bluuebunny/crossref_metadata_2025_split huggingface dataset:
YOGIC EXERCISE- ITS EFFECT ON BLOOD PRESSURE AND DEPRESSION SCORE IN MYOCARDIAL INFARCTION
Authors: Prasad Avneesh 
Published: May 2024

Objective:
1. To study the effect of yoga on blood pressure
2. To study the effect of yoga on Beck's depression score

Design and method:
Study was conducted on 200 patients randomized into test group (n=100), subjected to conventional treatment and yoga and control group (n=100),subjected to conventional treatment.
It was conducted on patients diagnosed as myocardial infarction aged >18 years and patient's consent. Patients with hemodynamic instability, heart failure, pregnancy, practiced yoga, arrhythmia, pacemaker, autonomic neuropathy and musculoskeletal disease were excluded.
Initially, assessment of clinical, biochemical parameters and routine investigations were performed. Blood pressure was noted and grading of hypertension was done. Beck's depression score was calculated by filling a questionnaire. Yoga was started on 4th day after MI and were encouraged to perform 10 minutes of pranayam, 15 minutes of shavasan and 15 minutes of transcendental meditation. Follow up after 18 weeks for assessment of blood pressure & depression score was done.
The primary outcome included change in blood pressure from baseline to end of study period and secondary outcome included change in BDI score.

Results:
After 18 weeks of intervention, a significant improvement (p=0.001)was seen for systolic as well as diastolic blood pressure in yoga as well as control group. A significant improvement was also noted for BDI score (p=0.001) among the yoga group as well as control group.
A statistically significant improvement in control group was seen for systolic blood pressure when compared to the yoga group (p=0.01) when both groups were compared after 18 weeks. An improvement was seen for diastolic blood pressure (p=0.44) and BDI score (p=0.304) among yoga group in comparison to control group that was not statistically significant.

Conclusions:
It was concluded from the study that when systolic blood pressure was compared between yoga and control group after 6 weeks, there was significant decrease among the controls. Rather, decrease was seen for diastolic blood pressure and BDI score among the yoga group but was not statistically significant.
Multi-center trials are needed with more sample size to ascertain the effect of yoga.
INFLUENCE OF VARIOUS FACTORS ON ANTI-XA LEVELS IN HOSPITALIZED MEDICAL PATIENTS RECEIVING PARENTERAL THROMBOPROPHYLAXIS
Authors: Papadakis Ioannis , Papazachariou Andria , Charizani Aikaterini , Malikides Vironas , Malikides Onoufrios , Anagnostakis Georgios , Zeniodi Maria -ELENI 
Published: May 2024

Objective:
Venous thromboembolism (VTE) stands as a prevalent vascular disease, intimately linked to increased risk for morbidity and mortality. The aim of this study was to investigate the influence of various factors on anti-Xa levels in hospitalized medical patients receiving parenteral thromboprophylaxis.

Design and method:
This is a single-center cohort study encompassing patients admitted to the Internal Medicine Department of the University Hospital of Heraklion, from March to August 2023. These patients were placed on thromboprophylaxis due to a heightened risk of developing VTE. Data regarding demographics, past medical history, somatometric and laboratory findings as well as the type and dose of parenteral anticoagulant were recorded. The measurement of anti-Xa levels were conducted 4 hours subsequent to the third subcutaneous administration of anticoagulant.

Results:
In this study, we enrolled 150 individuals [91 women (60.7%)], with an average age of 80 years. Sixty-two (41.4%) patients exhibited non-therapeutic anti-Xa levels. The levels were subtherapeutic (<0.2units/mL) in 36 patients and supratherapeutic (>0.5units/mL) in 26 patients. Non-therapeutic anti-Xa levels were observed in all underweight patients and in 12 out of 13 obese class II and III patients. It's noteworthy that therapeutic anti-Xa levels were observed in more than half of healthy-weight and overweight patients.
A univariate logistic regression analyses was conducted to explore factors (age, sex, past medical history, somatometric and laboratory findings) that had impact on anti-Xa levels. Among these, only body weight emerged as independent factor influencing anti-Xa levels.

Conclusions:
In our study, we demonstrated that 41.3% of medical patients who were administered parenteral thromboprophylaxis exhibited non-therapeutic anti-Xa levels. This was more profound for underweight or obese class II and III patients. Body weight was emerged as independent factor influencing anti-Xa levels. Further studies on weight-based LMWH thromboprophylaxis dosing in this population are likely to yield new insights improving decisions in daily clinical practice.
KNOWLEDGE ASSESSMENT OF CORONARY ARTERY DISEASE USING THE FILIPINO CORONARY ARTERY DISEASE QUESTIONNAIRE VERSION II, CARARAYAN NAGA CITY BICOL PHILIPPINES
Authors: Pado Mark Angelo , Santy Theo Jay 
Published: May 2024

Objective:
The researcher intends to identify these dilemmas in awareness of coronary artery disease at the community level to improve morbidity and mortality rates in the clinical setting significantly. This undertaking is consistent with the principal goal of disease prevention, which is to reduce exposure to health-related risks among Filipinos and empower them to improve their health.

Design and method:
The present study utilized a quantitative descriptive method using the Filipino version of Coronary Artery Disease Education-Questionnaire II, which involved five (5) domains of knowledge: medical condition, risk factors, exercise, nutrition, and psychosocial risk. The translated version of the CADE-Q II has an excellent internal consistency with a Cronbach's alpha of 0.75.

Results:
Respondents included in the study were found to be at low risk for coronary artery disease. Also, the study found that respondents obtained great rating in the medical condition domain. The nutrition domain had an overall acceptable, good, and poor rating based on study participants’ responses. On the other hand, study participants obtained insufficient rating for the exercise domain of the CADE-Q II. Females were found to be more knowledgeable about the medical condition domain of coronary artery disease than male patients. Other domains of the coronary artery disease questionnaire, specifically nutrition, risk factors, exercise, and psychosocial aspects, did not show any statistical significance.

Conclusions:
In low-risk cohort, the clinical importance of adherence to lifestyle modifications to reduce risk factors is recommended. Knowledge assessment on coronary artery disease will significantly impact decision-making for primary prevention and initiation of non-pharmacologic treatment options to decrease the risk of developing cardiovascular diseases in the community. The data indicate that respondents were familiar with coronary artery disease. However, results also showed they had poor knowledge of the importance of nutrition and food to consider and avoid. Regardless of the study participants’ demographic factors, such as age, sex, and educational attainment, they all shared similar ratings on the domains of the coronary artery disease questionnaire, and no variations were observed statistically.
ASSOCIATIONS BETWEEN GENETICALLY PREDICTED PULSE PRESSURE AND TARGET ORGAN DAMAGE: A MENDELIAN RANDOMIZATION STUDY
Authors: Dib Marie -JOE , Zagkos Loukas , Meena Devendra , Azzo Joe David , Salman Oday , Gan Sushrima , Pourmussa Bianca , Kun Seavmeiyin , Tzoulaki Ioanna , Gill Dipender , Burgess Stephen , Chirinos Julio 
Published: May 2024

Objective:
Large-artery stiffness (LAS) leads to an increased pulse pressure (PP) and is thought to induce target organ damage (TOD). However, causal associations of PP have not been unequivocally assessed in humans. We aimed to investigate the bi-directional associations between genetically predicted increased PP and phenotypes of TOD using Mendelian randomization (MR).

Design and method:
Bi-directional MR analyses were performed to investigate associations between genetically predicted PP and: left ventricular mass (LVM), myocardial interstitial fibrosis, heart failure (HF), chronic kidney disease (CKD), cognitive performance, brain white matter hyperintensities (WMH), type 2 diabetes (T2D) and preeclampsia (PrE). Multivariable MR was conducted to investigate the effect of PP on significant outcomes, independently of mean arterial pressure (MAP).

Results:
For a 10-mmHg increase in genetically-predicted PP, the odds ratios (ORs) were 1.113 (95%CI=1.085-1.137, P<0.001) for HF, 1.075 (95%CI=1.048-1.103, P<0.001) for CKD, 1.137 (95%CI=1.102-1.173, P<0.001) for T2D, and 1.435 (95%CI=1.256-1.638, P<0.001) for PrE. Similarly, a 10-mmHg increase in genetically-predicted PP was associated with a greater LVM (beta estimate=3.527 g/m2, 95%CI=3.026-4.028, P<0.001). The association of genetically predicted PP on risk of HF, CKD and T2D was independent of genetically-predicted MAP. Bidirectional MR also supported a causal effect of genetically predicted log-odds of T2D on PP (beta estimate=0.527 mmHg, 0.396-0.658, P<0.001), and PrE on PP (beta estimate=2.365 mmHg, 0.783-3.947, P=0.003) indicating a potential bidirectional relationship.

Conclusions:
We provide evidence supporting causal associations between PP and T2D, CKD, HF and increased risk of LV hypertrophy in humans, consistent with the deleterious effects of LAS on LV afterload and on microvascular integrity in low-resistance target organs. Early interventions aimed at lowering LAS may lead to lowering the risk of adverse outcomes.
PROGNOSTIC SIGNIFICANCE OF FATTY LIVER INDEX FOR THE DEVELOPMENT OF HYPERTENSION AND CARDIOVASCULAR EVENTS IN POPULATIONS WITH SUBOPTIMAL BLOOD PRESSURE
Authors: Bok Youngnam , An Soo Yeon , Kim Ji -YEON , Jin Seon -AH , Kim Jun Hyug , Roh Jae -HYUNG , Jeong Jin -OK 
Published: May 2024

Objective:
Non-alcoholic fatty liver disease (NAFLD) is a metabolic disorder with an increasing incidence and a known association with cardiovascular disease (CVD). The positive relationship between fatty liver index (FLI), a validated marker of NAFLD, and the development of hypertension has been studied in the general population. However, there is little evidence in prehypertensive groups. We investigated the association of FLI with incident hypertension and cardiovascular disease outcomes in a large cohort of adults with prehypertension.

Design and method:
We included 179,028 healthy Korean subjects from the National Health Insurance Service-National Sample Cohort without traditional risk factors who underwent a health examination between 2009 and 2014. Primary outcomes were new-onset hypertension and major adverse cardiac and cerebrovascular events (MACCE) in prehypertensive adults. Multivariate Cox proportional hazards regression analysis was used to assess the association between the FLI and the primary outcome.

Results:
During a median follow-up of 8.3 years, 34,667 subjects (19.36%) had new-onset hypertension. All subjects were divided into two groups based on BP, and categorized into quartile groups based on FLI. New-onset hypertension was significantly greater in ‘high normal BP’ group than in ‘normal BP’ group (25.95% vs 14.25%, p<0.0001). The incidence of the new-onset hypertension was significantly greater in the subjects with higher FLIs according to the FLI quartile values in both groups (p<0.0001).
In a median follow-up of 9.1 years, 3,339 cases (1.87%) of MACCE occurred. MACCE occurred more frequently in ‘high normal BP’ group than in ‘normal BP group’ (2.33% vs. 1.51%, p<0.0001). In ’high normal BP’ group, MACCE was also associated with FLI quartiles. With increasing FLI quartile, subjects had significantly more events. In the multivariable models adjusted for factors, the hazard ratio for MACCE comparing the highest vs. lowest quartiles of the FLI was 1.640 (95% confidence interval [CIs], 1.409–1.910) and 1.363 (95% CIs, 1.141–1.627) in the ‘high normal BP’ group and ‘normal BP’ group, respectively.

Conclusions:
Higher FLI was independently associated with development of hypertension and MACCE in prehypertensive Korean adults without traditional risk factors. FLI may be an important predictor of new-onset hypertension and adverse CV outcomes.
COMPARISON OF CARDIAC STRUCTURAL AND FUNCTIONAL CHANGES BETWEEN SURGERY AND MEDICATION TREATMENT IN PATIENTS WITH PRIMARY ALDOSTERONISM BASED ON ECHOCARDIOGRAPHY
Authors: Zhang Yong , Yu Heng , Zhang Fangjing , Zhang Kefan , Di Xiaofan , Bai Feng , Yu Jing , Wang Qiongying 
Published: May 2024

Objective:
Conducted a systematic meta-analysis on the changes in follow-up parameters of echocardiography in patients with primary aldosteronism after surgery and drug treatment, in order to explore their differences.

Design and method:
We conducted the PubMed, Embase, and Cochrane library databases for English full-text articles on the follow-up study of echocardiography parameters in PA patients before and after surgery and drug treatment published from its establishment until June 1, 2023,Perform meta-analysis on the included studies using RevMan software.

Results:
A total of 515 PA patients (>18 years old) were included in 4 studies, including the surgical group (n=303) and the medication group (n=212), 2 short-term follow-up studies (average follow-up time of 1 year), and 2 long-term follow-up studies (average follow-up time of 3.7 years). Surgery treatment had better performance in improving cardiac contractile function, The main manifestation is the reversal of left ventricular hypertrophy (LVMI: M=-2.6, p=0.047), while there is no significant improvement in cardiac diastolic function (E/A: M=+0.06, p=0.51); In long-term follow-up studies, surgery and medical treatment still showed significant benefits in reducing blood pressure (surgical group: -14 ± 6 mm Hg/-9 ± 10 mm Hg, p<0.001; drug group: -10 ± 12mmHg/-11 ± 9mmHg, p<0.001). Interestingly, the surgical group and drug group did not show better blood pressure control effects than short-term follow-up (p=0.56), Surgery (LVMI: M=-12.6, p=0.01)and medication (LVMI: M=-11.9, p=0.01])can significantly improve left ventricular hypertrophy in patients, with no significant difference (P=0.143). Although surgery (E/A: M=+0.14, p=0.125) and medication (E/A: M=+0.09, p=0.2) can numerically improve diastolic function, there is no statistically significant difference.

Conclusions:
Both medication and surgical treatment can reverse the damage to the heart structure and function in PA patients. In the short term, surgical treatment has a more significant reversal of cardiac function, especially in left ventricular hypertrophy, but in the long term, there is no significant difference between medication and surgical treatment.
FEASIBILITY OF SUBTYPING OF PRIMARY ALDOSTERONISM BY ADRENAL VEIN SAMPLING DURING MINERALOCORTICOID RECEPTOR ANTAGONIST TREATMENT
Authors: Pintus Giovanni , Teresa Seccia Maria , Domenico Bagordo , Brasilina Caroccia , Giulio Ceolotto , Livia Lenzini , Giacomo Rossitto , Paolo Rossi Gian 
Published: May 2024

Objective:
Current guidelines and consensus documents recommend withdrawal of mineralocorticoid receptor antagonists (MRA) before primary aldosteronism (PA) subtyping by adrenal venous sampling (AVS), but this practice can cause severe hypokalemia and/or uncontrolled high blood pressure (BP) values in PA patients.
The aim of the study was to investigate if identification of unilateral PA (uPA) by means of AVS is feasible in patients on MRA treatment.

Design and method:
We compared the rate of uPA identification between patients with and without MRA treatment in two large datasets of patients who were submitted to AVS from 2000 to 2023 without renin-angiotensin system blockers and beta-blockers. In sensitivity analyses, the between-groups differences of lateralization index (LI) values after propensity score matching and the rate of uPA identification in subgroups with undetectable (< 2 mUI/L), suppressed (< 8.2 mUI/L) and unsuppressed (> 8.2 mUI/L), direct renin concentration (DRC) levels were also evaluated.

Results:
A minority of the PA patients (n = 61, 7.3%) underwent AVS on MRA treatment, while the majority were off MRA (n = 779, 92.7%). Compared to non-MRA patients, those with MRA showed a higher daily drug dose (2.25 vs 1.5, p = 0.001), a higher rate of adrenal nodules at imaging (82 vs 67, p = 0.022) and of adrenalectomy (72 vs 54%, p = 0.01). The AUROC of lateralization index (LI) showed no significant differences between groups, either under unstimulated conditions (0.960 vs 0.937, p = 0.590) or after cosyntropin (0.923 vs 0.917, p = 0.938). Sensitivity analyses confirmed these results after propensity score matching in several adjusted models and in patients with undetectable, suppressed or unsuppressed renin levels.

Conclusions:
MRAs, at doses that controlled blood pressure and potassium levels in PA patients, did not preclude the identification of uPA at AVS.
BLOOD PRESSURE AND RENAL FUNCTION CHANGES AFTER REVASCULARIZATION OF RENAL ARTERY STENOSIS IN 3 DIFFERENT COHORTS OF PATIENTS
Authors: Pérez Juan Luís Martínez , Clarà Albert , Vázquez Susana , Mascaró Maria , Galceran Isabel , Oliveras Anna 
Published: May 2024

Objective:
To analyze the effects at 12 months on blood pressure (BP) and renal function in patients with renal artery stenosis (RAS) undergoing percutaneous transluminal angioplasty (PTA), recruited from 3 different sources (Vascular Surgery Department, Hypertension Unit and Renal Transplantation Department).

Design and method:
Observational, retrospective study of patients undergoing PTA because of RAS mostly detected when screening patients with peripheral artery disease (G.1, n=20), when studying patients with resistant hypertension or with clinical suspicion of RAS (G.2, n=28) or in kidney transplant patients (G.3, n=21) with renal function impairment and/or elevation of BP. RAS is defined as a reduction of >70% of the renal artery lumen.

Results:
Sixty-nine patients were analyzed (mean age: 67±12yr, 64% male). Overall, mean±S.D. SBP/DBP (mmHg) was 147.4±20.6 and 75.7±11.8, and the estimated glomerular filtration rate (eGFR) was 48.7±27.0 mL/min/1.73m2. At baseline, G.1 had a higher prevalence of smoking patients (90%) and patients with a history of major vascular events (100%), lower DBP (70.0±9.8 mmHg) and better renal function (eGFR: 62.5±23.2 mL/min/1.73m2), compared to G.2 and G.3.
12-months after PTA, patients in G.2 and G.3 (but not those in G.1) showed a decrease in BP: variation (δ) SBP(mmHg): mean (95%CI)= -18.9 (-26.7 to -11.0) and -20.0 (-29.8 to -10.1), respectively; p<0.001 for both; δDBP (mmHg): mean (95%CI)= -6.6(-10.7 to -2.4),p=0.003 and -6.3 (-11.7 to -0.8), p=0.027. Regarding renal function, it only improved in G.3 group: δeGFR (mL/min/1.73m2): mean (95%CI)= 8.9(1.5 to 16.4),p=0.022, and showed a trend to become worst in G.1 group: -6.5(-13.4 to 0.3),p=0.061. After adjusting for confounding variables, δSBP was associated with baseline SBP (r= -0.709,p<0.001) and the origin group (Rho = -0.362,p = 0.003); δeGFR was associated with baseline eGFR (r= -0.508,p<0.001) and the origin group (Rho= 0.356, p= 0.004).

Conclusions:
BP decreased 12-months after PTA in patients with suspected RAS because of resistant hypertension. BP and renal function improved after PTA in kidney transplant patients with diagnosis of RAS. Higher BP levels and lower eGFR correlated with better results. Patients with peripheral artery disease screened for RAS showed no change in BP or renal function after PTA.
COMPOSITE PHEOCHROMOCYTOMA (WITH ASSOCIATED GANGLIONEUROMA) AS A CAUSE OF SECONDARY ENDOCRINOLOGICAL HYPERTENSION
Authors: Kuzior Agnieszka , Hernandez-lazaro Alba , De Leon-durango Ricardo Jose , Rios-gomez Carlos , Santana-ojeda Borja , Molinero-marcos Inmaculada , Santana-suarez Ana Delia , Fernandeztrujillo-comenge Paula Maria , Arnas-leon Claudia , Acosta-merida Asuncion , Acosta-calero Carmen , Camacho-galan Rafael , Redondo-martinez Maria Elena , Martinez-martin Francisco Javier 
Published: May 2024

Objective:
To illustrate and understand a rare variant of pheochromocytoma, its clinical implications and prognosis, based on a clinical case of secondary hypertension.

Design and method:
Review of the patient's clinical record and the relevant literature.

Results:
Composite paraganglioma or pheochromocytoma is a rare tumour (<100 reported cases) composed of paraganglioma or pheochromocytoma plus another neurogenic tumour, most often (∼75%) ganglioneuroma, a typically benign tumour derived from the sympathogonia of the neural crest. It can be associated with neurofibromatosis type I, von Hippel-Lindau disease, or MEN2.
Our patient is a 64-year-old woman with uncontrolled hypertension, without a history of hypertensive crises. During follow-up for breast adenocarcinoma, a CT scan revealed bilateral adrenal nodules consistent with metastases. PET-CT showed increased metabolic uptake suggesting malignancy in the right adrenal. Plasma metanephrines were very high and MIBG scintigraphy was consistent with a right pheochromocytoma. Following doxazosin blockade, robotic adrenalectomy was performed, and a month later plasma metanephrines and blood pressure were normal. Pathology revealed a single mass of 4x3x2 cm labelled as composite pheochromocytoma (30%) - ganglioneuroma (705). There was no vascular invasion or necrosis, S-100 staining was preserved, and mitotic activity was minimal.
In addition to the PASS scale for prognosis of malignancy in pheochromocytoma, there is a specific COPPS scale for composite pheochromocytoma, based on necrosis, loss of S100, loss of SDHB, vascular invasion, and size >7 cm (5/2/1/1/1 points, respectively), with low risk if <3; our patient scores 0-1 (pending SDHB). The patient continues oncological follow-up for breast pathology, but her secondary hypertension is clinically resolved and the risk of pheochromocytoma-ganglioneuroma metastases is apparently low. There are no clinical signs of neurofibromatosis type 1, von Hippel-Lindau, or MEN2.

Conclusions:
Composite pheochromocytoma is a rare cause of secondary hypertension, often indistinguishable clinically from simple pheochromocytoma, except occasionally due to the larger lesion size. Diagnosis is typically confirmed through histopathological examination. In the most common association (with ganglioneuroma), additional malignancy implications are rare, unlike with other neurogenic tumours such as neuroblastoma or ganglioneuroblastoma. Due to insufficient current knowledge of its natural history, close monitoring is required.