bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF STATISTICAL AND MACHINE LEARNING APPROACHES IN A SURVEY FROM THE EPIDEMIOLOGY OF NON-COMMUNICABLE DISEASES
Authors: Vladimir Kutsenko , Pereverdieva Ksenia , Balanova Yulia , Imaeva Asiia , Shalnova Svetlana , Yarovaya Elena 
Published: April 2021

Objective:
To determine if the disuse of basic machine learning approaches may cause a significant loss of predictive power in the epidemiology study.
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Design and method:
A cross-sectional study «Epidemiology of Cardiovascular Diseases in the Russian federation (ESSE-RF)» was performed in 13 regions in 2012–2013. ESSE-RF included randomly selected 21768 participants aged 25–64 with a response rate > 80 %. Standard epidemiology methods and criteria were used. The current sub-study included 13912 participants. We chose lasso regression (L1Regression) and random forest (RF) as basic machine learning methods and logistic regression (LogRegression) as a basic statistical method. We compared these algorithms on predicting arterial hypertension (AH) from 18 clinical, demographic, and social risk factors from international AH guidelines. We fitted the models on the training sample and assessed their quality on the holdout sample with an AUC metric. We used 1000 random train-holdout splits to exclude randomness. We studied the RF feature impacts with model-agnostic techniques: partial dependence plots (PDPs), feature importances, and feature interaction measures. Statistical analysis was performed using R 3.6.1.

Results:
LogRegression had better performance (82.11 ± 0.42) than L1Regression (81.90 ± 0.40) and RF (81.60 ± 0.43) respectively. Nine out of the top ten important variables in LogRegression were in the top ten important variables of RF, and vice versa. However, RF feature importance was more compatible with the risk guidelines than the LogRegression one (fig. 1A). In particular, LDL and HDL levels were insignificant in the LogRegression but significant in the RF. PDPs of RF were strictly monotonous and close to linear (fig. 1B). There were no features with an interaction measure greater than 35 % except for age. Using the previous analysis information, we constructed new interpretable features, which improved the AUC of basic LogRegression by 0.21.

Conclusions:
Data from the ESSE-RF study is homogeneous. Associations between features and AH are approximately linear and non-interactive. Therefore, it is correct to adhere to the basic interpretable statistical algorithms. However, machine learning methods can provide additional information that can improve understanding of risk factors influence.
QUANTIFICATION OF CARDIAC KINETIC ENERGY AND ITS CHANGES DURING TRANSMURAL MYOCARDIAL INFARCTION ASSESSED BY MULTI-DIMENSIONAL SEISMOCARDIOGRAPHY
Authors: Morra Sofia , Pitisci Lorenzo , Su Fuhong , Hossein Amin , Rabineau Jérémy , Racape Judith , Gorlier Damien , Migeotte Pierre -François , Creteur Jacques , Van De Borne Philippe 
Published: April 2021

Objective:
Seismocardiography (SCG) records cardiac and blood-induced motion transmitted to the chest surface as vibratory phenomena. Evidences demonstrate that acute myocardial ischemia (AMI) profoundly affects the SCG signals. Multidimensional SCG records cardiac vibrations in linear and rotational dimensions and scalar parameter of kinetic energies can be computed. We speculate that AMI and revascularization profoundly modify cardiac kinetic energy as recorded by SCG.

Design and method:
Under general anesthesia, 21 swines underwent 90 minutes myocardial ischemia induced by percutaneous subocclusion of proximal left anterior descending (LAD) coronary artery and subsequent revascularization. Invasive hemodynamic parameters were continuously recorded. SCG was recorded during the baseline (BSL); immediately and 80 min after LAD subocclusion (AMI t0; AMIt80, respectively); immediately and 60 min after LAD reperfusion (RE t0, RE t80, respectively). iK was automatically computed for each cardiac cycle (iK_CC) in linear (iK_Lin) and rotational (iK_Rot) dimensions. iK was calculated during systole and diastole (iK_Sys and (iK_Dia, respectively).

Results:
Compared to baseline, troponins increased from 13.0 [6.5; 21.3] ng/dL to 170.5 [102.5; 475.0] ng/dL and LVEF dropped from 65.0 ± 0.0% to 30.6 ± 5.7% at the end of revascularization (both p < 0.0001).
In the linear dimension, iK_Lin-CC, iK_Lin-Sys, iK_Lin-Dia dropped by 43%, 52%, 53% respectively (p < 0.0001, p < 0.0001, p = 0.03, respectively) from baseline to the end of reperfusion. In the rotational dimension, iK_Rot-CC and iK_Rot-Sys dropped by 30% and 36% respectively (p = 0.0006, p < 0.0001), but iK_Rot-Dia did not change (p = 0.41).
The figure below represents the evolution of waveforms of iK computed from the SCG signals during the experimental procedure, specifically during BSL, AMIt0, AMIt80, REt0, REt60. Linear (B) and rotational (C) iK drop at AMIt0 compared to BSL, remain below baseline values during the all duration of AMI and returns to normal level during reperfusion.
The hemodynamic parameters, except the pulmonary artery pulse pressure, were significantly correlated with parameters of iK.

Conclusions:
Multidimensional SCG can detect changes in myocardial contractility during experimental AMI, providing information on the cardiac contractile status expressed in term of iK.
This automatic system may empower health care providers and patients to remotely monitor cardiovascular status in the near future.
CONTRIBUTION OF ARTIFICIAL INTELLIGENCE TO THE DECISION-MAKING PROCESS WHEN PERFORMING A HOME BLOOD PRESSURE MONITORING
Authors: Asmar Roland , De Buyer Paul , Boualit Robert , Girerd Xavier 
Published: April 2021

Objective:
Analyze home blood pressure monitoring data with the help of algorithms used in artificial intelligence and compare this method to traditional statistical analysis to categorize a subject with respect to its blood pressure status.

Design and method:
From an anonymized database of self-measurements performed in hypertensive patients followed in a hypertensive specialist center, artificial intelligence algorithms were used (logistic regression, gradient boosting tree, neural network) and compared with usual statistical methods. The self-measurement protocol consisted of 6 sequences over 3 days with 3 measurements per sequence, and 2 sequences per day. The mean of the 18 measures was used as a baseline to categorize the decision-making process with the thresholds SBP > = 135 or DBP>= 85 to define hypertension status.

Results:
The data base included 3910 HBPM which generated over 110,000 values to enter the analysis model. The figure shows that the AI allows to confirm or deny ‘hypertension’ in 46% of the subjects, as soon as sequence 2 is performed and that 82% of the subjects have a definite diagnosis after 4 sequences. In addition, AI is systematically more efficient than the statistical method whose performance, at 70% of patients with a definite diagnosis, remains at a plateau after sequence 4.

Conclusions:
Artificial intelligence algorithms are more efficient than conventional statistical methods to categorize the blood pressure status of a subject after only 2 sequences of a Home Blood Pressure Monitoring. From this hospital database it appears that 4 sequences performed over 2 days are sufficient to confirm or deny the diagnosis of hypertension in more than 80% of subjects.
ARTIFICIAL INTELLIGENCE FOR HYPERTENSION MANAGEMENT: A SYSTEMATIC REVIEW OF MEDICAL AND ENGINEERING LITERATURES
Authors: Tsoi K. , Lee H. W. Y. , Yiu K. K. L. , Leung C. L. T. , Wong S. Y. S. 
Published: April 2021

Objective:
The present study aims to review and clarify the current evidence on AI applications for hypertension management from medical and engineering perspectives.

Methods:
A literature search was conducted on major electronic databases: Embase, MEDLINE, CINAHL with keywords ‘artificial intelligence’, ‘hypertension’, and ‘blood pressure’. The quality of included studies was assessed with PROBAST tool. Included studies were categorised into (i) software and hardware development, (ii) disease prediction, and (iii) treatment recommendation. Results of individual studies were summarized for comparison.

Design and method:
A total of 92 articles were included for study, with more than half originated in Asia. Most studies involved blood pressure (BP) measurement with studies in engineering journals concerning the development of hardware and software, whereas medical researchers largely focused on the clinical use of these AI solutions. Electronic signals are the mainstay of BP measurement, although attempts were also made to extract useful information from health records. About a third of the studies were devoted to the identification of, and predicting the incidence and outcomes of hypertension using AI. In particular, studies that aimed to identify hypertension based on electronic signals achieved an AUC between 0.7 and 0.9, very similar to those concerning the incidence and prognosis of hypertension, despite different types of data and algorithms used. Studies on BP profiling and treatment with AI remained scant yet insightful.

Conclusion:
While a number of novel solutions have been invented for BP measurement and management, closer interdisciplinary collaboration between clinicians and engineers should further be encouraged to streamline BP profiling and treatment, personalised treatments with the aid of AI for example.
AMBULATORY BLOOD PRESSURE IN RELATION TO PLASMA AND URINARY MANGANESE
Authors: Zhang Zhen-Yu , Carmeli Cristian , Ponte Belen , Pruijm Menno , Ackermann Daniel , Ehret Georg , Guessous Idris , Petrovic Dusan , Pechère-Bertsc Antoinette , Vogt Bruno , Martin Pierre -Yves , Burnier Michel , Lenglet Sébastien , Augsburger Marc , Thomas Aurelien , Bochud Murielle 
Published: April 2021

Objective:
The association of blood pressure (BP) with manganese, an essential trace element required for human health, remains poorly studied.

Design and method:
In 734 randomly recruited Swiss participants (mean age, 47.5 years; 51.4% women), we related ambulatory BP to two biomarkers, plasma manganese (pMn) and the urinary manganese excretion (uMn). To allow for diurnal variation, we assessed BP and uMn over 24 h and during wakefulness and sleep, using split urine samples.

Results:
24 h, day- and night-time systolic/diastolic BPs averaged 119.8/78.1, 123.8/81.2 and 107.0/68.3 mm Hg; the corresponding medians uMn were 199.5, 83.0, 51.5 umol and median pMn 0.52 ug/L. In analyses dichotomized by the median of the biomarkers, greater pMn was associated with higher 24 h systolic/diastolic BP (+4.1/+ 2.3 mm Hg; P<= 0.0003), greater daytime uMn with lower daytime BP (3.5/ 1.9 mm Hg; P<= 0.0067) and greater nighttime uMn with higher nighttime BP (+2.9/+ 1.2 mm Hg; P<= 0.046). In multivariable-adjusted analyses, significance (P<= 0.030) was retained for the positive association of 24 h and daytime diastolic BP with pMn and for systolic BP in relation to uMn at night. The association sizes for a twofold increment in the biomarkers amounting to 0.77 mm Hg (95% confidence interval [CI], 0.08–1.47 mm Hg), 0.97 (CI, 0.20–1.76) and 1.33 (CI, 0.20–2.50 mm Hg), respectively.

Conclusions:
In conclusion, there were positive associations between diastolic BP and pMn over 24 h and during daytime and between systolic BP and uMn at night.
THE PROLACTIN MAY BE A SENSITIVE MARKER FOR MENOPAUSAL HYPERTENSIVE WOMEN WITH LEFT VENTRICULAR HYPERTROPHY
Authors: Wang Hongxing , Yu Jing 
Published: April 2021

Objective:
This study aimed to explore the relationship between the level of prolactin (PRL) and left ventricular hypertrophy (LVH) in postmenopausal women with hypertension.

Design and method:
A total of 128 menopausal women with hypertension were divided into hypertension with LVH group (n = 63, group 1) and hypertension without LVH group (n = 65, group 2). Selected healthy people matched the age, menopausal time with group 1 and group 2 as a control group (n = 57, group 3). Blood pressure, blood biochemistry, sexual hormones, including PRL were measured in these three groups. At the same time, echocardiography recorded the parameters including left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDd), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular ejection fraction (LVEF), and early diastolic mitral flow velocity (E) and systolic mitral flow velocity (A) ratio (E /A). central artery blood pressure and cervical -femoral pulse wave velocity (cf-PWV) were also measured. A statistical analysis was performed to compare the differences in these parameters among the three groups.

Results:
There was no significant difference in age and menopausal time among this three groups (P > 0.05). The body mass index (BMI) in the hypertension with LVH group was significantly higher than that of hypertension without LVH group (P < 0.05). There was no significant difference in estradiol, testosterone and progesterone among three groups (P > 0.05), but the PRL in the hypertension with LVH group was lower significantly than those of without LVH group (P < 0.05). In hypertension with LVH group, there were significantly higher in LAD, IVST and LVPWT compare with hypertension without LVH group. The cf-PWV in hypertension with LVH group were significantly higher than that of hypertension without LVH (P < 0.05). It was shown that the degree of decline in PRL was positively correlated with LVH in menopausal hypertensive women (P < 0.05).

Conclusions:
After menopause, the decline in PRL may be a more sensitive marker rather than other sexual hormones for menopausal hypertensive women with LVH.
INFLAMMATORY BIOMARKERS AND OBESITY IN RESISTANT HYPERTENSION
Authors: Vallaperde João Gabriel , Alves Hugo Farrah Afonso , Santo Bruno Dussoni Moreira Dos , Silva Joao Gabriel Bezerra Da , Gonçalves Larissa De Oliveira , Kimura Lucca Hiroshi De Sá , Nolasco Vitor De Melo , Carvalho Fernanda Oliveira De , Cortez Arthur Fernandes , Chedier Bernardo , Muxfeldt Elizabeth 
Published: April 2021

Objective:
To evaluate the relationship between inflammatory biomarkers and obesity in a large cohort of patients with resistant hypertension (RHT).

Design and method:
This cross-sectional study evaluated 423 subjects with RHT (30.5% male; 63.9 ± 10.8 years old), 215 (50,8%) of whom are obese. In all subjects the inflammatory biomarkers, TNF-alfa, MCP-1, E-Selectin and PAI-1, were dosed. Socio-demographic characteristics, anthropometric measurements and cardiovascular risk factors were recorded. Variance analysis compared the serum levels of 4 biomarkers inflammatory and the bivariate analysis compared resistant hypertensives with and without obesity.

Results:
Obese subjects are younger, with a higher prevalence of peripheral obstructive arterial disease. No difference was found concerning to the blood pressure, neither to subclinical lesions. The values of PAI-1 (123 [107–164] vs 113 [89–138] and E-Selectin (53.2 [34.2–68.6] vs 44.6 [20.8–62.0] were significantly higher in patients with obesity. The other biomarkers evaluated did not evidence association with obesity.

Conclusions:
Among the inflammatory biomarkers evaluated, which was most strongly correlated with obesity was PAI-1 and E-Selectin. According to literature PAI-1 is tightly linked to metabolic disorders, such as insulin resistance and central obesity, while E-Selectin has an important role on atherosclerosis's development.
RED BLOOD CELL DISTRIBUTION IS INDEPENDENTLY ASSOCIATED WITH DAILY DIASTOLIC BP VARIABILITY
Authors: Torbas Olena , Kushnir Svitlana , Rekovets Oksana , Sirenko Yuriy 
Published: April 2021

Objective:
Previously it was shown that in a large cohort of unselected outpatients there was a strong independent association between elevated red blood cell distribution width (RDW) and increased incidence of cardiovascular events which may be associated with inflammation. The aim of our analysis was to evaluate whether RDW was independently associated with any of proven cardiovascular diagnostic markers.

Design and method:
We included 171 patients with arterial hypertension who had underwent all diagnostic procedures: office BP measurement, ambulatory BP monitoring (ABPM), carotid-femoral pulse wave velocity (cfPWV), cardio-ankle vascular index (CAVI), haematology test with RDW, vascular ultrasound and echocardiography. The results of Spearman correlation was after that tested in a multivariant regression model.

Results:
Results. Mean age of our patients was 52,9 ± 1,1 y/o, mean BP was 154,4 ± 2,4/93,3 ± 1,3 mmHg, mean hear rate (HR) 78,3 ± 1,3 bits per min, 37% men and 63% women, mean RDW was 14,8 ± 0,7%. Among all the parameters we have obtained, RDW was significantly inversely associated only with office systolic and diastolic BP (r = -0,189, p = 0,023 and r = -0,206, p = 0,013 respectively), daily diastolic BP (DBP) variability (r = -0,270, p = 0,02) and daily HR variability (r = -0,314, p = 0,027). Moreover, the association RDW with DBP variability remained significant even after the adjustment for office DBP, hemoglobin and erythrocytes level (beta = -0,587, p = 0,022), but correlation of RDW with HR variability after the adjustment for office HR and hemoglobin was not significant (beta = -0,437, p = 0,116) which underlines that HR variability is more associated with blood hemoglobin level. Also we did not find any significant correlations of RDW with any of arterial stiffness, vessel wall thickness, echocardiographic left ventricle mass index and other parameters.

Conclusions:
A significant correlation of RDW with office systolic and diastolic BP, but more an independent correlation of RDW with DBP variability may demonstrate is role as a potential interesting biomarker which may be used in future studies.
ARTERIAL HYPERTENSION IN POSTMENOPAUSAL WOMEN WITH ABDOMINAL OBESITY: ROLE OF INFLAMMATORY RESPONSE MARKERS, LEPTIN AND SEX HORMONES IN PATHOGENESIS OF VASCULAR WALL STIFFNESS
Authors: Petelina Tatiana , Avdeeva Ksenia , Gapon Lyudmila , Musikhina Natalia , Suplotov Sergey , Zyeva Ekaterina , Gorbatenko Elena 
Published: April 2021

Objective:
Arterial hypertension (AH) with abdominal obesity, especially during postmenopause, remains one of the most serious medical and social problems. The objective was to study features of AH in postmenopausal women with abdominal obesity and to assess the role of markers of inflammatory response, leptin and female sex hormones in the pathogenesis of vascular wall stiffness.

Design and method:
The study included 164 patients randomized into 3 groups. Group 1 (control) consisted of 42 healthy women aged 44.43 ± 14.26 years, group 2 - 62 women aged 60.69 ± 7.09 years with AH and group 3 included 60 women aged 57.24 ± 7.4 years with AH and abdominal obesity. Parameters of 24-hour ambulatory blood pressure monitoring; sphygmography - pulse-wave velocity (PWV); lipid profile parameters, inflammatory markers (high-sensitivity C-reactive protein, TNF-alpha, homocysteine, interleukin-1 beta, -6, -8); endothelial dysfunction markers (endothelin-1, nitrites) and hormonal profile (sex hormone levels, cortisol and testosterone), leptin were measured.

Results:
Analysis results revealed that systolic and diastolic blood pressure indices were significantly higher in group 3 in comparison with group 2. An excess of the variability of systolic blood pressure at night was recorded in group 2 and 3 (p < 0.017). Higher PWV values were registered in group 2. Lower levels of sex hormones and significant increase in the level of inflammatory markers were found in groups 2 and 3 compared to the control group. We revealed multiple multidirectional correlations between the studied parameters. Logistic regression method detected the main biochemical markers that affect increase in stiffness of the vascular wall, such as leptin (odds ratio (OR): 1.021, 95% confidence interval (CI): 1.004–1.039, p = 0.018), high-sensitivity C-reactive protein (OR: 1.300; 95% CI 1.091–1.549, p = 0.003) and endothelin-1 (OR: 1.0242; 95% CI 1.042–1.794, p = 0.024). Rise of each marker by unit of measurement leads to increase in PWV by 2.1%; 1.3 times by 2.4%, respectively.

Conclusions:
Features of AH in postmenopausal women with abdominal obesity are systolic-diastolic AH with increase in variability of systolic blood pressure at night. The main markers determining the state of elastic properties of the vascular wall are leptin, high-sensitivity C-reactive protein and endothelin-1.
LINKS BETWEEN VITAMIN D, C REACTIVE PROTEIN, LDL, OXIDIZED LDL AND ECG VARIABLES IN HYPERTENSIVE PATIENTS
Authors: Mozos Ioana , Jianu Daniela 
Published: April 2021

Objective:
The present paper aimed to assess the relationship of electrocardiographic variables with vitamin D, C reactive protein (CRP), LDL and oxidized LDL level, respectively, in hypertensive patients.

Design and method:
A total of 40 hypertensive patients underwent standard 12-lead ECG, which enabled measurement of P wave, PR and QT interval and QRS duration, as well as R wave in V5 and V6 and S wave in V1, V2. The following laboratory tests were performed: vitamin D (25-hydroxycholecalciferol: liquid chromatography method), CRP (immunophelometry), LDL (photometric method) and oxidized LDL (ELISA method).

Results:
QRS complex and heart rate corrected QT interval (QTc) duration were prolonged in 27.5% and 25%, respectively, of the patients. Vitamin D was less than 20 microg/l (D20) in 35% of the patients, and less than 30 microg/l (D30) in 77.5%. Significant correlations were found between vitamin D level and QRS duration (rS = −0.334, p = 0.035), QT (rS = 0.383, p = 0.015), QTc (rS = 0.366, p = 0.020), RV5 (rP = 0.682, p less than 0.001), RV6 (rP = 0.573, p less than 0.001), SV2 (rP = 0.356, p = 0.024). QRS duration correlated with CRP exceeding 0.300 mg/dl (rK = 0.423, p = 0.008). LDL level was significantly associated with a prolonged P wave duration (P120) (rP = −0.327, p = 0.039). No correlation was found between oxidized LDL level and ECG variables.

Conclusions:
Vitamin D level can provide valuable information about QRS duration, QT interval, R in V5 and V6 and S in V2, CRP about QRS duration, and LDL level about P wave duration. Vitamin D, CRP and LDL level may inform about ventricular arrhythmia and atrial fibrillation risk, respectively, in hypertensive patients.