bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telomere length and uric acid in patients with new cases of hypertension according to the 10-year prospective study in urban randomized population
Authors: Podpalova O , Kaliadka M , Babenka A , Mrochek A 
Published: November 2020

Abstract

Objective
To reveal the association between lymphocyte telomere length and serum uric acid level in 10-year prospective randomized study of Belarusian urban population.

Design and method
In 2007/2008 a 10-year prospective study of 3500 persons living in a district of a belarussian city and selected by the random number method started (coverage of the survey was 97.9%). In 2012/2013 according to the results of the second screening 2888 people were examined (coverage of the survey was 84.3%). A 10-year prospective analysis was provided in 2017/2018 and included 145 randomized subjects with hypertension diagnosed in the second screening. Examination of these patients consisted of standard cardiovascular risk factors questionnaires, measurements of blood pressure, blood chemistry, electrocardiography, echocardiography, ultrasound examination of brachiocephalic vessels, real time PCR for the detection of telomere length of peripheral blood lymphocytes.

Results
2171 persons with normal blood pressure and 1257 persons with hypertension were examined in 2007/2008. In the second screening we established 286 new cases of hypertension (14,4% of men and 12,2% of women). According to multifactorial regression analysis, adjusted for age and sex, a significant positive relationship between new cases of hypertension and IV quartile of uric acid level (339–527 μmol/l) was revealed in 5 years (df=1; χ2 Wald=5,1; p&lt;0,05). Regression analysis of 145 randomized subjects of 286 new cases of hypertension showed that, adjusted for age and sex, the IV quartile of uric acid level (339–527 μmol/l), determined in the first screening, was also associated with the I quartile of telomere length in 10 years (df=1; χ2 Wald=4,5; p&lt;0,05). It was investigated that the level of telomere length had a significant negative association with BMI (p&lt;0.05), R wave in aVL (p&lt;0.05), IL-6 level (p&lt;0,05) in these subjects in cross-sectional study in 2017/2018.

Conclusions
Regardless of age and sex, level of serum uric acid ≥339 μmol/l was a risk factor for development of hypertension in randomized population in 5-year prospective analysis and predicted lower telomere length in patients with new cases of hypertension in 10-year prospective analysis.

Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): State scientific and technical program “Medical and diagnostic technologies”, subprograms “Heart and blood vessels”
Prevalence, pattern and associated cardiovascular risk of t-wave inversion in hypertensive patients: a 5-year follow-up study
Authors: Kasiakogias A , Konstantinidis D , Dimitriadis K , Tatakis F , Zammanis I , Iliakis P , Kouremeti M , Papakonstantinou P , Thomopoulos C , Tsioufis P , Sideris S , Tousoulis D , Tsioufis C 
Published: November 2020

Abstract

Background
Data on prevalence and associated prognosis of repolarization abnormalities among hypertensive patients are limited.

Purpose
We investigated the presence and extent of ST-segment and T-wave changes in a hypertensive population and their predictive ability for cardiovascular disease.

Methods
We studied 1851 white Caucasian hypertensive patients (age 58±12 years, 51%females) without a history of cardiovascular disease for a mean period of 5.3±3.4 years. At the baseline examination, all patients underwent standard 12-lead electrocardiography. T-wave inversion (TWI) was defined as T-wave deflection ≥−0.1 mV in ≥2 contiguous leads,unless associated with bundle branch block. Anterior, lateral or inferior TWI was defined as TWIin leads V2-V4 or V5,V6, I, AVL or II, aVF respectively. Thedepth in millimeters of TWI in each lead was recorded and the maximum depth per location was calculated. ST depression was defined as ≥1mm in depth in two or more contiguous leads.During follow-up, patients underwent clinic visits at least yearly for management of hypertension and risk factors. The outcome studied was theincidence of cardiovascular morbidity set as the composite of non-fatal coronary artery disease and stroke.

Results
In the entire population, prevalence of TWI was 3.8%, of which 39% presented withanterior TWI, 73% withlateral TWI and 11% with inferior TWI. ST depression was observed in 3.6% of patients (anterior in 0.8%, inferior in 0.9% and lateral in 2.6%). Incidence of the composite endpoint during follow-up was 4%. Cox regression analysis revealed that presence of TWI was associated with a significantly greater risk for cardiovascular events (HR: 2.6, 95% CI: 1.1–5.9, p=0.025). The association was stronger for lateral TWI (HR: 3.3, 95%: CI: 1.34–8.30, p=0.01) compared to other locations. In multivariate models controlling for standard confounders these associations were overall sustained. Depth of TWI and presence of ST depression were not associated with cardiovascular risk.

Conclusions
Among hypertensive patients without cardiovascular disease, TWI is infrequent but significantly associated with future cardiovascular events.Lateral TWI carries the worse prognosis

Funding Acknowledgement
Type of funding source: None
Time in blood pressure range for different blood pressure targets and risk of cardiovascular disease: an analysis of a 7-year follow-up registry
Authors: Sideris K , Kasiakogias A , Konstantinidis D , Papakonstantinou P , Tatakis F , Kouremeti M , Tsioufis P , Anastasiou A , Leontsinis I , Manta E , Tousoulis D , Tsioufis C 
Published: November 2020

Abstract

Objective
Recent guideline recommendations have revisited the optimal target blood pressure (BP) for hypertensive patients. The Time in BP Range (TBPR) is an alternative metric for evaluation of long-term achieved BP. We investigated the association of TBPR for different levels of BP control with cardiovascular outcome among treated hypertensives.

Design and method
This is a retrospective analysis of 1202 treated hypertensive patients (age 59±11 years) without a history of cardiovascular disease followed for a mean period of 7±3 years. We calculated the TBPR [(No of Visits in BP range/ Total No of Visits) x 100%] for office systolic BP targets of 130–139mmHg, 120–129mmHg and &lt;120mmHg and examined the associated cardiovascular risk. The outcome studied was the composite of stroke and coronary artery disease. Time spent in systolic BP≥140mmHg served as the reference.

Results
In the entire population, mean TBPR for systolic BP 130–139mmHg, 120–129mmH, and &lt;120mmHg were 26%, 19% and 11% respectively. A TBPR of ≥50% for systolic BP 130–139mmHg, 120–129mmHg and &lt;120mmHg was observed in 332 (28%), 226 (19%) and 107 (9%) patients respectively. The composite endpoint occurred in 54 patients (4.5%). Patients with a TBPR for 120–140mmHg of ≥50% presented with a HR: 0.6 (95% CI: 0.34–1.06) for cardiovascular events. The TBPR of ≥50% for systolic BP 130–139mmHg, 120–129mmHg and &lt;120mmHg was associated with HR of 0.48 (95% CI: 0.23–1.01, p=0.05), 0.64 (95% CI: 0.29–1.39, p=0.26) and 0.72 (95% CI: 0.26–2.05) respectively. This pattern was sustained but further attenuated after controlling for standard risk factors. In comparison, a mean BP across visits of 130–139mmHg, 120–129mmHg and &lt;120mmHg was associated with a HR of 0.54 (5% CI: 0.28–1.03), 0.61 (95% CI: 0.29–1.26) and 0.80 (95% CI: 0.24–2.65).

Conclusions
Among treated hypertensives, a time in BP of 130–140mmHg of more than 50% is associated with the greatest reduction in cardiovascular risk. The TBPR is a potentially useful measure of BP control for evaluation of risk reduction in hypertensive patients.

Funding Acknowledgement
Type of funding source: None
Exhaled air analysis for pulmonary arterial hypertension fingerprints identification
Authors: Swinarew A.S , Kusz B , Skoczynski S , Gabor J , Okla H , Mika B , Skoczylas I , Gasior M , Kopec G , Mizia-Stec K 
Published: November 2020

Abstract

Background
Pulmonary arterial hypertension (PAH) is a rare disease which is often diagnosed in the late phase as its symptoms are non-specific and there is a lack of screening tests. Therefore, there is a strong need for identifying of its biomarkers.

Aim
To identify the biomarkers for PAH in the exhaled breath and in the serum.

Methods
The breath phase of all the patients was collected on the highly porous aseptic material by the use of special patented holder PL 232911. The collected air was then examined with gas chromatography mass spectrometry (GC/MS). For the control of the obtained results plasma of all the patients was examined by the use of Ultra High Performance Liquid Chromatography (UHPLC). A group of 10 patients (2 men, 8 women, mean age 60.4±10.9 years, BMI 27.6±6.0 kg/m2) with diagnosed PAH as well as the group of 10 healthy persons (6 men, 4 women, mean age 35±11 years, BMI 25.6±6.0 kg/m2) were enrolled into the study.

Results
The obtained spectral and chromatographic results clearly presents the qualitative and quantitative QA/QC sensitivity to the metabolites changes in the patient's breath. The identification of changes in ratio of the whole spectra of biomarkers can allow to obtain a multi-dimensional pathways for PAH diagnostics fig. 1. The chromatography data from patients suffering from PAH have been processed by the aid of signal processing toolbox in MATLAB. Only the peaks of the prominence of at least 10000 (experimentally established) have been taken under consideration. The prominence of a peak measures how much the peak stands out due to its intrinsic height and its location relative to other peaks. Next, for the each found peak the arguments of the two neighboring local minima, have been determined and the integration range for calculating the area under the each peak have been established. The ratio of the area under the significant peak to its prominence have been applied for further analysis.

Conclusions
Based on our preliminary results it seems that our method is specific and sensitive in the range of selected bio-fingerprints in patients with PAH. If confirmed on larger population the molecular level breath analysis can be used as a screening test as well as complementary diagnostic method in PAH to the standard clinical practice.
Figure 1. The chromatograms of representative spectra for patients suffering from PAH (red), control (blue) with distinguished significant peaks (presented in the magnification according to their prominence). On the right side, there are the graphical presentation (area/prominence for peaks) of arbitrary chosen patient, but with reference to the original data and for two data approximations obtained by the DWT, which are important in the case of weak separated peaks.

Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): University of Silesia in Katowice
Dietary approaches to stop hypertension (DASH) diet and blood pressure reduction in adults with and without hypertension: a systematic review and meta-analysis of randomized controlled trials
Authors: Filippou C , Thomopoulos C , Mihas C , Dimitriadis K , Sotiropoulou L , Siafi E , Zammanis I , Dimitriadi M , Chrysochoou C , Nihoyannopoulos P , Tousoulis D , Tsioufis C 
Published: November 2020

Abstract

Background
The dietary approaches to stop hypertension (DASH) diet is recognized as an effective dietary intervention to reduce blood pressure (BP). However, among randomized controlled trials (RCTs) investigating the DASH diet mediated BP reduction,there are significant methodological and clinical differences.

Purpose
The purpose of this study was to comprehensively assess the effect of the DASH diet on BP levels in adults with and without hypertension, accounting for underlying methodological and clinical confounders.

Methods
We systematically searched Medline and the Cochrane Collaboration Library databases and identified 30 RCTs (n=5,545 participants) that investigated the BP effects of the DASH diet compared to a control diet in hypertensive and non-hypertensive adults. Both random-effects and fixed-effect models were used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted.

Results
The DASH diet reduced SBP and DBP significantly more compared to the control diet (difference in means: −3.2 mm Hg; 95% CI: −4.2, −2.3; P&lt;0.001, and −2.5 mm Hg; 95% CI: −3.5, −1.5; P&lt;0.001, respectively). Hypertension status did not modify the effect on BP reduction. The DASH diet compared to the control diet reduced SBP levels to a higher extent in trials with sodium intake &gt;2,400 mg/day compared to trials with sodium intake ≤2,400 mg/day, while both SBP and DBP were reducedmore in trials with mean age &lt;50 years compared to trials of older participants. The quality of evidence was rated as moderate forboth outcomes according to the Grading of Recommendations, Assessment, Development and Evaluation approach.

Conclusion
The adoption of the DASH diet was accompanied by significant BP reduction in adults with and without hypertension, while higher daily sodium intake and younger age enhanced the BP-lowering effect of the intervention. This meta-analysis was registered in the International Prospective Register of Systematic Reviews as CRD42019128120.

Funding Acknowledgement
Type of funding source: None
The mechanisms of age-realted difference of annual changes in ankle-brachial pressure index
Authors: Takahashi T , Tomiyama H , Abyoyans V , Matsumoto C , Nakano H , Iwasaki Y , Fujii M , Shiina K , Chikamori T , Yamashina A 
Published: November 2020

Abstract

In addition to both pulse wave velocity (PWV; a marker of arterial stiffness) and augmentation index (AI; a marker of central hemodynamics), not only the decrease of ankle-brachial pressure index (ABI) but also its increase predict the future cardiovascular events. While arterial stiffness and central hemodynamics have been proposed to affect the increase in ABI logically, their effects on increase in ABI have not been fully clarified. The present cross-sectional and longitudinal studies were conducted to examine the associations of arterial stiffness and central hemodynamics with increase in ABI and also examine the age-related difference of those associations. In 4016 men (42±9 years old), ABI, brachial-ankle PWV (baPWV) and radial AI (rAI) were measured annually for 9 years' observation period. In the cross-sectional analyses adjusted with age, heart rate and mean blood pressure, both baPWV and rAI were associated with ABI in men aged &lt;50, but not in men aged &gt;50. As shown in Figure, ABI was annually increased in subjects aged &lt;50 (n=2870), but not in those aged &gt;50 (n=1146) during the follow-up period. The mixed model linear regression analysis (MMA) conducted in 9 years' annual repeated measurement data demonstrated that increased baPWV (estimate = 0.017, p&lt;0.05) and increased rAI (estimate 0.254, p&lt;0.05) were significant determinant of annual increase of ABI (p&lt;0.01) in men aged &lt;50, but not in men aged &gt;50. In conclusion, the arterial stiffness and central hemodynamics may individually affect the increase in ABI in men aged &lt;50, but not in men &gt;50. Thus, further studies are needed to clarify whether ABI, arterial stiffness, and central hemodynamics individually predicts future cardiovascular events, and their age-related difference of their predictabilities.
figure1

Funding Acknowledgement
Type of funding source: Private hospital(s). Main funding source(s): Tokyo Medical University
Estimating the burden of hyperkalaemia in the UK in high-risk patient populations
Authors: McEwan P , Hoskin L , Badora K , Sugrue D , James G , Hurst M , Tafesse E 
Published: November 2020

Abstract

Background
Patients with chronic kidney disease (CKD), heart failure (HF), resistant hypertension (RHTN) and diabetes are at an increased risk of hyperkalaemia (HK) which can be potentially life-threatening, as a result of cardiac arrhythmias, cardiac arrest leading to sudden death. In these patients, renin-angiotensin-aldosterone system inhibitors (RAASi), are used to manage several cardiovascular and renal conditions, and are associated with an increased risk of HK. Assessing the burden of HK in real-world clinical practice may concentrate relevant care on those patients most in need, potentially improving patient outcomes and efficiency of the healthcare system.

Purpose
To assess the burden of HK in a real-world population of UK patients with at least one of: RHTN, Type I or II diabetes, CKD stage 3+, dialysis, HF, or in receipt of a prescription for RAASi.

Methods
Primary and secondary care data for this retrospective study were obtained from the UK Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES). Eligible patients were identified using READ codes defining the relevant diagnosis, receipt of indication-specific medication, or, in the case of CKD, an estimated glomerular filtration rate (eGFR) ≤60 ml/min/1.73m2 within the study period (01 January 2008 to 30 June 2018) or in the five-year lookback period (2003–2007). The index date was defined as 01 January 2008 or first diagnosis of an eligible condition or RAASi prescription, whichever occurred latest. HK was defined as K+ ≥5.0 mmol/L; thresholds of ≥5.5 mmol/L and ≥6.0 mmol/L were explored as sensitivity analyses. Incidence rates of HK were calculated with 95% confidence intervals (CI).

Results
The total eligible population across all cohorts was 931,460 patients. RHTN was the most prevalent comorbidity (n=317,135; 34.0%) and dialysis the least prevalent (n=4,415; 0.5%). The majority of the eligible population were prescribed RAASi during follow-up (n=754,523; 81.0%). At a K+ threshold of ≥5.0 mmol/L, the dialysis cohort had the highest rate of HK (501.0 events per 1,000 patient-years), followed by HF (490.9), CKD (410.9), diabetes (355.0), RHTN (261.4) and the RAASi cohort (211.2) (Figure 1). This pattern was still observed at alternative threshold definitions of HK.

Conclusion
This large real-world study of UK patients demonstrates the burden of hyperkalaemia in high-risk patient populations from the UK. There is a need for effective prevention and treatment of HK, particularly in patients with CKD, dialysis or HF where increased incidence rates are observed which in turn will improve patient outcomes and healthcare resource usage.
Figure 1. Rates of HK by condition

Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): AstraZeneca
Factor analysis for the clustering of cardiometabolic risk factors and sedentary behavior: a VGH-HEALTHCARE substudy
Authors: Tsai T.Y , Lim S.S , Chan S.C , Yang Y.L , Hsu P.F , Wu C.H , Huang S.S , Lin S.J , Pan J.P , Lu T.M , Huang P.H , Leu H.B 
Published: November 2020

Abstract

Background
Few studies have reported the clustering pattern of new CVD risk factors including sedentary behavior, systemic inflammation and cadiometabolic components in the general population.

Purpose
We aimed to explore the clustering pattern of CVD risk factors using exploratory factor analysis to investigate the underlying relationships between various CVD risk factors

Methods
A total of 5606 subjects (3157 male, 51.5±11.7y/o) were enrolled and 14 cardiovascular risk factors including sedentary behaviors and physical inactivity were analyzed in exploratory group (n=3926). The established model was validated with the validation group (n=1676).

Results
Five factor clusters had been identified to explained 69.4% of total variance, including adiposity (BMI, TG, HDL, UA, and HsCRP 21.3%), lipid, (Total cholesterol, and LDL-cholesterol 14.0%), blood pressure (SBP & DBP 13.3%), glucose (HbA1C, fasting glucose 12.9%) and sedentary behavior (MET per week and sitting time per day 8.0%), respectively. HsCRP was clustered with adiposity factors, not other cardiometabolic risk factors. This clustering pattern was verified in the validation group.

Conclusion
Our current study confirmed the clustering structure of cardiometabolic risk factors including sedentary behavior in general population. hsCRP was clustered with adiposity factors while physical inactivity and sedentary behavior were clustered with each other.

Funding Acknowledgement
Type of funding source: None
Sarcopenia-derived exosomal micro-RNA 16-5p exerts the cardio-repair disturbance via pro-apoptotic mechanism in myocardial infarction of mice
Authors: Hayasaka T , Takehara N , Horiuchi K , Kano K , Tomita Y , Yoshida Y , Maruyama K , Minoshima A , Kawabe J , Hasebe N 
Published: November 2020

Abstract

Background
Sarcopenia is a pathophysiological malfunction induced by skeletal muscle atrophy, and several studies reported an association between sarcopenia-induced cardiac cachexia and poor prognosis in heart disease. Since only a few established animal models are recently available, the underlying mechanism of disturbed cardiac repair accompanied with sarcopenia remains poorly understood.

Purpose
We hypothesized that specific microRNAs in sarcopenia-derived exosomes play crucial roles in disturbed cardiac repair with sarcopenia, and these microRNAs directly exacerbate cardiomyocyte injury following cardiac ischemia and reperfusion.

Methods
We developed a novel sarcopenia-induced cardiac repair disturbance mouse model that is induced by tail suspension (TS) 7 days after a 45-min coronary occlusion of cardiac ischemia and reperfusion (I/R). The reduction of the left ventricular ejection fraction (LVEF) after I/R was compared in mice with TS [I/R-TS(+), n=14] and without [I/R-TS(−), n=12] by echocardiography. To investigate the exosomal mechanism of cardiac repair disturbance, a comprehensive analysis of extracted exosomal microRNAs from mice serum was performed in the 2 groups at day 8. Then, we investigated the impact of the identified candidate microRNA in neonatal rat cardiomyocytes (NRVMs). After 4 days in primary culture, candidate microRNA was transfected into NRVMs under hypoxic culture conditions. TUNEL analysis and quantitative PCR analysis of apoptosis-related genes were performed on the NRVMs.

Results
At day 8 after I/R, the LVEF of I/R-TS(+) was not significantly ameliorated compared to that of I/R-TS(−) (ΔLVEF; 1.59±6.92 vs. 8.04±7.71% p=0.034). Four candidate microRNAs obtained from I/R mice serum were identified in the microRNA array analysis. The re-analysis of these candidate micro-RNAs using all I/R mice demonstrated that the level of mir-16-5p in I/R-TS(+) was raised by approximately nine-fold than that in I/R-TS(−) (9.67±13.35 vs. 0.99±1.41, p&lt;0.05). Next, an in vitro experimental model using a microRNA mimic revealed that apoptosis in NRVMs was greatly enhanced by the transfection of a mir-16-5p mimic in hypoxic culture conditions (mir-16-5p vs. control = 5.77±2.84 vs. 1.72±0.55%, p&lt;0.01). Furthermore, by qRT-PCR analysis, the expression of CASP3 and TRP53 were upregulated in NRVMs treated with a mir-16-5p mimic than in control NRVMs.

Conclusion
Myocardial I/R injury in sarcopenia ended in cardiac repair disturbance accompanying with the enhanced expression of exosomal-mir-16-5p. A pro-apoptotic effect of mir-16-5p may exacerbate myocardial I/R injury and thus can be a novel therapeutic target for cardiac repair disturbance in sarcopenia.

Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Japan Society for the Promotion of Science