bluuebunny/crossref_metadata_2025_split huggingface dataset:
RADIAL-FINGER PULSE WAVE VELOCITY: RESPONSE OF PERIPHERAL SMALLER ARTERIES TO NITROGLYCERIN
Authors: Fortier Catherine , Obeid Hasan , Garneau Charles-Antoine , Paré Mathilde , Marquis Karine , Agharazii Mohsen 
Published: April 2021

Objective:
We previously demonstrated a different regional stiffness response of elastic and muscular arteries after the administration of nitroglycerin, leading to an alteration of aortic-brachial stiffness gradient. Peripheral smaller arteries may also respond differently to nitroglycerin. The objectives of this study were 1- to assess the feasibility of measuring arterial stiffness of the hand, i.e. radial-finger pulse wave velocity (RF-PWV) using piezoelectric sensors, and 2- to measure RF-PWV and its response to nitroglycerin.

Design and method:
This study was conducted in 29 healthy participants (66% were women, mean age was 40.0 ± 15.1 yrs). Piezoelectric sensors (Complior) were place simultaneously on carotid and radial arteries, and tip of the index and/or third finger, to obtain carotid-radial PWV (CR-PWV) and RF-PWV. These measurements were repeated with a subgroup of 11 subjects after 4 minutes of 0.4mg NTG sublingual spray. Raw data were analyzed using Matlab to ensure good quality of signals and adequacy of the foot-to-foot method.

Results:
Visually, pressure curves at both fingers were obtained with an excellent quality, similar to radial and carotid pressure curves. Identification of the feet of the finger pulse waveforms was optimal with the second derivative algorithm. RF-PWV intra-session coefficient of variation was 7.3%. At baseline, mean CR-PWV and RF-PWV were respectively of 8.21 ± 1.44 m/sec and 4.65 ± 1.42m/sec. After NTG, CR-PWV decreased (7.75 ± 1.32 m/s) and RF-PWV increased (6.75 ± 2.58 m/s), both significantly (p<0.01). However, stiffness of the whole upper limb (carotid-finger PWV) did not change significantly (7.37 ± 0.87 m/s vs 7.29 ± 1.08 m/s, p=0.605).

Conclusions:
This first attempt to measure regional stiffness of small arteries shows that it is possible to measure hand PWV. Again, we observed opposite changes in regional stiffness of different vascular territories with a vasodilator drug. These results may open up the path to a better understanding of microcirculation consequences of an altered stiffness gradient.
THE ROLE OF MANIDIPINE IN HYPERTENSIVE PATIENTS WITH MICROALBINURIA
Authors: Tsoutsouli Vasiliki , Paskalis Georgios-Charis , Sachla Zacharo , Koursioumbas Georgios , Foutsitsakis Dimos , Gkogkos Konstantinos 
Published: April 2021

Objective:
Microalbuminuria is frequent in patients with established hypertension, and predicts increased cardiovascular risk in hypertensive patients and probably renal dysfunction. It is considered a routine measurement in hypertensive patients and treatment aims to decrease its prevalence. We aim to evaluate the possible role of CCB inhibitors on hypertension and microalbuminuria.

Design and method:
283 patients with hypertension and microalbuminuria were enrolled in the study, 130 men and 153 women, aged 40 to 70 years. Patients with diabetes mellitus were excluded. Manidipine 10 mg/daily was added for 6months to all patients, regardless if they received or not other anti-hypertension regimen and microalbuminuria was measured before the beginning of the treatment and after 6 months. Microalbuminuria levels were measured by 24-hour urine collection. Excretion between 30 mg/dL and 300 mg/dL was considered microalbuminuria.

Results:
The albumin excretion rate was decreased after 6 months of treatment by 24%. Microalbumin in 24-hour urine was reduced from a mean of 182 mg/dL to 138 mg/dL and in 15 patients (5%) microalbuminuria was not present in the second measurement (microalbumin < 30 mg/dL). Blood pressure was also reduced achieving blood-pressure goals in 40% of the patients.

Conclusions:
This study confirms that CCB inhibitors can play a role in the management of microalbuminuria, along with their well-known blood-pressure reduction effect. Study design did not allow subgroup analysis of the results according to other medication they received. The clinical significance of this level of reduction and its effect in reducing long-term renal damage or other clinical end-points has to be evaluated in further studies.
EVIDENCE HOW EPITHELIAL SODIUM CHANNEL PROMOTES STIFFNESS IN HUMAN AND MOUSE ENDOTHELIAL CELLS
Authors: Shah Vikash Kumar , Fronius Martin 
Published: April 2021

Objective:
The epithelial sodium channels (ENaCs) in the kidney maintain body salt/water balance and contributes to blood pressure regulation and hypertension. Recent finding suggests that ENaCs in endothelial cells are potential players mediating endothelial cell stiffness (ECS). Increased ECS is an important determinant of hypertension that coincides with altered endothelial nitric oxide (NO) production and endothelial dysfunction. Herein, we aim to uncover the molecular mechanism how ENaC influences ECS. I hypothesize that F-actin changes as a potential target through which ENaC mediates its effect.

Design and method:
ENaC subunit protein levels in Human Umbilical Vein Endothelial Cells (HUVECs) and Mouse Myocardial Endothelial Cells (MyEnd) cells were quantified by Western blotting. Aldosterone was used to increase ENaC expression. Changes in ECS assessed with Atomic Force Microscopy (AFM). If changes in F-actin cell cytoskeleton is correlated with ENaC expression and ECS, immunofluorescence microscopy was used and quantified.

Results:
Aldosterone was observed to significantly increase alpha-ENaC (both in human and mouse cells) and delta-ENaC (human specific) protein levels which were reversed by the additional incubation with amiloride (ENaC blocker). The elevated ENaC expression with aldosterone was associated with an increased Young's modulus that is indicative of elevated ECS observed in both human and mouse endothelial cells. The upregulated ENaC expression and increased stiffness was also translated into increased F-actin in response to aldosterone.

Conclusions:
Taken together, our study provides experimental evidence of increased ENaC protein level with increased F-actin cell cytoskeleton in endothelial cells that may promote ECS. This is a new mechanism through which ENaC mediate ECS and contributes to endothelial dysfunction and hypertension.
RELATION OF SUBCUTANEOUS, VISCERAL, PERIAORTIC, EPICARDIAL ADIPOSE TISSUE WITH CAROTID ARTERY INTIMA-MEDIA THICKNESS IN YOUNG PEOPLE WITH ABDOMINAL OBESITY
Authors: Zheleznova Ekaterina , Zhernakova Yu , Chazova I. , Pogorelova O. , Tripoten M. , Balakhonova T. , Shariya M. , Blinova N. , Azimova M. , Gorieva Sh , Maslov A. 
Published: April 2021

Objective:
The main aim of study was to investigate the association between subcutaneous (SF), visceral (VF), periaortic (PF), epicardial (EF) fat and carotid artery intima-media thickness (CIMT) in patients with abdominal obesity (AO) and whith metabolic syndrome (MS).

Design and method:
127 patients 18–45 y.o. (average age 38,4 ± 6,0) with AO (men (M) – 58,3%) were enrolled in study. Height, weight, BMI, waist circumference, blood tests (fast glucose (FG) and glucose tolerance (GT), lipid profile) were measured. MS was defined as AO (cut-off of > 80 cm in women (W) and > 94 cm in M) plus > 1 sign: HDL < 1,30 (w)/1,04 (m)mmol/l; triglycerides > 1,7mmol/l; FG > 5,6mmol/l; violation GT; BP > 140/90mmHg. The averaged TIM was measured on both sides in a longitudinal section in the distal third of thein left and right carotid artery at a distance of 1 cm proximal to the bifurcation, calculated as the maximum value of the two average values obtained during two successive measurements and direct access two consecutive measurements lateral access. SF, VF, PF, EF (range: -150 to -30 HU) was measured by computed tomography. We calculated ratio subcutaneous to visceral fat (RSV). 24 hour blood pressure monitoring was performed. We formed 2 groups: AO (AO plus 1 or less sing of MS) and MS.

Results:
No statistically significant difference between the groups was found in the assessment of TIM.Tab. 1. Correlations CIMT with age r = 0,406 (p = 0,000), BMI r = 0,225 (p = 0,000), WC r = 0,031 (p = 0,000), TG r = 0,215 (p = 0,013), daytime SBPm r = 0,187 (p = 0,031), with volume of VF r = 0,326 (p = 0,000), EF r = 0,329 (p = 0,000), PF r = 0,440 (p = 0,000), LDL r = 0,182 (p = 0,037) were found. An inverse correlation was found with RSV r = -0,241 (p = 0,005) and with HDL r = -0,239 (p = 0,005).

Conclusions:
This study shows the role of PVT and other fat depots in the development of structural and functional disorders of the vascular wall in young people. The revealed correlations prove the existence of a close pathogenetic relationship between obesity, lipid metabolism disorders and the state of the vascular wall.
A STUDY OF DETERMINANT OF BLOOD PRESSURE IN 6–9 YEAR OLD CHILDREN IN THE EASTERN CAPE OF SOUTH AFRICA
Authors: Nkeh-Chungag Benedicta Ngwenc , Matjuda Edna 
Published: April 2021

Objective:
Objective: The objective of this study was to investigate the contribution of both anthropometric measurements and selected urinary markers of oxidative stress and endothelial function to blood pressure parameters in 6–9 year old children.

Design and method:
Study design: A cross sectional study design was used.

Methods:
306 male and female school children aged 6–9 years old were recruited for the study. Anthropometry was performed, followed by blood pressure and pulse wave velocity (PWV) measurements and collection of urine for determination of albumin-creatinine ratio (ACR), concentration of 8-Hydroxy-2’-deoxyguanosine (8-OHdG) and asymmetric dimethyl arginine (ADMA).

Results:
Results: Besides neck circumference (p less than 0.0001), PWV (p less than 0.01) and albumin-creatinine ratio (ACR) (p less than 0.0001), there were no differences in all measured parameters between boys and girls. The prevalence of overweight/obesity and hypertension/pre-hypertension in the cohort were 19.2% and 42.2% respectively. In girls systolic blood pressure (SBP) correlated with BMI (r = 0.43); NEC (r = 0.37); mid upper arm circumference (MUAC) (r = 0.51) and WC (r = 0.47) while diastolic blood pressure (DBP) correlated with NEC (r = 0.34); MUAC (r = 0.26), WC (r = 0.27). Heart rate (HR) correlated with SBP (r = 0.26). Pulse wave velocity correlated with SBP (r = 0.26); DBP (r = 0.31); DBP (r = 0.31). In boys however, the only correlation was between PWV and DBP (r = 0.29). Linear regression analysis showed that for every unit increase in mid upper arm circumference, SBP increased by 2.056 mmHg in the cohort. In females additionally, every unit increase in8-OHdG increased SBP by 0.171 mmHg.

Conclusions:
Conclusion: Neck circumference, PWV and ACR were different between boys and girls showing subtle difference in risk factors for hypertension even in these young children. The higher ACR values corresponded with higher PWV in boys though MUAC seemed to be the best predictor of blood pressure in the cohort.
ALTERATIONS IN ANTHROPOMETRIC, PHYSIOLOGICAL AND BIOCHEMICAL PARAMETERS DURING A COMPLEX EXERCISE AND DIETARY TREATMENT PROGRAM FOR OBESE PATIENTS WITH CONTROLLED HYPERTENSION
Authors: Jenei Zoltán , Horváth Ágnes , Nagy Adél , Seres Ildikó , Paragh György , Fülöp Péter 
Published: April 2021

Objective:
Obesity and hypertension are considered as major risk factors of for cardiovascular diseases. Besides unfavorable metabolic processes, altered levels of pro-inflammatory factors and adipokines produced by the white adipose tissue have various role in atherogenesis. In our study, we aimed to investigate the impact of exercise and dietary therapies on these unfavorable processes in obese, controlled hypertensive patients.

Design and method:
Forty-two obese subjects with controlled hypertension were enrolled in our six-week self-controlled clinical trial. The load capacity was assessed by ergospirometry and the maximum VO2 uptake (VO2max), respiratory anaerobic threshold (V-slope) and maximum metabolic equivalent (MET) were determined. Body composition analysis and six- minute walking test (6MWT) were also performed. We also investigated serum lipid parameters, high-sensitivity C-reactive protein (hsCRP) levels, oxidized low-density lipoprotein (oxLDL) concentrations, paraoxonase (PON1) activities and calculated the homeostatic model assessment (HOMA)-insulin resistance (HOMA-IR). Serum adipokine levels including leptin, adiponectin, tumor necrosis factor (TNF)-alfa, chemerin, resistin, lipocalin-2 concentrations were also measured. All of our tests were repeated at the end of the six-week program, during which, the patients received 3 x 50 minutes of exercise training. Dietotherapy was also provided twice a week.

Results:
Each patient completed the program (age: 58.12 ± 10.4 years, M/F: 9/33, initial mean body mass index /BMI/: 44.24 ± 7.22 kg/m2, mean blood pressure /BP/: 132,21 ± 5,74 mmHg). At the end of the program, BMI and BP were significantly reduced (p < 0.00001, p < 0.01, respectively), with improvement in all functional tests (p < 0.0001), VO2max (p < 0.000002) and in V-slope (p = 0.001). LDL-cholesterol and oxLDL concentrations decreased significantly (p = 0.0005, p = 0.0009, respectively), while high-density lipoprotein (HDL)-cholesterol levels showed a significant increase (p = 0.0028). HOMA-IR also improved significantly (p = 0.006) and the percentage of body fat mass was reduced significantly (p = 0.000036). Among the adipokines, only the circulating concentrations of lipocalin-2 and leptin were significantly decreased (p = 0.036, p < 0.000001, respectively). HsCRP concentration and PON activity were also found to be significantly reduced (p < 0.00001, p = 0.0032, respectively).

Conclusions:
Besides its beneficial physiological effects, an aerobic exercise program combined with dietotherapy improves pro-atherogenic, pro-inflammatory and metabolic factors in obese patients with controlled hypertension.
AFRICAN'S LEAF (VERNONIA AMYGDALINA) EXTRACT EFFECT FOR TRYGLICERIDE LEVEL ON WISTAR RAT WITH METABOLIC SYNDROME
Authors: Kresna Deva Bayu , Widiasih Alifah Wahyu , Imani Namira Putri , Budiani Dyah Ratna , Hermawan Danus 
Published: April 2021

Objective:
This study was designed to determine the effect of African's leaf (Vernonia amygdalina) extract towards triglyceride level of Wistar rats (Rattus norvegicus) with metabolic syndrome model.

Design and method:
The research was laboratory experimental research using pretest- posttest control group design. It included 30 male Wistar rats that were divided into 5 groups of normal control group (KKn), positive control group (KKp), and treatment groups (KP1, KP2, KP3). KKp, KP1, KP2 and KP3 were metabolic syndrome induced, fed with high fat high fructose diet and were given with STZ- Na injection. KP1, KP2 and KP3 were given treament of ethanolic extract of Vernonia amygdalina with dosage 50 mg/KgBW, 100 mg/KgBW, and 150 mg/KgBW respectively. Metabolic syndrome induction were done with high fat high fructose diet for 31 days and injection of STZ-Na on the 28th. Treatment groups got the extract of Vernonia amygdalina for 28 days subsequent to metabolic syndrome induction. The result data of trygliceride level were analyzed using one way ANOVA and Post-Hoc Tukey.

Results:
There was a significant differences of trygliceride level between day 32th and 61st with p = 0.000 (p < 0,05) on all groups. Decreased level of trygliceride were showed the highest on KP3 with mean different value 28,7476 mg/dL, followed by KP1 with 23,7983 mg/dL, and KP2 with 20,8933 mg/dL.

Conclusions:
Extract of African's leaf (Vernonia amygdalina) has a significant effect of lowering trygliceride level.
OBESITY-RELATED CHANGES IN DIASTOLIC FUNCTION AND LEFT ATRIAL IN PATIENTS WITH RECURRENT ATRIAL FIBRILLATION AND PRESERVED EJECTION FRACTION: DOES GENDER MATTER?
Authors: Kokhan Elizaveta , Kiyakbaev Gayrat , Kobalava Zhanna 
Published: April 2021

Objective:
Both diastolic dysfunction (DD) and left atrial (LA) remodeling are closely associated with each other as well as with atrial fibrillation (AF) and heart failure with preserved ejection fraction. Obesity was traditionally considered to be a state of chronic volume overload, neurohumoral activation and, therefore, heart remodeling. But the data concerning relationship between obesity, DD and LA remodeling depending on gender is scarce. We aimed to evaluate the impact of gender on the association between body mass index (BMI), the presence of obesity and DD, LA remodeling in patients with recurrent AF, hypertension and preserved ejection fraction.

Design and method:
Twenty seven men and 28 women (median age of 65 [60;72]) with recurrent AF, hypertension and preserved ejection fraction (>50%) were enrolled in this study. Beyond conventional echocardiographic protocol, global peak LA longitudinal strain (PALS, %) in the reservoir (r) and contractile (c) phases was measured using two-dimensional speckle tracking echocardiography.

Results:
There were no significant differences between women and men in most clinical and demographic parameters including, duration of hypertension (65 vs 67 moths, respectively; p = 0.88) and AF (37 vs 42 moths, respectively; p = 0.83). DD was significantly more pronounced in women [E/E’ (13 vs 11.2; p = 0.03), but both groups had similar LA-volume index (41 vs 41 ml/m2; p = 0.97), PALSr (12.6 vs 12.4% p = 0.64) and PALSc (-12.9 vs -12.4% p = 0.65). Women, but not men, had significant association between BMI and PALSc (r = 0.6; p < 0.001 vs r = 0.2; p = 0.24), E’ (r = -0.41; p = 0.03 vs r = -0.04; p = 0.84); interaction p for PALSc = 0.043 and for E’ = 0.1. Only in women subgroups of patients with and without obesity differed by LA size (45 vs 36 mm p = 0.006), PALSr (11.7 vs 14.8% p = 0.03), PALSc (-12.5 vs -16.2% p = 0.002) and E’ (0.05 vs 0.07 m/s p = 0.02).

Conclusions:
Patients of both genders had similar patterns of LA remodeling. But only in women was diastolic relaxation and left atrial structural and functional parameters significantly related to BMI and the presence of obesity. It might indicate a higher susceptibility of the women's heart to remodeling associated with overweight.
LOW DOSE-EPLERENONE TREATMENT DECREASES AORTIC STIFFNESS IN PATIENTS WITH METABOLIC SYNDROME
Authors: Kannenkeril Dennis , Bosch Agnes , Kolwelter Julie , Striepe Kristina , Ott Christian , Schiffer Mario , Schmieder Roland E. 
Published: April 2021

Objective:
Metabolic syndorme is a well-established cardiovascular risk factor with increasing prevalence and incidence globally. Our aim in this study was to analyse the effect of a low dose steroidal mineralocorticoid receptor antagonist on metabolic parameters, aortic stiffness parameters and endothelial function (as assessed by measuring baseline nitric oxide activity) of the macrovasculature in patients with metabolic syndrome.

Design and method:
Patients with mild uncomplicated primary arterial hypertension and at least 2 of the following traits of the metabolic syndrome (Adult Treatment Panel III criteria: abdominal obesity (abdominal girth > 102 cm in males), triglyceride level > 150 mg/dL or treatment for elevated triglycerides, HDL < 40 mg/dL or treatment for low HDL, fasting blood glucose > 100 mg/dL and < 126 mg/dl) were included in the study. After the wash-out of antihypertensive medication (if applicable), patients were treated with eplerenone (EPL) 25 mg for the next 10 weeks. Pulse wave analysis was performed before and after infusion of L-NMMA (=nitric oxide-synthase inhibitor) at baseline and after treatment with EPL.

Results:
In patients with metabolic syndrome (n = 23), HbA1c (5.8 ± 0.3 vs. 6.0 ± 0.3 %; p = 0.012) and HDL (41.5 ± 8.1 vs. 44.1 ± 10 mg/dl; p = 0.046) increased significantly with EPL treatment. Central systolic pressure (132 ± 11.6 vs. 124.8 ± 12.9 mmHg; p = 0.015), augmentation pressure (15.2 ± 26.9 vs. 11.9 ± 23.1 mmHg; p = 0.011), augmentation index (22.5 ± 7.8 vs. 18 ± 11.1 %; p = 0.028, independent of systolic office blood pressure (BP) reduction), and augmentation index normalized to heart rate of 75/min (18.6 ± 7.8 vs. 14.5 ± 8.8 %; p = 0.006, independent of systolic office BP reduction) reduced significantly with EPL treatment. Augmentation index normalized to heart rate of 75/min increased significantly with infusion of L-NMMA after treatment with EPL (14.7 ± 8.8 vs. 17.6 ± 8.3 %; p = 0.004), whereas no such difference could be noticed at baseline (p = 0.230) thereby indicating an increased nitric oxide availability.

Conclusions:
Our data show that EPL beneficially affects markers of arterial stiffness in patients with metabolic syndrome, independent of systolic office BP reduction. Whether the observed benefits could be noticed with nonsteroidal mineralocorticoid receptor antagonists without change in metabolic parameters warrants further investigation.
PROVINCIAL DISPARITIES IN THE BURDEN OF CARDIOVASCULAR DISEASES ATTRIBUTABLE TO GENERAL, ABDOMINAL AND VISCERAL ADIPOSITY: RESULT FROM A RECENT NATIONAL REPRESENTATIVE STUDY
Authors: Kang Yuting , Wang Xin , Chen Zuo , Jiang Linlin , Zheng Congyi , Yin Peng , Dong Wenlan , Zhang Linfeng , Zhou Maigeng , Wang Zengwu , Gao Runlin 
Published: April 2021

Objective:
Recent data suggest that the burden of cardiovascular diseases (CVD) attributable to adipose differed by regions, while the disparity have not been fully discussed before in Chinese population.

Design and method:
Data on participants aged 35 years or over selected from China Hypertension Survey (CHS) was used to calculate prevalence of adipose. Meanwhile, cohort data selected randomly from CHS was used to calculate the multivariable-adjusted HRs by Cox regression. HRs along with the adipose prevalence were used to calculate the PAF.

Results:
During a mean of 4.56 years of follow up, 1,109 participants experienced at least a cardiovascular event. At national level, the PAF of CVD was 6.20 % [95% confidential interval (CI): 6.16%-6.24%] for overweight, 7.08% (95%CI: 6.99%-7.17%) for obesity, 13.30% (95%CI: 13.21%-13.37%) for abdominal obesity, 8.99% (95%CI: 8.94%-9.04%) for body fat percentage, and 5.14% (95%CI: 5.07%-5.21%) for visceral adipose index. At province level, the PAFs for obesity ranged from 13.31% in Tianjin to 2.37% in Hainan, from 20.78% in Tianjin to 5.38% in Hainan for abdominal obesity, with highest PAFs being in north and and west provinces, lowest in south and costal provinces.

Conclusions:
Our estimates are strikingly different across geographic regions, with a large proportion of CVD in China are attributable to adipose, including body fat percentage. Our findings support developing both national and provincially-specific strategies to reduce the burden of CVD and disparity in China.