bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between peripartum maternal cardiac phenotype and maternal outcome in women with hypertensive disorders of pregnancy
Authors: Giorgione V , O'Driscoll J , Di Fabrizio C , Frick A , Cauldwell M , Khalil A , Thilaganathan B 
Published: October 2021

Abstract

Background
Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and neonatal morbidity worldwide.

Purpose
The aim of this study is to assess maternal cardiac function in women affected by HDP in singleton pregnancy and investigate the relationship between abnormal cardiac findings and maternal outcomes.

Methods
In this single-centre prospective longitudinal study, 190 women with a diagnosis of HDP underwent standard trans-thoracic echocardiography (TTE) in the immediate peripartum period from February 2019 to December 2020. Left ventricle morphology (LVM) and diastolic dysfunction (DD) were evaluated according to according to British Society of Echocardiography guidelines. Patients were classified into three groups according to TTE findings: (1) normal LVM and DD, (2) abnormal LVM or abnormal DD, (3) abnormal LVM and abnormal DD. Maternal indices were compared among these groups.

Results
56 (29.5%) patients affected by HDP were included in group 1, 69 (36.3%) in group 2 and 65 (34.2%) in group 3. Gestational age at delivery and birthweight centile were similar among the groups. Women in group 3 were significantly older than group 2 and group 1 (35.1±5.4 years vs 32.6±6.3 vs 33.1±5.8 years years, respectively, p=0.043). Group 2 and 3 showed a higher blood pressure in the first trimester of pregnancy compared to group 1 (mean arterial pressure: 94.3±7.2 mmHg vs 95.5±8.2 mmHg vs 91.6±8.3 mmHg, p=0.024), while no significant difference was found in body mass index among the three groups (group 1: 26.4±5.4, group 2: 28.0±6.4; group 3: 27.7±5.0, p=0.293). HDP women with LVM and DD (group 3) were more likely to be admitted to high dependency unit (35.4%) than women in group 2 and 1 (14.5% and 23.6%, respectively, p=0.019).

Conclusions
Abnormal echocardiographic findings were associated with a worse maternal cardiovascular phenotype that required a closer maternal cardiovascular monitoring in the peripartum period.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Veronica Giorgione and Carolina Di Fabrizio have received funding from European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 765274 (iPLACENTA project).
Suboptimal blood pressure control and associated risk for cardiovascular mortality among stroke survivors in China
Authors: Wang B , Lu J P , Cai J 
Published: October 2021

Abstract

Background
Elevated blood pressure (BP) is associated with substantial morbidity and mortality in stroke survivors. China has approximately 7.5 million stroke survivors, and accounts for one third of stroke mortality worldwide, but little is known about the prevalence and management of elevated BP as well as its effect on cardiovascular death at the national level.

Purpose
We aim to describe the prevalence and treatment of elevated BP and assess the cardiovascular mortality attributable to elevated BP among stroke survivors in China.

Methods
Based on 3 million participants aged 35–75 years from all 31 provinces in mainland China recruited from September 2014 through August 2019, we assessed the prevalence and treatment of elevated BP (systolic BP ≥140mmHg or diastolic BP ≥90mmHg) among those with self-reported stroke. Cardiovascular death was recorded before December 31st 2019. The age- and sex- specific population attributable fractions of cardiovascular death from elevated BP were estimated based on hazard ratios derived by Cox regression analysis.

Results
Among 91,628 stroke survivors, the mean (SD) age was 62 (8) years, 49% were male sex. The median (IQR) stroke duration was 4 (2,7) years. 61.3% of the individuals had elevated BP, and the prevalence increased with age (from 47.6% at 35–44 years of age to 64.7% at 65–75 years of age) and was slightly higher in rural area (63.2%) than urban area (58.8%). 32.7% of the overall population were treated, and 23.4% of those with elevated BP were treated. Among stroke survivors, elevated BP accounted for 26% of cardiovascular death at 35–75 years of age, and about one third at 35–54 years of age. The age- and sex- specific results were shown in the Table.

Conclusions
In this nationwide cohort of stroke survivors from China, over 60% had elevated BP, and about one third were treated. Elevated BP was associated with particularly substantial cardiovascular mortality for young and middle-aged stroke survivors. National strategies targeting elevated BP are required to improve the prognosis of stroke survivors in China.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Key Research and Development Program from the Ministry of Science and Technology of China Age- and sex-specific HRs and PAFs
Sustained strong blood pressure lowering and preserved renal function during 3 year after anatomically optimized distal renal denervation according to the double blind randomized controlled study
Authors: Pekarskiy S , Baev A , Tarasov M , Falkovskaya A , Sitkova E , Zubanova I , Manukyan M , Mordovin V , Popov S 
Published: October 2021

Abstract

Aim
To evaluate long-term safety and efficacy of anatomically optimized distal renal denervation (RDN).

Methods
We assessed major adverse cardiovascular and renal events; changes in BP (office, ambulatory), and renal function (serum creatinine, eGFR) over 3 year follow-up extension of our double blind, randomized controlled study of the efficacy and safety of distal RDN versus conventional main trunk treatment in patients with true resistant hypertension (NCT02667912).

Results
Of 55 randomized patients (28/27, distal/main trunk RDN, respectively), 47 (23/24) were assessed at 1 year, and 39 (21/18) - at 3-year post-procedure. During 3-year follow-up 2 fatal and 2 non-fatal strokes were observed in distal RDN group versus one heart failure death and 2 non-fatal strokes in group of main trunk treatment.
In distal RDN arm BP remained powerfully and significantly lowered both at 1 and 3 years post-procedure: −18.0 (95% CI −27.6; −8.5) and −16.9 (95% CI −27.3; −6.5) mmHg, 24h ambulatory systolic. During 1st year this potent BP lowering effect was accompanied by moderate eGFR decrease: −8.9 (95% CI −14.8; −3.1) ml/min/sq.m, however, this decrease was later reduced to non-significant −6.5 (95% CI −13.2; 0.3) ml/min/sq.m at 3 year post-procedure signaling some improvement in renal function after 1st year despite sustained strong BP lowering.
In group of main trunk intervention BP only moderately decreased at 1 year −12.1 (95% CI −19.2; −5.0) mmHg, in parallel with small non-significant change in eGFR: −1.3 (95% CI −6.6; 4.0) ml/min/sq.m. Subsequently, BP lowering effect weakened and lost significance at 3 years post-procedure: −8.5 (95% CI −19.7; 2.2) mmHg. In contrast, eGFR continued to decline and reached significant −5.0 (95% CI −9.6; −0.3) ml/min/sq.m at the end of the study.
Five patients developed new onset chronic kidney disease after main trunk RDN versus 3 patients – after distal RDN. The number of concomitant antihypertensive medications did not significantly changed in either group.

Conclusion
Our data demonstrate strong long-term BP lowering efficacy of distal RDN and, also, the potential of this procedure to prevent the decline of renal function in patients with resistant hypertension.

Funding Acknowledgement
Type of funding sources: None.
Treatment with a fixed dose combination for cardiovascular disease-more than a health benefit?
Authors: Dima I , Andrikopoulos G , Demerouti E , Giannakoulas G , Kartalis A , Lambropoulos K , Marketou M , Papadopoulos C , Poulimenos L , Stalikas D , Stougiannos P , Tsiafoutis I , Tsioufis K , Vlachopoulos C 
Published: October 2021

Abstract

Background
Despite the proven benefits of cardiovascular disease medication, adherence to treatment remains poor. Fixed-dose combinations (FDC) have been proposed as a measure to enhance adherence.

Objective
To assess compliance to treatment with an FDC, consisting of acetylsalicylic acid, atorvastatin and ramipril, and to gauge its impact on cardiovascular risk factors.

Methods
This was a prospective, multicenter, observational, phase 4 study conducted for 6 months in Greece. 1444 participants (67% males, mean age 63.7 years old) that were prescribed the FDC for primary or secondary prevention were included in the analysis. Descriptive statistical analysis was performed to analyze clinical, sociodemographic and safety parameters.

Results
Approximately equal number of participants was recruited in the primary and secondary prevention group. The majority of patients were overweight and hypertensive. Dosing compliance was 88.6% at 3 months and 86.8% at 6 months. Adherence to treatment was 99.1% at 3 months and 97.6% at 6 months. Statistically significant changes at 6 months compared to baseline were documented in systolic/diastolic blood pressure of 15.7/7.5 mmHg and LDL-c of 32.6 mg/dl, in both CVD and non-CVD participants and in total population as well. The total 10-year risk for CV events was reduced by 34.1% at 6 months. Only 1.2% of the participants reported an adverse event and 0.8% an adverse event reaction.

Conclusions
Among patients with or without CVD, the use of acetylsalicylic acid, atorvastatin and ramipril FDC resulted in good medication adherence at 6 months and statistically significant improvements in blood pressure, total cholesterol and LDL levels.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Galenica SA
Association of daily coffee consumption with cardiovascular health – results from the UK Biobank
Authors: Simon J , Fung K , Raisi-Estabragh Z , Aung N , Khanji M Y , Kolossvary M , Merkely B , Munroe P B , Harvey N C , Piechnik S K , Neubauer S , Petersen S E , Maurovich-Horvat P 
Published: October 2021

Abstract

Background
There are conflicting reports on the association of coffee consumption with cardiovascular (CV) health. The UK Biobank is a prospective cohort study including data for half a million middle-aged individuals.

Purpose
We studied the association of daily coffee consumption with all-cause and CV mortality, and incidence of the major CV diseases in the UK Biobank. In a subgroup of participants who underwent cardiovascular magnetic resonance (CMR), we evaluated the association between regular coffee intake and cardiac structure and function parameters.

Methods
UK Biobank cohort of participants without clinically manifested heart disease at the time of recruitment were included. Regular coffee intake was categorized into 3 groups: zero, light-to-moderate (0.5–3 cups/day) and high (&gt;3 cups/day) coffee drinkers. We estimated association of daily coffee consumption with incident outcomes using multivariable Cox-regression models (median follow-up of 11 years) and, in the subset with CMR data, with left and right ventricular (LV, RV) end-systolic and end-diastolic volumes, LV mass, and LV/RV stroke volume using multivariable linear regression. Models were adjusted for potential confounders and mediators, including: age, sex, non-European ethnicities, body mass index, smoking, physical activity, Townsend deprivation index, alcohol, meat, fruit and vegetable intake, hypertension, diabetes mellitus, and cholesterol level.

Results
We included 468,629 individuals (mean age 56.2±8.1 years, 44.2% male). Among them, 22.1% did not consume coffee on a regular basis, 58.4% had 0.5–3 cups per day and 19.5% had &gt;3 cups per day. After adjustment for potential confounders and mediators, compared to non-coffee drinkers, light-to-moderate coffee drinking was associated with lower risk of all-cause mortality (HR=0.88, p&lt;0.001), CV mortality (HR=0.83, p=0.006), and incident stroke (HR=0.79; p=0.037). CMR data were available in 30,650 participants. In multivariable analysis, compared to non-coffee drinkers, both the light-to-moderate and high coffee consuming categories, were associated with significantly increased LV and RV ventricular end-systolic (β=0.91 and 1.64 for LV and 1.10 and 1.72 for RV), end-diastolic (β=2.21 and 3.28 for LV and 2.24 and 3.35 for RV) and stroke volumes (β=1.31 and 1.64 for LV and 1.15 and 1.63 for RV), as well as greater LV mass (β=0.78 and 1.64; all p&lt;0.001).

Conclusion
In this large study of the UK Biobank population, regular coffee consumption of up to 3 cups per day was associated with favorable cardiovascular outcomes, in particular, decreased all-cause and CV mortality and stroke incidence. Regular coffee consumption was also associated with a pattern of CMR metrics in keeping with the reverse of age-related cardiac alterations.

Funding Acknowledgement
Type of funding sources: None.
Echocardiographic parameters of myocardial work in relation to prolonged strenuous physical exercise
Authors: Erevik C , Kleiven Ø , Froysa V , Bjorkavoll-Bergseth M , Hansen M , Chivulescu M , Klaboe L G , Dejgaard L , Skadberg O , Melberg T , Urheim S , Haugaa K , Edvardsen T , Orn S ,   NEEDED
Published: October 2021

Abstract

Background
Myocardial work (MW) assessed by echocardiography is a novel measure of left ventricular (LV) function. This measure is load-independent, and therefore a more accurate method for assessing LV function when there are changes in loading conditions. The purpose of this study was to examine alterations in MW parameters, blood pressure (BP) and LV global longitudinal strain (LV GLS) in relation to strenuous exercise, and to compare the response between two different physical stress situations.

Methods
59 healthy recreational athletes were assessed by echocardiography before-, immediately- and 24 hours after two episodes of high-intensity endurance exercise. The first exercise was a cardiopulmonary exercise (CPX) test, which included both a stepwise lactate threshold- and a maximal oxygen uptake test. The second exercise was a 91-km mountain bike leisure sport cycling competition. Global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were estimated from LV pressure-strain loops, constructed from a combination of LV GLS and non-invasive BP, using commercially available software package (Echopac V.202, GE).

Results
Subjects were 52 (43–59) years old (73% men). The duration of the CPX-test was 43 (40–45) minutes, and the race was 230 (210–245) minutes. The average heart rate during the CPX-test and the race was 144 (140–153) and 154 (148–161) beats per minute (bpm), respectively. The relative changes (percent) in systolic blood pressure (SBP) and LV GLS compared with pre-exercise values are demonstrated in Figure 1a, and GWI and GCW compared with pre-exercise values in Figure 1b. GWI at baseline was 2156 (1899–2400) mmHg% and GCW 2383 (2152–2668) mmHg%. There was a significant reduction in LV GLS (p=0.015), SBP, GWI and GCW following the CPX-test and the race (p&lt;0.001), while there was an increase in heart rate and cardiac output (p&lt;0.001). After the race, there was a significant (p=0.001) increase in GWW, and a reduction (p=0.006) in GWE.

Conclusion
There was a significant reduction in GWI and GCW after both the CPX-test and the race, suggesting that these markers reflect increased myocardial exhaustion following strenuous physical exercise.

Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): This work was supported by ConocoPhillips and the Simon Fougner Hartmann Trust Figure 1aFigure 1b
Relationship between cardiovascular risk factors and adipocytokines gene expression in local fat depots
Authors: Dyleva Y U A , Gruzdeva O V , Belik E V , Sinitsky M Y U , Sotnikov A V , Barbarash O L 
Published: October 2021

Abstract

In this study we studied the relationships between adipokines (leptin, soluble leptin receptor) in adipose tissue (AT) and cardiovascular disease (CVD) risk factors.

Methods
Fat tissue biopsies were obtained from 134 patients median aged 64.0 (48.0; 68.0) with stable CAD undergoing coronary artery bypass grafting. Traditional cardiovascular risk factors and patient treatment have been recorded. AH was defined as systolic blood pressure &gt;140 mm Hg Art., diastolic blood pressure &gt;90 mm Hg. Dyslipidemia was defined as a previously detected increase in total serum cholesterol (&gt;200 mg/dl), triglycerides (&gt;200 mg/dl), or low-density lipoprotein (LDL) cholesterol (&gt;150 mg/dl) for at least 1 year, or use of lipid-lowering drugs. Smoking was classified as current or former smokers; current smoking status was defined as at least one cigarette daily over the last year. Adipocytes were isolated from subcutaneous (SAT), epicardial (EAT), and perivascular AT (PVAT) samples. Isolated adipocytes were cultured for 24-h after which, Then adipocytes were immediately processed to RNA extraction and determination of adipokines gene expression.

Results
In this study, we showed that men with CAD LEP and LEPR expression were lower in PVAT, whereas only the latter was decreased in SAT. Thus, LEPR expression in local fat depots appeared to differ in men and women, which is consistent with previous reports. Men with CAD showed lower LEP expression than women in EAT, whereas no significant differences were observed in SAT. Patients 51–59 years old were characterized by the lowest LEP expression in SAT and the highest LEP and LEPR expression in EAT and PVAT. Those &gt;60 years presented the highest levels of LEPR in SAT. The presence of dyslipidemia in patients with CAD correlated with decreased LEPR expression in EAT, which is an unfavorable sign and may potentially lead to the development of leptin resistance. In patients with AH, LEP expression in EAT and LEPR expression in SAT and PVAT is increased. AH &gt;20 years was associated with increased LEP in ATs. Smokers with CAD exhibited higher levels of LEP expression in SAT and EAT, and LEPR expression in SAT.

Conclusions
The results of the study indicate a close association of traditional CVD risk factors with adipocytokine imbalance in patients with CAD. The results indicate the potential of the fat depot and leptin and its receptor data as a drug application point. The study of the molecular basis of PVAT and EAT function can provide a more complete understanding of the etiopathogenetic mechanisms of CVD and develop an effective strategy for their prevention and control.

Funding Acknowledgement
Type of funding sources: None.
Predictors of deterioration in cardiorespiratory fitness among healthy adults: the importance of sex and obesity
Authors: Kaplan A , Fardman A , Tiosano S , Segev S , Scheinowitz M , Segev A , Klempfner R , Grossman E , Maor E 
Published: October 2021

Abstract

Introduction
Cardiorespiratory fitness (CRF) is associated with cardiovascular co-morbidities and is a strong predictor of adverse cardiovascular outcomes. However, data on the natural history of cardiorespiratory fitness among healthy subjects is limited.

Purpose
This study investigated what are the predictors of deterioration in CRF over time.

Methods
We investigated 36,239 men and women who were annually screened in a tertiary medical center and completed an exercise stress test in all visits, with a total of 175,596 annual visits. Subjects who failed to complete maximal exercise stress test according to the Bruce protocol at their first baseline visit were excluded. In addition, subjects with less than five visits to the center or those who developed ischemic heart disease during follow-up were excluded. Fitness was categorized into age- and sex-specific quintiles (Q) according to Bruce protocol treadmill time. Change in CRF between the first baseline visit and the fifth visit was used to calculate fitness deterioration. The primary study endpoint was defined as the lower sex-specific quintile of change in metabolic equivalents (METS) between visits 1 and 5. Logistic regression models were applied.

Results
Final study population included 10,841 subjects. The mean age of the study population was 49±10 years, the mean BMI was 26±4, and 8107 (75%) were men. Median METS at baseline were 10.8 (IQR 9–12.6) and 11.1 (IQR 9.4–13) at the first and fifth visit, respectively (p&lt;0.001 for METS between visits). Overall, 2189 (20%) subjects met the study endpoint. CFR deterioration was higher among women as compared to men (p=0.023). Out of obesity, hypertension, fasting blood glucose, LDL, and HDL cholesterol, after adjustments for age, sex, and baseline CFR, only obesity was independently associated with fitness deterioration in the multivariate model (OR=1.4 95% CI 1.2–1.5, p&lt;0.001). The association of obesity with fitness deterioration was modified by sex such that the risk of CRF deterioration was more pronounced in women (OR=1.6 95% CI 1.3–2, p&lt;0.001) than in men (OR=1.3 95% CI 1.1–1.4, p&lt;0.001).

Conclusion
Obesity is an independent predictor of future CRF deterioration. The effect of obesity on future CRF deterioration is more pronounced among women as compared to men.

Funding Acknowledgement
Type of funding sources: None.
The ceramide- and phosphatidylcholine- based Coronary Event Risk Test2 (CERT2) and cardiovascular mortality in men and women with type 2 diabetes
Authors: Leiherer A , Muendlein A , Saely C H , Larcher B , Mader A , Maechler M , Sprenger L , Mutschlechner B , Benda M , Laaksonen R , Laaperi M , Jylha A , Fraunberger P , Drexel H 
Published: October 2021

Abstract

The recently introduced Coronary Event Risk Test version 2 (CERT2) is a validated cardiovascular risk predictor score that uses circulating ceramide and phosphatidylcholine concentrations.
The purpose of this study was to investigate the power of CERT2 to predict cardiovascular mortality in 280 male and 121 female patients with type 2 diabetes (T2DM).
Prospectively, we recorded 55 cardiovascular deaths in men and 19 in women during a mean follow-up time of 7.6±3.6 and 8.1±3.4 years respectively.
Overall, cardiovascular survival decreased with increasing CERT2 risk categories (figure 1). In Cox regression models, CERT2 significantly predicted the incidence of cardiovascular mortality in male patients with T2DM (unadj. HR 1.82 [1.39–2.37] per standard deviation; p&lt;0.001), the unadj. HR in women was 1.36 [0.83–2.22]; p=0.228). After adjustment for age, BMI, current smoking, LDL cholesterol, HDL cholesterol, hypertension, and statin use the HR in men was 1.73 [1.31–2.29]; p&lt;0.001) and 1.40 [083–2.36]; p=0.210 in women. Interaction terms CERT2 x gender were non-significant both in univariate analysis (p=0.354) and after multivariate adjustment (p=0.359).
We conclude that sex does not significantly impact the association of CERT2 with cardiovascular mortality in patients with T2DM.

Funding Acknowledgement
Type of funding sources: None. Figure 1