bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcatheter aortic valve implantation outcomes compared between bicuspid aortic and tricuspid aortic valve stenosis: an updated systematic review and meta-analysis
Authors: Aedma S , Gupta R , Mahajan S , Mahajan P , Patel M , Malik A , Naik A , Mehta S , Patel N C 
Published: October 2021

Abstract

Background
TAVI has emerged as an attractive treatment modality based on promising recent trial data. Patients with BAV, a commonly encountered clinical condition have largely been excluded from a majority of trials.

Purpose
Elderly patients with BAV and severe AS are increasingly encountered in clinical practice. This meta-analysis compares clinical outcomes between bicuspid and tricuspid AV patients to address the current knowledge-gap and identify optimal management strategies of these patients.

Methods
A comprehensive literature search was performed in PubMed, Embase, and Cochrane to identify the available observational studies comparing outcomes of TAVI in BAV and TAV patients. Summary effects were calculated using a DerSimonian and Laird random-effects model as odds ratio with 95% confidence intervals for all the clinical endpoints.

Results
16 Observational studies met inclusion criteria, comprising 10,053 patients with BAV and 173,307 patients with TAV that underwent TAVI. No significant differences in 30-day and long-term mortality rates were observed. Patients with BAV had an increased risk of stroke (OR 1.23; 95% CI [1.06–1.44], p=0.007), re-intervention (OR 1.90; 95% CI [1.15–3.15], p=0.01), paravalvular leak (OR 1.42; 95% CI [1.25–1.61], p&lt;0.ehab724.22251), conversion to open surgery (OR 1.93; 95% CI [1.21–3.07], p=0.006), and new pacemaker implantation (1.57; 95% CI (1.06 - 2.33, p=0.02). Adverse event rates are lower with the use of newer generation of valves. No significant difference in major vascular complications, major bleeding, or incidence of AKI was noted.

Conclusions
Complication rates for BAV TAVI are higher, but mortality is similar to TAV TAVI indicating TAVI is an appropriate alternative for intermediate-high risk patients with BAV. A better understanding of valve anatomy, physician expertise, the use of newer-generation valves can help reduce these complications.

Funding Acknowledgement
Type of funding sources: None.
Circulating microRNA-133a and its associations with left ventricular hypertrophy in men with arterial hypertension
Authors: Koval S , Yushko K , Snihurska I , Mysnychenko O 
Published: October 2021

Abstract

Introduction
Arterial hypertension (AH) is the most common cardiovascular (CV) diseases and one of the major a risk factor for CV complications and mortality. An important reason for the development and progression of a number of CV diseases are epigenetic factors regulating gene expression, which include microRNAs. MicroRNA-133a is one the epigenetics factor, which has cardioprotective properties, but its role in the development of left ventricular hypertrophy (LVH) in patients with AH, including men, is not well understood.

Purpose
The aim of the study was to investigate the circulating microRNA-133a levels, its associations with left ventricular (LV) parameters and LVH in men with AH.

Methods
In study was included 57 men with AH grades 2–3 aged 43 to 64. The main group consists of 32 patients with LVH and the comparison group consists of 25 patients without LVH. The main and the comparison groups were comparable in age and duration of hypertension. The control group consisted of 22 practically healthy men of comparable age. The LVH was determined according to the 2018 ESC/ESH guidelines. Circulating plasma microRNA-133a levels were obtained by polymerase chain reaction using the CFX96 Touch System, “TaqMan microRNA Assay” and “TaqMan® Universal PCR Master Mix” reagent kits.

Results
In men with AH (total group) the levels of microRNA-133a were significantly lower than in practically healthy men in the control group (0.212 [0.091; 0.364]) vs (0.402 [0.178; 0.513]), p&lt;0.05). The levels of microRNA-133a in main group were significantly lower than in comparison group and control group (0.125 [0.078; 0.295] vs 0.276 [0.126; 0.397], p&lt;0.05 and 0.402 [0.178; 0.513]), p&lt;0.05). In the main group (men with AH and LVH) there was a statistically significant negative correlation between microRNA-133a levels and LV mass index (R=−0.42, p&lt;0.01) with no significant correlation with ejection fraction or E/e' (averaged) ratio (p&gt;0.05). In men with AH of the comparison group (without LVH) there were not significant associations of microRNA-133a levels with LV parameters (p&gt;0.05).

Conclusion
The obtained results may indicate a significant role of decreased circulating plasma microRNA-133a levels in men with AH in the pathogenesis and development of the LVH.

Funding Acknowledgement
Type of funding sources: None.
Relationship between transient symptomatic hypotensive episodes and 24-hour blood pressure variability in patients with arterial hypertension
Authors: Ermasova S , Popov K , Shvarts Y 
Published: October 2021

Abstract

Purpose
Low blood pressure may be as harmful as high. Symptomatic hypotensive episodes should be a manifestation of circulatory disorders of hypertension – mediated organs especially among hypertensive patients. However, the association of such episodes with blood pressure variability is unknown.

Aim
To study the relationship between the symptomatic hypotensive episodes and the daily blood pressure variability according to the ambulatory blood pressure monitoring (ABPM) in patients with hypertension.

Materials and methods
106 patients aged between 40 and 65 years with hypertension were studied. A questionnaire developed by the authors was used to identify symptomatic hypotension. During the study all the subjects had ABPM. Daily blood pressure variability was defined as standard deviation.

Results
Among all patients, symptomatic hypotensive episodes were observed in 60.6%. Among patients without myocardial infarction or stroke in anamnesis - 52.4%, with ones - 75% participants (p=0.05). Among patient without myocardial infarction or stroke and with symptomatic hypotensive episodes, the high variability of daily systolic BP was observed in 36% of the subjects and averaged 14.3 mm Hg, in the absence of symptomatic hypotensive episodes, the variability of daily systolic BP was 16.3 mm Hg, with a variety of blood pressure exceeding the norm, 80% of the participants (p&lt;0.05).
In case of stroke or myocardial infarction in anamnesis and the presence of symptomatic hypotensive episodes, the systolic BP variability of daytime (18.0 mm Hg) and nighttime (14.8 mm Hg) was the highest. The proportion of participants with daily systolic BP variability exceeding the norm was 78%. In the absence of symptomatic hypotensive episodes, the blood pressure variability indicators did not deviate from the norm (p&lt;0.05).

Conclusion
Heart attack and/or stroke in anamnesis with symptomatic hypotensive episodes are associated with lower daily systolic BP variability (14.3 mm Hg) in comparison with patients without symptomatic hypotensive episodes (16.3 mm Hg). If there were stroke or myocardial infarction in anamnesis, patients with symptomatic hypotensive episodes have higher daily systolic BP variability (18.0 mm Hg) than without hypotensive episodes (14.5 mm Hg). Symptomatic hypotensive episodes are not unidirectionally associated with the variability of blood pressure, the character of the relationship is associated with the presence of heart attack and/or stroke diseases in anamnesis.

Funding Acknowledgement
Type of funding sources: None.
24-hour ambulatory blood pressure measurement using a novel non-invasive, cuff-less, wireless device
Authors: Nachman D , Gilan A , Goldstein N , Constantini K , Littman R , Eisenkrafta A , Grossmanc E , Gepnerc Y 
Published: October 2021

Abstract

Background
Ambulatory blood pressure monitoring (ABPM) using cuff-based devices is used for diagnosis and treatment of hypertension. Technical limitations, low compliance and complex procedures limit their use.

Purpose
The aim of the present study was to test the accuracy of a new technique of 24H ABPM using a photoplethysmography (PPG)-based, wearable device (Wrist-monitor) as compared to the standard cuff-based ABPM device.

Methods
In this prospective observational study, 24H ABPM was performed in parallel for both devices on volunteers aged 18–65 years, while documenting their daily activities. Level of comfort and activity disturbance of both devices were recorded. Linear regression and Bland-Altman were used to evaluate the agreement between devices. Receiver Operating Characteristic (ROC) curve analysis was used to assess the capability of the Wrist-monitor to identify abnormal BP values.

Results
The study included 28 subjects (18 men) mean age 41.5±16.2 years. Bland-Altman analysis resulted in 24H bias of −1.1 mmHg for both diastolic blood pressure (DBP) and systolic blood pressure (SBP). Mean daytime bias was −1.9 mmHg for DBP and SBP, while nighttime bias was smaller (0.7 and 0.4 mmHg for DBP and SBP respectively). ROC curve analysis on all BP readings (n=2381) yielded a mean area under the curve (AUC) for 24H of 0.965 for both SBP and DBP. 24H ABPM with the Wrist-monitor caused significantly less inconvenience compared to the cuff-based device (p&lt;0.001).

Conclusions
The cuff-less device provides comparable measurements to those obtained with the currently used cuff-based ABPM device, with significantly less inconvenience to the subject.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): The ABPM devices were given for free by BioBeat LTD. Petach-Tikva, Israel. No other support was given.
Pilot study of comparability of a smartphone blood pressure monitoring algorithm to conventional cuff-based blood pressure measurements
Authors: Vischer A , Rosania J , Socrates T , Blaschke C , Proenca M , Bonnier G , Proust Y.-M , Ferrario D , Eckstein J , Lemay M , Burkard T 
Published: October 2021

Abstract

Background/Introduction
There is a growing market for smartphone applications (apps), offering medical assessments such as blood pressure measurements (BPM). These apps have the potential to improve blood pressure (BP) control by making BPM broadly and easily accessible. Yet, to be suitable for clinical and diagnostic purposes, BPM measured with smartphone apps need to be comparable to conventional BPM.

Purpose
We sought to compare a novel photoplethysmographic BPM algorithm used in a smartphone app to conventional cuff-based BPM.

Methods
We included consecutive patients with an indication for ambulatory BPM. Office blood pressure measurements (OBPM) were taken with an oscillometric cuff-based device (Welch Allyn SureBP). The algorithm of the smartphone app detects the pulse wave in finger capillaries using the phone's camera and estimates BP based on the form of the pulse wave. Before estimating a BP value, the algorithm performs a quality assessment to automatically reject recordings with insufficient quality. On the first day (D1), we took 6 OBPM alternating with 5 smartphone BPM (TestBP). On the second day (D2), 4 OBPM alternating with 3 TestBP were measured. TestBP calibrated based on the first OBPM of D1. Each TestBP was then compared to its RefBP (defined as mean of the previous and following OBPM).

Results
50 patients were included in the study, resulting in 50 TestBP values on D1 and 33 on D2. There was no difference at the 5% significance level between the TestBP and RefBP distributions on both days, and for both systolic and diastolic pressures. The mean ± standard deviation (SD) of the differences between TestBP and RefBP was 0.7±9.4 / 1.0±4.5 mmHg on D1 and 2.6±8.2 / 1.3±4.1 mmHg on D2 for systolic/diastolic values, respectively. The number of TestBP measurements within 5, 10 and 15 mmHg from RefBP are shown in Table 1. Bland-Altman plots depicting the agreement between TestBP and RefBP are shown in Figure 1.

Conclusion
This smartphone algorithm shows comparable values to oscillometric cuff-based especially diastolic values. Its differences between TestBP – RefBP have a good stability 1 day after calibration. Before clinical use, this algorithm needs to undergo formal validation against a reference BP method accepted by international standards (auscultatory or invasive methods).

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Centre Suisse d'Electronique et de Microtechnique Table 1Figure 1
Individualizing the target diastolic blood pressure in patients being treated for hypertension and diabetes
Authors: Sobieraj P , Sinski M , Lewandowski J 
Published: October 2021

Abstract

Background/Introduction
The J-curve hypothesis in hypertension is related to an increased risk of cardiovascular events associated with both too high and too low diastolic blood pressure (DBP) values.
European Society of Cardiology recommended DBP in the range of 70–80 mm Hg as a treatment target for subjects with hypertension, regardless of age, history of cardiovascular disease (CVD) or diabetes mellitus (DM) presence.
Such a recommendation is based on studies performed in subjects with prior CVD. There is no scientific evidence to support a target DBP of 70–80 mmHg in people with DM and without history of CVD.

Purpose
The aim of the study is to determine the relationship between DBP and cardiovascular risk according to age and the presence of CVD in people with DM.

Methods
The ACCORD study dataset (participants with diabetes) available from National Heart, Lung and Blood Institute was used to perform the analysis.
The DBP value during the study was defined as the mean of all DBP measurements obtained during the study individually for each participant.
The composite endpoint (CE) was defined as myocardial infarction, stroke, exacerbation of heart failure or cardiovascular death.
The relationship between the DBP value during the study and the risk of CE was presented using the Cox proportional hazard model and spline curves.
This analysis was performed for 4 sub-populations defined on the basis of 2 criteria: age &lt;65 years and the presence of CVD in the past. Each model was adjusted for other cardiovascular risk factors (age, sex, smoking, systolic blood pressure, chronic kidney disease).

Results
The data of 4,733 participants of the ACCORD BP study were analyzed. The table (Figure 1) presents the baseline characteristics of the 4 sub-populations and CE occurrence.
For each sub-population studied, a Cox model describing the relationship between DBP during the study and CE risk was developed and presented in the Figure 2.
In subjects with CVD the J-curve relationship between DBP and CE risk was observed. Among subjects without prior CVD, no J-curve relationship was observed.

Conclusions
Optimal DBP treatment target in subjects with CVD and DM is slightly lower than the currently recommended range of 70–80 mm Hg.
DBP values in the range of 70–80 mm Hg should not be recommended as the treatment target for subjects with DM and no history of CVD.

Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
High prevalence of non-dipping patterns among black Africans with uncontrolled hypertension: a secondary analysis of the CREOLE trial
Authors: Ingabire P M , Ojji D B , Rayner B , Ogola E , Damasceno A , Erika J , Dzudie A , Ogah O , Poulter N , Sani M U , Barasa F , Shedul G , Mukisa J , Mukunya D , Mondo C K ,   CREOLE Study Investigators
Published: October 2021

Abstract

Background
Dipping of blood pressure (BP) at night is a normal physiological phenomenon. However, a non-dipping pattern is associated with hypertension mediated organ damage, secondary forms of hypertension and poorer long-term outcome. Identifying a non-dipping pattern may be useful in assessing risk, aiding the decision to investigate for secondary causes, initiating treatment, assisting decisions on choice and timing of anti-hypertensive therapy, and intensifying salt restriction.

Objectives
To estimate the prevalence and factors associated with non-dipping pattern and determine the effect of three 6-months anti-hypertensive regimens on the dipping pattern among Black African hypertensive patients.

Methods
This was a secondary analysis of the CREOLE Study which was a randomized, single blind, three-group trial conducted in 10 sites in 6 Sub-Saharan African countries. The participants were 721 Black African patients, aged between 30 and 79 years, with uncontrolled hypertension and a baseline 24-hour ambulatory blood pressure monitoring (ABPM). Dipping was calculated from the average day and average night systolic blood pressure measures.

Results
The prevalence of non-dipping pattern was 78% (564 of 721). Factors that were independently associated with non-dipping were: serum sodium &gt;140mmol/l (OR=1.72, 95% CI: 1.17–2.51, p-value 0.005), a higher office systolic BP (OR=1.03, 95% CI: 1.01–1.05, p-value 0.003) and a lower office diastolic BP (OR=0.97, 95% CI: 0.95–0.99, p-value 0.03). Treatment allocation did not change dipping status at 6 months (McNemar's χ2 0.71, p-value 0.40).

Conclusion
There was a high prevalence of non-dipping among Black Africans with uncontrolled hypertension. ABPM should be considered more routinely in Black Africans with uncontrolled hypertension, if resources permit, to help personalise therapy. Further research is needed to understand the mechanisms and causes of non-dipping pattern and if targeting night-time BP improves clinical outcomes.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Fogarty International Center and the National Institutes of Health of the United States of America Figure 1
Atherosclerosis risk factors may be underestimated in patients with pulmonary hypertension associated with congenital heart disease – results of Polish snapshot registry
Authors: Mamzer A , Kopec G , Kusmierczyk-Droszcz B , Skowron W , Mroczek E , Lewicka E , Kaminski K , Karasek D , Mularek-Kubzdela T , Mizia-Stec K , Kurzyna M , Gasior Z , Ciurzynski M , Plonska-Gosciniak E , Kasprzak J D ,   SKP/PTK study group
Published: October 2021

Abstract

Introduction
Classic risk factors of atherosclerosis may contribute to cardiovascular (CV) risk in patients (pts) with pulmonary hypertension associated with congenital heart disease (PAH-CHD), but their prevalence is poorly studied.

Purpose
We evaluated a large cohort of Polish PAH-CHD patients (PAHpts) treated with specific therapies with regard to prevalence of classic risk factors for atherosclerosis.

Methods
A multicenter observational snapshot registry was conducted under the auspices of Polish Cardiac Society to study PAH pts, identified in centers treating &gt;5 such pts in years 2008–2018. The analysis included 250 PAH-CHD pts, including non-corrected CHD – predominantly Eisenmenger Syndrome (Gr. 1, 224 pts, mean age 42±2 years, 63% females) and pts after heart disease correction (Gr. 2, 26 pts, mean age 42±6.5 years, 62% females). The incidence of classic CV risk factors was compared in both groups.

Results
The prevalence of risk factors was considerable considering young age of the cohort and statistically similar in both groups (Figure). Hypertension was present in 14% in Gr. 1 and 15% in Gr. 2. The incidence of diabetes was comparable in both groups (3% vs. 4%). Hyperlipidemia was nearly numerically twice as frequent in Gr. 1 (23% vs. 12%, p=0.18). Current smokers (1%) were only present in Gr. 1, while history of smoking was 4% in both groups. Symptomatic atherosclerosis of peripheral arteries was twice as frequent in Gr. 1 (8% vs. 4%, p=0,71). There was no difference regarding prior stroke (3,6% vs 4%, p=0,63). Chronic kidney disease and atrial fibrillation were one and a half more often in Gr. 1 (respectively, 12% vs. 8%, p=0,81; 12% vs. 8%, p=0.75). Mean heart rate was 72±2 bpm in Gr. 1 and 77±7 bpm in Gr. 2. Gastrointestinal bleeding was reported only in Gr. 1 (2.7%). SCORE calculated risks were low due to low age, but high risk was identified in 9.3% of Gr. 1 and 20% of Gr. 2 (p=0.096).

Conclusions
Based on our data from national survey, classic atherosclerosis CV risk factors are not uncommon in the population of relatively young patients with PAH-CHD, parallel to improved longevity. Selected pts from both groups present with elevated risk of death from atherosclerotic complications. This finding may influence the overall mortality risk in PAH-CHD population and reflects new challenges in management despite progress in specific therapies of pulmonary hypertension.

Funding Acknowledgement
Type of funding sources: None. Figure 1
Psychosocial and behavioral characteristics of still smokers at 6 months after acute cerebro or cardiovascular events: preliminary findings from INEV@L, a prospective pilot study
Authors: Zeller M , Sales-Wuillemin E , Guinchard S , Chappe J , Chague F , Ayari H , Maza M , Aboa-Eboule C , Truchot D , Lorgis L , Giroud M , Cottin Y , Bejot Y 
Published: October 2021

Abstract

Introduction
Considering the benefits of smoking cessation, and evolving new tobacco-product consumption, such as e-cigarettes (e-cig), contemporary behavioral and psychosocial factors (PSF) associated with smoking after acute stroke or myocardial infarction (MI) remain to be investigated.

Methods
From INEV@L, a prospective pilot study in 128 workers hospitalized for MI or stroke (MI/stroke: 199/57) &lt;65 y, between 2016 and 2017 in CHU Dijon. Among them, 67 (52%) current smokers were analyzed. PSF (education level (EL), socioeconomic status (SES), perceived disease severity (PDS), anxiety/depression), and health behavior (adhesion to Mediterranean diet (AMD), BMI, physical activity (PA), smoking) were collected at the acute phase and at 6 Months Follow-Up. Patients who quit smoking were compared with non-quitting patients.

Results
Still smokers at 6-M FU were frequent (30 (45%)) and had similar risk factors including age (51±7 y) than quitters. Rate of overweight/obese patients and AMD were similar (52 vs 65%, p=0.281 and 29±6 vs 26±7, p=0.207). SES and EL were slightly higher in still smokers group. The level of anxiety or depression was as high in the 2 groups (63 vs 68%, and 19 vs 20%, p=0.717 and 0.911). Although similar at the acute phase (p=0.867), PDS at 6-M FU, trended to be lower in non-quitters (57 vs 78%, p=0.057). At FU, only few returned to work (57% for both groups). Overweight/obese who reduced their weight were more common in non-quitters (60 vs 38%, p=0.170). Patients who improved AMD or PA level were similar (62 vs 78%, p=0.166, and 67 vs 92%, p=0.317). The vast majority of non-quitters introduced the use of e-cig (80% vs 0%, p&lt;0.001).

Conclusion
Our pilot study in young workers highlights the low rate of smoking cessation, and generalized dual use of electronic+conventional cigarette at mid-term after acute MI or stroke. Our findings further suggest specific PSF pattern of non-quitters, associated with loss of perceived disease severity.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Conseil Régional de Bourgogne Franche Comté et CHU Dijon Bourgogne