bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECT OF SYMPATHETIC RENAL DENERVATION ON ARRHYTHMIAS BURDEN IN PATIENTS WITH UNCONTROLLED HYPERTENSION
Authors: Papakonstantinou Panteleimon , Konstadinidis Dimitrios , Iiliakis Panayiotis , Dimitriadis Kyriakos , Tousoulis Dimitrios , Tsioufis Konstadinidis 
Published: April 2021

Objective:
Increased tone of the autonomic sympathetic nervous system plays a dominant role in the pathophysiology of cardiac arrhythmias. Sympathetic Renal Denervation (RDN) is a minimally invasive, alternative method of treating drug resistant arterial hypertension (HTN) with recent data also showing its positive effect in patients with atrial fibrillation (AF), atrial and ventricular arrhythmias. The aim of this study was to evaluate the effect of RDN on the total arrhythmias burden in patients with uncontrolled HTN.

Design and method:
The present clinical study is a randomized, single-center study including thirty (30) consecutive patients (> 18 years) with uncontrolled HTN. Patients will be randomized (1: 1) either to RDN (n = 15) or to conventional treatment of HTN with drugs (n = 15) according to the current European guidelines for the treatment of HTN. Patients will receive a 24-hour ECG Holter monitoring upon enrollment. All persistent and non-persistent atrial and ventricular arrhythmias will be recorded. After randomization, patients will be monitored for six months. 24-hour ECG Holter monitoring will also take place at 3 months after the enrollment. Office blood pressure (OBP) measurements as well as a 24-hour ambulatory blood pressure monitoring (ABPM) will be recorded at baseline and 3 months.

Results:
The primary endpoint of the study is the change in the total arrhythmias ’burden’ from inclusion to 3 months (Number of supraventricular and ventricular arrhythmias, premature atrial and ventricular comlexes). Secondary endpoints will include the change in the symptomatic and asymptomatic ’burden’ of the arrhythmias, the change in the supraventricular and ventricular arrhythmias burden, and the change in the OBP and ABPM from baseline to 3 months.

Conclusions:
This is the first study in the literature which aims to provide additional evidence for the pleotropic effect of RDN in patients with uncontrolled HTN and the total both symptomatic and asymptomatic atrial and ventricular arrhythmia burden. The relationship between the level of arterial hypertension reduction and arrhythmias will also be studied.
ASSOCIATION BETWEEN PRE-TRANSPLANT MEDIAL ARTERIAL CALCIFICATION AND EARLY POST-KIDNEY TRANSPLANT HYPERTENSION FROM A PROPENSITY SCORE WEIGHTING ANALYSIS
Authors: Tantisattamo Ekamol , Leelaviwat Natnicha , Polpichai Natchaya , Lopimpisuth Chawit , Saowapa Sakditad , Vutthikraivit Possawat 
Published: April 2021

Objective:
Medial arterial calcification (MAC) detected by mammography (MG) is exclusively in the medial layer of the arteries and associated with cardiovascular (CV) outcomes in end-stage renal disease (ESRD) patients. Association between MAC and hypertension (HTN) after successful kidney transplantation (KT) is unclear.

Design and method:
Female KT patients with pre-KT MG was divided into MAC and non-MAC groups. Baseline characteristics including age, race, and pre-KT diabetes were balanced by propensity score weighting (PSW). Association between MAC and systolic HTN (SBP <130 mmHg) and diastolic HTN (DBP <80 mmHg) at a 24-week post-KT is examined by multiple logistic regression.

Results:
Of 51 KT candidates, mean age ± SD was 50.08 ± 10.47 years old and 18 patients (35.29%) were Black and the remaining non-Black were 33 (64.71%). Twenty patients (39.23%) had MAC and 21 patients (41.18%) had diabetes. Among 20 patients in MAC group, 14 and 7 patients had SHTN and DHTN at a 24-week post-KT, respectively; whereas, 17 out of 30 patients (missing 1 patient) in non-MAC group had both SHTN and DHTN (MAC vs. non-MAC for SHTN p 0.341 and for DHTN p 0.133). Compared to non-MAC group, MAC group had higher mean SBP (137.45 ± 18.52 vs. 130.70 ± 17.67; p 0.2060); whereas, its mean DBP was lower (74.15 ± 14.17 vs. 78.73 ± 10.55; p 0.2253). By using generalized boosted modeling-based PSW to balance baseline characteristics (Figure 1A&B) and adjusting for potential confounders including age, race, cause of kidney disease, pre-KT diabetes, serum albumin, corrected calcium, phosphorus, dialysis modality, type of KT, donor age, induction immunosuppressive medications, MAC group had 89% lower the odds of having DHTN compared to non-MAC group (OR 0.11; 95%CI 0.02 to 0.84). However, MAC group appeared to have higher, but not significant, risk for SBP (OR 2.24, 95%CI 0.35 to 14.46).

Conclusions:
KT patients with pre-KT MAC had lower the risk of developing DHTN during early post-KT period. DHTN, which indicates vascular stiffness and increases risk of CV mortality in ESRD, may not explain CV risk in KT recipients. Pathophysiology of DHTN and CV diseases in KT patients after successful KT may be different from ESRD population.
URINARY AMMONIUM EXCRETION BY ALDOSTERONE THROUGH THE REGULATION OF RH C GLYCOPROTEIN IN THE INTERCALATED CELLS OF THE RENAL COLLECTING DUCT
Authors: Izumi Yuichiro , Eguchi Koji , Ono Makoto , Hiramatsu Akiko , Inoue Hideki , Nakayama Yushi , Nonoguchi Hiroshi , Kakizoe Yutaka , Kuwabara Takashige , Mukoyama Masashi 
Published: April 2021

Objective:
Aldosterone is a key hormone that regulates sodium reabsorption in the principal cells (PCs) of the renal collecting duct, maintaining blood pressure. Alternatively, aldosterone is involved in urinary acid excretion mainly via ammonia as ammonium ions in the intercalated cells (ICs) of the collecting duct, although its mechanisms are obscure. Rh C glycoprotein (Rhcg), an ammonia transporter, is expressed mainly in the intercalated cells. Direct regulation of ammonium excretion by aldosterone through the Rhcg in metabolic acidosis was investigated.

Design and method:
C57BL/6J mice were divided into four groups: 1) sham-operation, 2) sham and NH4Cl drinking (Sham-NH4Cl), 3) adrenalectomy and NH4Cl drinking (ADX-NH4Cl), and 4) adrenalectomy with continuous administration of aldosterone and NH4Cl drinking (ADX-Aldo-NH4Cl). Mice were sacrificed three days after NH4Cl drinking. Urinary ammonium excretion and localizations of Rhcg and ubiquitin were examined. For in vitro experiments, IN-IC cells, an intercalated cell-derived cell line, that stably express flag-tagged Rhcg (Rhcg-flag) were generated. The effects of aldosterone, spironolactone, Go6983 (a PKC inhibitor) and MG132 (a proteasome inhibitor) on the expression of Rhcg-flag were examined.

Results:
NH4Cl-induced urinary ammonium excretion was inhibited by adrenalectomy in ADX-NH4Cl mice. Aldosterone replacement restored ammonium excretion in ADX-Aldo-NH4Cl mice. Immunohistochemical study revealed that NH4Cl drinking increased the accumulation of Rhcg at apical and basolateral membranes and subapical sites of the ICs in sham-NH4Cl mice. Adrenalectomy and aldosterone replacement decreased and increased the accumulation of Rhcg at apical membrane of the ICs in ADX-NH4Cl and ADX-Aldo-NH4Cl mice, respectively. Ubiquitin expression was not changed between in PCs and ICs of sham-NH4Cl mice, while it was less in ICs than in PCs in ADX-NH4Cl mice. Aldosterone restored the ubiquitin expression in ICs. In IN-IC cells, Western blotting showed that aldosterone increased the expression of Rhcg-flag in the membrane fraction. Spironolactone and Go6983 each inhibited the expression of Rhcg-flag. Treatment with MG132 increased the expression of Rhcg-flag in whole cell lysate. Immunoprecipitation revealed the association of Rhcg with the ubiquitin.

Conclusions:
Aldosterone could directly regulate Rhcg expression through the mineralocorticoid receptor-PKC pathway. Furthermore, aldosterone could modulate Rhcg expression through the ubiquitin-proteasome pathway.
AMBULATORY BLOOD PRESSURE PROFILE AND BLOOD PRESSURE VARIABILITY IN PERITONEAL DIALYSIS COMPARED TO HEMODIALYSIS AND CHRONIC KIDNEY DISEASE PATIENTS
Authors: Alexandrou Maria-Eleni , Loutradis Charalampos , Kouris Nikolas , Sarris Dimitrsi , Schoina Maria , Tzanis George , Dimitriadis Chrisostomos , Sachpekidis Vasileios , Papadopolou Dorothea , Gkaliagkousi Eugenia , Papagianni Aikaterini , Parati Gianfranco , Sarafidis Pantelis 
Published: April 2021

Objective:
Hypertension in ESRD patients is highly prevalent and poorly controlled. Data on ambulatory blood pressure (BP) profile and BP variability (BPV) in peritoneal dialysis (PD) patients are absent. This study examined the BP profile and BPV of patients undergoing PD in comparison to hemodialysis (HD) and pre-dialysis CKD patients.

Design and method:
Thirty-eight PD patients were matched for age, gender and dialysis vintage with 76 HD patients and for age and gender with 38 patients with CKD stage 2–4. Patients under PD and HD underwent 48-hour and CKD patients 24-hour ambulatory BP monitoring. BP levels and BPV indexes were compared for the 48hour, 1st and 2nd 24hour, daytime and nighttime periods. Two-way mixed ANOVA analysis for repeated measurements was used to evaluate the effect of dialysis modality and time on ambulatory BP in PD and HD.

Results:
During all periods studied, SBP and DBP were numerically higher but not statistically different in PD than in HD patients. Systolic BP was significantly higher in PD or HD compared with predialysis CKD (PD:138.38 ± 20.97; HD:133.75 ± 15.5; CKD:125.52 ± 13.4, p = 0.003), a difference evident also during daytime and night-time periods. Repeated-measurements analysis showed no effect of dialysis modality on ambulatory BP during all periods studied. All BPV indexes studied were similar between PD and HD patients and higher than CKD individuals (1st-24hour systolic-ARV: PD: 11.86 ± 3.19; HD:11.23 ± 3.45; CKD:9.81 ± 2.49, p = 0.016).

Conclusions:
Average BP levels and BPV indices are similar between PD and HD patients and higher compared to CKD counterparts. The dialysis modality has no effect on ambulatory BP profile. These results suggest that PD is no better than HD with regards to overall BP control or BP fluctuations over time.
EGFR-CYSTATINC/EGFR-CREATININE RATIO AS A POTENTIAL MARKER OF EARLY VASCULAR AND KIDNEY AGEING
Authors: Agne Laucyte-Cibulsk , Anders Christensson , Peter Nilsson 
Published: April 2021

Objective:
Much of the research up to now has observed a link between cystatin C and pulse wave velocity (PWV) in patients with no or mild chronic kidney disease (CKD) that leads us to think that cystatin C is also related to arteriosclerosis. In fact, the relation between heart and kidney may be caused by common vascular changes giving rise to different elimination patterns for small and large molecules in kidneys. With this knowledge we propose that lower eGFRcystatin C/eGFRcreatinine ratio is potentially associated with early vascular aging (EVA). This relationship might be bidirectional, also incorporating early structural changes in glomerular filtration barrier, as a component of so-called “Shrunken pore syndrome” (SPS), further leading to CKD.

Design and method:
Data were extracted from the population based Malmö Diet and Cancer (MDC) study (n = 28 449) cardiovascular cohort (MDC CC) that enrolled a random sample of study subjects invited to participate in carotid artery disease epidemiological analysis (n = 6103) during the year 1991–1994. Our study sample consisted of 2685 subjects (1542 women, 834 men) who had carotid-femoral pulse wave velocity measurements and cystatin C available. Estimated glomerular filtration rate (eGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2012 creatinine-cystatin C equation was calculated. Carotid-femoral pulse wave velocity (cfPWV) and central hemodynamics were measured by applanation tonometry (SphygmoCor).

Results:
Study subjects were classified according eGFR-cystatinC/eGFR-creatinine ratio: 6% (n = 159) of subjects with lower that 0.7 ratio, representing SPS, 59% (n = 1591) – as ratio between 0.7 to 1.0, and 35% (n = 935) – as ratio >1.0. There was pronounced sex specific trend because SPS group consisted mainly from women. We found that cfPWV was associated with the eGFR-cystatinC/eGFR-creatinine ratio, representing the decreased arterial stiffness at the ratio >1.0 and stiffer arteries at the ratio lower than < 0.7. We have identified factors that are related to early vascular ageing and on the opposite are related to better kidney function and lower arterial stiffness.

Conclusions:
The ratio of eGFR-cystatinC/eGFR-creatinine is a potential marker of early vascular ageing encompassing also early kidney function deteriorating.
AUTOMATED BRACHIAL-ANKLE VERSUS CAROTID-FEMORAL PULSE WAVE VELOCITY: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Kyriakoulis Konstantinos , Kollias Anastasios , Chatzopoulos Michail , Stergiou George S. 
Published: April 2021

Objective:
Carotid femoral pulse wave velocity (cfPWV) is the gold standard for measuring large artery stiffness. Automated brachial ankle pulse wave velocity (baPWV) is an alternative observer-independent method for assessing arterial stiffness at the level of both large (elastic) and small (muscular) arteries.

Design and method:
A systematic review and meta-analysis of PubMed and EMBASE studies was performed aiming to compare cfPWV and baPWV in terms of (i) absolute numerical difference, (ii) correlation coefficient and (iii) correlations with target organ damage (TOD).

Results:
Among 486 retrieved studies 44 were analyzed (n = 32.064, weighted age 59.4 ± 11.6 years, 48% hypertensives). Meta-analysis of 41 studies (n = 23.145, weighted age [SD] 60.2 ± 13.6 years, pooled cfPWV 9.4 [95% CI 8.8, 10.1] m/s) showed pooled baPWV-cfPWV difference at 4.6 m/s (95% CI 3.1, 6.1). There was considerable heterogeneity among the studies (I2 = 100%). Meta-analysis of 21 studies (n = 16.429) showed pooled correlation coefficient between baPWV and cfPWV at 0.67 (0.60, 0.74). Sensitivity analyses based on the technology used for cfPWV assessment showed baPWV minus cfPWV difference at (i) 6.5 (5.6, 7.5) m/s with the SphygmoCor (10 studies), and (ii) 3.8 (1.9, 5.6) m/s with the Omron VP1000/2000 Vascular Profiler (26 studies). Analysis of 16 high quality studies (n = 5.877) showed baPWV-cfPWV difference at 3.8 (2.9, 4.7) m/s. Three studies (n = 2,003) compared the correlation of left ventricular mass index with cfPWV (pooled r = 0.16, 95% CI 0.09, 0.23) vs. baPWV (r = 0.21, 95% CI 0.07, 0.35) (p < 0.05 for comparison).

Conclusions:
The current evidence indicates that baPWV gives higher values than cfPWV, which is probably due to the fact that these two indices assess the stiffness at different parts of the arterial tree. The two methods appear to be closely correlated and are associated with left ventricular mass.
THE ROLE OF MATRIX METALLOPROTEINASE (MMP)-2 TO TYPE I COLLAGEN TURNOVER CONTRIBUTING TO HYPERTROPHIC ARTERIAL REMODELING IN RENOVASCULAR HYPERTENSION
Authors: Neves Viviano Gomes de , Mello Marcela Maria Blascke de , Silva Pedro Henrique L , Pernomian Laena , Parente Juliana Monteneg , Castro Michele Mazzaron 
Published: April 2021

Objective:
Type I collagen proteolytic products contribute to VSMC proliferation via integrin receptor and focal adhesion kinase (FAK) activation. We then evaluated whether the early activation of MMP-2 in hypertension induces VSMC proliferation, due to type I collagen proteolysis, which may activate integrin and FAK to develop hypertrophic arterial remodeling.

Design and method:
Sprague Dawley rats were submitted to 2K1C surgery to induce hypertension and they were orally treated with doxycycline or vehicle (five days at first week (acute) and eight weeks at ten weeks of hypertension (chronic)); (CEUA-USP 165/2019). In the aorta, we evaluated the expression of MMP-2 and type I collagen by Western blotting; MMP-2 activity by gelatin and in situ zymography, arterial morphology by HE, and collagen deposition by picrosirius red. All statistical analyzes used two-way ANOVA followed by Tukey post hoc test with p < 0.05.

Results:
Our results showed that 2K1C rats developed high systolic blood pressure at the first week (156 ± 13 mmHg vs. Sham (p < 0,001)), which was progressively higher at ten weeks (219 ± 6 mmHg, p < 0,0001). Moreover, there was a significant increase in the MMP-2 expression and activity in the 2K1C rats at the first and tenth weeks of hypertension (p < 0.05). Treatment with doxycycline reduced MMP-2 activity only in the acute situation (p < 0.05). The 2K1C showed increased levels of type I collagen as well as its potential degradation products (p < 0.05) in the aorta during the first week of hypertension. However, the deposition of collagen was notably resynthesized in the aortas of chronic 2K1C rats (p < 0.05).

Conclusions:
Treatment with doxycycline reduced such effects in hypertensive rats. At this moment, we concluded that increased activity of MMP-2 may contribute to type I collagen proteolysis in aortas at early stages of hypertension, with its potential re-synthesis at late stages. This proteolytic effect of MMP-2 on collagen may contribute to stimulating VSMCs proliferation through integrins and FAK, mechanisms that we are currently investigating.
EFFECT OF 24-WEEK ATORVASTATIN THERAPY IN STEMI PATIENTS ON ARTERIAL STIFFNESS
Authors: Oleynikov Valentin , Matrosova Irina , Borisova Natalia , Babina Anastasia 
Published: April 2021

Objective:
To study the parameters of regional arterial stiffness in patients after acute myocardial infarction with ST segment elevation (STEMI) depending on the achievement of the target level of low-density lipoprotein cholesterol (LDL-C) during 24-week therapy with atorvastatin 40–80 mg.

Design and method:
The study included 80 STEMI patients (mean age 51.8 ± 8.2 years) in the first 24–96 hours from the disease onset. The diagnosis was confirmed by biomarkers of myocardial necrosis, electrocardiography, coronary angiography. All patients received treatment for STEMI. On 7th-9th day from the disease onset and after 24 weeks of follow-up, the regional arterial stiffness was assessed by volume sphygmography (VaSera-1000, “Fukuda Denshi”, Japan). The following indicators were determined: the pulse wave velocity in the aorta (PWV), in the arteries of elastic type on the right and left (R/L-PWV), cardio-ankle vascular index - CAVI (CAVI-1 and L-CAVI-1). CAVI-1- reflects the true arterial stiffness between the heart valve and the leg artery, L-CAVI-1 - between the groin area and the leg artery. The patients were divided into two groups depending on the LDL-C level after 24 weeks. Group 1 included 39 patients who did not reach the LDL-C < 1.4 mmol/L and/or decrease by 50% from the initial. The second consisted of 41 people who reached the target LDL-C level.

Results:
After 24 weeks of therapy in patients of group 1, there was no significant dynamics in all studied parameters. While in the 2nd group, there was a statistically significant decrease in almost all characteristics of vascular rigidity: PWV - from 8.1 ± 1.8 to 7.1 (5.6;7.3) m/s - by 21.7% (p = 0.01); R-PWV - from 13.1 (12.5;14.2) to 12.0 ± 0.84 m/s - by 8.1% (p = 0.03); L-PWV- from 6.8 (12.5;15.1) to 12.2 (11.2; 12.9) m/s - by 6.8% (p = 0.001). No significant changes were observed in CAVI-1. L-CAVI-1 decreased from 7.8 (7.3;8.4) to 7.4 ± 0.9 - by 4.6% (p = 0.03).

Conclusions:
Achievement of the LDL-C target level in patients after STEMI during 24-week therapy with atorvastatin 40–80 mg was accompanied by a significant improvement in the structural and functional properties of arteries according to volume sphygmography.
ADHERENCE TO ANTI-HYPERTENSIVE TREATMENT ON THE COVID-19 PANDEMIC
Authors: Guimaraes Mayra Cristina Luz Pádua , Coelho Juliana Chaves , Dos Santos Juliano , Higa Camila Braga De Oliveira , Florido Carime Farah , Lee Renata Jae Won , Soares Grazielli Pessoa , Silva Giovanio Vieira Da , Pierin Angela Maria Geraldo 
Published: April 2021

Objective:
To evaluate the adherence to antihypertensive treatment during the COVID-19 pandemic and associated variables.

Design and method:
Cross-sectional study was performed with outpatient, from a Hospital in São Paulo, Brazil. Inclusion criteria were: age >18 years old, telephone number, in treatment for at least six months. Pregnant women were excluded. The period defined to characterize the assessment of social distance due to the COVID-19 pandemic was from March, 24 until August, 31. Hypertensive patients were interviewed by telephone. The adherence to treatment was assessed by Morisky and Green scale and the BP control was systolic BP < 140 mmHg and diastolic BP < 90 mmHg. Biosocial data, habits and lifestyles and attitudes towards social distancing measures were evaluated. The study was approved by the Research Ethics Committee. The significance level was p< = 0.05.

Results:
The sample was 281 hypertensive patients: 62.3% women; 66 (14) years old; 348,7 (255,8) $USA monthly income; 43.8% completed high school; 60.5% white; 47.0% married; and 59.1% retired. It was found that 58.7% were adherent to antihypertensive treatment and BP control was 51.6%. The systolic BP was 138.5 (22.7) mmHg and diastolic BP was 77.3 (14.4) mmHg. As for drug treatment, 55.2% of hypertensive patients received the drugs sent by the hospital pharmacy via mail, 63.9% reported that during the COVID-19 pandemic there was a problem in receiving the drugs and 10% was without antihypertensive sometime at home. The variables associated with treatment adherence were: race black (OR 0.40; 95% CI: 0.21 – 0.73), education elementary school II (OR 2.97; 95% CI: 1.24 – 7.06), stayed without antihypertensive at home someday from quarantine (OR 0.40; 95% CI: 0.17 – 0.95) and diastolic BP (OR 0.98; CI: 0.96 – 0.99). During the period of the pandemic evaluated, it was also observed that 77.6% reported leaving home, 13.5% had contact with people with the disease and 91.8% reported not feeling safe to leave the house after the end of quarantine.

Conclusions:
The rate of non-adherence to antihypertensive treatment during the COVID-19 pandemic was high and was associated with unfavorable biosocial variables.
EFFICACY OF A PSYCHOTHERAPEUTIC GROUP ON PATIENTS WITH OBESITY AND HYPERTENSION
Authors: Gabos Priscila , Watanabe Danielle , Bortolotto Luiz Aparecido 
Published: April 2021

Objective:
OBJECTIVE: A) To evaluate the effects of a brief psychotherapeutic group for patients with obesity and hypertension of a Psychology Ambulatory Service over clinical parameters. B) To evaluate the viability and efficacy of a brief group psychoterapy program these patients regarding the learning of new coping responses to daily stressful situations.

Design and method:
DESIGN AND METHOD: It was a clinical trial, which the independent variable was the psychotherapic group with 12-weekly session conducted by a psychologist. The dependent variables were: weight and BMI, blood pressure and glucose, cholesterol and triglycerides; coping strategies measured by the Brief-COPE. All data was collected before and after the intervention. For variable comparison, it was used the non-parametric T-Student and Wilcoxon test.

Results:
RESULTS: A total of 19 patients with mean age of 57 years participated in 3 groups. After the sessions we observed significant reductions in BMI (kg/m2) (before = 39 ± 6, after = 34 ± 7; p < 0.05); weight (kg) (before = 102 ± 22, after = 91 ± 24; p < 0.05); systolic blood pressure (mmHg) (before = 149 ± 24, after = 132 ± 13; p < 0.05); and LDL (mg/dL) ((before = 134 ± 44, after = 90 ± 22; p < 0.05). Patients also developed an increase in the frequence of healthier coping strategies with active coping, planning, positive reframing and acceptance; and a decrease of unhealthy coping strategies, such as denial and behavioral disengagement.

Conclusions:
CONCLUSIONS: The brief psychotherapeutic group was effective for improvement of BMI, weight,blood pressure, and LDL, as well as the development of new coping strategies for the patients, facilitating self-care and treatment adherence.