bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence of jet-induced optical microvariability in radio-loud narrow-line Seyfert 1 galaxies
Authors: Ojha Vineet , Jha Vivek Kumar , Chand Hum , Singh Veeresh
Published: June 2022

To quantify the role of radio jets for Intra-Night Optical Variability (INOV) in radio-loud narrow-line Seyfert 1 (RLNLSy1) galaxies, we report the first systematic comparative INOV study of 23 RLNLSy1 galaxies, with 15 RLNLSy1s having confirmed detection of jets (jetted) and the remaining 8 RLNLSy1s having no detection of jets (non-jetted) based on their Very Long Baseline Array observations. We have monitored these two samples, respectively, in 37 and 16 sessions of a minimum 3-h duration each. Based upon Fη-test at 99 per cent confidence level with a typical INOV amplitude (ψ) detection threshold of >3 per cent, we find the INOV duty cycles (DC) of 12 per cent for the sample of jetted RLNLSy1s, however, none of the sources showed INOV in the sample of non-jetted RLNLSy1s. Among the jetted RLNLSy1s, we find that the DC for jetted γ-ray detected (γ-ray) RLNLSy1s is found to be 34 per cent in contrast to null INOV detection in the case of non-γ-ray RLNLSy1s. It suggests that instead of the mere presence of a jet, relativistic beaming plays a significant role for INOV in the case of low-luminous high accreting AGNs, such as NLSy1s, in which dilution of the AGN’s non-thermal optical emission by the (much steadier) optical emission contributed by the nuclear accretion disc is quite likely. Our study of jetted γ-ray RLNLSy1s shows more frequent INOV detection for sources with higher apparent jet speed. Further, our results also suggest that among the NLSy1s, only jetted γ-ray RNLSy1 galaxies DC approach blazar-like DC.
Identifying clinically applicable machine learning algorithms for glioma segmentation: recent advances and discoveries
Authors: Tillmanns Niklas , Lum Avery E , Cassinelli Gabriel , Merkaj Sara , Verma Tej , Zeevi Tal , Staib Lawrence , Subramanian Harry , Bahar Ryan C , Brim Waverly , Lost Jan , Jekel Leon , Brackett Alexandria , Payabvash Sam , Ikuta Ichiro , Lin MingDe , Bousabarah Khaled , Johnson Michele H , Cui Jin , Malhotra Ajay , Omuro Antonio , Turowski Bernd , Aboian Mariam S
Published: June 2022

Background

While there are innumerable machine learning (ML) research algorithms used for segmentation of gliomas, there is yet to be a US FDA cleared product. The aim of this study is to explore the systemic limitations of research algorithms that have prevented translation from concept to product by a review of the current research literature.

Methods

We performed a systematic literature review on 4 databases. Of 11 727 articles, 58 articles met the inclusion criteria and were used for data extraction and screening using TRIPOD.

Results

We found that while many articles were published on ML-based glioma segmentation and report high accuracy results, there were substantial limitations in the methods and results portions of the papers that result in difficulty reproducing the methods and translation into clinical practice.

Conclusions

In addition, we identified that more than a third of the articles used the same publicly available BRaTS and TCIA datasets and are responsible for the majority of patient data on which ML algorithms were trained, which leads to limited generalizability and potential for overfitting and bias.
IMPACT OF ARTERIAL HYPERTENSION VERSUS AGING TO THE STRUCTURES OF EPICARDIAC NERVES IN SPONTANEOUSLY HYPERTENSIVE RATS
Authors: Ranceviene Dalia , Azukaite Joana , Rysevaite-Kyguoliene Kristina , Pauziene Neringa
Published: June 2022

Objective:

To detect changes of epicardiac nerves due to arterial hypertension along with aging.

Design and method:

12 Spontaneously hypertensive rats (SHR) and 9 Wistar-Kyoto rats (WKY) were examined in the following age groups (weeks): juvenile (8–9), adult (12–16), and old (46–47). Neural structures of transverse ventricular cryosections were stained immunohistochemically for protein gene product 9.5 (PGP9.5 – general neuronal marker) and calcitonin gene-related peptide (CGRP – potent vasodilator). The stained neural structures and total cross-section area of epicardiac nerves were measured, and the area stained with each neuromarker was expressed as a percentage. Results were described as means (standard error) and compared by the Mann-Whitney test, p-value < 0.05.

Results:

In the juvenile group, the area stained by PGP9.5 did not differ between WKY and SHR nerves. However, the area of PGP9.5 was 12.0% smaller in the adult SHR than in the adult WKY. Furthermore, the PGP9.5 area was 5.7% larger in the old SHR than in the old WKY group. On the other hand, the distribution of CGRP remained similar between all age groups (Table 1).

Comparing WKY age groups, the PGP9.5 area tends to increase from juvenile to adult by 5.7% (p = 0.032) but decreases from adult to old by 17.5% (p = 0.000). In contrast, the PGP9.5 ratio in the SHR was highest in the juvenile group but decreased in the adult group by 5.5% (p = 0.008). The ratio between SHR adult and old groups did not differ significantly.

CGRP area tends to decrease during senility in both groups. In WKY, just like in SHR, the CGRP area did not differ between juveniles and adults but significantly decreased from adult to old by 41.8% (p = 0.000) and 40.0% (p = 0.005) correspondingly.

Conclusions:

In normotensive rats, neuronal structures stained by PGP9.5 tend to peak up in epicardiac nerves to adulthood and decrease during senility. At the same time, in hypertensive rats, neural components start to degenerate gradually from a young age up to old age. Vasodilator component ratio tends to decrease during senility only in normotensive and hypertensive groups.
PROGNOSTIC SIGNIFICANCE OF BLOOD PRESSURE PARAMETERS FOR PREDICTING CARDIOVASCULAR DEATH
Authors: Wang Weiting
Published: June 2022

Objective:

The nycterohemeral rhythm of blood pressure (BP) and heart rate has been associated with cardiovascular outcomes. However, long-term prognostic significance of BP at different levels of heart rates has rarely been studied. We therefore conducted the present analysis to investigate the prognostic values for cardiovascular outcome by the ambulatory BP parameters during different time windows

Design and method:

We enrolled 5 large cohorts from whole world, including CARDIA, IDACO, JHS, SPRINT to find out independent prognostic factors for cardiovascular disease mortality, feature engineering and feature transformation were used. Several statistical and machine learning methods including the stepwise procedure, lasso penalty, and random survival forest with bootstrap technique were used to screen important candidates of risk factors. Models building are based on systolic BP replacement into the established Framingham risk score. Directly one to one replacement and indirectly two stage replacement methods are considered with variable diversity. C-statistics, NRI are used for model performance evaluation.

Results:

In model building procedure, nighttime BP combined with pulse pressure, morning-evening difference of SBP and weighted SBP consistently had a higher C-statistics than had office systolic BP. In validation datasets, equations incorporating mean BP and pulse pressure had best performance in C-index (0.754). In contrast, the C-index (higher is better), of the usual Framingham risk score with office systolic BP are 0.744. Furthermore, the best model had acceptable predicted accuracy based on model calibration statistics (p > 0.05).

Conclusions:

Our study demonstrated that mean BP at night combined with pulse pressure, morning-evening difference of SBP and weighted SBP, throughout 24 hours had the largest predictive power of 20-year cardiovascular death in population with ABPM recordings. The transportability of the proposed cardiovascular risk function should be evaluated in future studies.
WHITE-COAT HYPERTENSION WITHOUT ORGAN DAMAGE: IMPACT OF LONG-TERM MORTALITY, NEW HYPERTENSION AND NEW ORGAN DAMAGE
Authors: Seravalle Gino , Facchetti Rita , Vanoli Jennifer , Dell’oro Raffaella , Grassi Guido , Mancia Giuseppe
Published: June 2022

Objective:

According to some guidelines white-coat hypertension (WCH) carries little or no increase of cardiovascular (CV) risk in absence of organ damage (OD) but no data are available on this issue.

Design and method:

Using the population data from Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA), we evaluated CV and total mortality over a median follow-up of 29 years in WCH (elevated office and normal 24-hour or home blood pressure, BP) and normotensive controls (N, normal in- and out-of-office BP) with no echocardiographic left ventricular hypertrophy and no reduction of estimated glomerular filtration rate. Analysis was extended to sustained hypertension (SH, in- and out-of-office BP elevation) and to N, WCH and SH with cardiac and renal OD.

Results:

During the 29 years follow-up there were in the 1423 subjects nalysed 165 CV and 526 all cause deaths. OD was detected in 10.6%, 30.5% and 43.8% of N, WCH and SH, respectively. After adjustment for confounders no-ODWCH exhibited a risk of fatal CV events lower than that of no-ODSH but greater than that of no-ODN (HR 2.0, 95% CI: 1.1–3.6, P = 0.02), this being the case also for all cause mortality. Compared with no-ODN, no-ODWCH also exhibited a greater 10 year adjusted risk to develop new SH or OD. Similar findings were obtained in N, WCH and SH with OD. The present study provides the first evidence that WCH with no cardiac and renal OD is accompanied by an increased long-term risk of mortality, new hypertension and new OD, thereby not representing a clinically innocent condition.

Conclusions:

The present study provides the first evidence that WCH with no cardiac and renal OD is accompanied by an increased long-term risk of mortality, new hypertension and new OD, thereby not representing a clinically innocent condition.
SIMPLE PREDICTIVE SCORE FOR NOCTURNAL HYPERTENSION AND MASKED NOCTURNAL HYPERTENSION USING HOME BLOOD PRESSURE MONITORING IN CLINICAL PRACTICE
Authors: Narita Keisuke , Hoshide Satoshi , Kario Kazuomi
Published: June 2022

Objective:

The decision whether to measure nighttime blood pressure (BP) is challenging because these values cannot be easily evaluated due to problems with measurement devices and related stress. Using the nationwide, practice-based Japan Morning Surge-Home BP Nocturnal BP study data, we developed a simple predictive score that physicians can use to diagnose nocturnal hypertension.

Design and method:

We divided 2,765 outpatients (mean age 63 years; hypertensives 92%) with cardiovascular risks who underwent morning, evening, and nighttime home BP (HBP) measurements (2:00, 3:00, and 4:00 a.m.) into a calibration group (n = 2,212) and validation group (n = 553). We used logistic-regression models in the calibration group to identify the predictive score for nocturnal hypertension (nighttime HBP > = 120/70 mmHg) and then evaluated the score's predictive ability in the validation group.

Results:

In the logistic-regression model, male sex, increased body mass index (BMI) (> = 25 kg/m2), diabetes, elevated urine-albumin creatinine ratio (UACR) (> = 30 mg/g Cr), elevated office BP (> = 140/90 mmHg), and elevated morning and evening HBP (> = 135/85 mmHg) had positive relationships with nocturnal hypertension. The predictive scores for nocturnal hypertension were 1-point (male, BMI, diabetes, and UACR); 2-points (office BP > = 140/90 mmHg); 3-points (evening HBP > = 135/85 mmHg); 4-points (morning HBP > = 135/85 mmHg); total 13 points. Over 80% of the nocturnal hypertension cases in the validation group showed > = 10-points (AUC = 0.705, 95%CI: 0.661–0.748). We also developed a score for masked nocturnal hypertension, i.e., nocturnal hypertension despite controlled daytime HBP.

Conclusions:

We developed a simple predictive score for nocturnal hypertension that can be used in clinical settings and for diagnoses.
ARM BASED ON LEG BLOOD PRESSURES (ABLE-BP): CAN SYSTOLIC LEG BLOOD PRESSURE MEASUREMENTS PREDICT BRACHIAL BLOOD PRESSURE? AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS
Authors: McDonagh Sinead , Sheppard James , Warren Fiona , Boddy Kate , Farmer Leon , Shore Helen , Williams Phil , Lewis Philip , Fordham A Jayne , Martin Una , Aboyans Victor , Clark Christopher
Published: June 2022

Objective:

Hypertension is diagnosed and managed using brachial blood pressures; accurate measurement can be impeded by several temporary or permanent factors, including fractures, presence of vascular access devices, limb deformities and altered muscle tone after stroke. Leg (ankle) blood pressure measurement is a practical alternative, but limited data exist to guide clinicians’ interpretation of leg blood pressure values for hypertension diagnosis and treatment.

Design and method:

Individual participant data meta-analyses were undertaken, using data from 14 studies within the international inter-arm blood pressure difference individual participant data (INTERPRESS-IPD) Collaboration, to 1) determine the relationship between arm and leg systolic blood pressure, 2) develop and validate a multivariable model predicting arm from leg systolic blood pressure, and 3) investigate the prognostic association between leg systolic blood pressure and cardiovascular disease and mortality.

Results:

Arm and leg systolic blood pressure data existed for 33,710 individuals (mean age: 58 years, mean arm systolic/diastolic blood pressure at baseline: 138/80 mmHg, 45% female). Mean leg systolic blood pressure was 12.0 (95% CI, 8.8 to 15.2) mmHg higher than arm systolic blood pressure. The multivariable model derived to predict highest arm from highest leg systolic blood pressure demonstrated excellent performance (area under receiver operating characteristic curves, sensitivity and specificity remained above 0.89, 0.80 and 0.81, respectively, across blood pressure thresholds from 160 to 130 mmHg). Lowest leg systolic blood pressure was a predictor of all-cause mortality and cardiovascular events over a 10-year period. Cardiovascular risk scores were similar for observed arm systolic blood pressure and the highest arm systolic blood pressure predicted from lowest leg systolic blood pressure [Atherosclerotic Cardiovascular Disease Score: 16.73% (12.65) vs 17.17% (12.61), Framingham Score: 19.33% (15.05) vs 19.91% (15.06)].

Conclusions:

These results provide a robust evidence-based method for describing the arm-leg systolic blood pressure relationship and estimating individual brachial systolic blood pressure and cardiovascular risk from leg blood pressure measurements using individual participant data. A freely available and easy-to-use web-based calculator has been created to support patients and clinicians in estimating equivalent arm blood pressure when only leg blood pressure measurements and patient characteristics are available.
SCREENING FOR ATRIAL FIBRILLATION WITH ROUTINE AUTOMATED BLOOD PRESSURE MEASUREMENT IN THE ELDERLY: THE NATIONAL HEALTH SURVEY EMENO IN GREECE
Authors: Stergiou George S. , Menti Ariadni , Kalpourtzi Natasa , Gavana Magda , Vantarakis Apostolos , Chlouverakis Gregory , Hadjichristodoulou Christos , Trypsianis Gregory , Voulgari Paraskevi , Alamanos Yannis , Karakosta Argiro , Touloumi Giota
Published: June 2022

Objective:

Atrial fibrillation (AF) is the most common sustained arrhythmia which often is asymptomatic and undiagnosed. An automated blood pressure (BP) monitor with an algorithm which detects atrial fibrillation with high diagnostic accuracy during routine measurement was used for AF screening in the elderly general population Greece.

Design and method:

EMENO health survey (2013 to 2016) applied a multi-stage stratified random sampling method to select a random sample of the general adult (> = 18 years) population of Greece. For participants aged > = 65 years screening for AF was performed with triplicate automated BP measurements using a validated automated upper-arm cuff oscillometric device with embedded algorithm for detecting AF (Microlife BPA100 Plus AFIB).

Results:

A total of 1,838 individuals aged > = 65 years were recruited and 975 with AF data on at least 1 BP measurement were analysed (mean [SD] age 75.3 (6.6)) years, men 45.1%, BMI 30.3 (5.2) kg/m2, hypertensives 80.7%). Of them, 65 (7.1%) had AF detected in all their 3 BP readings (AF group), 661 (69.5%) have no AF in all 3 readings (no AF group), and 249 (23.4%) had AF in 1 or 2 readings (uncertain AF group). Participants with AF were older than non-AF (by 3.4 years on average, p < 0.001), had lower systolic BP (by 4.6 mmHg, p < 0.05), and more frequent cardiovascular disease (29% vs 14%, p < 0.01). Among AF patients, 43% reported a previous AF diagnosis compared to 8.8% and 11.9% in no AF and uncertain AF group respectively (p < 0.001). Hypertension tended to be more common in the AF than the non-AF group (88% vs. 80%, p = NS). Of the 65 AF group, 57% were undiagnosed and all required anticoagulant therapy (men with CHA2DS2-VASc > = 1 or women > = 2).

Conclusions:

Almost 7% of people aged > = 65 years in Greece had AF detected during routine automated BP measurement. 57% of them were undiagnosed and all required anticoagulant treatment for stroke prevention. Screening for AF using routing automated BP measurement in the elderly appears to be a useful method for early detection and management of asymptomatic AF.
ACUTE CORONARY SYNDROMES DURING PREGNANCY AND POST-PARTUM IN FRANCE, THE NATIONWIDE CONCEPTION STUDY
Authors: Blacher Jacques , Lailler Gregory , Gabet Amélie , Grave Clémence , Regnault Nolwenn , Deneux-Tharaux Catherine , Kretz Sandrine , Tsatsaris Vassilis , Plu-Bureau Geneviève , Olié Valérie
Published: June 2022

Objective:

Very different estimated incidences have been reported concerning pregnancy-related acute coronary syndrome (ACS). The objective of our study was to assess the incidence of ACS during pregnancy, peripartum and postpartum, to compare it with the incidence of ACS in non-pregnant women of childbearing age and to study characteristics associated with pregnancy-related ACS.

Design and method:

All women without ischemic heart disease who delivered between 2010 and 2018 in France were included in the CONCEPTION cohort. We used Poisson regression to estimate the crude incidence of ACS and age-adjusted Poisson models to estimate the incidence risk ratio (IRR) of ACS in pregnant versus nonpregnant women, with 95% confidence interval (CI).

Results:

Among 6 298 967 pregnancies in France, 225 experienced a first ever ACS. The global ACS incidence in women giving birth was 4.34 per 100 000 person-years, stable between 2010 and 2018 (1 ACS every 23 000 pregnancies). Compared with nonpregnant women, age-adjusted incidence rates of ACS were lower during pregnancy IRR: 0.76 (95%CI: 0.57–0.98) (p < 0.05). In a multivariate analysis, independent factors associated with ACS were age, social deprivation (OR = 1.91 (1.42–2.58)), obesity (OR = 1.73 (1.13–2.65)), tobacco use (OR = 3.43 (2.55–4.61)) (Table). The risk of ACS associated with chronic hypertension and hypertensive disorders of pregnancy was 4.5 (2.90–6.95) and 2.09 (1.43–3.06) respectively.

Conclusions:

Global incidence of pregancy-related ACS was 4.34 per 100 000 person-years. The pregnancy-related ACS incidence was 24% lower than the ACS incidence in age-adjusted non-pregnant women. More efforts should be made in terms of prevention, considering the frequency of treatable cardiovascular risk factors such as tobacco use and hypertensive disorders of pregnancy.
MICROCIRCULATION AND SARS-COV-2 INFECTION: A FOLLOW UP STUDY
Authors: Malerba Paolo , Rosei Claudia Agabiti , Chiarini Giulia , Nardin Matteo , Petelca Alina , Gaggero Andrea , Lemoli Matteo , Famà Francesca , Boari Gianluca Edoardo , Baresi Mattia , Bondioli Nicolò , Porteri Enzo , Paini Anna , Salvetti Massimo , Muiesan Maria Lorenza , Rizzoni Damiano , De Ciuceis Carolina
Published: June 2022

Objective:

SARS-CoV2 infection can lead to several clinical scenarios, named COVID-19, ranging from mild manifestations to acute respiratory distress syndrome (ARDS), coagulation alterations and endothelial dysfunction. The functional impairment of the microcirculation seems play a key role in the pathophysiology and clinical consequences of COVID-19. However, to date there is no evidence of structural microvascular damage related to COVID-19.

Design and method:

The aim of this study is to investigate microvascular alterations by adaptive optics and vide-ocapillaroscopy in patients recently admitted for COVID-19 and re-evaluated one year later.

Methods: We enrolled 153 patients admitted between February and April 2020 at the Hospital of Montichiari (Brescia) and at the Internal Medicine Department of ASST Spedali Civili - University of Brescia for respiratory failure due to SARS-CoV2-related interstitial pneumonia. Patients were evaluated two months after nalysedsation and after one year. All patients underwent a venous blood sampling for hematochemical tests, evaluation of retinal arteriolar morphology by adaptive optics, assessment of basal and total capillary density (BCD and TCD respectively) at the dorsum of the fourth finger of the non-dominant hand by videocapillaroscopy.

Results:

Fifty patients with completed follow-up were nalysed. An increase of internal lumen (93.8 ± 13.3 vs. 97.3 ± 14.2 micron, p < 0.001) and a reduction of wall to lumen ratio (WLR 0.30 ± 0.03 vs. 0.27 ± 0.03, p < 0.001) were observed at the follow up visit after one year (Figure). No significant differences were observed in BCD in the dorsum of the finger after one year, whereas a significant reduction in TCD was observed (p < 0.001). Microvascular changes were independent of body mass index and the presence of hypertension or diabetes mellitus.

Conclusions:

Preliminary data from this study show that patients with SARS-Cov2 infection present an improvement of microvascular structure after one year from the disease, such as a reduction in WLR of retinal arterioles. This suggests that COVID19 might induce structural alterations in the microcirculation which contribute to vascular damage. These changes do not seem to be influenced by the weight, presence of hypertension or diabetes.
EFFECT OF THE COVID-19 PANDEMIC ON THE NYCHTHEMERAL BLOOD PRESSURE PROFILE
Authors: Nzokou Daryl Tcheutchoua , van de Borne Phillipe , Chaumont Martin
Published: June 2022

Objective:

The world is currently facing the fourth wave of the COVID-19 pandemic. The purpose of this study was to assess the effect of this pandemic on ambulatory blood pressure measurements and to compare the blood pressure profile between COVID-19 positive and negative patients.

Design and method:

We performed a unicentric, retrospective study on the register of ambulatory blood pressure measurements (ABPM) of the ERASME Hospital from 2010 to 2021. ABPMs performed during the pandemic period (January 2020 to October 2021) were compared with those from 5 previous control periods. In order to improve the comparison of the different periods, we considered variations (delta) of each period from the previous 3 months. For all patients whose ABPM was performed during the COVID-19 period, we looked for COVID test results preceding the ABPM. These patients were classified into 2 groups COVID positive, if at least one PCR or serological test was positive, and COVID negative if not. Data analysis was performed using SPSS version 23.0.

Results:

After exclusion of incomplete and poor-quality ABPMs, 18766 were retained, of which 1796 (9.57%) were for the COVID-19 period. The control periods represented 14.77% to 18.81% of the MAPAs in the study. We observed that diurnal, nocturnal and 24-hour diastolic blood pressures (BP) were higher in the COVID-19 period than in the previous 5 periods ranging from January 2010 to October 2019. Pulse pressure was lower in the COVID-19 period compared to the previous periods. Of the 1796 patients in the COVID-19 period, pre-ABPM COVID-19 status were obtained from 368 patients, 322 negatives and 46 positives. In COVID-19 positive patients, daytime systolic BP was higher than in COVID-19 negative patients (88,41 ± 11,74 vs 84,63 ± 12,24; p = 0.047). Also, the pulse pressure of COVID-19 positive patients was lower (44,46 ± 7,72 vs 47,57 ± 8,84). No significant differences were observed between the two groups for the other parameters.

Conclusions:

The COVID-19 pandemic resulted in increased daytime and night-time diastolic blood pressures. Also, this study suggests an increase in diurnal diastolic blood pressure after COVID-19 infection.
COMPARATIVE TRANSCRIPTOMIC ANALYSIS IDENTIFIES EPITHELIAL-MESENCHYMAL TRANSITION AND INFLAMMATION AS COMMON PATHOGENETIC MECHANISMS IN HYPERTENSIVE AND DIABETIC NEPHROPATHY
Authors: Nordb⊘ Ole Petter , Landolt Lea , Eikrem Øystein , Scherer Andreas , Leh Sabine , Palmer Jessica Furriol , Apeland Terje , Mydel Piotr , Marti Hans-Peter
Published: June 2022

Objective:

Type 2 diabetic (T2DN) and hypertensive nephrosclerosis (HN) are the main causes of chronic kidney disease (CKD). To obtain novel insights into pathogenetic mechanisms, potentially suggesting common therapeutic procedures, we comparatively nalysed transcriptomes of kidney biopsies obtained from patients with T2DN or HN and control archived formalin-fixed and paraffin-embedded (FFPE) kidney biopsies.

Design and method:

FFPE kidney biopsies from adult patients were selected from the Norwegian Kidney Biopsy Registry. Specimens from patients with HN, T2DN and normal-appearing control renal biopsies (Ctrl) (n = 6 for each group) were assessed. Total RNA was extracted from 10 μm whole kidney sections and processed for RNA sequencing, while immunohistochemistry (IHC) was performed on 3-μm tissue sections. Enzyme-Linked ImmunoSorbent Assay (ELISA) targeting the AXL receptor tyrosine kinase was performed on serum from separate cohorts with HN and T2DN/T1DN.

Results:

Gene expression analysis showed 769 differentially expressed genes (DEG) for T2DN and 284 HN genes (log fold change > 1, adjusted P < 0.05). Only 39 of the HN genes were uniquely DEG compared to T2DN. Cluster analysis on the RNA seq data separated diseased and normal tissues, also with a distinct overlap between HN and T2DN profiles. Detailed analysis of gene expression profiles revealed upregulation of pathways related to partial epithelial to mesenchymal transition, including extracellular matrix organisation in both diseases. AXL and vimentin expression was also enhanced at the protein level in both HN and T2DN biopsies, as detected by immunohistochemistry (IHC). AXL abundance was also increased in serum from T2DN/T1DN and HN patients. Pathways related to inflammation was also overexpressed, particularly related to TH1 and TH2 helper cell pathways. The presence of CD4 and CD8 positive T- cells were confirmed by IHC.

Conclusions:

Similarities of T2DN and HN proteomes suggest common pathogenetic mechanisms and the possibility to envisage targeted treatments addressing both main causes of CKD.
HIDDEN CENTRAL HYPERTENSION AND SPURIOUS HYPERTENSION IN ELDERLY PEOPLE
Authors: Miserque Leila , Boscaro Marcelo , Kotliar Carol , Obrego Sebastian
Published: June 2022

Objective:

Determination of brachial systolic blood pressure (SBP-b) and central systolic blood pressure (SBP-c) in the elderly could contribute to their better management by the identification of hidden central hypertension (HCH) and spurious hypertension (SH).

Objectives: a) to analyse SBP-b and SBP-c relationship, b) to determine prevalence and phenotypes of HCH and SH, c) to evaluate antihypertensive treatment; d) to identify risk of orthostatic hypotension (OH).

Methods: We included patients older than 65 years old who consecutively consulted to the participating sites (2014–2019) retrospectively and accordingly to their previous hypertension diagnosis were classified as hypertensives or normotensives. Brachial and central blood pressure measurements allow us to identify four phenotypes: 1) normal SBP-b with high SBP-c, 2) high SBP-b with normal SBP-c, 3) both normal, 4) both high. Statistical: Student test, ANOVA, Chi2.

Design and method:

1595 subjects were recruited (female 47.8%, 70.9 ± 5.2 years); 66.6%(n:1063) hypertensive/33.3%(n:532) normotensives. We identified HCH in 7.9%(n:84), SH in 5.2%(n:55) in hypertensive group, compared with 10.7%(n:57) and 3.4%(n:18) respectively in normotensives. Elevated values of SBP-b were detected in 27.1% normotensives, although 10.7% had normal SBP-c. Table 1 shows the baseline and hemodynamic characteristics of general population according to phenotypes. No differences were found between different classes of antihypertensive drugs, but a higher number of medications was reported in SH. OH was identified in 35%, showing 48% of them SH.

Conclusion:

Hidden central hypertension was present in almost 5% of elderly people while spurious hypertension in 9%, similar in hypertensives and normotensives. Phenotypically HCH subjects were older, less active, with increase PWV and AIX, but with lower HR than those with SH, who showed higher CI, HR and SVR. As it was expected, our study results suggest that elderly people with HCH could be at risk of being sub-treated and inversely, those with SH could be over-treated. The OH prevalence in SH supports this latter issue. Finally, the measurement of SBP-c seems to be a useful clinical variable that could lead to a better management of blood pressure in the elderly.
ASSESSMENT OF STIFFNESS OF LARGE TO SMALL ARTERIES IN MULTI-STAGE RENAL DISEASE: A NUMERICAL STUDY
Authors: Obeid Hasan , Bikia Vasiliki , Fortier Catherine , Pare Mathilde , Segers Patrick , Stergiopulos Nikos , Agharazii Mohsen
Published: June 2022

Objective:

Arterial stiffness, as assessed via pulse wave velocity (PWV), is a major biomarker for risk assessment in patients with chronic kidney disease. However, the mechanisms responsible for the changes in PWV in the presence of kidney disease are not yet fully elucidated. In the present study, we aimed to investigate the direct effects attributable to biomechanical alterations to the arterial tree caused by renal disease progression on arterial stiffness, independent of any biochemical or compensatory effects.

Design and method:

Particularly, we used a previously validated one-dimensional (1-D) model of the cardiovascular system to simulate arterial pressure and flow at control with two kidneys (2KDN) and in arterial tree configurations representative of different stages of kidney disease, namely subject with a single functional kidney (1KDN), without any functional kidney (0KDN) and a transplant recipient (TX) with a single functional kidney re-attached to the external iliac artery. We evaluated the respective variations in blood pressure (BP), as well as arterial stiffness of large, medium, and small-sized vessels via carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV), and radial-digital PWV (rdPWV), respectively.

Results:

Our results showed that BP was increased in 1KDN and 0KDN, and that systolic BP values were restored in the TX configuration. Furthermore, a rise was reported in all PWVs for all tested configurations. The relative difference in stiffness from control to 0KDN was higher in the case of crPWV (+20 %); approximately twice the difference observed for cfPWV and rdPWV (+11 %). In TX, we observed a restoration of the PWVs to values close to 1KDN. Globally, it was demonstrated that alterations of the outflow boundaries to the renal arteries as occurring in different stages of renal disease lead to changes in blood pressure and central and peripheral PWV in line with previously reported clinical data.

Conclusions:

Our findings suggest that the PWV variations observed in clinical practice with renal disease progression may be partially attributed to biomechanical alterations of the arterial tree, and their effect on blood pressure.
PREVALENCE OF HYPERTENSION AND DISTRIBUTION OF BODY MASS INDEX LEVELS AMONG OLDER ADULTS WITH TYPE 2 DIABETES MELLITUS IN VIETNAM: A MULTICENTRE STUDY
Authors: Thanh Huan Nguyen , Trong Khang Ha Pham , Huu An Nguyen , Xuan Giao Nguyen Thi , My Hang Lam , Thanh Thu Nguyen , My Phuong Le Thi
Published: June 2022

Objective:

The coexistence of hypertension and diabetes can increase the risk of cardiovascular events. However, in Vietnam, little information is known about the clinical characteristics of older adults with type 2 diabetes mellitus (T2DM) and the prevalence of hypertension in these patients. This study aims to investigate the prevalence of hypertension and the distribution of body mass index (BMI) among older adults with T2DM in Vietnam.

Design and method:

This cross-sectional study was conducted among outpatients aged 60 years or over at five geriatric clinics from January 2019 to July 2020. The patients were diagnosed with T2DM and hypertension based on the recent clinical guidelines of the European Society of Cardiology. The BMI was stratified according to the guidelines set by the World Health Organization for the Asia-Pacific region.

Results:

The 1,296 patients with T2DM enrolled in this study had a mean age of 69.9 ± 7.3 years, an age range of 60–94 years, and a male predominance of 54.4%. The prevalence of hypertension was 82.5% (n = 1069). For the BMI, 4.5% (n = 58) were underweight, 39.4% (n = 510) were of normal weight, 24.2% (n = 314) were overweight, and 31.9% (n = 414) were obese. Obesity was more prevalent in men than in women (35.5% vs. 27.7%), and women presented a higher rate of having normal weight than men (45.0% vs. 34.6%). There was no statistically significant difference in the distribution of BMI between the hypertensive and non-hypertensive groups (Figure 1).

Conclusions:

The prevalence of hypertension among older adults with T2DM was high among the Vietnamese study participants (82.5%). The distribution of BMI levels was not different between the hypertensive and non-hypertensive groups but was significantly different between the males and females.
THE ACTION OF ANTIHYPERTENSIVES ON CENTRAL VESSEL STIFFNESS IN THE ELDERLY: A SUBSTUDY OF EVOUPIU (BRAZILIAN STUDY OF PULSE WAVE VELOCITY IN ELDERLY)
Authors: Ferreira Flávio , Freitas Erci , Souza Denis , Rodrigues Cléria , Rodrigues Cristiane , Prado Erick , Ferreira-Filho Sebastião
Published: June 2022

Objective:

Central arterial stiffness (CAS) is increased in the elderly, and its acceleration may be induced by systemic hypertension. The increased pulsatile pressure may promote damage to vital organs. Antihypertensive drugs can act on the CAS and decrease these patients’ cardiovascular risk. The present study aimed to compare the CAS of hypertensive elderly patients with different therapeutic schemes, using only two antihypertensive drugs: hydrochlorothiazide (HCTZ) as monotherapy or HCTZ associated with another class of antihypertensive drugs

Design and method:

This study is a cross-sectional analysis of elderly patients included in the data bank of EVOPIU. The data were extracted from the first medical consultation of the study. A total of 293 elderly hypertensive patients were separated into seven groups: those taking no antihypertensive medication (NAM, n = 47); hydrochlorothiazide alone (HCTZ, n = 25), HCTZ, and beta-blockers (n = 51); HCTZ and calcium channel blockers (n = 24); HCTZ and AII receptor blockers (n = 59); HCTZ and AII-converting enzyme inhibitors (n = 61); and HCTZ and spironolactone (HCTZ +SPIRO, n = 27). CAS was measured by femoral-carotid wave velocity (c-fPWV).

Results:

When compared to NAM patients, only the HCTZ + SPYRO group showed significantly lower values in c-fPWV (12.1 ± 0.44 vs. 10.5 ± 0.56 ms; P < 0.05, respectively), central pulse pressure (PP) augmentation index (Alx) (52.0 ± 1.9 vs. 45.6 ± 2.5 mmHg, P < 0.05), brachial PP (68.6 ± 2.1 vs. 61.5 ± 2.7 mmHg, P < 0.05). This group did not show higher serum potassium levels than the other groups studied.

Conclusions:

The results suggest that arterial stiffness in elderly patients may be, at least in part, caused by an effect of aldosterone on the arterial wall. CAS may be partially reversible with spironolactone. Its effect seems independent of observed effects on systemic arterial blood pressure.
EARLY VASCULAR AGEING IN PATIENTS WITH HYPOPARATHYROIDISM
Authors: Fabbri Saverio , Boutouyrie Pierre , Khettab Hakim , Maruani Gérard , Houillier Pascal , Bruno Rosa Maria
Published: June 2022

Objective:

Hypoparathyroidism may induce arterial damage, but underlying mechanisms are not well established. Few papers have addressed the topic, reporting an increase in central values and in carotid intima-media thickness [1][2]. The aim of this study was to determine the presence of early vascular ageing signs in large and small arteries.

Design and method:

17 patients affected by hypoparathyroidism and 17 healthy controls (matched for age, sex, blood pressure and risk factors) were studied to obtain carotid-femoral PWV, carotid and digital intima-media thickness and stiffness bystandard and ultta-high frequency ultrasound respectively. In the patients affected by hypoparathyroidism, complete calcium-phosphorus metabolism blood tests were taken.

Results:

carotid distensibility was significatively lower in the patients group (18,7 ± 6.0 vs 39,4 ± 10,5 (kPa at(-1)) p < 0.001), with a marked increase in carotid stiffness (7,6 ± 1,3 vs 5,3 ± 0,9 m/s, p < 0.001). No significant difference was reported in PWV and central pressure among the groups. A reduced digital artery diameter was present (mean diameter 0,8 ± 0,1 vs 1,0 ± 0,2 mm p = 0.005), with a reduced stiffness (5,6 ± 2,5 vs 9,2 ± 4,9 m/s p < 0.05). A positive correlation between carotid artery stiffness and Calcium – Phosphorus product was found in the patients group (r = 0.538 p = 0.031).

Conclusions:

Hypoparathyroidism is characterized by increased carotid artery stiffness. Digital stiffness (UFHS) is paradoxically reduced (possibly as compensatory mechanism), with hypotrophic emodelling. Our data support altered calcium-phosphorus metabolism as mechanism of arterial damage.
PREDICTING INDIVIDUAL RISK OF MUSCLE DISORDERS IN PATIENTS ELIGIBLE FOR STATIN TREATMENT: STRATIFY-STATINMD MODEL DERIVATION USING DATA FROM ELECTRONIC HEALTH RECORDS
Authors: Cai Ting , Koshiaris Constantinos , Hirst Jennifer A. , Hobbs F.D. Richard , McManus Richard J. , Sheppard James P.
Published: June 2022

Objective:

Concerns about muscle-related adverse events have posed a dilemma when considering statin prescription for prevention of cardiovascular disease (CVD). This study aimed to develop a prediction model for an individual’s risk of muscle disorders to support clinical decision making in primary care.

Design and method:

A prospective cohort design was adopted, using electronic health records from the Clinical Practice Research Datalink in the UK. Males aged over 50 and females aged over 60, who were potentially eligible for statin treatment based on their underlying CVD risk, were followed-up for ten years. The primary outcome was hospitalisation or death in those with a diagnosis of muscle disorders. The Fine-Gray proportional sub-distribution hazards model was fitted to address competing risk of death from other causes. Statin prescriptions within the 12 months before follow up and other predictors were included in the model based on a literature review.

Results:

The cohort included 1,785,207 patients, with a mean age of 64 and 44% females. Patients prescribed statins were predicted to have a higher risk of muscle disorders (atorvastatin: hazard ratio = 1.77 [95% confidence interval: 1.58 - 1.97]; rosuvastatin: 2.04 [1.58 - 2.63]; simvastatin: 1.58 [1.45 - 1.71]; other statins (fluvastatin/pravastatin): 1.38 [1.14 - 1.68]). Female sex, deprivation, smoking, obesity, frailty, liver or kidney disease, rheumatic arthritis, previous muscle problems, degenerative joint disorders, hypothyroidism, vitamin D or B12 deficiency, and the use of drugs that are potentially myotoxic or interact with statins also increased an individual’s risk (Table). An automated risk calculator was developed based on the model (Figure).

Conclusions:

This model uses routinely available patient characteristics and medical history to predict an individual’s risk of muscle disorders. The calculator may help clinicians and patients communicate the safety concerns and make shared decisions or monitoring strategies on statin treatment. External validation of this model is ongoing to support general application of the risk calculator in clinical practice.
IMBALANCE IN BONE MORPHOGENIC PROTEINS 2 AND 7 IS ASSOCIATED WITH HYPERTENSION AND ARTERIAL STIFFNESS IN CHRONIC KIDNEY DISEASE
Authors: Manzano-Lista Francisco J. , Sanz-Gómez Marta , González-Moreno Daniel , Vega-Martín Elena , Gil-Ortega Marta , Aránguez Isabel , Schulz Angela , Rubio Miguel Ángel , Ruiz-Hurtado Gema , Ruilope Luis M. , Kreutz Reinhold , Fernández-Alfonso María S.
Published: June 2022

Objective:

Patients with chronic kidney disease (CKD) exhibit an elevated cardiovascular risk from the early stages (I-III) with an exponentially increasing risk of cardiovascular death as kidney function worsens. The hypothesis of this study is that there is a imbalance in bone morphogenetic proteins BMP-2 (procalcifying) and BMP-7 (renoprotective) at early CKD stages associated with the development of hypertension, vascular stiffness and progressive kidney damage.

Design and method:

BMP-2 and BMP-7 levels were determined by ELISA in samples of CKD patients (stages I-III; n = 95) and of Munich Wistar Frömter (MWF) rats (22 weeks old; n = 6), a genetic model with spontaneous nondiabetic CKD, compared to age-matched Wistar rats.

Results:

Plasma BMP-2 levels were significantly higher in stage III CKD patients compared to controls. BMP-7 was, however, significantly lower at any stage of CKD compared to the control group with a significant further reduction in stage III patients. MWF rats presented significantly higher BMP-2 plasma levels compared to Wistar rats, whereas BMP-7 level was lower. The MWF strain showed an elevation of both systolic (SBP) and diastolic blood pressure (DBP), as well as pulse wave velocity (PWV) compared to the Wistar group. A positive correlation was observed between the BMP-2/BMP-7 ratio and SBP, DBP, and PWV, respectively. Plasma 25-OH cholecalciferol concentration was lower in MWF showing a negative correlation with the BMP-2/BMP-7 plasma ratio. Urinary albumin excretion (UAE), tubular damage markers, Kim-1 and Ngal, as well as renal BMP-2 were significantly higher in the MWF group compared to Wistar, whereas renal BMP-7 expression was significantly lower. A positive correlation was detected between the BMP-2/BMP-7 ratio and both the UAE and plasma creatinine level. Periaortic and mesenteric perivascular adipose tissue (PVAT) from MWF rats showed an altered expression of BMP-2, BMP-7, profibrotic and calcification markers.

Conclusions:

Our data show an imbalance in plasma, kidney and PVAT-derived BMP-2 and BMP-7 levels associated with hypertension and arterial stiffness. This might reflect a profibrotic/pro-calcifying propensity related with progressive CKD.
A SMART SENSING MODULE AIMS AT REDUCTION OF MOTION ARTIFACT FOR WEARABLE TONOMETRY BLOOD PRESSURE DEVICE
Authors: Liu Weiting , Zhu Tao , Xie Fuyuan , Zhan Binpeng , Xu Man
Published: June 2022

Objective:

This work focuses on development a unique mini sensing module to alleviate muscle action induced rtefacts and in the meanwhile to enable the alignment free capability for radial BP measurement.

Design and method:

The coupling variations from motion rtefacts tremendously distorts the sensing signal thus leads the measuring results unreliable and limits the applications of wearable blood pressure monitoring in daily life. It is key to have capability of sensing and recognizing the muscle action induced stress at the measuring site and then have the opportunity to eliminate misleading coupling variation. The mini sensing module consists of two independent sensing channels, which are neighboring distributed in parallel (Fig. 1). The channels are arranged enough close with the spacing only 2 mm in order to guarantee them sensing the same induced stress. The two channels have identical dimension feature with10 mm length and 3 mm width. And a 3 mm × 3 mm hard block is integrated into the middle segment of one channel. The channels are filled with degassed silicon oil and a silicon die is embedded and serves as pressure sensor unit. TPU flexible film is used to seal the channels, which serves also as the mechanical stimulation interface. The smart module is fixed to wrist with channel direction transversal to the arterial path during radial BP measuring. The blocked channel isolates completely (partly at least) stimulating from the vascular and serves as skin stress sensing reference, and the other sensing channel gets combination of the skin stress together with fully stimulating of vascular BP. It is straightforward that the difference two signal can partly at least eliminate the stress induced error, which also is presented in Fig.2. Further rtefacts reduction can be achieved by exploiting specific adaptive filtering algorithm with the blocked signal as disturbance input and the other as source.

Results:

Experiments have proved the effectiveness of the scheme.

Conclusions:

By comparison with the BP signal under optimal condition, the sensing module can provide with accurate BP pulse waves in the presence of motion interference.
VALIDITY CHECKING OF OSCILLOMETRIC AND AUSCULTATORY BLOOD PRESSURE MONITORING IN CLINICAL PRACTICE
Authors: Zhemanyuk Svitlana , Syvolap Vitaliy
Published: June 2022

Objective:

Ambulatory blood pressure monitoring (ABPM) is an out-of-office method of blood pressure (BP) measurement, that could detect pressure with oscillometric or auscultatory devices. According to the 2021 practice guideline, one of the principles of ABPM implementation in routine clinical practice is validity checking, which means result elimination in case of the insufficient number of readings. However, the prevalence of correct ABPM data is unclear in daily practice. The study aimed was to analyze the validation procedure of two algorithms of blood pressure detection (oscillometric and auscultatory).

Design and method:

We study ABPM patterns in sinus 242 patients (mean age, 62 [95% CI, 60–63] years, 57% men). The day-night period was determined as 24-hour clock-based definitions (nighttime: 01:00 to 05:59). Validity was verified by nalysing readings numbers in awake and night periods (not-valid: < 20 and < 7 readings, respectively). To compare groups, we used Mann-Whitney two-sample statistic (Stata 15).

Results:

The total number of non-valid readings was 19,8% (48/242) in oscillometric and 45,9% (111/242) auscultatory devices (p < 0,001).

Conclusions:

The oscillometric devices show better validity checking in daily practice compare to auscultatory. Approximately one-fifth of ABPM results in oscillometric devices have to be repeated due to non-valid readings in daily clinical practice.