenone in patients with T2DM.

Design and method:

We pooled data from the two relevant, published RCTs with finerenone in patients with T2DM, to provide pooled effect estimates for its cardio-renal efficacy and safety. We utilized data from published reports, also searching relevant supplementary appendices for any missing data. We assessed the following safety outcomes: acute kidney injury (AKI), hospitalization due to AKI, hyperkalemia, hospitalization due to hyperkalemia, all-cause death, hospitalization for any cause

Results:

We demonstrated that finerenone increased the risk for hyperkalemia by two times compared to placebo (RR = 2.03, 95% CI; 1.82–2.26, I2 = 0%, p < 0.00001), while it also significantly increased the risk for hospitalization due to hyperkalemia (RR = 5.86, 95% CI; 2.99 – 11.47, I2 = 0%, p < 0.00001). We have also documented that finerenone did not significantly affect the risk for development of AKI (p = 0.94) or hospitalization in the context of AKI (p = 0.92). In addition, finerenone resulted in a marginally non-significant reduction in the risk for all-cause death, equal to 10% (p = 0.05).

Conclusions:

Finerenone appears to provide significant cardiovascular and renal benefits for patients with T2DM. However, extra caution is required, since hyperkalemia appears to be the most important side effect with the use of finerenone, representing also the main cause of hospitalization due to a drug side effect. Large-scale use of potassium-binding drugs, such as patiromer or zirconium, as adjunct to finerenone might be a reasonable treatment combination in high-risk patients for hyperkalemia.
THE STATE OF ELASTIC PROPERTIES OF ARTERIES IN PATIENTS WITH CHRONIC PANCREATITIS IN COMBINATION WITH ARTERIAL HYPERTENSION
Authors: Kryvoshei Volodymyr , Filippova Aleksandra
Published: June 2022

Objective:

Arterial stiffness is considered to be an independent predictor of cardiovascular events. Factors associated with increased arterial stiffness in patients with hypertension continue to be actively studied. The aim of this study was to determine whether the presence of chronic pancreatitis is associated with arterial stiffness in patients with hypertension.

Design and method:

110 patients aged 45–65 years with chronic pancreatitis were examined. The first group consisted of patients with a combined course of chronic pancreatitis with arterial hypertension; the second group - patients with chronic pancreatitis without concomitant hypertension. All patients were examined for blood lipids. Arterial stiffness was determined by the pulse wave velocity.

Results:

The level of brachial artery augmentation index was significantly lower by 43% in patients with chronic pancreatitis in combination with arterial hypertension, while the aortic augmentation index was significantly higher by 37.6% (p < 0.01). It was found that patients of the 1st group had a significantly higher pulse wave velocity in the carotid-femoral segment in comparison with 2nd group - 9.3 [8.5;9.7] and 8.6 [8.1;8.9] respectively (p < 0.01). Significant correlations have been established between the brachial artery augmentation index and age, total cholesterol, atherogenic ratio, high and low density lipoprotein cholesterol, triglycerides, cardiovascular risk level by the SCORE scale – r = 0.39; p < 0.01; r = 0.31; p < 0.01 r = 0.34; p < 0.01; r = 0.36; p < 0.01; r = 0.42; p < 0.01; r = 0.43; p < 0.01; r = 0.36; p < 0.01 respectively.

Conclusions:

The presence of chronic panreatitis is associated with increased arterial stiffness in patients with hypertension.
GENETIC DETERMINANTS OF ACTIVATED FACTOR VII-ANTITHROMBIN COMPLEX (FVIIA-AT) PLASMA LEVELS AND MORTALITY IN PATIENTS WITH ANGIOGRAPHICALLY DEMONSTRATED CORONARY ARTERY DISEASE
Authors: Pizzolo Francesca , Veneri Mariangela , Sartori Filippo , Osti Nicola , Donini Martino , Moruzzi Sara , Mazzi Filippo , Castagna Annalisa , Udali Silvia , Pattini Patrizia , Lunghi Barbara , Baroni Marcello , Bernardi Francesco , Olivieri Oliviero , Friso Simonetta , Martinelli Nicola
Published: June 2022

Objective:

Plasma concentration of activated factor VII (FVIIa)-antithrombin (AT) complex is considered as a marker of interaction between tissue factor (TF) and FVIIa. Data on possible genetic determinants of FVIIa-AT plasma levels are scarce until now. In this observational study we assessed 7 gene polymorphisms within 4 potential candidate genes, i.e. TF, coagulation factor 7 (F7), endothelial protein C receptor (EPCR), and LDL-receptor related protein 1 (LRP1) genes, which may contribute to the modulation of TF/FVIIa pathway.

Design and method:

Within the frame of Verona Heart Study and we selected 610 subjects (478 CAD and

132 CAD-free) for whom DNA for genotype analysis and FVIIa - ATplasma levels were available. Genotyping of TF (-603 A>G and + 5466 A>G), F7 (-402 G>A, -323 A1/A2 and R353Q), EPCR (219 A>G), and LRP1 (25 C>G) polymorphisms was performed on all the subjects. Patients with acute coronary syndromes and those taking anticoagulant drugs at enrolment were excluded.

Results:

TF -603 G>A, EPCR 219 A>G, and F7 -323 A1/A2 polymorphisms were predictors of FVIIa-AT plasma levels in adjusted linear regression models. Subjects carrying TF -603 A allele or EPCR 219 G allele had higher FVIIa-AT levels, while F7 A2 allele was associated with lower levels. Among the evaluated genotypes F7 -323 A1/A2 polymorphism was the strongest genetic determinant of FVIIa-AT variability and its association with FVIIa-AT levels was consistent with the influence on FVIIa levels. None of the polymorphisms had a different distribution between CAD and CAD-free subjects. In the follow-up analysis TF -603 G>A polymorphism was associated with mortality in CAD patients, with carriers of A allele having an increased risk of both total (sex and age-adjusted HR 1.93 with 95%CI 1.09–3.42) and cardiovascular mortality (sex and age-adjusted HR 2.54 with 95%CI 1.15–5.63), consistent with the higher FVIIa-AT levels.

Conclusions:

Polymorphisms in TF, EPCR, and F7 genes may contribute to the modulation of FVIIa-AT plasma levels. Results on the different genotypes suggest that the mechanisms originating the increase of FVIIa-AT plasma concentration may have a key role in CAD prognosis, addressing the interest on TF pathway.