bluuebunny/crossref_metadata_2025_split huggingface dataset:
GLUCOCORTICOID EXCESS INDUCES NON-DIPPING BLOOD PRESSURE AND RENAL VASCULAR DYSFUNCTION
Authors: Costello Hannah , Jones Natalie , Grenier Celine , Stewart Kevin , Holmes Megan , Livingstone Dawn , Dhaun Neeraj (Bean) , Bailey Matthew 
Published: April 2021

Abstract

Objective:
Blood pressure (BP) abnormalities such as loss/attenuation of nocturnal BP dip (non-dipping) increase cardiovascular risk. The mechanisms underlying non-dipping are not clear, but renal and vascular dysfunction has been implicated. People with abnormal glucocorticoid (GC) homeostasis, such as in Cushing's syndrome, often display non-dipping BP therefore, here we investigated the contribution of GCs to BP rhythmicity.

Design and method:
The effect of GC excess, driven by ACTH infusion, on BP and plasma GC rhythmicity was examined in adult male C57BL/6J mice. Radiotelemetry was used to measure BP longitudinally before and after ACTH infusion (2.5 mg/day for 14days via minipump). Diurnal plasma GCs was measured by ELISA. Diurnal renal vascular function was investigated ex vivo by wire myography in isolated renal arteries from separate cohorts of mice either control or ACTH-treated collected between 7–8AM (day) or 7–8PM (night). Vascular reactivity to vasoconstrictor phenylephrine (PHE), endothelium-dependent acetylcholine (ACh) and endothelium-independent sodium nitroprusside (SNP) vasodilators was assessed. Data are mean ± SD.

Results:
After 5days of baseline measurements, 24-hour systolic BP (SBP) was 123.8 ± 4.2 mmHg and 24-hour diastolic BP (DBP) was 96.2 ± 5.6 mmHg. The day:night SBP and DBP variation was 12.8 ± 4.5 mmHg and 12.3 ± 4.8 mmHg, respectively. ACTH-excess increased 24-hour SBP to 133.8 ± 1.7 mmHg and 24-hour DBP to 101.4 ± 2.1 mmHg. The day:night SBP and DBP variation was reduced to 0.6 ± 7.2 mmHg (p = 0.0166) and 2.4 ± 9.6 mmHg (p = 0.0235), respectively. Day:night activity count during BP measurements was similar before and after ACTH infusion. Diurnal plasma GCs was increased following ACTH infusion, compared with baseline (p < 0.0001). Furthermore, ACTH-excess flipped the diurnal rhythm of GC, so the day plasma GC concentration is higher than the night. Day control renal arteries showed a trend for an increase in sensitivity to PHE (p = 0.0578) and SNP (p = 0.0795), with no changes in ACh (p = 0.1299), compared with night control renal arteries. ACTH-excess caused no differences in day and night responses to PHE (p = 0.5526), ACh (p = 0.1169), and SNP (p = 0.9466). ACTH-excess caused renal vascular dysfunction, compared with controls, causing a significant reduction in sensitivity to PHE (p = 0.0005), ACh (p = 0.0128) and SNP (p = 0.0002).

Conclusions:
These data show that chronic GC induces non-dipping BP and renal vascular dysfunction.
THE EFFECT OF AGE, BMI, AND SEX ON ALDOSTERONE, RENIN AND THE ALDOSTERONE-TO-RENIN RATIO IN ESSENTIAL HYPERTENSIVES
Authors: Alnazer Rawan , Veldhuizen Gregory , de Leeuw Peter 
Published: April 2021

Abstract

Objective:
The aldosterone-to-renin ratio (ARR) is widely used as a screening test for primary aldosteronism (PA) in patients with hypertension. The purpose of the present investigation is to identify the impact of age, body mass index (BMI) and sex on renin, aldosterone, and the ARR, when measured under strictly standardised conditions.

Design and method:
We measured plasma aldosterone, plasma renin concentration and the ARR in 190 essential hypertensive patients (120 males, 70 females). All measurements were taken in the supine position at 9am. A low sodium diet (55mmol/day) was in place for no less than two weeks prior to screening. In those who were receiving antihypertensive medications, all medications were discontinued at least 2 week before testing.

Results:
Renin and aldosterone were significantly higher in men, and remained so when controlling for BMI and age. However, the ARR was not significantly affected by sex.
Aldosterone was not significantly influenced by age but renin correlated inversely with age, with and without controlling for BMI (r = -0.285, p < 0.001). The ARR was positively correlated with age (r = 0.236, p < 0.001), with and without controlling for BMI. Subgroup analysis demonstrated a significant effect on the ARR in males only, with and without controlling for BMI (p < 0.001 and p0.004, respectively).
Although renin and aldosterone individually were not significantly influenced by BMI, the ARR showed a positive correlation (p = 0.022). However, this effect was not seen when age was controlled for nor was it seen in the subgroup analysis of males and females (p = 0.125, p = 0.515, p = 0.207, respectively)

Conclusions:
Under strictly standardized conditions, advanced age is associated with an increased ARR in male essential hypertensives. BMI when controlling for age does not influence the ARR. The impact of sex on the ARR appears negligible.
ADDED VALUE OF CATECHOLAMINE PHENOTYPING AND GENETIC SCREENING FOR THE CHARACTERIZATION OF PHEOCHROMOCYTOMA: A BELGIAN MULTICENTRE COHORT
Authors: Courcelles Louisiane , Gruson Damien , Evenepoel Lucie , Maiter Dominique , Persu Alexandre 
Published: April 2021

Abstract

Objective:
Pheochromocytomas/paragangliomas (PPGL) are rare neuroendocrine tumors arising from chromaffin cells of the adrenal medulla or from neural-crest derived sympathetic tissue. They secrete catecholamines in varying amounts, which accounts for their symptomatology. Hypertension is the most common sign, found in approximately 95% of patients. Nowadays, biochemical testing remains the simplest and most widely available method to assess PPGL in first intention. Identification of mutations in known susceptibility genes may help further refining tumor characterization and prognosis assessment. The objective of this study was to analyze clinical characteristics of PPGL from Belgium according to their secretory and genetic profiles.

Design and method:
We retrospectively analyzed a cohort of 120 cases of non-syndromic PPGL diagnosed in 19 Belgian centres. Clinical characteristics were correlated with three catecholamine phenotypes based on urinary metanephrines (noradrenergic, adrenergic and silent) and with the results of genetic screening.

Results:
Our cohort included a majority of women (59%). The mean age at diagnosis was 47 ± 7 years. We documented the prevalence of pediatric (7.5%), extra-adrenal (13.3%), bilateral (2.9%), multifocal (5.1%), recurrent (8.5%), metastatic (7.6%) and familial (5.9%) cases. While the yield of positive genetic screening was low (15%), the presence of at least one of these criteria was associated with a 4-fold increased prevalence of mutation (30.3 vs 8.5%; p = 0.03). In the subset in whom metanephrines values were available (n = 62), the prevalence of adrenergic, noradrenergic and silent phenotypes was 58%, 34% and 8% respectively. Patients belonging to these three subsets differed by age at diagnosis (51 ± 14; 38 ± 17; 42 ± 13 years; p = 0.009), the proportion of extra-adrenal tumors (2.8%; 9.5%; 40%; p = 0.016), pediatric (2.8%; 19%; 0%; p = 0.074) and familial (0%; 18.8%; 0%; p = 0.041) cases. Finally, an excess of dopamine secretion was associated with a higher prevalence of metastatic disease (25% vs 1.9%; p = 0.005).

Conclusions:
Secretory phenotypes and genetic profiles deserve to be integrated in the preoperative characterization of PPGL and may help orienting management and follow-up. Simple clinical features are associated with an increased probability of inherited tumor. Identification of an increased dopamine secretion should raise the suspicion of metastatic PPGL.
THE EFFECT OF THE MENSTRUAL CYCLE ON RENIN, ALDOSTERONE AND ALDOSTERONE-TO-RENIN RATIO IN FORMERLY PREECLAMPTIC AND HEALTHY WOMEN
Authors: Alnazer Rawan , Veldhuizen Gregory , Spaanderman Marc , De Leeuw Peter 
Published: April 2021

Abstract

Objective:
The aldosterone-to-renin ratio (ARR) is widely used as a screening test for primary aldosteronism (PA) in patients with hypertension. The purpose of the present original investigation is to identify the impact hormonal changes have on renin, aldosterone, and the ARR during the menstrual cycle of premenopausal women when measured in strict standardised conditions.

Design and method:
We analysed 59 women with a history of preeclampsia and 6 healthy parous controls. Blood values were determined during both follicular and luteal phases of the menstrual cycle (days 1 and 14 respectively). Plasma aldosterone, active plasma renin concentration (APRC) and the ARR were measured under standardised conditions. All measurements were taken in the supine position at 9am, all patients maintained a standardised sodium diet (100 mmol/day) for no less than two weeks. In those who were receiving antihypertensive medications (n = 2), all medications were discontinued at least 1 week prior to screening.

Results:
When performing the Friedman's Test and the Wilcoxon signed rank test in formerly preeclamptic women (n = 59), aldosterone and renin were both significantly elevated in the luteal phase (mean rank aldosterone 1.2 and 1.8 p0.000 Z-4.7, mean rank renin 1.23 and 1.77 p0.000 Z -4.5, respectively), however the ARR values did not significantly differ between phases (mean rank 1.53 and 1.47 p0.7 Z-0.14). When performing the Friendman's Test in the control group (n = 6), the difference in aldosterone, renin and the ARR between the follicular and luteal phase was not significant (p0.059 for all parameters). Wilcoxon signed test revealed a significant difference in aldosterone (Z-2.02 p0.04), but the difference in renin and the ARR remained insignificant (p0.06).

Conclusions:
In this study of premenopausal women we found that both renin and aldosterone are significantly affected by the menstrual cycle. However the resulting ARR was not statistically significantly altered. Our study indicates that it is not necessary to take the menstrual phase of patients into account when performing and interpreting the ARR as a screening test for PA in patients with a history of preeclampsia.
FOLLOW THE HEART OR THE GUT?
Authors: Munteanu Alice Elena , Diaconescu Corina , Casian Mihnea , Ionita Iulia 
Published: April 2021

Abstract

Objective:
This case underlines the importance of thoroughly investigating alternative causes for hypertension in patients with atypical presentations, regardless of their age and risk factors.

Design and method:
Clinical case.

Results:
We present the case of a 68 year old woman without known cardiovascular diseases who came to the ER complaining of headaches, palpitations and chest pain of two hours duration. Upon admission, her blood pressure was 300/150 mmHg - overlapping values in all limbs with no asymmetric pulse. Heart rate was 140 bpm, rhythmic and without heart murmurs, abdomen without murmurs or palpable masses. Her ECG showed diffuse ST segment depression and high sensitivity troponin level at 0 h was 258 ng/L. Cardiac echo showed no wall motion abnormalities and no hypertrophy of the left ventricle. Her BP was acutely controlled with ACEi and iv nitroglycerin. Two hours after admission her BP returned to normal and remained within normal range without medication. Her ECG showed normal sinus rhythm with no other pathological findings. Coronary angiography was performed the next day and showed no atherosclerotic lesions. At this stage, her diagnosis was type 2 MI caused by severely elevated BP. Blood and urine tests revealed high levels of serum catecholamines and urinary normetanephrines - over 4000 micrograms/24 h. Abdominal ultrasound found a mass near her right kidney. Abdominal CT confirmed the presence of a nodular 5 × 3 cm mass in the right adrenal gland, compatible with a pheochromocytoma. She was submitted to laparoscopic adrenalectomy with normalization of her BP after the surgery. During follow-up, the patient presented with persistently normal blood pressure and normal ECG aspect without any chronic medication.

Conclusions:
Pheochromocytoma is a rare neuroendocrine tumour originating in the adrenal gland medulla. Sustained or paroxysmal arterial hypertension is sometimes associated with the classic triad: episodic headaches, profuse sweating and tachycardia. A timely diagnosis and an effective therapeutic strategy are important, as this is a potentially fatal disease with a very good prognosis if discovered and treated early. It should be excluded in patients with high paroxysmal BP, especially if under 20 or over 50 years old.
HDL CHOLESTEROL LEVELS AND ENDOTHELIAL GLYCOCALYX INTEGRITY IN TREATED HYPERTENSIVE PATIENTS OVER 40 YEARS OLD
Authors: Triantafyllidi Helen , Benas Dimitrios , Schoinas Antonios , Mpirmpa Dionyssia , Ikonomidis Ignatios , Iliodromitis Efstathios 
Published: April 2021

Abstract

Objective:
Endothelial dysfunction indicates target organ damage in hypertensive patients. The integrity of endothelial glycocalyx (EG) plays a vital role in vascular permeability, inflammation and elasticity and finally to cardiovascular disease. We aimed to investigate the role of increased HDL cholesterol levels (HDL-C), which usually are considered protective against cardiovascular disease, in EG integrity in middle aged hypertensive patients.

Design and method:
We studied 186 treated hypertensive patients, apparently healthy and older than 40 years. They were divided regarding sex distribution in two groups. In males’ group, HDL-C was 48 + 19 mg/dl (n = 77, mean age 51 + 11 years) while in females’ group, HDL-C was 67 + 16 mg/dl (n = 109, mean age 63 + 12 years). Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (ranged from 5–9 micrometers) using Sideview Darkfield imaging (Microscan, Glycocheck) was measured as a non-invasive accurate index of reduced EG thickness.

Results:
Females were older (p = 0.04) with fewer smokers (p = 0.04), higher levels of office SBP (148 + 19 mmHg vs. 139 + 15 mmHg, p < 0.001) as well as higher HDL levels (p < 0.001). No differences were found within groups regarding BMI, DBP, total Cholestelol and PBR 5–9. In males, HDL-C was inversely related with PBR 5–9 (r = -0.29, p = 0.01). In a multiple linear regression analysis model, using smoking habit and office SBP levels, as independent variables, we found that HDL-C independently predicted PBR 5–9 (Beta = 0.25, p = 0.006) in male hypertensives.

Conclusions:
In middle-aged, apparently healthy, hypertensive patients, higher HDL-C levels protect EG and subsequently endothelial function. However, the role of EG as a novel index regarding cardiovascular risk in essential hypertension needs to be extensively investigated in future studies.
CIGARETTE SMOKE EXTRACT INDUCES DNA DAMAGE AND ACCELERATES CELLULAR SENESCENCE IN HUMAN ENDOTHELIAL CELLS
Authors: Ishida Mari , Ueda Keitaro , Sakai Chiemi , Yoshizumi Masao , Ishida Takafumi 
Published: April 2021

Abstract

Objective:
Elevated blood pressure and tobacco smoking are causes of preventable mortality. The effects of tobacco smoking on blood pressure are complex and chronic effects of tobacco smoking are inconsistent. We reported that DNA damage was increased in smokers’ blood cells compared to non-smokers. Recently, it has been reported that DNA damage is involved in cellular senescence. In this study, we investigated whether cigarette smoke extract (CSE) exerts DNA damage and cellular senescence in endothelial cells and the physiological influence of DNA damage.

Design and method:
The effect of CSE extracted from tobacco smoke was examined in human umbilical vein endothelial cells (HUVEC). CSE was added to HUVEC and DNA damage formation was quantified by fluorescence immunostaining; DNA single strand breaks (SSBs) with RPA 2 and double-strand breaks (DSBs) with phosphorylated histone H2AX as indices. Cellular senescence was quantified by senescence-associated -b galactosidase activity. The mRNA expression of inflammatory cytokines was quantified by real-time RT PCR.

Results:
SSBs increased at 24 hours after CSE stimulation, and DSBs increased significantly at 72 hours after stimulation. Continuous stimulation with CSE for 7 days resulted in an accumulation of cytosolic DNA (percentage of cells with cytosolic DNA; control: 3.4 ± 1.1, 7 days stimulation: 11.8 ± 1.8, p < 0.01)and accelerated cellular senescence (percentage of senescent cells; control: 32.5 ± 3.4, 7 days stimulation: 61.5 ± 5.2, p < 0.01). The mRNA expression of inflammatory cytokines, such as IL-6 and IL-1a was increased and prolonged by continuous CSE stimulation.

Conclusions:
CSE was shown to induce DNA damage, accumulation of cytosolic DNA, cellular senescence and inflammation of vascular endothelial cells.
THE IMPACT OF ISCHEMIA-REPERFUSION ON LANGENDORFF RABBIT HEART WITH EXPERIMENTAL ATHEROSCLEROSIS
Authors: Revnic Cristian Romeo , Sonea Cosmin , Revnic Flory 
Published: April 2021

Abstract

Objective:
To examine the effect of hypercholesterolemia (HC)on cardiac function in rabbit model.

Design and method:
12 adult rabbits divided into 2 groups of 6 rabbits each:Control(C) fed on normal chow, and (HC) fed on 2% cholesterol (Iard mixed with chow) for 16 weeks. After treatment, rabbits from (C) and (HC) groups were sacrificed and hearts were quicky removed, and perfused with standard Krebs Hanseleit buffer at a rate of 10 ml/minute at 37°C, pH 74 in Langendorff retrograde perfusion system at a constant pressure.45 minutes ischemia was followed by 120 minutes reperfusion and parameters of cardiac function: coronary flow (HC), Heart rate (H.R.) and left ventricle developed pressure (LVDP) of hearts from (C) and (HC) groups were measured. TACS DNA laddering kit was used to assess left ventricle cardiomyocytes from group (HC) for apoptosis, also fragments of left ventricle from (HC) were processed for Electron Microscopy (EM).

Results:
Evaluation of (C.F.), (H.R.) and (LVDP) in (C) and (HC) groups have pointed out a 50% reduction in (C.F). in (HC) group versus (C) during stabilization period In (HC) group, LVDP was depressed during the whole experiment, while in (C) group is was almost constant. Protection of myocardium against oxidative stress was significantly depressed following (HC) treatment, synthesis and utilization of GSH was limited versus (C). Cardiac hypertrophy experimentally induced with (HC) was related with a decrease in (C.F.) and LVDP associated with an increase in lipid peroxidase, in LDH and CK as markers of myocardial lesion and GGT activity in myocardial tissue. Myocyte apoptosis was present in (HC) group, pointed out by DNA laddering pattern on gel electrophoresis. (E.M.) studies have pointed out perinuclear edema of myocytes, dilated sarcoplasmic reticulum and swollen mitochondria.

Conclusions:
High cholesterol diet in (HC) rabbits induces cardiac hypertrophy and changes in physiological parameters of heart with a negative impact upon synthesis of antioxidant enzymes as well as changes in ultrastructure of heart muscle and at the molecular level (DNA laddering is present as a sign of apoptosis in ventricular myocytes).
HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS HAVE SEVERELY IMPAIRED ENDOTHELIAL POST-OCCLUSIVE FOREARM VASODILATORY RESPONSE ASSESSED WITH LASER SPECKLE CONTRAST IMAGING
Authors: Alexandrou Maria-Eleni , Gkaliagkousi Eugenia , Loutradis Charalampos , Dimitriadis Chrysostomos , Mitsopoulos Efstathios , Lazaridis Antonios , Nikolaidou Varvara , Dolgiras Panagiotis , Papadopoulou Dorothea , Douma Stella , Papagianni Aikaterini , Sarafidis Pantelis 
Published: April 2021

Abstract

Objective:
Endothelial dysfunction is associated with cardiovascular events and mortality in various disease states, including end-stage-renal-disease (ESRD). Novel technological approaches have emerged for real-time assessment of endothelial reactivity. This study examined forearm skin microcirculation using Laser Speckle Contrast Imaging (LSCI) before and after arterial occlusion in ESRD patients undergoing hemodialysis (HD) or peritoneal dialysis (PD).

Design and method:
Thirty-eight patients undergoing HD were matched in a 1:1 ratio with 38 PD patients (for age, sex and dialysis vintage) and 38 controls (for age and sex). Skin microvascular reactivity parameters assessed with LSCI included baseline perfusion, occlusion perfusion, and peak perfusion during post-occlusive reactive hyperemia (PORH); time to peak perfusion; proportional change from baseline to peak perfusion; baseline and peak cutaneous vascular conductance (CVC); proportional change from baseline to peak CVC; and the amplitude of the PORH response (calculated as the difference between peak and baseline CVC).

Results:
Baseline perfusion [HD: 46.97 ± 14.6; PD: 49.32 ± 18.07; controls: 42.02 ± 11.94 Laser-Specle-Perfusion-Units (LSPU), p = 0.097] and peak post-occlusion perfusion (104.77 ± 28.68 vs 109.04 ± 40.77 vs 116.96 ± 30.96 LSPU, p = 0.238) did not differ between groups. However, the post-occlusive vascular response was completely different, since time to peak response (HD: 7.24 ± 6.99; PD: 10.68 ± 9.45; controls: 11.11 ± 5.1 sec, p = 0.003) and the (%) increase from baseline to peak perfusion (HD: 133% ± 66; PD: 149% ± 125; controls: 187% ± 61, p = 0.001) was significantly lower in ESRD patients. ESRD patients had also lower levels of peak CVC, indicating the maximum capillary recruitment (HD: 1.05 ± 0.3; PD: 1.07 ± 0.44; controls: 1.57 ± 0.52 LSPU/mmHg, p < 0.001), lower % increase of CVC at peak (p = 0.001), and lower amplitude of the PORH response (p = 0.001) (a measure of the difference between baseline and maximum capillary recruitment).

Conclusions:
Using this novel non-invasive technology endothelial post-occlusive skin vasodilatory response was found to be similar between HD and PD patients and significantly impaired compared to controls. Future studies are needed to assess the prognostic implications of this microcirculatory functional defect.
THE EFFECT OF ELEPHANTOPUS SCABER EXTRACT ON HISTOPATOLOGY OF AORTA SECTION IN SPRAGUE-DAWLEY RATS WITH HYPERCHOLESTROLEMIA DIET MODEL
Authors: Kresna Deva Bayu , Ardiansyah Rizki , Imani Namira Putri , Budiani Dyah Ratna 
Published: April 2021

Abstract

Objective:
This study was designed to evaluate the antihypercholesterolemic effect of Elephantosus scaber on histopatology of Sprague-Dawley rat's aorta with hypercholesterolemia diet model.

Design and method:
This is an Experimental study with post test only control group design. Twenty-one (21) Sprague-Dawley rats of about 2–3 months old, weighing between 150–200 g body weight, were used for the study with incidental sampling. The rats were divided into three groups (3) of seven animals in each cage. First group (G1) was the normal control administered standard meal. Positive control group (G2) and Treatment group (G3) were administered with high fat diet. Administration of 400 mg/kg body weight of Elephantopus scaber extract was given to the third group in 7–11 weeks after induced by high fat diet. Termination was done after last feed administration. Aorta section was done with Hematoxylin eosin stain. Data analysis used Kruskal-wallis followed by Mann-Whitney test.

Results:
Proximate measurement was carried out on the Sprague-Dawley rat's aorta section with the following results: wall thickness in normal control group 85.19 ± 8.35 mm; positive control group 95.78 ± 17.64 mm and treatment group 80.50 ± 8.41 mm. Data analysis of Kruskal-Wallis was obtained P = 0.018, a > P. The results obtained from the analysis of Mann-Whitney test are significant difference between normal control group (G1) and positive control group (G2). And non-significant difference between normal control group (G1) and treatment group (G3).

Conclusions:
Elephantosus scaber extract has antihypercholesterolemic potential effect that could reduce atherosclerosis on histopatology of aorta section in Sprague-Dawley rats with hypercholesterolemia diet model.