bluuebunny/crossref_metadata_2025_split huggingface dataset:
CROSSTALK BETWEEN INTRINSIC HEART RATE AND PULSE WAVE ANALYSIS IN SMOKERS
Authors: Mozos Ioana , Jianu Daniela , Mozos Costin , Gug Cristina , Stoian Dana 
Published: April 2021

Objective:
Heart rate and pulse wave analysis provide useful information for cardiovascular risk. It was the aim of the present study to assess the relationship between heart rate and pulse wave variables in healthy smokers.

Design and method:
A total of 68 middle-aged, healthy smokers, underwent pulse wave analysis using an Arteriograph. Blood pressure variables, pulse wave velocity (PWV), brachial and aortic augmentation indices (AixBrach, AixAo), vascular (arterial) age (AA) and coronary perfusion indices (diastolic reflection area DRA, diastolic area index DAI) were assessed. Resting heart rate (HR) and intrinsic heart rate (IHR) were assessed for each patient. Data about smoking history were collected and smoking pack years (SPY) were calculated.

Results:
HR, IHR, SPY, pulse wave velocity (PWV), systolic blood pressure (SBP), mean arterial pressure (MAP), systolic blood pressure in the aorta (SBPAo), AixBrach, AixAo, were, as follows: 73 ± 11 beats/minute, 101 ± 13 beats/minute, 7.56 ± 9.31 pack years, 8.73 ± 5.06 m/s, 126 ± 15 mmHg, 91 ± 12 mmHg, 116 ± 16 mmHg, -42.27 ± 28%, 16 ± 14%, respectively. Significant correlations were obtained between HR and PWV, AA, DAI, DRA and between IHR and number of cigarettes smoked/day, SPY, AixBrach, AA, DAI, DRA, SBPAo, PPAo, AixAo, PWV and pulse pressure. Linear regression analysis revealed significant associations between IHR and AixBrach, SBPAo, PPAo, AixAo and AA. Multiple regression analysis revealed significant associations between IHR and SBPAo and AA, respectively (multiple R = 0.539, R square = 0.291, p = 0.006 and 0.013).

Conclusions:
IHR is significantly associated with brachial and aortic augmentation indices, central blood pressure and vascular age. Systolic blood pressure in the aorta and vascular age are independent predictors of IHR in healthy smokers.
EVALUATION OF CARDIOVASCULAR FUNCTIONAL RESPONSE TO ORTHOSTATISM IN TREATED HYPERTENSIVE PATIENTS: RESULTS OF THE IMPEDDANS STUDY
Authors: Leão Rodrigo , Janeiro Claudia , Silva Pedro 
Published: April 2021

Objective:
Arterial Hypertension (AHT) is one of the main causes of morbidity and mortality in the world. Generally defined as an increase in blood pressure (BP), it is characterized by hemodynamic changes that have implications for diagnosis, risk stratification and therapy. In this study we intend to characterize the hemodynamic response to orthostatism in a group of treated hypertensive patients using impedance cardiography (ICG).

Design and method:
Resistant hypertensive patients without heart failure, ischemic heart disease, valvular heart disease or dysrhythmia were prospectively selected. All patients underwent ICG in the supine position and in orthostatism. After ICG, they were classified into patterns: vasoconstrictor (systemic vascular resistance (SVR) > 2500 dyn.s.cm-5.m2), hyperdynamic (cardiac index (CI) > 4.2 l / min / m2 and / or heart rate HR > 80 cycles / min), hypervolemic (thoracic fluid (CFT) > 34 1 / kOhm) or balanced (hemodynamic parameters below the established limit values). All patients underwent transthoracic echocardiography to exclude major morphologic changes.

Results:
We included 178 patients, 56.1% males, age 63 ± 11 years, medicated with 4 ± 1 antihypertensives. In ICG, 56.5% were vasoconstrictors, 11.8% hyperdynamic, 33.4% hypervolemic and 22.9% had a balanced hemodynamic profile. In the supine position the patients had systolic blood pressure 134 ± 18, diastolic blood pressure 79 ± 11, HR 69 ± 10, indexed ejection volume 42 ± 9, pre-ejection period 95 ± 15 ms, ejection time 333 ± 17 ms, systolic time ratio 0.28 ± 0.06, RVSI 2687 ± 621, cardiac index 2.8 ± 0.4 and CFT 32 ± 5. In the orthostatic position some of these values were significantly higher: diastolic blood pressure 82 ± 12 (p < 0.001), HR 73 ± 12 (p < 0.001), pre-ejection period 119 ± 23 (p < 0.001), systolic time ratio 0.41 ± 0.11 (p < 0.001). The indexed ejection volume 39 ± 9 (p < 0.001), ejection time 301 ± 46 (p < 0.001) and CFT 28 ± 3 (p < 0.001) were significantly lower.

Conclusions:
Although polymedicated, most patients had an unbalanced hemodynamic profile. The analysis of the impedance waveform with postural modification can be used to clarify the response to orthostatism and to better characterise the hemodynamic phenotype.
COMBINATION OF NON-DIPPING PROFILE WITH HIGH NIGHTTIME SYSTOLIC BLOOD PRESSURE IN RHEUMATOID ARTHRITIS IS ASSOCIATED WITH HIGHER CARDIOVASCULAR RISK
Authors: Troitskaya Elena , Velmakin Sergei , Kobalava Zhanna 
Published: April 2021

Objective:
Non-dipping profile is an important predictor of adverse cardiovascular (CV) outcomes. Its associations with subclinical vascular damage in rheumatoid arthritis (RA) are not known yet. We aimed to assess dipping patterns and nighttime systolic blood pressure (SBPn) and their associations with CV risk in patients with RA.

Design and method:
The study group included 85 patients with RA (females 77.6%, aged 59.7 ± 14.3 years, HTN 65%, mean DAS-28 3.7 ± 1.1) and control group (40 patients matched by gender, age and risk factors). Office BP was measured with a validated oscillometric device, 24-hour ABPM by BPLab Vasotens. CV risk was calculated as mSCORE. 3 groups were formed after adjustment of dipping state by SBPn: dippers (G1), non-dippers with SBPn < 120 mmHg (G2), non-dippers with SBPn > 120 (G3). p < 0.05 was considered significant.

Results:
Rate of BP control was 58% in RA and 67% in the controls (p = 0.48). Patients with RA vs controls were characterized by higher mean SBPn (123 ± 17 vs 112 ± 10 mmHg, p = 0.002), lower diurnal index (DI) (median 4 vs 7.5%, p = 0.006), higher rate of night hypertension (49.4 vs 12.5% (χ2 = 17, p < 0.001)). RA patients more often had non-dipping profile (DI < 10%): 83.5 vs 62.5%, (χ2 = 7.4, p = 0.02). In RA group patients with SBPn > 120mmHg had higher age (64.8 ± 12.6 vs 54.8 ± 14.3 years), office BP (142 ± 19/82 ± 11 vs 121 ± 14/76 ± 9mmHg), HTN duration (med 5.5 vs 0 years), mSCORE (med 6.1 vs 2.5%), p < 0.001 for trend. Patients with DI < 10% had higher age (60.8 ± 14.8 vs54.1 ± 10 years, p = 0.04). SBPn significantly correlated with age (r = 0.5), office SBP (r = 0.6) and DBP (r = 0.3), mSCORE (r = 0.5);non-dipping pattern–with age (r = 0.2). After adjustment by SBPn, no differences were observed between G1 and G2. Patients in G3 vs G1 had higher CRP (med 16.6 vs 6.7 mg/l, p = 0.03), mSCORE (med 7.1 vs2.3%, p < 0.001 for both); in G3 vs G2–higher mSCORE (med 7.1 vs 2.1%), p < 0.001 for trend and ESR (med 46 vs 23 mm/h, p = 0.03).

Conclusions:
Patients with RA were characterized by higher incidence of non-dipping pattern, SBPn elevation. Combination of high SBPn and non-dipping pattern was associated with higher CV risk. These associations may be mediated by inflammation.
The publication was prepared with the support of the RUDN University Program 5-100.
GAMMA-DELTA T CELLS MEDIATE ALPHA-BETA T CELL ACTIVATION IN ANGIOTENSIN II-INDUCED HYPERTENSION
Authors: Caillon Antoine , Paradis Pierre , Schiffrin Ernesto L. 
Published: April 2021

Objective:
Both innate and adaptive immune cells have been shown to play a role in hypertension and vascular injury. Recently, we demonstrated that a small subset of “innate-like” T lymphocytes, expressing the γδ T cell receptor (TCR) rather than the αβ TCR, plays a key role in hypertension and vascular injury. We demonstrated an increased number and activation (CD69+) of αβ and γδ T cells during the development of hypertension caused by angiotensin (Ang) II infusion, and that deficiency in γδ T cells prevented Ang II-induced hypertension, resistance artery endothelial dysfunction and spleen T-cell activation in mice. We hypothesized that γδ T cells mediate activation of other T cells in hypertension.

Design and method:
Fourteen to 15-week-old aged C57BL/6J male mice were infused or not with Ang II (490 ng/kg/min, SC) for 7 and 14 days (n = 5–7). γδ and αβ T cells were isolated from peripheral lymph nodes and spleen and αβ T cells were cultured alone or with γδ T cells (5:1) in presence of anti-CD3 antibodies plus or minus Ang II. T cell phenotype was evaluated by flow cytometry.

Results:
Close correlations were demonstrated between the number (#) of activated CD69 + γδ T cells and CD4 + CD69 + T cells (r2 = 0.74, P < 0.01) and CD8 + CD69 + T cells (r2 = 0.64, P < 0.01) after 7-day Ang II infusion. In vitro, Ang II increased the fraction of CD69 + αβ T cells when αβ T cells were co-cultured with γδ T cells isolated from control mice (% of αβ T cells: 19.9 ± 2.9 vs. 16.4 ± 2.6, P < 0.001) but not when cultured alone. The fractions of CD69 + (% of CD69 + αβ T cells: 35.7 ± 2.7 vs. 18.9 ± 1.5, P < 0.001) and CCR6 + αβ T cells (% of CCR6 + αβ T cells: 27.6 ± 2.4 vs. 19.2 ± 3.5, P < 0.05) were increased when αβ T cells were co-cultured with γδ T cells isolated from Ang II-infused compared to control mice.

Conclusions:
These results suggest that γδ T cells mediate activation of αβ T cells in Ang II-induced hypertension. Targeting γδ T cells may contribute to reduce the low-grade inflammation found in hypertension.
THE 10-YEAR RELATIONSHIP BETWEEN SUPAR AND CENTRAL SYSTOLIC BLOOD PRESSURE IN AN HIV INFECTED POPULATION
Authors: Le Roux Shani , Kruger Ruan , Schutte Aletta , Brits Sanette , Fourie Carla 
Published: April 2021

Objective:
Inflammation plays a role in vascular wall changes which may lead to aortic stiffening. Soluble urokinase plasminogen activator receptor (suPAR), a low-grade inflammatory marker, is predictive of cardiovascular disease and mortality in the general and HIV infected populations. We determined the 10-year relationship between suPAR and central SBP in the HIV infected.

Design and method:
HIV uninfected and infected participants from the PURE study, conducted in the North West province, South Africa, were matched by age and sex and followed for a median of 9.87 years (HIV uninfected: baseline = 211 and follow-up = 159; HIV infected: baseline = 92 and follow-up = 144 of which 69% initiated antiretroviral treatment (ART)). We obtained demographic and cardiometabolic data and measured EDTA plasma suPAR with suPARnostic® ELISA kits at baseline and follow-up and measured central SBP at follow-up.

Results:
Median suPAR was higher in HIV infected (ART-naive) compared to uninfected participants at baseline (3.61 vs 3.26 ng/ml; p = 0.038) but not at follow-up (p = 0.45). Cox-regression analyses (Figure 1) showed that, in the HIV infected group only and independent of ART, suPAR predicted a higher central SBP (> = 118 mmHg) after 10 years, but only when lipids, glomerular filtration rate or gamma-glutamyl transferase were added to the model.

Conclusions:
The initiation of ART may contribute to lower inflammation (as measured with suPAR) in HIV infected compared to uninfected individuals. SuPAR associated with central SBP over 10 years, but only when metabolic markers or renal function were taken into account. This may suggest a significant mediating effect between inflammation and cardiometabolic risk markers in increasing central aortic pressure and therefore future cardiovascular risk in the HIV infected.
FEATURES OF THE BLOOD PRESSURE DYNAMICS AND PRO-INFLAMMATORY CYTOKINES IN PATIENTS WITH RESISTANT HYPERTENSION AND CORONARY ATHEROSCLEROSIS AFTER RENAL DENERVATION
Authors: Zyubanova Irina , Mordovin Viktor , Pekarskiy Stanislav , Tatyana Ripp , Falkovskaya Alla , Lichikaki Valeriya , Sitkova Ekaterina , Baev Andrey , Gusakova Anna 
Published: April 2021

Objective:
Inhibition of sympathetic activity via renal denervation (RDN) is associated with a reduction of blood pressure and variety of inflammatory markers in patients with resistant hypertension (RH).
The purpose of this study was to investigate the effects of RDN on BP, TNF-alpha and hs-CRP in patients with confirmed atherosclerosis, to compare the studied parameters in revascularized and conservatively treated patients groups.

Design and method:
In 35 patients with RH associated with CAD and confirmed by coronary angiography atherosclerosis, levels of 24-h BP, TNF-alpha and hs-CRP analyzed by ELISA were identified before and 12 months after RDN. Baseline 24-h systolic (SBP), diastolic (DBP) and pulse (PBP) BP were 154 ± 12 mmHg, 82 ± 13 mmHg and 73 ± 13 mmHg respectively. Then patients retrospectively where divided into two groups according to the severity of coronary artery disease (CAD): the first group underwent coronary stenting or coronary artery bypass grafting, the second had no need for revascularization and was treated conservatively.

Results:
12 month after RDN all the patients had significant (p < 0,05) 24-h SBP (144 ± 15 mmHg), DBP (77 ± 11 mmHg) and PBP (67 ± 14 mmHg) and TNF-alpha from 7,0 ± 3,4 ng/ml to 6,6 ± 3,0 ng/ml, p = 0,03 reduction and downward trend in hs-CRP from 4,0 ± 3,5 ng/ml to 2,8 ± 2,4 ng/ml, p = 0,07, that correlated with PBP reduction (r = 0,47, p < 0,05).
It was no difference between SBP and hs-CRP levels in the two groups.
In the first group baseline levels of PBP and TNF-alpha where higher than in the second: 78,9 ± 12,8 mmHg vs 69,0 ± 12,1 mmHg, p = 0,03; 9,0 ± 1,2 ng/ml vs 5,7 ± 3,7 ng/ml, p = 0,01.
Downward trend in TNF-alpha and hs-CRP persisted in both groups.
In conservatively treated group there was significant 24-h SBP/DBP reduction 12 months after RDN (p < 0,05) on 15 (3; 23) / 7 (4; 16) mmHg, whereas in the revascularized group SBP, DBP and PBP did not change (p > 0,05).

Conclusions:
Patients with RH associated with CAD have significant TNF-alpha reduction, downward trend in hs-CRP 12 months after RDN. Patients with severe coronary atherosclerosis have higher levels of TNF-alpha and are non-responders for RDN.
EFFECT OF RENAL DENERVATION ON OFFICE BLOOD PRESSURE IN PATIENTS WITH UNCONTROLLED HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED, SHAM-CONTROLLED TRIALS
Authors: Stavropoulos Konstantinos , Imprialos Konstantinos , Patoulias Dimitrios , Katsimardou Alexandra , Koutsampasopoulos Konstantinos , Alataki Sofia , Kerpiniotis Georgios , Dimitriadis Kyriakos , Papademetriou Vassilios , Tsioufis Konstantinos , Doumas Michael 
Published: April 2021

Objective:
Untreated and uncontrolled hypertension remain a significant global health problem and a major cardiovascular risk factor. The role of renal denervation (RDN) in the treatment of hypertension has been studied extensively at basic and clinical research level during the last decade. We aimed to provide precise effects estimates about the effect of RDN on office blood pressure levels in patients with untreated or uncontrolled hypertension.

Design and method:
PubMed and CENTRAL, along with grey literature sources, were searched from their inception to May 2019 for randomized, sham-controlled trials evaluating the efficacy and safety of RDN on the management of hypertension, irrespective of study blinding, setting and sample size.

Results:
Six randomized, sham-controlled trials were identified and included in the meta-analysis. In total, 981 patients with hypertension were randomized in all 6 trials to undergo either RDN (n = 585) or sham-procedure (n = 396). Compared to sham, RDN resulted in a significant decrease in office systolic blood pressure levels by 5.47 mmHg (95% CI: -8.10 to -2.84; I^2 = 0%) and in office diastolic blood pressure levels by 4.25 mmHg (95% CI: -6.16 to -2.33; I^2 = 0%), compared to sham procedure. No major safety issues were detected.

Conclusions:
RDN is associated with a significant reduction in both systolic and diastolic office blood pressure levels, confirming its promising role in the field of hypertension treatment.
PATIENTS WITH RESISTANT HYPERTENSION AND ATRIAL FIBRILLATION ARE THE BEST RESPONDERS FOR RENAL DENERVATION
Authors: Plashchinskaya Larisa , Goncharik Dmitry , Barsukevich Veronika , Chasnoits Alexandr , Rebeko Ekaterina , Persidskikh Yuliya , Podpalova Olga , Mrochek Alexandr 
Published: April 2021

Objective:
The search for the ideal candidate for renal denervation (RDN) is one of the priority treatments of patients with resistant hypertention (RH). Our objective was to identify the predictors of the efficiency of renal denervation.

Design and method:
The study included 112 patients with RH. The average age of patients was 53 [19; 69] years. Twenty-four (21.4%) patients had atrial fibrillation (AF). Four (16.7%) patients had chronic AF, 8 (33.3%) patients had persistent AF, and 12 (50%) – paroxysmal AF. All patients underwent RDN. Procedure was performed by an experienced electrophysiologist at the renal arteries using specialized electrode Symplicity Flex (Medtronic): ablation power = 8 - 10 W at 55°C, 4 – 10 points for each renal artery (including brunches), 2 minutes per point. Office BP and 24-hour ambulatory BP, 24-hour ECG monitoring, arrhythmia chronocard diaries were measured before, at 6 and 12 months of follow-up. A logistic regression analysis included the following parameters: gender, age, body mass index, office and 24-hour ambulatory systolic blood pressure (SBP), diabetes mellitus and the AF presence.

Results:
baseline office SBP and DBP in patients with RH were 185.4 ± 29.19 and 109.96 ± 17.95 respectively. Office BP decreased by 29.8 /14.1 mmHg at 12 month after RDN (p < 0.001). 24-hour ambulatory SBP decreased from 161.3 ± 25.9 mm Hg to 148.1 ± 21.3 mm Hg at 12 months after the intervention, DBP from 94.3 ± 16.4 mm Hg to 87.2 ± 15.9 mmHg (p < 0,001). It was found that all patients (100%) with RH and AF were responders to renal denervation. This response is defined as a reduction of office SBP of less than 10 mmHg following RDN. Whereas 17.2% of non-AF group patients were non-responders. The number of symptomatic AF paroxysms significantly decreased from 9 [2; 11] to 2 [1; 3] one year after RDN (p = 0.001).

Conclusions:
Patients with RH and AF are among the best candidates for RDN. It may help to improve the selection of patients with arterial hypertension for the RDN.
THREE-YEAR RESULTS OF RENAL DENERVATION: PRESERVATION OF POSITIVE TRENDS
Authors: Zyubanova Irina , Falkovskaja Alla , Mordovin Viktor , Manukyan Musheg , Pekarskiy Stanislav , Lichikaki Valeriya , Baev Andrey , Gusakova Anna , Ryabova Tamara 
Published: April 2021

Objective:
To assess the persistence of the beneficial effects of renal denervation (RD) over a three-year follow-up

Design and method:
The study included 42 patients, 27 women and 15 men (mean age 57,2 ± 7,9 years) with resistant hypertension. 24-hour blood pressure (24-h BP) monitoring, echocardiography with left ventricular mass (LVM) determination, and blood sampling from a peripheral vein for pro-inflammatory cytokines by ELISA and creatinine level determination with a calculation of the glomerular filtration rate (GFR) were performed at baseline and 3 years after RD

Results:
The number of antihypertensive drugs did not change significantly from 4,0 ± 0,9 to 4,3 ± 0,9 (p > 0.05). The studied indicators dynamics after 3 years was as follows: 24-h BP decreased from 159,9 ± 16,5 / 88,0 ± 13,4 mmHg to 143,3 ± 17,2 / 79,0 ± 13,5 mmHg (p = 0,000); LVM - from 251,9 ± 64,1 g to 229,7 ± 61,9 g (p = 0,015).
Tumor necrosis factor alpha changed from 4,1 ± 3,6 ng/ml to 2,5 ± 2,2 ng/ml (p = 0,042); interleukin-1 (IL-1) from 5,6 ± 4,4 ng/ml to 3,2 ± 2,1 ng/ml (p = 0,010); IL-6 from 3,6 ± 3,0 ng/ml to 2,7 ± 1,5 ng/ml (p > 0,05); IL-10 from 5,6 ± 3,6 ng/ml to 2,8 ± 0,7 ng/ml (p = 0,000).
The creatinine level did not change significantly over 3 years from 82,1 ± 18,2 mmol/l to 85,6 ± 23,1 mmol/l (p > 0,05). GFR, determined by the CKD-EPI, decreased from 78,8 ± 16,1 to 74,5 ± 20,2 ml/min/1,73m2 for 3 years mainly by the first year due to BP decrease.
No adverse events were registered

Conclusions:
RD is an effective and safe method for the treatment of resistant hypertension. We indicate target organ damage regression, including an LVM decrease and a slowdown in chronic kidney disease progression. There is a decrease in proinflammatory cytokines levels as well as in IL-10, probably by a feedback mechanism, which may also indicate a persistent sympathetic tone decline.
BLOOD PRESSURE DURING HEMODIALYSIS AS PREDICTOR OF MORTALITY IN END-STAGE RENAL DISEASE PATIENTS
Authors: Zakauskiene Urte , Vickiene Alvita , Vicka Vaidas , Sukackiene Diana , Rimsevicius Laurynas , Miglinas Marius 
Published: April 2021

Objective:
High blood pressure (BP) and consequential cardiovascular complications remain the leading cause of death in hemodialysis (HD) patients. Aim of this study is to link BP variations during HD with a 1 year mortality.

Design and method:
We conducted a cohort study in tertiary reference dialysis center. Patients undergoing HD were enrolled. Systolic, diastolic and mean arterial BP were measured before, every hour during and after HD procedure. These patients were observed for 12 months and mortality rate was evaluated. Mean values of measurements were compared across the groups. Furthermore, these measurements were included in univariate and multivariate regression analysis, determining their potency to predict 1 year mortality.

Results:
Study enrolled 99 patients. Mean age of patients was 58.7 ± 14.4 years, more than a half of them were men 51 (51.5%) with median time on HD for 4,5 [2,0–8,5] years. Mortality rate was 15.2 % (n = 15). All of the BP measurements were significantly lower in deceased group, except of BP before HD. (Table 1). Univariate regression analysis revealed that all of these pressures were linked to 1 year mortality, however, after application of stepwise forward selection model in multivariate analysis the most potent predictor was eluded to be MAP of the 1st HD hour (OR CI95% p), tripling the risk of mortality per every decrease of 10mmHg. However, the difference in precipitated risk of mortality for 2nd h, 3rd h and post HD MAP was minimal.

Conclusions:
One year mortality in HD patients is substantial. Blood pressure during and post HD is a more potent predictor of mortality than a blood pressure measured before the procedure. Further studies should investigate the application of intradialytic BP for the timely intervention.