bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the cross-talk between liver and vessels through increased morning blood pressure in hypertension
Authors: Kakouri N , Konstantinidis D , Siafi E , Tatakis F , Drogkaris S , Polyzos D , Thomopoulos C , Koullias M , Tsioufis K 
Published: October 2021

Abstract

Background
Nonalcoholic fatty liver disease (NAFLD) is associated with hypertension and predicts future cardiovascular events.

Purpose
To compare blood pressure (BP) morning surge assessed by ambulatory blood pressure monitoring (ABPM) in hypertensive patients with and without NAFLD.

Methods
Sixty-five consecutive patients with newly diagnosed essential hypertension (age 57±10 years, office BP 139/87±16/9 mmHg) were studied. In all patients a routine biochemical blood examination was undertaken while BP morning surge was automatically calculated by a Spacelabs 90207 device. NAFLD was confirmed by a liver ultrasound. Accordingly, patients were divided in those with and without NAFLD (control group).

Results
Patients with NAFLD (n=44) in comparison with controls (n=21) had similar 24h systolic (141.6±9.9 vs 143.2±10.4 mmHg) and diastolic BP (83.6±10.23 vs 84.7±9.53 mmHg) while office BP was also not different between groups (p=NS). However, those with NAFLD were younger (55±10 vs 61±9 years, respectively, p=0.046), had higher body mass index (32.5±4.5 vs 26.3±3.8 kg/m2, p&lt;0.001), glomerular filtration rate (93.8±17 vs 82.6±9.2 ml/min/1.73m2, p=0.013), and higher levels of morning BP surge (14.29±8.5 vs 5.92±9.01mmHg, p=0.034), compared to the non-NAFLD group. Standard deviation of BP, average real variability, coefficient of variation and dipping status were not different between groups.

Conclusions
At the same levels of clinic and ambulatory BP, hypertensive patients with NAFLD compared to their non-NAFLD counterparts demonstrated increased morning surge BP levels. Our finding suggests that NAFLD may demonstrate a detrimental effect to early-morning at variance to the whole-day hemodynamics.

Funding Acknowledgement
Type of funding sources: None.
Effect of the Mediterranean diet on blood pressure in adults with and without hypertension: a systematic review and meta-analysis of randomized controlled trials
Authors: Filippou C , Thomopoulos C , Kouremeti M , Sotiropoulou L , Nihoyannopoulos P , Tousoulis D , Tsioufis K 
Published: October 2021

Abstract

Background
It is unclear whether the Mediterranean diet (MedDiet) has a favorable effect on blood pressure (BP) levels because among randomized controlled trials (RCTs) investigating the MedDiet-mediated BP reduction there are significant methodological and clinical differences.

Purpose
The purpose of this study was to comprehensively assess the MedDiet BP-effect compared to the usual diet or another dietary intervention (e.g. low-fat diet) in adults with and without hypertension, accounting for different confounders.

Methods
We systematically searched Medline and the Cochrane Collaboration Library databases and identified 35 RCTs (13,943 participants). Random-effects model was used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted.

Results
Compared to the usual diet and all other active intervention diets the MedDiet reduced SBP and DBP (difference in means: −1.5 mm Hg; 95% CI: −2.8, −0.1; P=0.035, and −0.9 mm Hg; 95% CI: −1.5, −0.3; P=0.002, respectively). Compared only to the usual diet the MedDiet reduced SBP and DBP, while compared to all other active intervention diets or only to the low-fat diet the MedDiet did not reduce SBP and DBP. The MedDiet reduced DBP levels to a higher extent in trials with a mean baseline SBP ≥130 mm Hg, while both SBP and DBP were reduced more in trials with a mean follow-up period ≥16 weeks. The quality of evidence was rated as moderate for both outcomes according to the grading of recommendations, assessment, development and evaluation (GRADE) approach.

Conclusions
The adoption of the MedDiet was accompanied by a relatively small, but yet significant BP reduction, while higher baseline SBP levels and longer follow-up duration enhanced the BP-lowering effect of the intervention

Funding Acknowledgement
Type of funding sources: None.
Structure and predictors of repolarization disorders in patients with severe COVID-19 infection
Authors: Danilevych T D , Mostovoy Y M , Rasputina L V 
Published: October 2021

Abstract

Background
COVID-19 infection can adversely affect the function of cardiac ion channels, leading to changes of the properties of conductivity and repolarization, which increases arrhythmogenesis.

Purpose
To determine the features of the structure and predictors of repolarization disorders in the patients with severe COVID-infection.

Methods
133 patients with severe COVID-19 infection were examined, who were in the intensive care unit of the clinical hospital No. 1 in our city in the period from April to December 2020 and as a result of treatment with improved health were discharged from the hospital.
Among them there were 65 (48.9%) men and 68 (51.1%) women (X2=0.068, p=0.79). The age of patients ranged from 24 to 90 years, averaging 61.38±12.96 years. Middle-aged and elderly patients were dominated at age structure (p=0.001). The total duration of staying in the hospital was 18.9±9.12 days. The duration of staying in the intensive care unit was 8.32±6.91 days. Statistical processing of the obtained data was performed using the statistical software package SPSS 12.0 for Windows.

Results
ECG analysis showed that most of the patients had various ischemic changes and/or myocardial repolarization disorders – in 119 (89.5%) patients. Thus, inversion of the T wave was registered – in 91 (68.4%), signs of early ventricular repolarization – in 14 (10.5%), elevation of ST segment – in 6 (4.5%), depression of ST segment – in 54 (40.6%), pathological Q wave – in 9 (6.8%). In turn, signs of an overload of a left ventricle (LV) – in 27 (20,3%), signs of an overload of a right ventricle (RV) – in 8 (6,0%), a sign of SIQIIITIII – in 7 (5,3%), prolongation of QT interval – in 6 (4.5%) patients, respectively. Also signs of LV hypertrophy – in 45 (33.8%), signs of RV hypertrophy – in 12 (9.0%), the presence of p-pulmonale – in 6 (4.5%), p-mitrale – in 7 (5.3%) patients, respectively.
Predictors of ischemic changes and/or repolarization disorders in the patients with severe COVID infection are: a decrease of glomerular filtration rate (GFR) &lt;60 ml/min/1.73 m2 – r=0.580, p=0.006; time of hospitalization r=−0,204, p=0,02; elderly patients – r=0,184; p=0.02.

Conclusions
The prevalence of ischemic changes and/or myocardial repolarization disorders according to ECG data is 89.5%. Presence of inversion of T wave (68.4%) and depression of ST segment (40.6%) were dominated in the structure of ischemic changes and/or myocardial repolarization disorders. Their predictors are: decrease of GFR &lt;60 ml/min/1.73 m2; time of hospitalization; elderly patients.

Funding Acknowledgement
Type of funding sources: None.
Association of food intake with cardiometabolic diseases among filipino adults
Authors: Lusica P , Jimeno C 
Published: October 2021

Abstract

Background
The prevalence of Metabolic Syndrome among Filipino adults was found to be 12–15% in 2003. Diet has been one of the identified modifiable risk factors targeted to prevent cardiovascular disease or its complications, however the association of each macronutrient component with metabolic syndrome remains unclear. There is no Philippine data on macronutrient intake and cardiometabolic diseases, thus, the primary objective of this study is to determine the association of food intake with cardiometabolic diseases among Filipino adults.

Methodology
This study utilized a cross-sectional analytic design. Data was taken from the results of the 8th NNHeS in 2013–2015 by the Food and Nutrition Research Institute. Filipino adults from different regions of the Philippines who consented to participate in the interview, anthropometrics, blood collection for clinical data, and other measurements were included in this study.

Results
There were 8,056 adults included in the NNHeS 2013. The prevalence of Metabolic Syndrome was 33%. Median total calorie intake in one day was 1,524.1 kcal (range: 148.3 to 7349.5) while median total carbohydrates, protein and fat intake in one day were 273.3 grams (range: 33.8 to 1309.2), 49.4 grams (range: 2.8 to 273.3) and 19.8 g (range: 0.2 to 334.9). Multivariate analysis showed that the following were associated with an increased risk for MetS: increased total protein intake OR 1.391 (1.150–1.684), increased daily consumption of meat and poultry OR 1.397 (1.163–1.677), and decreased vegetable intake OR 1.3 (1.080–1.565)

Conclusion
Increased age, higher socioeconomic status, female sex, increased total protein intake and daily consumption of meat and poultry, and decreased vegetable intake are associated with an increased risk for metabolic syndrome.

Funding Acknowledgement
Type of funding sources: None.
Epicardial adipose tissue (EAT) volume is related to subclinical atherosclerosis and major adverse cardiovascular events (MACE) in asymptomatic subjects
Authors: Sousa A , Mendonca M I , Santos M , Temtem M , 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

Introduction
Epicardial adipose tissue (EAT) is an emerging cardiovascular risk marker. It has been suggested to be an inflammatory mediator with a role in subclinical atherosclerosis and coronary artery disease. However, its prognostic relevance in hard clinical outcomes remains thoroughly unexplored in the literature.

Purpose
Evaluate the prognostic relevance of EAT, regarding the occurrence of major adverse cardiovascular events (MACE) in an asymptomatic population.

Methods
895 asymptomatic volunteers were prospectively enrolled in a single Portuguese center (mean age 51.9±7.7, 78.5% male) and underwent a median follow-up time of 3.7 years (IQR 5.0). EAT volume was measured by Cardiac Computed Tomography (CCT) using a modified simplified method. Participants were distributed into two groups, above and below the EAT-volume median. We compared both groups regarding the occurrence of MACE through univariate analysis, Kaplan-Meier Survival curves and log-rank test. Association to subclinical atherosclerosis was addressed using correlation between EAT volume and calcium score (Agatson).

Results
There is a strong correlation between EAT volume and calcium score (r=0.205, p&lt;0.0001), sustaining that it may play an important role in mediating coronary artery disease and subclinical atherosclerosis. Patients with higher EAT volume, were exposed to higher occurrence of MACE on follow-up [70.4% (19 of 27) vs 49.4% (429 of 868), p=0.032] with a clearer separation of the curves after 5.7 years.

Conclusion
In an asymptomatic population, EAT volume seems to be related to subclinical atherosclerosis and to the occurrence of adverse cardiovascular events on long-term follow-up. Our study addresses some unanswered questions, such as the prognostic relevance of EAT as an emerging cardiovascular risk marker.

Funding Acknowledgement
Type of funding sources: None.
Gender differences low-density lipoprotein cholesterol reduction with PCSK9 inhibitors in real world patients
Authors: Cordero A , Fernandez Del Olmo M R , Cortez Quiroga G A , Romero C , Facila L , Fornovi A , Rondan J , Bello Mora M C , Valle A , Sandin A.L.B.E.R.T , Freixa R , Sanchez-Alvare S , Blanch P , Clemente Lorente M , Gonzalez-Juanatey J R ,   LIPID-REAL study
Published: October 2021

Abstract

Background
Monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 55%, regardless of baseline treatments, and are supposed to have a homogenous effect. We tested possible gender differences in a large multicenter registry of real-world patients treated with PCSK9 inhibitors.

Methods
Multicentre and retrospective registry of patients treated with PCSK9 inhibitors from 14 different hospitals from Spain. Before and on-treatment LDLc cholesterol was recorded as well as medical treatments, clinical indication and clinical features.

Results
A total of 562 patients were analysed, mean age 60.2 (9.6) years and 79.2% males. Most frequent indication for PCSK9 inhibitor treatment was established cardiovascular disease (CVD) with LDLc &gt;100 mg/dl (58.1%) followed by familial hypercholesterolemia (23.4%) and statin intolerance (18.5%). Indications other than CVD were more frequent in women (53.3% vs. 39.1%; p=0.03). Women were more frequently ezetimibe (67.5% vs. 50.6%; p=0.001) before PCSK9 treatment; although no gender differences in statin use was observed (78.6% vs. 83.6%; p=0.93) in the whole cohort it was significantly lower in patients with coronary heart disease (91.4% vs. 98.9%; p=0.005). Before treatment LDLc was 148.7 (50.1) mg/dl and it was higher women vs. men (160.3 (59.3) vs. 145.6 (47.0); p=0.005). Evolocumab was initiated in 318 (56.6%) patients; 229 (40.7%) alirocumab 75 mg and 15 (2.7%) alirocumab 150 mg. No gender differences in PCSK9 inhibitors drug or dose were observed.
Median time to second blood determination were 187.5 (IQR 101–242) days. Mean on-treatment LDLc was 66.7 (46.4) mg/dl and it was also higher in women vs. men (84.4 (58.6) vs. 61.9 (41.3); p&lt;0.001). Mean LDLc reduction was 54.7% but it was higher in men as compared to women (57.0% vs. 46.1%; p=0.0003). Higher LDLc reductions were also observed in patients with CVD as compared to the other 2 indications (57.1% vs. 47.3%; p=0.002). Moreover, LDLc reduction with PCSK9 inhibitors treatment was also higher in men vs women among patients with CVD (58.9% vs. 48.0%; p=0.04)

Conclusions
This multicentre and retrospective registry of real-world patients treated with PCSK9 inhibitors highlights significant gender differences in LDLc reduction.

Funding Acknowledgement
Type of funding sources: None.
Metabolically healthy obesity in a young population assisted by the Family Health Strategy in Brazil. LapARC study
Authors: Vasconcellos C A M , Boghossian R B , Machado M K , Muguet C M C , Cervasio A R B , Flumignan V S M , Barbalho D G , Wandermurem D C R , Marinho B D , Botelho E G , Tostes F R C , Barradas F C , Bica R B S , Kendler D B , Muxfeldt E S ,   LapARC study
Published: October 2021

Abstract

Background
Obesity is increasing in younger populations, and is associated with a high cardiovascular (CV) risk, however, it is not clear whether metabolically healthy obesity (MHO) may have a lower CV risk or if it is just an earlier stage of the disease.

Objective
To evaluate the prevalence and CV risk factors associated with MHO in a young population assisted by a Family Health Care unit in a large urban center in Brazil.

Methods
A cross-sectional population study for CV risk assessment in adults aged 20–50 years old from a FHC unit in Brazil. Demographic, anthropometric data and CV risk factors were recorded. All underwent office blood pressure (OBP) measurements, laboratory evaluation (lipid and glycidic profile). Obesity was defined as a BMI ≥30 kg/m2 and MHO are those who have less than 3 of the following criteria: hypertension, diabetes, total cholesterol ≥200 mg/dL, HDL&lt;40 mg/dL (men) and 50 mg/dL (women), triglycerides&gt;150 mg/dL and increased waist circumference.

Results
A total of 632 individuals were evaluated (60% female; mean age 37±9 years). The prevalence of obesity was 26%, of which 73% were classified as MHO.
Obeses are older, with a higher prevalence of physical inactivity (51% vs 41%, p=0.03), hypertension (44% vs 19%, p&lt;0.001), dyslipidemia (50% vs 36%, p=0.002) and diabetes (7% vs 2%, p=0.001) with higher systolic OBP.
MHO compared to unhealthy ones are significantly younger and smoke less. Despite being obese, they have lower BMI (33.6 vs 35.2 kg/m2, p=0.02) and abdominal circumference (102 vs 110 cm, p=0.03), with lower diastolic BP.

Conclusion
MHO was more prevalent in this young population and seems to have a lower CV risk, however it is not clear whether these younger and less obese individuals are only at an earlier stage of the disease. Perhaps the CV diseases onset is postponed for a few years. Even so, these individuals should not be excluded from public health policies as a form of primary prevention

Funding Acknowledgement
Type of funding sources: None.
Effects of canagliflozin on hyperkalaemia and serum potassium in people with diabetes and chronic kidney disease: insights from the CREDENCE trial
Authors: Neuen B L , Oshima M , Perkovic V , Arnott C , Bakris G , Cannon C P , Charytan D M , Jardine M , Levin A , Neal B , Pollock C , Wheeler D C , Mahaffey K W , Heerspink H J L 
Published: October 2021

Abstract

Background
Hyperkalaemia is a common complication of type 2 diabetes mellitus (T2DM) and limits the optimal use of agents that block the renin-angiotensin aldosterone system (RAAS), particularly in patients with chronic kidney disease (CKD). In patients with CKD, sodium glucose cotransporter 2 (SGLT2) inhibitors provide cardiorenal protection, but whether they affect the risk of hyperkalaemia remains uncertain.

Purpose
We sought to assess the effect of canagliflozin on hyperkalaemia and other potassium-related outcomes in people with T2DM and CKD by conducting a post-hoc analysis of the CREDENCE trial.

Methods
The CREDENCE trial randomized 4401 participants with T2DM and CKD to the SGLT2 inhibitor canagliflozin or matching placebo. In this post-hoc analysis using an intention-to-treat approach, we assessed the effect of canagliflozin on a composite outcome of time to either investigator-reported hyperkalaemia or the initiation of potassium binders. We also analysed effects on central laboratory-determined hyper- and hypokalaemia (serum potassium ≥6.0 and &lt;3.5 mmol/L, respectively) and change in serum potassium.

Results
At baseline the mean serum potassium in canagliflozin and placebo arms was 4.5 mmol/L; 4395 (99.9%) participants were receiving renin angiotensin system blockade. Canagliflozin reduced the risk of investigator-reported hyperkalaemia or initiation of potassium binders (HR 0.78, 95% CI 0.64–0.95, p=0.014; Figure 1). The incidence of laboratory-determined hyperkalaemia was similarly reduced (HR 0.77, 95% CI 0.61–0.98, p=0.031; Figure 2); the risk of hypokalaemia (HR 0.92, 95% CI 0.71–1.20, p=0.53) was not increased. Mean serum potassium over time with canagliflozin was similar to that of placebo.

Conclusion
Among patients treated with RAAS inhibitors, SGLT2 inhibition with canagliflozin may reduce the risk of hyperkalaemia in people with T2DM and CKD without increasing the risk of hypokalaemia.

Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
Associations between kidney function and outcomes following cardiac rehabilitation in patients with heart failure
Authors: Hamazaki N , Kamiya K , Nozaki K , Ichikawa T , Yamashita M , Uchida S , Noda T , Maekawa E , Meguro K , Yamaoka-Tojo M , Matsunaga A , Ako J 
Published: October 2021

Abstract

Background
Kidney dysfunction is considered one of the most prevalent comorbidities in patients with heart failure (HF). A combination of HF and kidney dysfunction is associated with peripheral muscle impairment, exercise intolerance, and poor prognosis. Conversely, cardiac rehabilitation (CR) for HF patients has been recognized to improve their clinical outcomes. However, the impact of kidney function on responses to CR in patients with HF is still unclear.

Purpose
This study aimed to investigate the associations between baseline kidney function and outcomes following CR including changes in physical function and prognosis in HF patients.

Methods
We reviewed a total of 3,727 patients who were admitted for HF treatment and underwent comprehensive CR during hospitalization. In addition to clinical characteristics, we assessed the kidney function using estimated glomerular filtration rate (eGFR) based on serum creatinine level at hospital discharge as baseline. The quadriceps strength (QS) and 6-minute walk distance (6MWD) were measured as muscle strength and functional capacity, respectively, at baseline. We also remeasured these parameter 5 months after hospital discharge in patients who participated in outpatient CR. The association between participation in outpatient CR and composite outcome of all-cause death and/or unplanned readmission were assessed using the multivariate Cox proportional hazard models in a subgroup of baseline eGFR. We also compared the changes in QS and 6MWD (ΔQS and Δ6MWD) between the eGFR stages.

Results
During the median follow-up period of 1.9 years, all-cause death/readmission occurred in 1604 (43.0%) patients, and their rate of incidence was 20.9/100 person-years. Out of studied patients, 1,585 (42.5%) patients participated in outpatient CR that was significantly associated with lower incidences of all-cause clinical events in patients with both eGFR ≥60 (adjusted hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.60–0.89, P=0.002) and eGFR &lt;60 (adjusted HR: 0.88, 95% CI: 0.78–0.99, P=0.045), but those with an eGFR &lt;60 showed significant interaction between CR participation and adverse clinical events (interaction P&lt;0.035, Figure 1). Among the outpatient CR participants, QS and 6MWD were significantly higher after 5-month CR than those at baseline (P&lt;0.001, respectively), but the low baseline eGFR correlated with low ΔQS and Δ6MWD (trend P&lt;0.001, respectively) even after adjustment for clinical confounding factors (Figure 2).

Conclusions
Although the outcomes following CR is affected by baseline kidney function, outpatient CR is significantly associated with the positive change in physical function and better prognosis in HF patients with low kidney function.

Funding Acknowledgement
Type of funding sources: None.