bluuebunny/crossref_metadata_2025_split huggingface dataset:
META-ANALYSIS ASSESSING THE EFFECTS OF ALLOPURINOL ON LEFT VENTRICULAR MASS AND OTHER INDICES OF LEFT VENTRICULAR REMODELING AS EVALUATED BY CARDIAC MAGNETIC RESONANCE IMAGING
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Stavropoulos Konstantinos , Imprialos Konstantinos , Toumpourleka Maria , Kalogirou Maria -Styliani , Tegou Zoi , Koutsampasopoulos Konstantinos , Mavridou Maria , Siskos Fotios , Papadopoulos Christodoulos , Doumas Michael 
Published: April 2021

Objective:
Hyperuricemia is a relatively common morbidity, featuring a close relationship with cardiovascular disease, hypertension, heart failure and chronic kidney disease, while it is also related to the development of type 2 diabetes mellitus. Allopurinol remains the mainstay of treatment. We sought to determine whether allopurinol affects left ventricular (LV) mass and other measures of LV remodeling, as assessed by cardiac magnetic resonance imaging (cMRI).

Design and method:
We performed a systematic search in two major electronic databases, PubMed and Cochrane Central Register of Controlled Trials (CENTRAL), for eligible randomized controlled trials (RCTs), from their inception to September 2020, along with grey literature sources.

Results:
Our search yielded 84 results in total. Finally, 4 records were included in our quantitative synthesis. Our analysis in a total of 225 patients showed that allopurinol treatment produced a non-significant decrease in LV mass by 1.42 g (MD = -1.42, 95% CI -6.34 to 3.50, I2 = 90%), and a non-significant decrease in LV mass index by 1.47 g/m2 (MD = -1.47, 95% CI -3.91 to 0.96, I2 = 91%). In addition, allopurinol did not decrease significantly neither LV end systolic volume (MD = -0.45 mL, 95% CI -5.53 to 4.64, I2 = 56%) nor LV end diastolic volume (MD = -2.98 mL, 95% CI –9.39 to 3.43, I2 = 35%). Finally, allopurinol did not affect significantly LV stroke volume (MD = 2.06 mL, 95% CI –2.02 to 6.14, I2 = 0%). We consider as major limitations of the present meta-analysis the small number of included RCTs and enrolled participants, which did not permit us to perform subgroup analyses in order to investigate the sources of heterogeneity.

Conclusions:
Conclusion: Allopurinol does not exert a significant effect on LV mass and other indices of LV remodeling, as quantified by cMRI, in a broad population with significant cardiovascular co-morbidities.
LONG-TERM TEMPERATURE VARIABILITY AND THE INCIDENCE OF CARDIOVASCULAR DISEASES: A LARGE, REPRESENTATIVE COHORT STUDY IN CHINA
Authors: Kang Yuting , Tang Haosu , Zhang Linfeng , Wang Su , Wang Xin , Chen Zuo , Zheng Congyi , Yang Ying , Wang Zengwu , Huang Gang , Gao Runlin 
Published: April 2021

Objective:
In the context of global climate change, far less is known about the impact of long-term temperature variability (TV), especially in developing countries. The current study was aimed to estimate the effect of long-term TV on cardiovascular disease in China.

Design and method:
The current study enrolled 23,721 individuals with mean age of 56.15 years in China from 2012–2016 and followed up during 2017 and 2019. TV was defined as the standard deviation of daily temperatures during survey years. The Cox regression was used to estimate the multivariable-adjusted hazard ratio (HR) between TV and cardiovascular diseases (CVD).

Results:
During the follow-up time, we ascertained 836 cases of incident of CVD. A significant positive trend was observed between CVD risk and increasing levels of TV comparing to the lowest tertile with an HR = 1.343 (95% CI: 1.133–1.591) for the medium tertile and an OR = 1.717(95% CI: 1.347–2.189) for the highest tertile (ptrend < 0.001). The HR per 1°C increase in TV was 1.062 (95% CI:1.014–1.112) for CVD. We also estimated that exposure to high TV would lost 2.11 years disease-free years for population aged 35 to 65 years, and was attributable to 2.93 million CVD cases (or 12.14% cases) in China.

Conclusions:
Long-term TV was associated with higher risk of incident CVD. Our findings will be valuable for future efforts assessing health risks related to the climate change and developing related policies to reduce TV related adverse health effect.
THE PREVALENCE AND RISK FACTORS OF HIGH-ALTITUDE PULMONARY HYPERTENSION AMONG THE HIGHLANDERS IN TIBETAN AREA
Authors: Gou Qiling , Li Xinran , Rong Xi , Zhang Xin , Ye Runyu , Zhang Zhipeng , Hu Xianjin , Chen Xiaoping 
Published: April 2021

Objective:
The study aimed to investigate the prevalence and risk factors of high-altitude pulmonary hypertension (HAPH) among the highlanders living at 3500m above sea level in Tibetan area of China.

Design and method:
we conducted a cross-sectional survey on the permanent Tibetans residing at an average altitude of 3500m. Age 18 years and above were selected by stratified cluster random sampling technique and screened for recording questionnaire, anthropometric indices, blood pressure, biochemical factors and echocardiography. HAPH was defined as mean pulmonary artery pressure over30mmHg indicated by echocardiography. Data of 1130 subjects were analyzed who were free of polycythemia and cardiorespiratory diseases to determine the prevalence of HAPH and its predisposing factors.

Results:
The prevalence of HAPH was different in males and females (8.7% vs 4.6%,P = 0.033). Patients with hypertension are more likely to develop HAPH compared with normal blood pressure (9.6% vs 4.4%,P = 0.010). T-test analysis suggested that patients with HAPH had lower pulse oxygen saturation and estimated glomerular filtration rate. In addition, patients with HAPH have more significant metabolic abnormalities (including elevated blood pressure, blood glucose, triglyceride, low density lipoprotein cholesterol, uric acid, waist circumference, hip circumference, BMI. all p value < 0.05), patients with HAPH have mildly increased RV, RA, and diameter of the main pulmonary artery. After stepwise multivariate logistic regression, it was suggested that age, hemoglobin level, and increased TG were independent risk factors for HAPH.

Conclusions:
It can be concluded that HAPH is prevalent in 5.8% of natives of Tibetan area in China. Increasing age, hemoglobin and triglyceride are independent predisposing factors.
ASSOCIATIONS OF PARITY AND AGE AT MENARCHE WITH SILENT CEREBROVASCULAR LESIONS OF BRAIN MAGNETIC RESONANCE IMAGING: THE OHASAMA STUDY
Authors: Nomura Kyoko , Sato Wakana , Satoh Michihro , Hara Azusa , Tsubota-Utsugi Megumi , Kobayashi Yuuki , Murakami Takahisa , Totsune Tomoko , Hirose Takuo , Tatsumi Yukako , Inoue Ryusuke , Asayama Kei , Kikuya Masahiro , Metoki Hirohito , Hozawa Atsushi , Watanabe Hiroyuki , Imai Yutaka , Ohkubo Takayoshi 
Published: April 2021

Objective:
Objective: Previous studies suggest that parity and menstrual factors were associated with an increased risk of cerebrocardiovascular diseases. We aimed to investigate if parity and menstrual factors are associated with brain ischemic lesions diagnosed by magnetic resonance imaging (MRI).

Design and method:
Materials and Methods: We identified 511 women aged 60 years or older from the general population of Ohasama, a rural Japanese community, who answered a questionnaire on parity and gravidity and age at menarche and menopause, were free of previous cardiocerebrovascular disease including atrial fibrillation, and underwent MRI. Silent cerebrovascular lesions were diagnosed by MRI and assessed by the presence of either lacunar infarcts or white matter hyperintensity, or both. Logistic regression model was used to investigate an association between any of quartiles of parity, gravidity, and age at menarche and menopause, and silent cerebrovascular lesions with adjustment for possible confounding factors including self-measured blood pressure values at home (home BP).

Results:
Results: Silent cerebrovascular lesion was observed in 269 subjects (53%) including lacunar infarcts (26%) and white matter hyperintensity (49%). Means of home systolic and diastolic BP levels were 128.9 ± 14.8 mmHg and 74.2 ± 8.6mmHg, respectively. Approximately 31% of subjects were under antihypertensive medication and 36 % had hypertension defined by home BP levels greater than or equal to 135/85. Age adjusted odds ratio of the highest quartile of parity (4- vs. 2 as reference) was 1.84 (1.10–3.06) for having silent cerebrovascular lesions and 1.83 (1.11–3.01) for white matter hyperintensity. Adjusting for age (p < 0.001), body mass index (p = 0.005), home systolic BP level (p = 0.039), hypertensive drug use (p = 0.001), impaired glucose tolerance (p = 0.418), hyperlipidemia (p = 0.103), and current smoker (p = 0.938) and drinker (p = 0.716), compared with women who had two children, women who had four or more children were more likely to have an increased risk with silent ischemic lesions (OR 1.88, 95%CI, 1.11–3.20). Similar association was also observed with white matter hyperintensity (OR 1.86, 95%CI, 1.11–3.12).

Conclusions:
Conclusion: Higher parity was associated with silent brain ischemic lesions and white matter hyperintensity diagnosed by MRI, independent of confounding factors including age and home BP levels.
IMPAIRED NO SIGNALLING, ER STRESS AND RHO KINASE MEDIATE PERIPHERAL VASCULAR DYSFUNCTION IN A MODEL OF SMALL VESSEL DISEASE OF THE BRAIN (CADASIL)
Authors: Neves Karla , Morris Hannah , Alves-Lopes Rheure , Montezano Augusto , Touyz Rhian 
Published: April 2021

Objective:
CADASIL, a monogenic condition due to Notch3 mutations, is a very aggressive small vessel disease of the brain resulting in premature vascular dementia and stroke. Changes in cerebral vessels include vascular dysfunction and narrowing, and accumulation of granular osmiophilic material (GOM). It is not clear whether small peripheral arteries undergo similar damage. Thus our aim is to assess vascular dysfunction and associated mechanisms in mesenteric resistance arteries from CADASIL mice.

Design and method:
Mesenteric arteries (MA) from male CADASIL-causing Notch3 mutation (TgNotch3R169C) and wildtype (TgNotch3WT) mice (6 months old) were investigated. Blood pressure (BP) was assessed by tail-cuff and vascular function by myography.

Results:
BP and cardiac function were unchanged in CADASIL mice. By electron microscopy GOM deposits were identified in MA from CADASIL mice. Notch3 (WT: 2.0 ± 0.5 vs. 6.0 ± 1.3) and HeyL (WT: 1.1 ± 0.4 vs. 2.9 ± 0.6) mRNA were augmented in CADASIL mice (p < 0.01). CADASIL mice exhibited endothelial (Emax 109.9 ± 7.4 vs. 81.3 ± 5.4) and VSMC-dysfunction (pD2 7.8 ± 0.1 vs 6.8 ± 0.3); effects associated with increased eNOS inhibition (p-Thr495) (1.8-fold increase) and decreased cGMP levels (1.2 ± 0.2 vs 0.59 ± 0.2) (p < 0.05). Contraction to Ang II (Emax 33.7 ± 6.8 vs. 72.8 ± 4.4), phenylephrine (Emax: 70.6 ± 7.2 vs. 92.1 ± 4.2) and U46619 (Emax: 123.4 ± 4.4 vs. 215.1 ± 24.4) (p < 0.05) was increased in CADASIL; effects attenuated by fasudil (Rho-kinase inhibitor) and 4-PBA (ER stress inhibitor) (p < 0.05). MA structure and mechanics from CADASIL mice remain unchanged at this stage. U46619-induced calcium influx was increased in TgNotch3R169C VSMCs (AUC: 1.3-fold increase) as well as SERCA (1.5 ± 0.7 vs. 8.1 ± 1.4) and TRPM2 (0.7 ± 0.3 vs. 4.5 ± 1.6) mRNA levels (p < 0.05). BiP protein expression (ER stress marker) (1.7-fold increase) and gene expression of Rho GEFs (LARG: 1.1 ± 0.1 vs. 2.1 ± 0.3; PDZ: 0.9 ± 0.1 vs. 2.9 ± 0.4) were increased in MA from TgNotch3R169C vs. TgNotch3WT mice (p < 0.05). These effects may be associated with the increase in oxidative stress observed in VSMCs from peripheral arteries and brain vessels from CADASIL patients (p < 0.05).

Conclusions:
Our findings demonstrate that the cerebral vasculopathy associated with Notch3 mutations is also present in peripheral small vessels and identify ER stress and Rho kinase as potential new therapeutic targets in CADASIL, for which there are no disease-specific treatments.
NEUROLOGICAL HYPERTENSIVE EMERGENCIES: CORRELATION OF BLOOD PRESSURE VALUES WITH IN-HOSPITAL MORTALITY AND DISCHARGE DISABILITY
Authors: Giani Valentina , Maloberti Alessandro , Biolcati Marco , Bianchi Sofia , Magni Gloria , Albertini Valentina , Conti Matilde , Curci Camilla , Porta Lorenzo , Rigamonti Annalisa , Trucchi Andrea , Battistini Marta , Bergamaschi Marta , Valobra Tommaso , Capsoni Niccolo , Cassano Giulio , Gheda Silvia , Ceresa Chiara , Agostoni Elio Clemente , Beretta Andrea , Bellone Andrea , Giannattasio Cristina 
Published: April 2021

Objective:
Definitive data on acute management of Blood Pressure (BP) in neurological Hypertensive Emergencies (HE) are still lacking. Aim of our study was to evaluate BP values and management as a determinant of in-hospital mortality and early complications in stroke patients.

Design and method:
We collected data of 267 patients, who presented with ischemic stroke and BP > 180/120 mmHg at the Emergency Department of Niguarda Hospital from 2015 to 2017. In-hospital mortality, hospitalization length and discharge disability (evaluated with modified Rankin score – mRs) were considered as outcomes.

Results:
Mean age was 75.7 ± 11.7 years with SBP values of 194.9 ± 14.9 mmHg at admission. 34.8% of the patients received anti-hypertensive treatment with those achieving a higher SBP reduction in comparison with the untreated one (dSBP 37.8 ± 26.8 mmHg vs 30.7 ± 20.8 mmHg p = 0.034). At the multivariate analysis in the overall population, no SBP values are related to all causes in-hospital mortality. Instead, higher admission SBP relates to high discharge disability and hospitalization length. Furthermore, SBP values at admission in Emergency Department appear as disability determinants in patients who did not receive systemic thrombolysis and in patients who did not receive antihypertensive drugs. In these two subgroups, higher SBP values at department entrance determine a higher in-hospital mortality.

Conclusions:
In overall population, no BP values are related to all causes in-hospital mortality while higher admission BP relates to high disability and hospitalization length.
COGNITIVE FUNCTION AND CAROTID STRUCTURE OVER LONG-TERM OBSERVATION IN PATIENTS WITH RESISTANCE HYPERTENSION
Authors: Gulkevych Oksana , Mishchenko Larisa , Matova Olena , Logvinenko Alla , Bezrodnyj Volodymyr , Serbeniuk Kateryna 
Published: April 2021

Objective:
to investigate the changes of cognitive function and carotid structure in patients with résistance hypertension (RH) over 24 months observation

Design and method:
In 51 pts with RH (average age 52,3 ± 0,9; 27 males) we measured ultrasonographically diameter (D) of common carotid arteries (CCA), carotid intima-media thickness (IMT) value at the carotid bifurcations and at the level of CCA, blood flow velocities (BFV) of CCA, internal carotid arteries (ICA) and cognitive function by Montreal cognitive assessment (MoCA) test twice: at baseline and after 24 months. Changes in D CCA, IMT and MoCA test were defined as a difference between subject's baseline D CCA, IMT, MoCA test and subsequent measurements obtained 24 months later. All pts received 4 antihypertensive drugs during observation period

Results:
systolic and diastolic blood pressure were significantly decreased at the end of observation period. Carotid diameter and IMT value at the level of CCA were significantly decreased during observation period (DCCA from 8,6 ± 0,03 to 8,3 ± 0,03 mm, p = 0,02, CCA IMT from 1,24 ± 0,02 to 1,11 ± 0,02 mm, p = 0,01). IMT value at carotid bifurcation didn’t change significantly. We observed improvement in cognitive function: MoCA test results at baseline was 22,2 ± 0,5 after 24 months - 24,9 ± 0,5. The end diastolic BFV in CCA, ICA were significantly increased (accordingly: CCA – 0,14 ± 0,03 vs 0,34 ± 0,03m/s, p = 0,001, ICA – 0,23 ± 0,02 vs 0,48 ± 0,03m/s, p = 0,001) and resistance index (RI) of ICA was significantly decreased from 0,65 ± 0,02 to 0,61 ± 0,02. Changes of peak systolic BFV were not significant. Changes of MoCA results were related to IMT value at the level of CCA at baseline and at the end of observation (accordingly: r = -0,81; p < 0,01 and r = -0,79; p < 0,02). The same relations were between MoCA results and IMT value at bifurcation CCA.

Conclusions:
our 24 months study showed the positive dynamics of cognitive function and carotid structure such as decreasing of carotid diameters, intima-media thickness at level CCA and carotid resistance in patients with resistance hypertension who were receiving antihypertensive treatment.
ASSOCIATION OF AMBULATORY BLOOD PRESSURE WITH FRONTAL CORTICAL THICKNESS AND HIPPOCAMPAL VOLUME
Authors: Ha Jeongha , Lee Chan Joo , Kim Woojin , Jang Heeseon , Oh Jaewon , Lee Sang -Hak , Kang Seok -Min , Lee Seung -Koo , Kim Changsoo , Park Sungha , Seo Sangwon 
Published: April 2021

Objective:
In the elderly, the effect of blood pressure on brain structure or cognitive function has not been clear. However, there are limitations in that most of studies was done using serial change in clinic blood pressure. We sought to determine the association of the ambulatory blood pressure over time with the brain structural alterations and cognitive function

Design and method:
In this study, we sought to examine the association between blood pressure and brain structure/cognitive function in the elderly over the age of 60 by using the 24-hour ambulatory blood pressure information at 2 different visits (mean time interval is 3.4 years). From October 2018, we included participants performed Korean Mini Mental State Exam; older than 60 years old among the participants in Cardiovascular and Metabolic Disease Etiology Research Center-High Risk Cohort.

Results:
When we divided the 170 participants into two groups according to the control of cumulative average daytime blood pressure, the cortical thickness of frontal lobe was thinner and the average hippocampal volume was smaller in the uncontrolled group (P = 0.002, P = 0.01 respectively). In multivariate linear analysis, the uncontrolled group for cumulative average daytime blood pressure was associated with thinner cortical thickness of frontal lobe and smaller average hippocampal volume (P = 0.007, P = 0.024 respectively). However, the baseline daytime blood pressure had no associations with brain structure or cognitive function.

Conclusions:
Our observations suggest that serial measurements of 24-hour ambulatory blood pressure may be important to assess the cumulative pressure load and the association with structural changes of the brain.
ASSESSMENT OF CAROTID INTRAPLAQUE HEMORRAGE BY PHOTOACUSTICS IMAGING (PAI) IN PATIENTS UNDERGOING TROMBOENDOARTERIECTOMY: FIRST IN-VIVO HUMAN VALIDATION STUDY
Authors: Bruno Rosa Maria , Imaizumi Yuki , Hobeid Hasan , Jaeger Michael , Julia Pierre , Bruneval Patrick , Calvet David , Boutouyrie Pierre 
Published: April 2021

Objective:
The aim of the study is the validation of a portable multimodal photoacoustic imaging (PAI) system, for the identification of intraplaque haemorrhage and compare with MRI and histology (gold standard).

Design and method:
25 patients with carotid stenosis>70% and clinical indication to tromboendoarterectomy were recruited. Angio-MRI for intraplaque hemorrhage assessment (Cube sequence) was performed. PAI clips (5 seconds, Frame rate 1000/sec) were acquired. Each clip was scored for the presence of PAI signal by means of an integrated scoring system (semiquantitative, from 0 to 12). Semiquantitative grading scales were used to assess plaque histological features of hemorrage and vulnerability.

Results:
18 patients had no missing MRI, PAI and histology data and were included in this analysis. Mean age was 73 ± 8 years, 60% men, 80% Caucasians, 92% hypertensives, 60% with a previous stroke. Only 3 plaques out of 21 showed no signs of intraplaque hemorrhage, 4 showed small hemorrage, while 14 (67%) showed large hemorrhages. PAI score (best cut-off >4) correctly classified 14 out of 18 patients (Sensitivity 73.3%, specificity 100%, AUC 0.867). MRI performance was substantially similar (Sensitivity 60%, specificity 100%, AUC 0.800, 12 patients correctly classified), with a non-significant difference in AUC compared to PAI (p = 0.420).

Conclusions:
In this first in-vivo human study, PAI is able to identify histological intraplaque hemorrhage with an excellent specificity and acceptable sensitivity, equivalent to MRI. The very high specificity, with a low number of false positives, make PAI a good candidate for evaluation of plaques prior to surgery to i.e. reinforce the decision to perform surgery.
BLOOD PRESSURE IN RELATION TO INTERACTION BETWEEN DIETARY SODIUM INTAKE AND SERUM URIC ACID IN CHILDREN AND ADOLESCENTS WITH PRIMARY HYPERTENSION
Authors: Zhang Wei , Wang Dian , Xu Jian-Zhong , Li Yan , Wang Ji-Guang 
Published: April 2021

Abstract

Objective:
We investigated ambulatory blood pressure in relation to interaction between dietary sodium intake and serum uric acid in children and adolescents with primary hypertension.

Design and method:
The study subjects were in the age range from 10 to 24 years, admitted in Ruijin Hospital because of hypertension. Ambulatory blood pressure monitoring was performed during hospitalization using SpaceLabs 90217 monitors. We collected 24-hour urine for measurements of sodium excretion. We measured serum uric acid concentration with a blood chemistry autoanalyzer, and defined hyperuricemia as a serum uric acid concentration of at least 5.5 mg/dl. Our analysis was restricted to those with primary hypertension (n = 580).

Results:
The prevalence of hyperuricemia was 48.7%, being higher in male (n = 252) than female (n = 31, 54.9% vs 25.4%) and in untreated (n = 84) than treated patients (n = 199, 56.4% vs 46.1%). Ambulatory blood pressure did not differ across the quartile distributions of urinary sodium excretion (P > = 0.05), but was significantly (P <  = 0.04) higher in patients with hyperuricemia than those without for all components, except 24-hour and daytime systolic blood pressure (P > = 0.15). In multivariable regression analysis adjusted for age, sex, body mass index, current smoking and alcohol intake, there was a significant (P < = 0.03) interaction between urinary sodium excretion and serum uric acid in relation to 24-hour systolic and diastolic blood pressure. Indeed, in the presence of hyperuricemia, 24-hour systolic/diastolic blood pressure was 2.2/1.1 mm Hg higher with 100 mmol increase in urinary sodium excretion.

Conclusions:
Dietary sodium intake interacts with serum uric acid to be associated with ambulatory blood pressure.