bluuebunny/crossref_metadata_2025_split huggingface dataset:
P55 Remote Ischaemic Preconditioning Reduces Cardiac Biomarkers During Vascular Surgery
Authors: Kepler Teele , Kuusik Karl , Lepner Urmas , Starkopf Joel , Zilmer Mihkel , Eha Jaan , Paapstel Kaido , Kals Jaak 
Published: March 2020

Abstract
Objectives
The primary aim of this study was to evaluate the effects of remote ischaemic preconditioning (RIPC) on preventing the leakage of cardiac damage biomarkers in patients undergoing vascular surgery.

Methods
Randomised, sham-controlled, double-blinded, single-centre study has been carried out. In recruitment patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were enrolled non-consecutively. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A RIPC or a sham procedure was performed noninvasively at the same time as the patient was prepared for anaesthesia. High sensitivity troponin T level was measured preoperatively as well as 2, 8 and 24 hours after surgery and pro b-type natriuretic peptide was measured preoperatively and 24 hours after surgery.

Results
There was significantly higher leakage of high sensitivity troponin T (peak change median 2 ng/L, IQR 0.9–6.2 ng/L vs 0.6 ng/L, IQR 0.7–2.1 ng/L, p = 0.0002) and pro b-type natriuretic peptide (change median 144 pg/mL, IQR 17–318 pg/mL vs 51 pg/mL, IQR 12–196 pg/mL, p = 0.02) in the sham group compared to the RIPC group.

Conclusion
RIPC reduces the leakage of high sensitivity troponin T and pro b-type natriuretic peptide. Therefore, it may reduce cardiac damage in patients undergoing non-cardiac vascular surgery. The clinical significance of RIPC has to be evaluated in larger studies excluding the factors known to influence its effect.
P57 In Patients with Chronic Descending Aorta Dissection the Maximum Systolic Flow Deceleration Rate in the False Lumen is Associated with Aortic Dilatation: a 4D-flow MRI Study
Authors: Guala Andrea , Ruiz-Muñoz Aroa , Duz-Santoy Lydia , Teixido-Tura Gisela , Granato Chiara , Sao-Aviles Augusto , La Mura Lucia , Lopez-Sainz Angela , Servato Maria Luz , Evangelista Arturo , Ferreira Ignacio , Rodriguez-Palomares Jose 
Published: March 2020

Abstract
Background
Aortic type B dissection is a life-threating condition in which blood flows between aortic wall layers. Despite a role for morphological variables, such as entry tear location and dimension, in the prediction of progressive false lumen (FL) dilation has been suggested, the role of flow characteristics has not been studied due to the unavailability of proper flow descriptions. Now that 4D phase-contrast magnetic resonance imaging (4D-flow MRI) allows for the evaluation of flow field with unprecedented detail, we tested whether flow deceleration in the FL, being a marker of occluded flow exit, is related to FL dilation.

Methods
In 29 patients with a patent FL and with a retrospective CT-based follow-up >3 years underwent 4D-flow MRI. Flow acceleration in the FL was calculated in a standardized sub-volume of the descending aorta. The maximum systolic flow deceleration rate (MSDR) was quantified as maximum minus minimum acceleration during systole divided by the corresponding time interval (Figure 1a).

Results
Demographic and clinical variables were similar among growth-rate (GR) tertiles. MSDR was statistically different in patients with a GR <1 mm/year (group 1) compared to fast-dilating patients (groups 2, 3) (Figure 1c). MSDR showed a positive linear correlation with GR (R = 0.48; p = 0.008) (Figure 1b).

Conclusion
The intensity of flow deceleration in the FL of chronic type B dissection is related to its retrospective growth rate. If confirmed in prospective studies, this marker may be useful to discriminate aorta enlargement and identify high-risk patients.
P60 Invasive Validation of Antares, a New Algorithm to Calculate Central Blood Pressure from Oscillometric Upper Arm Pulse Waves
Authors: Doerr Marcus , Richter Stefan , Eckert Siegfried , Ohlow Marc-Alexander , Hammer Fabian , Hummel Astrid , Dornberger Vivien , Genzel Elisabeth , Baulmann Johannes 
Published: March 2020

Abstract
Background
Antares is an algorithm for pulse wave analysis (PWA) by oscillometric blood pressure monitors in order to estimate central (aortic) blood pressure (cBP). Antares aims to enable brachial cuff-based blood pressure (BP) monitors to be type II-devices, determining absolute cBP values independently of potential peripheral BP inaccuracies. The present study is an invasive validation of the Antares algorithm.

Methods
We followed entirely the 2017 ARTERY protocol for validation of non-invasive cBP devices, the 2013 ANSI/AAMI/ ISO 81060-2 and 2018 AAMI/ESH/ISO validation standard protocols. In total, 191 patients undergoing cardiac catheterization were included, of which 145 patients entered analysis. Invasive cBP recordings were prospectively compared to simultaneous non-invasive cBP estimations using Antares, integrated into an oscillometric BP monitor. Antares analyses pulse waves during deflation of the cuff (patent of Redwave Medical GmbH). Generally speaking, pulse waves of a normal oscillometric BP measurement are taken for PWA with no need for altering standard BP pump operation.

Results
Mean difference between invasive and non-invasively estimated systolic cBP was 0.71 mmHg with standard deviation of 5.95 mmHg, fulfilling the highest validation criteria. Bland-Altman plot reveals good limits of agreement.

Conclusion
Antares is the first algorithm for estimation of cBP that entirely fulfills the 2017 ARTERY and AAMI/ESH/ISO validation protocols including criteria for high accuracy devices. The Antares algorithm turns the oscillometric upper arm blood pressure monitor into a type II-device for estimation of true cBP. Integration of Antares into BP monitors could enable the measurement of PWA parameters in virtually every practice in future.
P65 A Beat-to-Beat Quality Indicator Based on Piecewise Spatiotemporal Estimates of Carotid Pulse Wave Velocity Improves Correlation with Pulse Pressure
Authors: Beutel Fabian , Chris Van Hoof , Hermeling Evelien 
Published: March 2020

Abstract
Background
Local carotid pulse wave velocity (PWV) estimation is challenging due to a complex anatomy and associated wave reflections [1]. Wave interference is both blood pressure (BP) and position dependent, hence causing nonlinearity in the spatiotemporal PWV estimation [2]. In lack of beat-to-beat quality assessment [3], we propose a method to quantify this nonlinearity and thereby introduce a quality indicator (QI) for reliable PWV estimation.

Methodology
Carotid artery ultrasound (Vantage64, VerasonicsInc., USA) was acquired from 10 subjects (38 ± 10 years) in six repeated measurements. Simultaneously, ECG (ECG100C, BIOPACInc., USA) and noninvasive BP (NOVA, FinapresMedicalSystems B.V., NL) were recorded. Signals were processed into distension waveforms to extract systolic foot (SF) and dicrotic notch (DN) fiducials [4]. Beat-to-beat PWV estimates at SF (PWVSF) and DN (PWVDN) were obtained via spatiotemporal fitting of respective fiducial timings against transducer element distances. The proposed nonlinearity QI was quantified as standard deviation of the error between full-length PWV estimate and piecewise PWV estimates from the proximal, middle and distal subset of transducer elements. Linear regression was performed between independent pulse pressure (PP, in 2 [mmHg] intervals) and dependent PWV (means of all estimates) to validate QI according to Bramwell-Hill [5].

Results
When qualifying PWV estimates with QI ≤1 [m/s] we observed a significant R2 increase for both PWVSF (0.22 to 0.41, with decreased RMSE from 0.47 to 0.42 [m/s]) and PWVDN (0.21 to 0.53, although with constant RMSE of 0.32 [m/s]) as shown in annexed figure.

Conclusion
The proposed beat-to-beat QI accounts for significant variability in the PWV-PP relation, albeit at substantial data reduction. Therefore, the QI may facilitate real-time quality assessment towards reliable local PWV estimation. The unexplained variability remainder requires further investigations for confounding variables.
P69 The Initial Upstroke Time is Most Strongly Associated with the Severity of as Among Brachial Pulse Wave Parameters
Authors: Takahashi Masao , Fukatani Kyohei , Kabutoya Tomoyuki , Hoshide Satoshi , Yoneyama Tatsuya , Ito Tetsuya , Kario Kazuomi 
Published: March 2020

Abstract
Background
Aortic valve stenosis (AS) is the most common valve disease in an elderly population, therefore, simple screening examination for AS is needed. Although a prolonged carotid upstroke time (UT), and prolonged ejection time (ET) of a brachial pulse wave (BPW) have been observed in severe AS patients, it has been unclear which BPW parameters have a better correlation with the severity of AS. The aim of this study was to examine which BPW parameters are most relevant to the severity of AS.

Methods
Sixty-five Consecutive moderate and severe AS patients who were evaluated by trans-thoracic echocardiography were enrolled in this study. Control patients who were adjusted for age, gender, and blood pressure among outpatients were enrolled (N = 110). UT, ET, initial upstroke time (iUT), and half rise time of upstroke (1/2 hrUT) were evaluated correlations between mean pressure gradient (mPG) among AS patients.

Results
iUT and 1/2 hrUT have significant correlations with mPG among AS patients (iUT: R = 0.50, 95% CI = 0.29–0.67, p < 0.0001; 1/2 hrUT: R = 0.41, 95% CI = 0.19–0.60, p < 0.001), whereas UT and ET did not. Multivariate logistic regression analysis showed area under curve (AUC) of iUT and 1/2 hrUT were higher than UT and ET to predict mPG >40 mmHg (AUC: iUT vs 1/2 hrUT vs UT vs ET = 0.90 vs 0.89 vs 0.69 vs 0.77).

Conclusion
The severity of AS appeared strongly in the first half of the BPW upstroke. iUT and 1/2 hrUT may be a simple and useful screening test to assess the severity of AS.
P71 The Interrelationship Between the Alteration of Arterial Markers and Left Ventricular Diastolic Dysfunction in Metabolic Syndrome Subjects
Authors: Solovjova Svetlana , Ryliskyte Ligita , Celutkiene Jelena , Badariene Jolita , Laucevicius Aleksandras 
Published: March 2020

AbstractWe aimed to determine how the alteration of arterial stiffness (AS) affects the dynamics of left ventricular (LV) diastolic dysfunction (DD) in metabolic syndrome (MetS) subjects during longitudinal observation (3.8 ± 0.6 years).
Methods
A follow-up study was carried out in 573 (53.4 ± 5.8 years, 211 men [36.8%]) MetS subjects without overt atherosclerotic disease. Carotid-to-femoral pulse wave velocity (cfPWV), augmentation index (AIxHR75), mean aortic pressure (mAP), central pulse pressure(cPP) were assessed by applanation tonometry. Diastolic function (LVDF) was defined according to the 2016ESC Guidelines for diagnosis of acute and chronic heart failure.

Results
Depending on the LVDD dynamics analysis focused on the comparison of arterial markers in 2 subgroups (Figure 1): GRI (LVDD improved: 22%, n = 126) and GRIII (LVDF worsened: 19.2%, n = 110). After 3 years in both groups (all p < 0.05): decreased HR (GRI 66.27 ± 10.09 to 62.15 ± 8.86 b/min; GRIII 65.17 ± 9.41 to 62.07 ± 8.51 b/min) and mAP (GRI 107.60 ± 10.89 to 100.48 ± 16.55 mmHg; GRIII 104.07 ± 10.94 to 99.73 ± 13.17 mmHg). cfPWV and AIx significantly increased only in GRIII (cfPWV: 8.25 ± 1.36 to 8.68 ± 1.73 m/s; AIx 23.16 ± 9.94 to 25.16 ± 10.08%). These results confirm, that the negative dynamics of LVDF is associated with the progression of the arterial stiffening. For more accurate evaluation of the relationship between alterations of AS indices and the dynamics of LVDD the conditional random forests analysis was performed. Random forests analysis demonstrated that cfPWV, BMI, weight had prognostic significance for the worsening of LVDF.

Conclusion
In conclusion, the increase of cfPWV and AIx are significantly associated with negative dynamics of LVDF. In MetS subjects progression in arterial stiffening, assessed as an increase in cfPWV, significantly predicts the worsening of the LVDF. Our findings suggest that increased arterial stiffness is a pathogenetic factor of LVDD.
P77 Long-term Effects of LDL Apheresis on Carotid Arterial Atherosclerosis in Two Severe Heterozygous Familial Hypercholesterolemic Patients
Authors: Diószegi Ágnes , Juhász Lilla , Nádró Bíborka , Paragh György , Oláh László , Páll Dénes , Balla József , Harangi Mariann 
Published: March 2020

AbstractThe long-term effects of low-density lipoprotein (LDL) apheresis (LA) on the progression and regression of atherosclerosis were evaluated by carotid ultrasonography in two severe heterozygous familial hypercholesterolemic patients with carotid artery stenosis. Furthermore, the lipid-lowering efficacy of LA was evaluated. A 63-year-old male and a 64-year-old female patient have been followed for severe heterozygous FH, being treated by LA for 5 years continuously, at 4-week intervals, added on a standard high-dose statin and ezetimibe therapy. The regular LA treatment significantly decreased the levels of total cholesterol (by −58.1 and −53.8%) and LDL-C (by −69 and −66%), while the HDL-C levels did not change significantly. The time-averaged LDL-C (TAL) levels were also significantly decreased (by 20.8 and 30.1%). Still, we could not achieve the 1.8 mmol/L LDL-C goal values (average TAL levels were 4.1 and 5.1 mmol/L). Carotid ultrasonography was performed in every 6 months; internal carotid arteries (ICA) and common carotid arteries (CCA) were evaluated on both sides. Although during the 5-year follow-up we found a progression in the left ICA of the male patient (from 20% to 45%), all the other parameters showed the slow up of the atherogenesis in the studied arteries. The results suggest that monthly LA-treatment can significantly delay the progression of the atherosclerotic process in FH patients, however, it is not adequate to stop progression in every case because of TAL levels exceeding the LDL-C goal value. LA treatment twice a month or PCSK9 inhibitor therapy should be considered to further lower LDL-C.
P79 Non-invasive Estimation of Central Pressures in Abdominal Aortic Aneurysm Patients and Changes in PWV After EVAR
Authors: Holewijn Suzanne , van de Velde Lennart , Vermeulen Jenske , Reijnen Michel 
Published: March 2020

Abstract
Background
Abdominal aortic aneurysm (AAA) disease is mainly treated by endovascular aneurysm repair (EVAR) and PWV has been shown to increase after EVAR. Arterial stiffness is predictive of cardiovascular disease, but has not been investigated in AAA-patients. We investigated if central pressures (CP) can be estimated correctly in AAA-patients and changes over time in pulse wave velocity (PWV), since PWV-changes during follow-up are currently unknown.

Methods
Non-invasive (SphygmoCor) and invasive waveform recordings were performed simultaneously before and after EVAR. A generalized ascending-to-abdominal aorta transfer function (GTFAA) was used to estimate CP from the invasively measured abdominal aorta pressure-waveform, and compared to the non-invasively estimated CP. Changes in PWV were evaluated compared to baseline (6-weeks and 1-year).

Results
The mean difference between invasive and non-invasive central systolic pressure was −11.5 mmHg (limits-of-agreement: −63.5; 40.6) before and 0.03 (−33.5; 33.6) after implant. For central diastolic and mean pressure mean difference was −12.2 (−39.3; 14.8) and −9.6 (−45.3; 26.1), respectively. Median (IQR) PWV was 10.5 (9.2; 13.2) at baseline, 10.5 (10.1; 12.4) at discharge, 11.5 (10.6; 12.9) at 6 weeks, and 11.3 (9.9; 13.0) at 1 year follow-up without significant differences over time. Increases in CP were equal to peripheral pressure increases.

Conclusion
Synthesizing CP with non-invasive measurements in combination with the use of a GTFAA in patients with AAA is feasible especially after EVAR. No changes over time in PWV were observed. Current ongoing analyses include evaluation by prosthesis type, wave type, and influence of intra-luminal thrombus (NCT01220245).
P83 Effect of Aging on the Aortic Reservoir and Excess Pressure in Normal Humans
Authors: Yamakado Tetsu , Ko Hideyoshi 
Published: March 2020

Abstract
Background
Reservoir pressure analysis has been newly introduced to analyze arterial waveform and function. There are few data regarding the effect of aging on the aortic reservoir and excess pressures in normal humans.

Objectives and Methods
To investigate this issue, we analyzed high-fidelity aortic pressures, measured by a catheter-tipped manometer in 81 normal subjects who underwent diagnostic cardiac catheterization but proved to have normal coronary artery and LV function. Subjects who had hypertension, diabetes, renal disease or dyslipidemia were excluded. There were 57 men and 24 women, ranging in age from 21 to 80 years. We analyzed the entire AoP and calculated the reservoir pressure (Pr) and the excess pressure (Pex) according to the method by Aguado-Sierra et al., and augmented pressure (AP) was obtained as well.

Results
Systolic AoP and pulse pressure (PP) were significantly increased with age. Pr (amplitude) and Pex (amplitude) were 38.2 ± 6.3 mmHg and 17.8 ± 4.2 mmHg, respectively. Both Pr and Pex showed significant age-related change (Pr: r = 0.40, p < 0.001, Pex: r = 0.26, p < 0.05). Age-related increase in PP or AP was more strongly correlated with the Pr (r = 0.88 and 0.90, both p < 0.001) than the Pex (r = 0.56 and 0.35, both p < 0.001).

Conclusion
We documented the aortic Pr and Pex in normal humans. The Pr and Pex were both roughly but significantly correlated with aging at least until the ninth decade, while the Pr contributes more to age-related change in PP and AP than the Pex. These data may provide reference data about an arterial function in normal and pathological conditions.
P87 Ultra–high Frequency Ultrasound Assessment in Vascular Ehlers Danlos Syndrome: a Validation and Reproducibility Study
Authors: Bruno Rosa Maria , Alexopoulou Magdalini , Khettab Hakim , Jeunemaitre Xavier , Boutouyrie Pierre 
Published: March 2020

Abstract
Background
In patients with Vascular Ehlers-Danlos syndrome (vEDS), an abnormally low carotid intima-media thickness (CIMT) may increase the risk of arterial dissection and rupture. Thus its accurate assessment by ultra–high frequency ultrasound (UHFUS), thanks to its higher spatial resolution, may be clinically relevant.

Aim
To assess the feasibility and reproducibility of carotid parameters, assessed by UHFUS in vESD patients, and to evaluate the agreement with the gold standard technique, echotracking by radiofrequency.

Methods
16 vEDS patients were recruited (6 women, 40 ± 11 years, BP 115 ± 6/62 ± 6 mmHg). Common carotid parameters were assessed by echotracking (Esaote, Artlab software) and UHFUS (VevoMD, Visualsonics; CVSuite software, Quipu srl), to evaluate agreement. The coefficient of variation between two consecutive clips was computed. The results were compared to those of 16 age-, sex- and BP-matched healthy individuals.

Results
In all 16 patients the acquisition and automated analysis of carotid clips was feasible. Correlation between echotracking and UHFUS was satisfactory (diameter r = 0.63, p = 0.001; CIMT r = 0.65, p = 0.006; distension r = 0.84, p < 0.001). Bland-Altman plots showed a good agreement between the two techniques, with a non significant bias either for diameter [110 μm (−184; 404)] or CIMT [27 μm (−10; 75)]. Intra-operator coefficient of variation was 3.26% (diameter), 7.11% (CIMT) and 5.65% (distension). vEDS patients had reduced CIMT (419 ± 85 vs 522 ± 97 μm, p = 0.004) and distension (453 ± 150 vs 613 ± 176 μm, p = 0.01) than controls and tended to have a reduced diameter (6558 ± 525 vs 6945 ± 653 μm, p = 0.08), while carotid-femoral pulse wave velocity was similar (7.38 ± 1.08 vs 7.46 ± 1.396 m/s, p = 0.78).

Conclusion
UHFUS is feasible, accurate and reproducible for the evaluation of carotid parameters in vEDS.
P90 Indexing Left Ventricular Mass to Body Size: Which Method is the Most Appropriate in Early Adulthood?
Authors: Taylor Hannah , Park Chloe , Fraser Abigail , Howe Laura , Ferreira Dianna , Timpson Nic , Lawlor Debbie , Davey-Smith George , Chaturvedi Nishi , Hughes Alun 
Published: March 2020

Abstract
Introduction
Left ventricular mass (LVM) predicts cardiovascular risk. In early life, LVM is conventionally indexed to height 2.7 [1], although this may not account for sex differences in growth. We investigated allometric scaling of LVM to height, lean mass (LM) and body surface area (BSA) in a UK birth cohort.

Methods
861 individuals underwent echocardiography to assess LVM at age 17.7 (SD 0.3) years and 24.0 (SD 0.6) years. LM was quantified using dual-energy X-ray absorptiometry. Group and sex-specific allometric relationships were determined by linear regression, following log transformation of x and y variables (log(y) = a + b* log(x)) (b = scaling exponent).

Results
LVM showed a linear relationship with LM and log(height), although the intercepts differed by sex. At age 17, the exponent relating LVM to height in males and females combined was 2.67 (95% CI: 2.41, 2.91), very close to the suggestion of height 2.7. Sex-specific estimates for height were lower and close to the estimate of 1.7 [2], at 1.77 (1.17, 2.37) and 1.83 (1.35, 2.31), for males and females, respectively. The female exponent at age 24 remained close to 1.7, while the male exponent increased to 2.14 (1.54, 2.73). Exponents for LM and BSA remained similar between ages 17 and 24 (see Table 1 for detail).

Conclusion
A universal approach for allometric indexing of LVM may be inappropriate in early adulthood, and indexation may need to be both age- and gender-specific. It remains unclear which indexing method is superior at these ages, although height may be unsuitable. These observations may have important implications for identifying young individuals with cardiac hypertrophy.

Table 1

Height
Lean
BSA

n
Coefficient (+ 95% CI)
p
n
Coefficient (+ 95% CI)
p
n
Coefficient (+ 95% CI)
p

Age 17
Group
861
2.67 (2.41, 2.91)
<0.001
861
0.85 (0.80, 0.91)
<0.001
861
1.76 (1.64, 1.88)
<0.001

Male
333
1.77 (1.17, 2.37)
<0.001
333
1.18 (1.00, 1.36)
<0.001
333
1.69 (1.45, 1.93)
<0.001

Female
528
1.83 (1.35, 2.31)
<0.001
528
1.10 (0.96, 1.24)
<0.001
528
1.36 (1.20, 1.53)
<0.001

Age 24
Group
861
2.97 (2.70, 3.23)
<0.001
861
1.07 (1.01, 1.13)
<0.001
861
1.78 (1.66, 1.90)
<0.001

Male
333
2.14 (1.54, 2.73)
<0.001
333
1.20 (1.05, 1.35)
<0.001
333
1.60 (1.36, 1.84)
<0.001

Female
528
1.65 (1.11, 2.19)
<0.001
528
1.10 (0.98, 1.23)
<0.001
528
1.32 (1.15, 1.50)
<0.001
P92 The Association of Agreeableness and Conscientiousness with 24-Hour Brachial Blood Pressure and Hemodynamic Parameters in Untreated Hypertensive Patients
Authors: Vecsey-Nagy Milán , Kőrösi Beáta , Batta Dóra , Gonda Xénia , Rihmer Zoltán , Nemcsik-Bencze Zsófia , László Andrea , Nemcsik János 
Published: March 2020

Abstract
Background
There is growing evidence that Five Factor Model personality traits (extraversion agreeableness, conscientiousness, neuroticism, and openness) have an impact on cardiovascular (CV) risk. The aim of our study was to evaluate their associations with 24-hour brachial and central hemodynamic parameters and arterial stiffness in untreated patients who were studied because of elevated office blood pressure.

Methods
Mobil-O-Graph was used to measure the 24-hour brachial and central parameters. The Big Five Dimensions were evaluated with the BFI questionnaire. 68 patients were involved into the study (45 men).

Results
Agreeableness was inversely associated with nighttime brachial systolic blood pressure (r = −0.255, p = 0.036), with 24-hour heart rate (r = −0.243, p = 0.046), with 24-hour cardiac output (r = −0.314, p = 0.009) and with daytime cardiac output (r = −0.341, p = 0.004). Conscientiousness was inversely associated with 24-hour heart rate (r = −0.276, p = 0.023) and daytime heart rate (r = −0.283, p = 0.019).

Conclusion
In conclusions, agreeableness and conscientiousness can have an impact on 24-hour hemodynamic parameters in untreated hypertensive patients.