bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy comparison of transcatheter aorticorenal ganglion ablation and renal denervation in a hypertensive canine model
Authors: Long Y X , Lai Y C , Li D , Ren Y W , Ma X M , Zhou H , Yi X , Chen L Y , Yin Y H 
Published: October 2024

Abstract

Background
Transcatheter renal sympathetic denervation (RDN) has been proposed to be an adjunctive treatment in uncontrolled hypertension. However, non-responders to RDN were not rare. Considering the lack of a procedure endpoint and the limitation of anatomic-based ablation strategy, incomplete or futile denervation may contribute to non-responsiveness. Aorticorenal ganglion (ARG) is a purely sympathetic ganglion that projects to the proximal and distal renal artery, forming the peri-arterial nerve network. Ablation of this ganglion results in significant renal denervation. However, it remains unknown whether ARG ablation has a superior effect in lowering blood pressure (BP) compared to RDN.

Purpose
The aim of the study was to determine whether ARG ablation improved the BP-lowering effect compared to RDN in a hypertensive canine model.

Methods
A total of 21 male Chinese Kunming dogs were included and randomized into three groups: ARG ablation group (n=7), RDN group (n=7) and control group (n=7). In the ARG ablation group, anatomically based high-frequency stimulation (HFS) was performed in the aorta and inferior vena cava (IVC) under the guidance of 3D anatomical construction (Figure 1A). ARG ablation sites were identified by HFS-induced BP elevation response (&gt;10mmHg) and renal artery vasoconstriction (Figure 1B). In the RDN group, HFS-guided ablation was conducted at the positive site (BP elevation response &gt;5mmHg) from the distal to proximal renal artery. Endpoint of the procedure was defined as the elimination or attenuation of BP elevation induced by HFS. BP was assessed at baseline and 4 weeks after the procedure.

Results
The left ARG ablations were performed at the inferior aspect of superior mesenteric artery (4/7), the abdominal aorta (2/7) and the proximal renal artery (1/7), while the right ARG ablations were performed at the posterior aspect of the IVC (6/7) and the ostium of the left renal vein (1/7). The gross anatomy of bilateral ARGs was shown in Figure 1C. The hemodynamic response to ARG stimulation was significantly greater than that of renal artery stimulation (40.0±13.4 vs 13.3±3.7 mmHg, Figure 2A, B); meanwhile, ARG ablation is more effective in blunting the BP elevation response compared to RDN (30.7±11.7 vs 9.6±2.6, P=0.001, Figure 2A, C). With a 4-week follow-up, ARG ablation demonstrated a greater systolic BP-lowering effect than RDN (-29.6±12.0 vs -15.3±6.9 mmHg, P=0.018, Figure 2D). No complications were found during the procedure or follow-up.

Conclusion
Our study suggests that ARG ablation could lead to a more efficient BP-lowering effect compared to RDN, which provides a novel paradigm for autonomic modulation in the treatment of hypertension.Figure 1Figure 2
Cumulative effect of lifetime smoking history on arterial stiffness and subclinical atherosclerosis in patients with arterial hypertension
Authors: Ioakeimidis N , Kouroutzoglou A , Terentes-Printzios D , Dima I , Laina A , Angelis A , Lazarou E , Papadatos S , Kalfountzos D , Tsioufis K , Vlachopoulos C 
Published: October 2024

Abstract

Introduction
Although the effect of smoking status on blood pressure (BP) changes is well known an adverse association between cumulative smoke exposure (by pack-years) and functional and structural changes in arteries of patients with high BP has not been consistently demonstrated. Aim of the study was to explore the contributions of cumulative smoke exposure to the vascular consequences of arterial hypertension.

Methods
Indices of vascular function and structure including carotid-femoral pulse wave velocity (PWV), augmentation index (AIx) and carotid intima media thickness (cIMT) were measured in 485 adults aged less than 60 years old without a history of cardiovascular disease. The cohort was divided into three groups according to office systolic BP (SBP) and diastolic BP (DBP): normal (SBP &lt;130 and DBP &lt;85 mmHg, n=242), high normal (130≤SBP&lt;140 or DBP 85≤DBP&lt;90mmHg, n=96), and hypertension (SBP≥140 or DBP≥90mmHg, n=147). The cohort was subdivided according to pack-years of smoking history as never smokers (0.0 pack-years), light smokers (&lt;20 pack-years), moderate smokers (20-40 pack-years), and heavy smokers (&gt; 40 pack-years).

Results
The three BP groups had similar age and metabolic parameters (body mass index, fasting blood glucose and LDL-C). Figure shows PWV, AIx and carotid IMT by smoking exposure, stratified by BP level. The lowest PWV level was observed in never smokers with normal BP; whereas heavy smokers with hypertension exhibited the highest PWV. Also of note, heavy smokers with normal BP exhibited comparable PWV to light and never smokers with hypertension. Furthermore, in smokers with more than 20 pack-years tobacco exposure, PWV was higher among patients with high normal BP compared to subjects with normal BP (all P&lt;0.01). In contrast to the monotonic increases in PWV and AIx by BP and pack-years smoking history, carotid IMT was generally similar among BP groups on the basis of cumulative exposure category. This finding may indicate a plateau in subclinical atherosclerotic burden over cumulative tobacco exposure for all BP categories.

Conclusion
Tobacco cumulative exposure adversely modify the effect of BP on arterial stiffness. Given that most adults who smoke start before the age 18 years, efforts to promote smoking cessation should continue to target younger adults with high BP.BP, tobacco exposure-vascular changes
Remnant cholesterol and cardiovascular and all-cause mortality in Korean adults
Authors: Kim B J , Kang J G 
Published: October 2024

Abstract

Background
Although previous studies have reported that remnant cholesterol (RC) is associated with cardiovascular disease, studies on RC and various mortality related outcomes including cardiovascular mortality in the general population are scarce and most of them are limited to Western populations.

Purpose
This study aims to evaluate the effect of RC on mortality related outcomes in a relatively young and middle-aged Korean population.

Methods
This cohort study included 268,219 subjects (mean age, 38 years and 50.6% men) who were enrolled in the Kangbuk Samsung Health Study between 2003 and 2016. Fasting RC was calculated as total cholesterol minus high-density lipoprotein cholesterol minus low-density lipoprotein cholesterol (LDLC).

Results
The median RC was 0.47 mmol/L (18 mg/dL) and the prevalence of ≥ 1 mmol/L RC was 11.4%. During the median FU of 6.7 years, high RC (RC ≥ 0.47 mmol/L) significantly increased the risk of multivariable-adjusted cardiovascular mortality compared with low RC (HR[95% CI], 1.43[1.07, 1/93]). Compared with the lowest quintile (RC &lt;0.31 mmol/L), the HRs for cardiovascular mortality were 1.95[0.78, 4.84], 2.47[1.03, 5.91], 2.39[1.00, 5.72], and 2.84[1.19, 6.78] in the second, third, fourth, and highest quintiles, respectively. The HRs for all-cause mortality in the 3rd, 4th, and highest quintiles remained significant (1.24[0.97, 1.59], 1.38[1.08, 1.76], 1.34[1.05, 1/71], and 1.32[1.03, 1.69] in the 2nd, 3rd, 4th, and highest quintiles, respectively). However, there was no significant risk for cancer mortality between RC quintiles. Notably, subgroup analysis showed that individuals with high RC and high hsCRP and high RC and high lipoprotein(a) had a more than twofold and threefold increased risk of cardiovascular mortality, respectively, compared with low RC and low hsCRP and low RC and low lipoprotein(a).

Conclusions
High RC was significantly associated with increased risk of cardiovascular and all-cause mortality, but not with cancer mortality. In particular, high hsCRP and high lipoprotein(a) weighted the risk association between high RC and cardiovascular mortality.
The projected global burden of modifiable risk factors on cardiovascular disease from 2025 to 2100
Authors: Chong B , Jayabaskaran J , Kueh M , Goh R , Li H , Foo R , Chan M , Chew N 
Published: October 2024

Abstract

Background
Cardiovascular diseases (CVDs) are the primary cause of global mortality and morbidity. Controlling modifiable risk factors driving the CVD epidemic is a vital focus of primary prevention efforts worldwide. Understanding the epidemiological trends in these risk factors is therefore essential in designing effective countermeasures against CVDs for the years to come.

Purpose
This study aims to forecast the disability-adjusted life years (DALYs) associated with CVDs attributable to high systolic blood pressure (SBP), high body-mass index (BMI), high fasting plasma glucose (FPG), high low-density lipoprotein (LDL) and tobacco use from 2025 to 2100, stratified by GBD super-regions, sex, sociodemographic index (SDI), and age-groups.

Methods
Historical data on DALYs from 1990 to 2019 from the Global Burden of Disease (GBD) study was used to project DALYs associated with modifiable risk factors of CVDs from 2025 to 2100. Trends across GBD super-regions, sex, SDI, and age-groups were also examined.

Results
Between 2025 and 2100, age-standardised DALY rates (ASDR) per 100,000 population are forecasted to fall across all modifiable risk factors, with the greatest decline seen in tobacco use (-76.0%) and high LDL (-66.9%). Globally, high SBP and high BMI expect the greatest ASDR in 2100 (both 891 per 100,000 population), while tobacco use expects the least (213 per 100,000 population). High BMI is expected to rise 623.0% in South Asia and 221.5% in South-east Asia, East Asia and Oceania from 2025 to 2100, while high FPG is expected to rise 114.2% in North Africa and the Middle-east and 110.6% in South Asia. Females are expected to have lower overall and greater reductions in ASDR across all modifiable risk factors when compared to males from 2025 to 2100. Notably, males expect a 11.0% rise in high BMI worldwide across this period. The age-prevalence of modifiable risk factors is expected to be bimodal in 2100, highest in those aged 50-59 as well as 75-84 years old, possibly suggesting improvements in global screening efforts or the earlier development of metabolic dysfunction. All modifiable risk factors are predicted to fall in high and high-middle SDI regions from 2025 to 2100. In contrast, low, low-middle, and middle SDI regions expect a rise in high FPG and high BMI across this same time frame. The burden of modifiable CVD risk factors is expected to be highest in low-middle SDI regions in 2100, as compared to high-middle SDI regions in 2025.

Conclusion
While the global decline in ASDR of modifiable risk factors suggests overall improvements in the primary prevention of CVDs, regional spikes in high BMI and FPG calls for the implementation of timely, targeted interventions accounting for local trends in CVD. Moreover, the disproportionate metabolic burden expected in lower SDI regions in the coming decades requires concerted, international support to alleviate the global burden of CVDs.
Systolic blood pressure time in target range and cardiovascular disease and premature death
Authors: Han X , Yang Q , Zhou X , Wu S 
Published: October 2024

Abstract

Background
Time-in-target range (TTR) for systolic blood pressure (SBP) independently predicts cardiovascular outcomes. However, there are limited research based on real-world data.

Purpose
To estimate SBP-TTR associated with cardiovascular disease (CVD) and premature death among the employed individuals with hypertension.

Methods
This study is based on the Kailuan cohort. As part of the Kailuan study, a workplace-based hypertension management programme was initiated in 2009 for employed people with hypertension. The TTR was defined as 120 to 140 mmHg according to the current guidelines, and in the sensitivity analyses it was further defined as 110 to 130 mmHg. TTR was estimated over the first 6 months of follow-up using linear interpolation. The association between SBP-TTR with CVD, premature CVD and premature death was estimated using adjusted Cox proportional hazards regression models to adjust for multiple confounders.

Results
A total of 9552 hypertensive participants were included. A one standard deviation increase in SBP-TTR is associated with a 19% reduction in the risk of CVD (HR:0.81; 95%CI: 0.74 to 0.88), a 24% reduction in the risk of premature CVD (HR:0.76; 95%CI: 0.67 to 0.86), and a 17% reduction in the risk of premature death (HR:0.83; 95%CI: 0.74 to 0.92). When SBP-TTR is redefined as 110-130 mmHg, a one standard deviation increase in SBP-TTR is associated with a 23% reduction in the risk of CVD (HR:0.77; 95%CI: 0.70 to 0.84), a 30% reduction in the risk of premature CVD (HR:0.70; 95%CI: 0.60 to 0.81), and a 27% reduction in the risk of premature death (HR:0.73; 95%CI: 0.66 to 0.80). These associations were independent of SBP-mean and SBP-SD. Subgroup analysis results indicate that SBP-TTR contributes to a reduction in the risk of premature death in individuals with a high cardiovascular risk score.

Conclusions
SBP-TTR was statistically associated with a decreased risk of CVD, premature CVD and premature death. Intensifying blood pressure control measures can further increase cardiovascular benefits.
Associations of omega-3 fatty acid subclasses with cardiovascular diseases in 500,000 individuals
Authors: Kerminen S , Jostins-Dean L , Schut K , Wurtz P , Barrett J C 
Published: October 2024

Abstract

Increased blood levels of omega-3 fatty acids have consistently been shown to be associated with reduced risk of cardiovascular diseases (CVD). However, large scale placebo-controlled trials of omega-3 supplementation have had discordant results: in 2018 REDUCE-IT reported a 25% risk reduction, whereas in 2020 STRENGTH reported no risk reduction. The two trials had both different placebos (mineral vs corn oil) and omega-3 formulations (EPA vs DHA+EPA). There is not yet a consensus on what explains these results.
Here we describe the profiling of omega-3 fatty acid subclasses, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) with nuclear magnetic resonance (NMR), and test their associations with incident CVD in 500,000 individuals from UK Biobank.
We utilized 500 MHz NMR spectrometers to analyze total omega-3 and its subclasses in EDTA plasma samples and employed biomarker-specific quantification algorithms to measure their absolute concentrations. In this study, we developed a novel algorithm to quantify EPA, complementing previously described algorithms for omega-3 and DHA. Correlation (r^2) of this novel NMR-based quantification and gas chromatography-based measurements was 0.77 for EPA. On average, DHA comprised 44.5% of the total omega-3 concentration, EPA accounted for 22.2%, and other subclasses constituted 34.3% in the cohort.
We computed age and sex adjusted associations of omega-3, DHA, and EPA with 10-year risk of CVD among individuals who were not taking cholesterol lowering medication. We discovered protective associations: for DHA a hazard ratio of 0.85 (0.86-0.89, 95% confidence interval) per standard deviation versus 0.96 (0.95-0.98) for EPA, and 0.95 (0.93-0.97) for total omega-3 (Figure).
Since DHA (used in the STRENGTH trial with a null result) has a significantly stronger epidemiological association than EPA, these results from a large-scale observational study do not support the hypothesis that the differential use of DHA and EPA in the REDUCE-IT and STRENGTH trials explains their divergent results.Figure
Study design of the CARDIO-TTRansform cardiac magnetic resonance imaging substudy
Authors: Fontana M , Masri A , Garcia-Pavia P , Cuddy S , Cappelli F , Cipriani A , Gillmore J D , Razvi Y , Moon J C , Reicher B , Chen J , Viney N , Duran J M , Tsimikas S 
Published: October 2024

Abstract

Background
Cardiac magnetic resonance (CMR) with extracellular volume (ECV) mapping can track treatment response in patients with cardiac amyloidosis by assessing changes in cardiac amyloid burden along with associated changes in structure and function. The CARDIO-TTRansform trial is a phase 3, multicentre, double-blind, randomised, placebo-controlled trial designed to assess the efficacy and safety of eplontersen in transthyretin amyloid cardiomyopathy (ATTR-CM). Eplontersen is a ligand-conjugated antisense oligonucleotide designed to reduce hepatic production of transthyretin protein, the amyloid fibril precursor protein in ATTR-CM. Patients with hereditary or wild-type ATTR-CM on available standard of care were randomized 1:1 to receive 45 mg of eplontersen or placebo via subcutaneous injection every 4 weeks. Patients in the main study with no contraindication to CMR were invited to participate in this sub-study.

Purpose
The primary objective is to measure the change in amyloid burden (defined as % change in ECV from baseline) over time in patients receiving eplontersen versus placebo.

Methods
Participants will undergo CMR with ECV mapping at baseline, 25, 49, 97 and 140 weeks (Figure 1). Images will be acquired under a standardized protocol comprising cine imaging with steady state free precession sequence, late gadolinium enhancement imaging (LGE) and T1 mapping. T1 mapping will be performed before the administration of contrast and will be repeated 15 minutes post-contrast using the same slice locations, to produce ECV maps.

Results
In the main study, 1432 patients were randomized from 120 sites across 20 countries. Of these patients, 157 patients were enrolled in the CMR sub-study, from 6 centers across 4 countries. Images will be read centrally at the end of the study. All participants in the study will also receive serial transthoracic echocardiography with strain analysis to correlate findings with conventional imaging techniques, and a subset of patients from the CMR substudy will be co-enrolled in a scintigraphy substudy for further characterization of amyloid deposition in their heart.

Conclusion
The CARDIO-TTRansform CMR substudy represents the largest CMR study of ATTR-CM. The CMR sub-study has enrolled a broad global population of patients with hereditary and wild-type ATTR-CM and will provide key information on the impact of eplontersen on the cardiac amyloid load and the associated change in structure and function.
Association of a healthy plant-based heart-protective diet with reduced cardiovascular disease incidence and mortality: findings from the UK Biobank Study
Authors: Wang T , Nova A , Cassidy S , Fazia T , Mitra S , Kroeger C M , Masedunskas A , Bernardinelli L , Willett W C , Fontana L 
Published: October 2024

Abstract

Importance
Previous research examining the effects of omnivorous and plant-based diets on CVD outcomes has produced inconsistent findings, and the importance of diet quality is overlooked.

Objective
To assess the relation between adherence to a healthy plant-based, heart-protective diet and the risk of cardiovascular disease (CVD) events.
Design: Prospective cohort study.

Methods and Results
192,274 (mean age: 56.3±7.9 years, 43.3% males) participants in UK Biobank without CVD at baseline who completed a 24-hour recall questionnaire. Using data generated by Oxford WebQ, we developed a novel heart-protective diet score (HPDS) based on 22 food groups. Cox proportional hazard models were used to study associations. During a median follow-up of 12.3 years, there were 20,692 CVD events and 1,131 CVD deaths. After adjusting for demographics, Townsend deprivation index, lifestyle factors, and history of chronic diseases, participants in the top quartile of the HPDS were at the lower risk of overall CVD (HR: 0.92, 95% CI: 0.88 to 0.95), ischemic heart disease (HR: 0.88 [95% CI: 0.83 to 0.93]), myocardial infarction (HR: 0.82, 95% CI: 0.74 to 0.90), and heart failure (HR: 0.86, 95% CI: 0.78 to 0.95) than those in the bottom quartile. Participants who adhered closely to a healthy plant-based heart-protective diet had the lowest risk of overall CVD (HR: 0.72, 95% CI: 0.61 to 0.86), ischemic heart disease (HR: 0.68, 95% CI: 0.52 to 0.89), myocardial infarction (HR: 0.65, 95% CI: 0.46 to 0.91), and heart failure (HR: 0.51, 95% CI: 0.30 to 0.85) mortality.

Conclusions
and relevance: Adherence to a healthy plant-based heart-protective diet rich in non-starchy vegetables, fruits, whole grains, legumes, and fish, is associated with a reduced cardiovascular disease incidence and mortality. Further research in diverse ethnic populations is necessary to validate our findings and enhance their generalizability.
Cocoa flavanols alleviate early diastolic dysfunction by decreasing left atrial volume in healthy elderly individuals
Authors: Duse D A , Groene M , Ophoff N , Kramser N , Schweers H , Schroeter H , Quast C , Boenner F , Heiss C , Sansone R , Jung C , Kelm M , Erkens R 
Published: October 2024

Abstract

Background
Enlargement of the left atrium (LA) predicts future cardiovascular events. Current guidelines recommend cocoa flavanol (CF) intake as it provides cardiovascular and metabolic benefits, although underlying mechanisms are not fully revealed. In this study, we hypothesized that CF intake reverses LA enlargement as a surrogate marker for diastolic dysfunction in elderly individuals without cardiovascular diseases.

Methods and Results
In a randomized, double-blinded trial, we investigated the effects of CF on systolic and diastolic heart function in healthy elderly individuals. Precise assessment of left-atrial and left-ventricular volume as well as strain rates, all together as emblems of early subclinical cardiac impairment, and markers of systolic function were measured by high-resolution cardiac magnetic resonance (CMR) imaging before and after CF intake. Sixty-three participants (59% male) aged ≥ 55 years received either 500 mg CF (n=30) or a placebo (n=33) twice daily for 30 days. CF counteracted subclinical cardiac dysfunction, evidenced by a reduction in maximal LA volume and LA volume index by 12.6±3.5% (p=0.0063 and p=0.0067) and LV end-diastolic volume (LVEDV) and LVEDV index by ~4.9±1.9% (p=0.049 and p=0.0413). CF intake did not influence strain, strain rate, and systolic function parameters, while the systolic blood pressure decreased by 7 mmHg [~4.7±1.9% (p=0.04)].

Conclusion
We provide evidence that CF intake mitigates early changes of diastolic dysfunction and improves cardiovascular health by reversing left atrial and left ventricular remodeling.
Cocoa flavanol consumption may prevent age-related cardiac changes in healthy elderly individuals and promote a health span free from cardiovascular diseases.