bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlations between sympathetic nervous system activity and smoking, as well as unattended blood pressure in essential hypertension
Authors: Manta E , Konstantinidis D , Dimitriadis K , Tatakis F , Drogkaris S , Polyzos D , Ntalakouras I , Leontsinis I , Thomopoulos C , Tsioufis K 
Published: October 2021

Abstract

Background/Introduction
It is a well-known fact that the sympathetic nervous system is involved with the pathophysiology of hypertension. Smoking, which is one of the most significant risk factors for cardiovascular morbidity and mortality, also contributes to the development of hypertension mainly through the stimulation of the sympathetic nervous system. Moreover, measurement of unattended blood pressure (BP) may provide additional information compared to conventionally attended BP.

Purpose
The aim of this study was to demonstrate the impact of smoking on sympathetic nervous system stimulation, and on BP measurement variations with and without medical supervision.

Methods
We studied patients with essential hypertension, who were separated into two groups, depending on their smoking habits (Group I: non-smokers, Group II: smokers). In all participants, sympathetic drive was assessed by MSNA estimations based on established methodology (microneurography). Both unattended (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, at 1-minute intervals, after 5 minutes of rest) and attended BP measurements were conducted with the same device, on the same day of MSNA recording, in random order. Then, we compared the two BP measurement values of each patient to assess which of the two was higher.

Results
Ninety-two consecutive patients (58±11 years, 50 males) were evaluated. Smokers (n=19) did not differ as regards 24-h ambulatory BP levels, glucose levels, renal function and left ventricular mass index when compared to non-smokers (n=73). However, higher levels of MSNA were recorded to smokers (73.16±13.42 vs. 61.04±18.10 bursts per 100 heartbeats, p&lt;0.01). Furthermore, higher percentage of smokers recorded to have unattended BP values higher than attended (73.7% vs. 47.9% of them respectively, p=0.045). In particular, in smokers unattended BP was higher than attended by 10.07±6.7 mmHg, while in non-smokers unattended BP was lower than attended by 6.6±7.14 mmHg. No correlation was found between the MSNA and the differences observed in the two values resulting from the two different measurements of BP, maybe due to the small size of the sample.

Conclusions
Cigarette smoking is accompanied with higher sympathetic nervous system activation. Moreover, smokers exhibit higher unattended blood pressure values than normal measurements. The emerging hypothesis is that the stimulation of the sympathetic system causes this difference in measurements. A larger sample of patients is needed to fully determine the clinical significance of the above observation.

Funding Acknowledgement
Type of funding sources: None.
Efficacy and safety of e-cigarette use for smoking cessation: a systematic review and meta-analysis of randomized controlled trials
Authors: Levett J Y , Filion K B , Reynier P , Prell C , Eisenberg M J 
Published: October 2021

Abstract

Background
Quitting smoking substantially reduces the risk of developing cardiovascular disease. Smokers are increasingly turning to electronic cigarettes (e-cigarettes) to help them quit smoking combustible cigarettes. However, the efficacy and safety of e-cigarettes for smoking cessation remain controversial.

Purpose
To examine the efficacy and safety of e-cigarette use for smoking cessation.

Methods
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing nicotine and non-nicotine e-cigarettes (alone, or in combination with behavioural and/or pharmacological interventions) to conventional smoking cessation therapies (pharmacological, behavioural, or both). We systematically searched MEDLINE, Embase, and the Cochrane Libraries. Inclusion was restricted to RCTs that reported biochemically validated abstinence at six months or greater. The primary comparison was nicotine e-cigarettes versus any (non-e-cigarette) conventional smoking cessation therapy. Count data were pooled using DerSimonian and Laird random-effects models with inverse variance weighting to obtain relative risks (RRs) and 95% confidence intervals (CIs).

Results
A total of six RCTs (n=3,401) were included, with maximum follow-up durations ranging from six to 12 months. Compared with conventional smoking cessation therapies, point estimates favoured nicotine e-cigarettes for the most rigorous criterion of abstinence, continuous abstinence, and point prevalence abstinence, although findings were inconclusive due to wide 95% CIs (Table 1). Similar trends were observed when comparing non-nicotine e-cigarettes to traditional smoking cessation therapies. Compared with non-nicotine e-cigarettes, nicotine e-cigarettes increased abstinence as defined by the most rigorous criterion. Although there was a signal suggesting a potential increased risk of respiratory adverse events with nicotine e-cigarettes versus traditional therapies, the 95% CI is wide.

Conclusion
E-cigarettes appear to be more efficacious than conventional nicotine pharmacotherapies and behavioural smoking cessation therapies. Although currently available safety data are inconclusive, e-cigarettes may be considered for smoking cessation given the established long-term health consequences of continued smoking.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Mr. Levett is supported by an Ivan Racheff Scholarship, funded through the McGill University Faculty of Medicine and Health Sciences Research Bursary Program. Dr. Filion is supported by a Senior Research Scholar award from the Fonds de recherche du Québec – Santé and a William Dawson Scholar award from McGill University.
Prevalences and incidences of cardiovascular and renal diseases in type 1 compared with type 2 diabetes: a nationwide observational study
Authors: Angoulvant D , Fauchier G , Semaan C , Bisson A , Herbert J , Ducluzeau P H , Fauchier L 
Published: October 2021

Abstract

Background
Type 1 diabetes (T1D) and type 2 diabetes (T2D) increase risks of cardiovascular (CV) and renal disease compared with diabetes-free populations. There are only few studies comparing T1D and T2D for the risk of these clinical events. We examined these issues in a nationwide analysis in France.

Methods
All patients aged ≥18 seen in French hospitals in 2013 with at least 5 years of follow-up were identified and categorized by their diabetes status. A total of 50,623 patients with T1D (age 61.4±18.6, 53% male) and 425,207 patients with T2D (age 68.6±14.3, 55% male) were followed over a mean period of 4.3±2.1 years (median 5.3, interquartile 2.8–5.8 years). Prevalence and event rates of myocardial infarction (MI), heart failure (HF), ischemic stroke, chronic kidney disease (CKD), all-cause death and CV death were assessed with age stratification of 10-year intervals. Cox regression analyses were used to estimate risk with adjustment on sex and age.

Results
The age and sex-adjusted prevalence of CV diseases was higher in T2D for ages above 40 years whereas the adjusted prevalence of CKD was more common in T1D between ages 18 and 69 years and higher in T2D for ages above 80 years.
During 2,033,239 person-years of follow-up, there were 27,497 patients with MIs (yearly rate 1.4%), 24,892 with ischemic strokes (yearly rate 1.2%), 100,769 with incident HF (yearly rate 5.4%), 65,928 with incident CKD (yearly rate 3.4%) and 197,858 deaths (yearly rate 9.7%) including 49,026 CV deaths (yearly rate 2.4%) were recorded. Age and sex-adjusted event rates comparing T1D versus T2D showed that MI risk was increased for ages above 60 (1.2-fold for T1D versus T2D) and HF between ages 18–29 and above 60 years (1.1–1.4-fold). Adjusted risk of ischemic stroke did not markedly differ between T1D and T2D. Risk of incident CKD was 1.1–2.4-fold higher in T1D between ages 18–49 and above 60 years. The all-cause death risk was 1.1-fold higher in T1D at age ≥60 years, the cardiovascular death risk being 1.1-fold higher in T1D between 60 and 69 years.

Conclusions
The adjusted prevalent burden and risk of incident renal disease are greater among patients with T1D compared with T2D patients across most ages. Although the prevalent burden of cardiovascular diseases may be lower in T1D than in T2D, patients with T1D may have a higher risk of incident MI, HF, all-cause death and cardiovascular death at middle-older ages, highlighting their need for improved prevention.

Funding Acknowledgement
Type of funding sources: None.
The association of soluble ACE2 change with metabolic health, body composition and proteome dynamics during a weight loss diet intervention: implications for the COVID-19 pandemic
Authors: Cauwenberghs N , Prunicki M , Sabovcik F , Perelman D , Contrepois K , Li X , Snyder M P , Nadeau K C , Kuznetsova T , Haddad F , Gardner C D 
Published: October 2021

Abstract

Background
Angiotensin-converting enzyme 2 (ACE2) serves protective functions in metabolic, cardiovascular, renal and pulmonary diseases and is linked to COVID-19 pathology. We explored the association between soluble AC2 (sACE2) and metabolic health and proteome dynamics during a weight loss diet intervention.

Methods
We analyzed 457 healthy individuals (mean age 39.8±6.6) with BMI 28–40 kg/m2 who participated in the Diet Intervention Examining the Factors Interacting with Treatment Success (DIETFITS). Biochemical markers of metabolic health and 236 proteins measured by Olink CVD II, CVD III and Inflammation arrays were available at baseline and 6 months following dietary intervention. We determined clinical and routine biochemical correlates of the diet-induced change in sACE2 (ΔsACE2) using stepwise linear regression. We then combined feature selection models and multivariable-adjusted linear regression to identify protein dynamics associated with ΔsACE2.

Results
sACE2 decreased significantly on average at 6-months in the diet intervention. A stronger decline in sACE2 during the diet intervention was independently associated with female sex, lower HOMA-IR and LDL cholesterol at baseline, and a stronger decline in HOMA-IR, triglycerides, HDL-cholesterol and fat mass. In line, participants with decreasing HOMA-IR and triglycerides had significantly higher odds for a decrease in sACE2 during the diet intervention than those who did not (P≤0.0073 for both). Feature selection models linked ΔsACE2 to changes in AMBP, E-selectin, HAOX1, KIM-1, MERTK, PGF, thrombomodulin and TRAIL-R2. ΔsACE2 remained independently associated with these protein changes in multivariable-adjusted linear regression.

Conclusion
Decrease in sACE2 during a weight loss diet intervention was associated with improvements in metabolic health, fat mass and markers of angiotensin peptide metabolism, vascular injury, renal function, chronic inflammation and oxidative stress. Our findings may improve the risk stratification, prevention, and management of cardiometabolic and COVID-19-related complications.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIHResearch Foundation Flanders
The significant role of coronary artery calcification score in asymptomatic patients with metabolic syndrome
Authors: Temtem M , Serrao M , Mendonca M I , Santos M , Sousa J A , Mendonca F , Sousa A C , Rodrigues M , Freitas S , Henriques E , Borges S , Guerra G , Drumond A , Palma Dos Reis R ,   GENEMACOR study
Published: October 2021

Abstract

Background
Metabolic syndrome (MetS) is a clinical condition composed of metabolic and cardiovascular risk factors, such as abdominal obesity, hyperglycemia, dyslipidemia and hypertension. Many patients with MetS suffer major adverse cardiovascular events (MACE) that are not adequately identified by traditional risk assessment, suggesting the need for early detection of subclinical coronary heart disease to identify those at high-risk. Coronary artery calcification (CAC) screening has added utility in categorizing patients with low, intermediate and high cardiovascular risk.

Purpose
Evaluate the prognostic role of CAC score in asymptomatic population patients with metabolic syndrome in cardiovascular events risk prediction.

Methods
A total of 1,122 asymptomatic individuals without known coronary heart disease, enrolled from GENEMACOR study, were followed for a mean of 5.3±3.4 years for the primary endpoint of all-cause of cardiovascular events. All were referred for computed tomography for the CAC scoring assessment. According to the Hoff's nomogram, 3 categories were created: low CAC (0≤CAC&lt;100 or P&lt;50); moderate CAC (100≤CAC&lt;400 or P50–75) and high or severe CAC (CAC≥400 or P&gt;75). In a subgroup of 507 individuals with MetS and 615 controls, CAC values were compared by T-student and association of CAC severity with events occurrence was evaluated. Finally, a logistic regression model adjusted for CAC severity was performed in patients with MetS.

Results
Among our population, the extent of CAC differs significantly between men and women in the same age group. Patients with Mets (23.2%, n=115) had higher CAC scores than controls (219.0±486.0 vs 115.8±370.8, p&lt;0.0001). In this cohort, with higher CAC scores, 46.7% vs 22.5% had MACEs (p=0.049) during the follow-up. The logistic regression analysis revealed that CAC≥400 is a MACE predictor (OR=4.326, CI 95% 1.241–15.080, p=0.021) in patients with MetS.

Conclusion
Our results point to the importance of the inclusion of CAC screening in patients with MetS to further stratify those patients that, despite tight control of cardiovascular risk factors, may benefit from more intensive therapies. This tool is a useful and straightforward method that could have a significant impact on the prognosis of future cardiovascular disease in patients with MetS.

Funding Acknowledgement
Type of funding sources: None.
Heterogeneity of cardiorespiratory fitness among Brazilian regions and comparison with Norwegian values
Authors: Milani M , Milani J G P O , Cipriano G F B , Cipriano Junior G 
Published: October 2021

Abstract

Introduction
Cardiorespiratory fitness (CRF) is an important component of health-related physical fitness, and its reduction is associated with a higher risk of cardiovascular disease and increased mortality. Maximal oxygen consumption (VO2 max) measured in the Cardiopulmonary Exercise Test (CPET) is the gold standard for CRF evaluation. The measured VO2 max is compared to predicted normal reference values to provide an accurate and individualized evaluation and classification. However, predicted values have gender and age differences, and data from different regions and countries can be heterogenous due to different demographic and biopsychosocial characteristics.

Purpose
To compare reference values of VO2 max in Brazilian and Norwegian population samples do analyze geographical CRF differences.

Method
Brazilian reference values for CRF were compared within each other and with Norwegian values. The included studies evaluated healthy individual with CPET and direct measurement of VO2 max on a treadmill. Mean, standard deviation and sample size were obtained from the published articles in the last decade, and and standard error of mean (SEM) were calculated. The differences on CRF between studies were analyzed using SEM and the 95% confidence interval.

Results
Brazilian reference values for CRF were different between each other, with lower values at Northeast region and higher values at Southeast for all age groups and both genders. Midwest region showed CRF with intermediate values between these two regions. Comparisons also revealed different values from Norway, which presented the highest CRF for all age groups and both genders (Pictures 1 and 2). Observed heterogeneity in CRF may be explained by anthropometric differences, as Northeast individuals had lower height than the other Brazilian samples, and the Norwegians were the tallest. Other demographic and biopsychosocial characteristics may also play a role.

Conclusion
The present study revealed differences on CRF between countries and within Brazilian population, with a negative gradient from southern to northern regions of Brazil. This finding reinforces the appropriateness of adequate use of regional and country specific reference values for VO2 max to ensure a correct CRF evaluation and classification.

Funding Acknowledgement
Type of funding sources: None.
Cardiac rehabilitation do not diminish the socioeconomic and ethnical disparity in patients with coronary heart disease
Authors: Kjesbu I , Prescott E , Rasmusen H K , Osler M , Larsen M L , Gustafsson I , Zwisler A D , Sibilitz K L 
Published: October 2021

Abstract

Aims
Cardiac patients with low socioeconomic status and non-western ethnic background have worse outcomes. The aim of this nationwide study was to determine whether the immediate effect of CR differs between groups defined by socioeconomic status and ethnic background, and whether disparity in the prognosis of cardiac patients is diminished by CR participation.

Methods
We included all patients in Denmark with myocardial infarction and/or coronary revascularization from August 2015 until March 2018. Level of education, as a marker for socioeconomic status, was divided into four groups, and ethnicity into Danish, non-Western and Western. Participation in CR was identified through the Danish Cardiac Rehabilitation Database (DHRD) and the Danish National Patient Register. Primary outcome was achievement of CR quality indicators, including risk factor control and medication, from DHRD, and secondary outcome a composite endpoint of cardiovascular disease hospitalization and all-cause mortality (MACE).

Results
We identified 34,511 patients of whom 19,383 had participated in CR and 9,882 provided information on CR data from DHRD. Higher education was associated with greater improvement in VO2peak and non-western patients were less likely to be screened for depression or receive dietary consulting. No other significant disparity in CR quality indicators, was found across education and ethnicity. There was a strong socioeconomic gradient in MACE irrespective of CR participation, medication and risk factor control (adjusted HR 0.71 (0.58–0.86) for high versus low education). Similarly, non-western origin was associated with higher risk of MACE (adjusted HR 1.2 (1.1–1.4).

Conclusion
We found strong socioeconomic and ethnic disparity in prognosis of CHD patients which were unaffected by CR participation. The results indicate that CR, conventional risk factor control and medical treatment have limited impact on these disparities.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation Figure 1Figure 2
Exercise training induces benign right ventricular hypertrophy along with functional improvement and without pathological processes or arrhythmogenicity in a rodent model of athletes heart
Authors: Olah A , Bodi B , Sayour A A , Ruppert M , Barta B A , Virag-Tulassay E , Bottlik O , Papp Z , Merkely B , Radovits T 
Published: October 2021

Abstract

Introduction
Regular sport activity leads to the adaptation of cardiac structure and function, the so-called athlete's heart. Research projects over the last years have focused on exercise-induced adaptation of the right ventricle (RV), because the disproportionate load on the RV - when compared with the left ventricle - might lead to pathological consequences, such as myocardial interstital fibrosis or chamber dilation.

Purpose
We aimed at investigating comprehensively RV alterations induced by regular aerobic exercise training in a rat model of athlete's heart.

Methods
Young, adult rats were divided into control (Co) and exercised (Ex) groups (n=12–12). Exercised rats underwent a 12-week-long swim training program. In vivo electrophysiological study and in vitro cellular force assessments on isolated cardiomyocytes were carried out to investigate electrical and functional RV alterations, respectively. Molecular biological (qRT-PCR, Western-blot) and histological investigations were applied to reveal underlying mechanisms.

Results
Exercise training was associated with increased RV cardiomyocyte diameter (12.5±0.1 μm Co vs. 13.8±0.2 μm Ex, p&lt;0.05), that was associated with hyperphosphorylation of protein kinase B (Akt). RV cardiomyocytes from exercised animals showed improved calcium sensitivity and increased maximal force development, that was associated with hypophosphorylation of troponin I. We found increased length of repolarization as reflected by prolonged QT interval and ventricular effective refracter period (VERP: 44.0±1.6 ms Co vs. 52.8±2.1 ms Ex, p&lt;0.05) along with decreased gene expression of potassium channels (Kcnd2, Kcnj2). We could not induce ventricular arrhythmia by programmed stimulation. Picrosirius staining did not reveal fibrosis, that was associated with unchanged protein expression of connective tissue growth factor (CTGF) and gene expression of profibrotic markers (such as TGF-β). Gene expression of apoptotic markers (Bax, Bcl-2) and fetal gene program (such as β-MHC) did not differ between groups.

Conclusions
According to our data, regular swim training induced RV hypertrophy, that was associated with functional improvement (improved calcium sensitivity and maximal force), hypophosphorylation of troponin I and prolonged repolarization without characteristic pathological alterations or arrhythmogenicity of RV myocardial tissue.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research, Development and Innovation Office of Hungary