bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHARACTERISING A UK COHORT WITH RETINAL ISCHAEMIC EVENTS
Authors: Tanner Alexander , Santos-paulo Stephanie , Mensah Ekow , Sunnasy Nilesh , Vundavall Sriram , Kane Ingrid , Rajkumar Chakravarthi 
Published: May 2024

Objective:
Retinal ischaemic events (RIE), consisting of central retinal artery occlusions (CRAO), branch retinal artery occlusion (BRAO), and amaurosis fugax (Amfug), are commonly observed in older adults, often manifesting as sudden painless monocular visual loss. CRAO and BRAO are regarded as minor strokes, while Amfug is likened to a cerebral TIA. We present an RIE patient cohort, their clinical characteristics, and outcomes as a first step in evaluating our patient outcomes, service provision, and potentially highlighting areas for improvement.

Design and method:
This study is a retrospective consecutive case series from a major stroke centre in the UK: Royal Sussex County Hospital, Brighton. The electronic patient records of the stroke department were reviewed to identify all patients between August 2018 and December 2021 who had been managed following a diagnosis of RIE. Descriptive and inferential statistics were conducted on detailed clinical and demographic data of study participants, exploring their frequency distributions and testing associations between the three groups of RIE.

Results:
One hundred and eleven (111) study participants with RIE were identified from the stroke register, with 56.8% (n=63) diagnosed with amaurosis fugax, 25.2% (n=28) with BRAO, and 18.0% (n=20) with CRAO. Mean age was 70.6 ± 1.2 years (SEM) and 35.1% (n=39) were female. Characteristics such as blood pressure, total cholesterol, glucose and inflammatory markers (ESR and CRP) were noted to be higher in CRAO and BRAO compared to Amfug, though not statistically significant (p>0.05). Similarly, 97%(n=195) carotid doppler scans showed greater or equal stenosis ipsilateral to the RIE, with calculated Fazeka scores showing 1.2 ± 0.1 (SEM) (n=49). Outcomes post RIE demonstrated 6.8% mortality within one year of RIE diagnosis and 14.3% of this attributable to ischaemic stroke.

Conclusions:
Our cohort demonstrates that RIE is largely a large vessel disease as depicted in the risk factors identified and scores from carotid doppler and Fazeka. With RIE showing similar risk factors as that for strokes, it is essential that patients presenting with RIE should have their risk factors strictly addressed to reduce complications, morbidity and mortality associated with RIE as in all large vessel diseases.
THE PROGNOSTIC ROLE OF CARDIAC HEMODYNAMIC RESERVES IN HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Ovchinnikov Artem , Filatova Anastasiia , Sobolevskaya Mariya , Potekhina Alexandra , Svirida Olga , Ageev Fail , Belyavskiy Evgeny 
Published: May 2024

Objective:
Reduced cardiac reserves play an important role in poor exercise tolerance in heart failure with preserved ejection fraction (HFpEF). However, their prognostic role in HFpEF is not well defined. We aimed to evaluate the prognostic significance of key cardiac reserves in patients with HFpEF.

Design and method:
348 patients (164 men, median age 68 years) with stable heart failure in NYHA functional class II-III, preserved left ventricular (LV) ejection fraction (>=50%), and increased LV filling pressure at rest and/or during exercise (determined by echocardiography) were included in retrospective cohort analysis. The median follow-up period between the initial visit and the follow-up call was 5.4 (3.5-7.0) years. Primary outcome included a composite of all-cause mortality and hospitalizations for congestive heart failure (HF). Primary outcome occurred in 166 patients (73 patients died and 93 patients were hospitalized for exacerbation of HF); 182 patients survived without hospitalizations. The event-free survival rate between groups were analysed using the Kaplan-Meier method, and the significance was evaluated using log-rank tests.

Results:
Patients who experienced primary endpoint had a greater enhancement in the early mitral inflow to mitral annulus relaxation velocity ratio (E/e’ ratio) on exercise (reflecting LV filling pressure and diastolic reserve), as well as a lesser enhancement in left atrial reservoir strain (LA reserve) and tricuspid annular plane systolic excursion (right ventricular [RV] reserve) on exercise. There were no differences in global longitudinal strain enhancement on exercise (LV contractility reserve) between groups. Reserve dysfunction showed a strong association with poor HFpEF prognosis: LA reserve (RR 1.81 [95% CI 1.28-2.56], P<0.001), LV diastolic reserve (RR 1.62 (95% CI 1.25-2.27, P<0.01), and RV reserve (RR 1.47 (95% CI 1.05-2.05), P<0.05).

Conclusions:
Here, we demonstrated for the first time the high predictive accuracy of cardiac reserves (LV diastolic, LA, RV) in HFpEF.
CYSTATIN C IS DIAGNOSTIC AND PROGNOSTIC FACTOR OF THE DEVELOPMENT OF CARDIORENAL SYNDROME IN COMORBID PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Dunaieva Inna , Bilovol Olexandr 
Published: May 2024

Objective:
The purpose of the study was to determine the diagnostic and prognostic role of cystatin C in the development of cardiorenal syndrome in the case of arterial hypertension syndrome and maximum comorbid conditions.

Design and method:
111 patients with AH (men/women – 50/61) and 20 control subjects were examined. All patients with AH at the age of 54.37±1.18 During a thorough examination and follow-up of patients, they were classified into 4 groups depending on the comorbidities they had: patients with AH – group 1 – 22 persons; patients with AH in combination with obesity – group 2 – 30 persons; AH in combination with type 2 diabetes – group 3 – 31 persons; patients with AH, type 2 diabetes and obesity – group 4 – 28 persons.

Results:
According to the study, the Cys C level in the examined patients with AH and various comorbidities was significantly higher compared with the control group, with p < 0.0001.
We found that cardiotrophin-1, a versatile biomarker for the development and progression of cardiovascular disorders in patients with AH and various comorbidities, has a significant impact on this index (ρ=0.015). The first place among the properties of cardiotrophin-1 in the body is its role in the regulation of heart remodeling in patients with hypertension, heart failure, coronary heart disease in combination with T2DM and hypertension. The resulting relationship between cardiotrophin-1 and Cys C can testify to the latter's contribution to the development of cardiovascular complications in patients with AH, T2DM, and obesity.

Conclusions:
Serum cystatin C level is a reliable marker of glomerular filtration rate with high diagnostic accuracy, which improves risk stratification for the development of chronic kidney disease in comorbid patients with AH. Elevated cystatin C level may be associated with increased blood pressure, cardiotrophin-1 level, and serum catestatin value, which indicates its importance for the early development of cardiovascular complications in patients with AH and various comorbidities and proves the significance of adipose tissue hormonal activity for the development of glomerular and tubular dysfunctions.
PREDICTIVE FACTORS FOR ACHIEVEMENT OF TARGET SYSTOLIC BLOOD PRESSURE AND HEART RATE: SUB-ANALYSIS OF PRIDE STUDY
Authors: Khomitskaya Yunona , Kobalava Zhanna , Petrova Parvoleta , Kvasnikov Boris , Burtsev Yuriy 
Published: May 2024

Objective:
To define predictors for achievement of target systolic blood pressure (SBP) and heart rate (HR) in the PRIDE study (NCT03730116).

Design and method:
It was a 12-week ambispective observational study to assess antihypertensive and antianginal effectiveness of Bisoprolol/ Perindopril (Biso/Per) single-pill combination (SPC) in outpatients with coronary artery disease (CAD), history of myocardial infarction (MI) and arterial hypertension (HTN). This analysis aimed to evaluate predictive values of baseline (BL) demographic and clinical characteristics to achieve target SBP and HR in study population.

Results:
Of 481 included patients, 154 (32.0%) were female, mean age 61.4 (8.9) years. Prevalence of type 2 diabetes mellitus (T2D) at BL was 24.1%. Proportions of patients with Grade I, II, III or isolated HTN (ISH) and those with controlled HTN (BP< 140/90 mm Hg) at BL were 55.3% (n=266), 10.8% (n=52), 5.0% (n=24), 5.0% (n=24), 23.9% (n=115), correspondingly. Mean duration of HTN and CAD were 12.8 (8.4) and 6.1 (6.3) years. Proportions of patients treated with 2,5/2,5, 5/5, 5/10 and 10/10 mg of Biso/Per SPC at BL were 12.1%, 33.5%, 34.3%, 20.2% correspondingly. Doses were changed in 1.6% of cases by week 12 of observation. At week 12, mean SBP, DBP and HR significantly decreased by 24.9 (16.4), 12.2 (11.0) mm Hg and 14.4 (11.7) bpm, respectively (p< 0.001 for all). Multivariable analyses revealed grade III HTN at BL was the only significant negative predictor for achieving SBP< 140 mm Hg, whereas grade III HTN, CAD with angina of functional class II and older age (more 65 y.o.) were negative predictors for achieving SBP < or equal 130 mm Hg at week 12 of observation. Grade III HTN at or presence of T2D at BL decreased the likelihood of achieving target HR (55-60 bpm), according to the data given in Table 2.

Conclusions:
Grade III HTN, concomitant T2D and symptomatic angina were negative predictors for achievement of the target SBP and HR in patients with HTN and a history of MI. There were no positive predictors for achievement of the target BP and HR explored.
HYPERTENSION RELATED NETOSIS IS STRONGLY DEPENDENT ON NIGHTTIME BLOOD PRESSURE IN A COHORT OF NEWLY DIAGNOSED, TREATMENT NAÏVE HYPERTENSIVE PATIENTS
Authors: Lazaridis Antonios , Malliora Anastasia , Natsi Anna -MARIA , Papadopoulos Vasilios , Antoniadou Christina , Gavriilidis Eustratios , Mastrogiannis Konstantinos , Kotsis Vasilios , Skendros Panagiotis , Gkaliagkousi Eugenia 
Published: May 2024

Objective:
Over the last years, accumulating evidence has highlighted the key role of immunity in the inflammatory environment of essential hypertension (EH). Neutrophil extracellular traps (NETs) formation represents a protective innate immune mechanism of the neutrophils. However, excessive release of NETs (NETosis) has been shown to exert a potent pro-inflammatory and pro-thrombotic effect. Even though NETosis is increasingly implicated in the thrombo-inflammatory environment of cardiovascular disease, experimental and clinical data regarding the association between NETs and EH are scarce.

Design and method:
We recruited newly diagnosed, untreated hypertensives (UHTs) without overt cardiovascular disease and healthy, normotensive individuals (NTs). Office BP was measured according to guidelines. Ambulatory and central BP parameters were measured with the Mobil-O-Graph device. Plasma levels of NETs including myeloperoxidase (MPO)-DNA were determined by ELISA.

Results:
A total of 139 individuals including 99 UHTs and 40 NTs were included in the study. Levels of MPO-DNA were increased in UHTs compared to NTs (p<0.001). In multivariate analysis after adjustment for confounding variables (body mass index, hemoglobin, uric acid, high sensitivity c-reactive protein), hypertension was the strongest independent predictor of incident NETosis (p<0.001). Among the ambulatory BP indices, peripheral nighttime systolic BP (F:5.937; p=0.016) and central nighttime diastolic BP (F:4.751; p=0.031) were the strongest prognosticators of hypertension related NETosis (Optimal Scaling ANOVA; p=0.028).

Conclusions:
In a cohort of newly diagnosed, treatment-naïve hypertensive patients, nighttime BP indices are the strongest factors that can predict, independently, an increased NETosis, adding to the superior significance of nocturnal BP in cardiovascular prognosis. Further research is needed to clarify the association of NETs with hypertension as well as hypertension-mediated target organ damage.
EXPOSURE TO AIR POLLUTION FINE PARTICULATE MATTER (PM2.5) ALTERS SYSTEMIC AND TISSUE-SPECIFIC COMPONENTS OF THE RENIN-ANGIOTENSIN SYSTEM
Authors: Dominici Fernando , Pardo Jorge Andres Narvaez , Natalia Magnani , Andres Evelson Pablo , Bruno Bucholz 
Published: May 2024

Objective:
Previous studies have implicated air pollution fine particulate matter (PM2.5) in various cardiovascular cardiometabolic and renal disease states. However, the molecular mechanisms by which these pollutants mediate these comorbidities have not been fully elucidated. Dysregulation of the renin-angiotensin system (RAS) may be one potential mechanism. This study aimed to investigate the participation of the RAS in air pollution-associated pathologies.

Design and method:
To study the impact of PM2.5 on systemic and tissue components of the RAS, male 8-week-old Balb/C mice were exposed to filtered air (FA) or urban air (UA) from Buenos Aires City, in whole-body exposure chambers for 14 weeks. Levels of main RAS components including angiotensin-converting enzyme (ACE) and ACE2, as well as AT1, AT2, and Mas receptors (R) abundance, were determined in kidney, heart, and lung tissue by Western Blotting (WB) and their corresponding mRNA expression was detected by RT-qPCR. Circulating angiotensin (Ang) II levels were determined by radioimmunoassay.

Results:
Exposure to air pollution resulted in increased mRNA levels of ACE and MasR, and increased protein levels of ACE in the kidney; upregulated mRNA and protein abundance of cardiac and pulmonary AT2R and MasR, together with increased levels of proteins nitrated at Tyr residues in both kidney and lung homogenates, indicative of nitrosative stress in these tissues. In addition, exposure to PM2.5 was associated with increased levels of circulating Ang II, indicative of an exacerbation of the RAS.

Conclusions:
Our findings indicate that chronic exposure to air pollution induces an altered expression of both tissue and systemic components of the RAS. Given that both the AT2R and the MasR have been ascribed to participate in tissue-repair mechanisms, the upregulation of these receptors detected in mouse heart and lung after chronic exposure to polluted air could represent a mechanism of tissue protection against damage induced by PM2.5.
CORTISOL CONCENTRATIONS AFTER DEXAMETHASONE SUPPRESSION TEST ARE RELATED TO THE ALDOSTERONE RESPONSE TO SALINE INFUSION TEST IN TREATMENT NAIVE ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Bulfone Luca , Catena Cristiana , Da Porto Andrea , Brosolo Gabriele , Bortolin Giulia , Comand Jacopo , Sechi Leonardo 
Published: May 2024

Objective:
The study of cortisol secretion and the response of plasma aldosterone concentration (PAC) to saline infusion test (SIT) are used to exclude some forms of secondary arterial hypertension. Some studies show a relationship between agents stimulating cortisol and aldosterone production, but the mechanisms have not yet been clarified, moreover the effects of cortisol concentration on PAC after a SIT test have never been studied.

Design and method:
In 112 essential hypertensive (EH) patients (age 48±13 years, 63 males, free of interfering hypertensive treatment) we evaluated clinical characteristics, plasma and urinary sodium and potassium, plasma cortisol at 8AM, 5PM, 11PM, 24-h urinary free cortisol, cortisol values after an overnight suppression test with 1 mg of dexamethasone (DST), and active renin and PAC before and after a saline infusion test.

Results:
PAC after SIT was significantly and directly related to PAC before SIT (r=0.349, P<0.001), ACTH level (r=0,233, P=0,021) and inversely related to post-DST cortisol level (r=-0.225, P=0.018), while being weakly related to GFR (r=-0,179, P=0,060). We performed a multivariate analysis with post-SIT PAC as dependent variable, including PAC before SIT test, post-DST cortisol, ACTH levels and GFR as independent variables. In this analysis post-SIT PAC was independently associated with pre-SIT PAC (B=0.225, P=0,024) and post-DST cortisol (B=-0.213, P=0.027).

Conclusions:
Although the physiological relationship between glucocorticoid and mineralocorticoid synthesis is not yet fully understood, these results indicate that a mild overproduction of cortisol, even if subclinical, might influence the PAC response to SIT test. We believe that this fact should be considered by the physician during the diagnostic work-up of secondary and resistant hypertension.
EFFECTS OF ANTIHYPERTENSIVE THERAPY ON MACRO- AND MICROCIRCULATION IN ADOLESCENTS WITH ARTERIAL HYPERTENSION – A PROSPECTIVE STUDY
Authors: Pac Michal , Rogowska Anna , Obrycki Lukasz , Feber Janusz , Litwin Mieczyslaw 
Published: May 2024

Objective:
Our cross-sectional study showed that arterial hypertension (AH) in children not only leads to macrovascular remodeling but also to alterations in retinal microcirculation which correlates with subclinical injury in common carotid arteries. However, no studies evaluated antihypertensive therapy's effects on microcirculation.
The study aimed to prospectively evaluate hypertension-associated changes in retinal microcirculation and their correlation with hypertension-mediated organ damage (HMOD): carotid intima-media thickness (cIMT), pulse wave velocity (PWV) and left ventricular mass index (LVMi).

Design and method:
: 47/157 children (mean+-SD age = 14.74±3.1 years) enrolled in the cross-sectional study were observed for a mean+-SD period of 1.13±0.9 years while receiving pharmacological/non-pharmacological treatment for AH. All participants underwent ambulatory blood pressure monitoring (ABPM), HMOD assessment, and an ophthalmic examination assessing retinal vessel density (VD), foveal thickness, thickness of retinal nerve fiber layer, ganglion cell complex, and foveal avascular zone using optical coherence tomography at the start of the study and the end of follow-up.

Results:
At baseline, we observed a lower density of retinal vessels correlated with increased cIMT. 33/47 (70%) patients achieved normotension (24 systolic blood pressure <=95th percentile) at the end of follow-up, in whom the 24h systolic, diastolic, and mean arterial pressure (MAP) Z-scores decreased significantly by a mean of -0.70 to 0.94 Z-scores, significantly different (p<0.05) from 14 patients, in whom the BP increased/did not change during follow-up. Patients who achieved normotension significantly decreased serum cholesterol and LVMi (p<0.05) compared to patients with persistent hypertension. There were, however, no significant differences in other HMOD parameters (PWV, cIMT) and retinal VD parameters between patients achieving normotension and those with persistent hypertension. Similar results were obtained using 24h MAP or 24 diastolic blood pressure and lower BP cutoffs for normotension (90th and 75th percentiles).
A trend was observed in the association between a decrease in vascular density and an increase in cIMT-SDS (p=0,088; r=-0,28). No significant correlation with microvascular parameters was found for LVMi and PWV.

Conclusions:
Our results show that, despite normalization of blood pressure at the end of 1 year of follow-up, there was no significant improvement in retinal microcirculation.
ANTIHYPERTENSIVE THERAPY AND DYSLIPIDEMIA. SIAMESE TREATMENT!
Authors: Meireles-brandao Joaquim , Meireles-brandao Lucia , Coelho Rui , Rocha-goncalves Francisco 
Published: May 2024

Objective:
Cardiovascular diseases are the leading cause of morbidity and mortality in industrialized countries. This was a retrospective observational study, evaluating clinical outcomes, metabolic consequences and survival rate resulting from prolonged intermediate-intensity statin therapy dosages for primary prevention
In this study we set out to analyze the importance of the repercussions of synergies anti-hypertension therapies in conditioning the results in the dyslipidemia profile.

Design and method:
Among the 1677 patients who attended a medical consultation between January 1995 and May 2015, a population-based sample of 516 patients were included in the study.
After signing the informed consent, data were collected from the patients’ medical charts. Selection criteria: 1) patients who had at least two personal and/or family-related CVRF: 2) regularly attended a quarterly consultation for a minimum of two years, 3) performed an annual biochemical examination, including cardiovascular complementary exams with clinical evaluation

Results:
Statins, angiotensin converting enzyme inhibitors (ACEI), ARB-II, oral antidiabetics (OAD), antiplatelets, calcium channels antagonists (CCA) and allopurinol were selected for the initial regression model, due to their clinical influence on LDLc variation (Table 3). Again, only patients under treatment and who have not died during the study were considered in this analysis.
Results from the optimized final model (Table 2, supplemental material) revealed that LDLc decreased in patients taking statins 51.780 mg/dL more than in those who did not, after adjustment for ACEI and ARB-II. LDLc decreased in patients taking ACEI 12.563 mg/dL more than in those who did not, after adjustment for statins and ARB-II. Moreover, LDLc decreased in patients taking ARB-II 8.221 mg/dL more than in those who did not, after adjustment for statins and ACEI.

Conclusions:
This study shows the benefits of an early and continued therapy with intermediate-intensity statins for primary prevention and highlights the synergic effects with other drugs for treatment of hypertension such as ACEI, ARB-II, CCA,
COMPARATIVE EFFICACY OF AMLODIPINE AND LERCANIDIPINE IN THE PREVENTION OF MAJOR ADVERSE CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS
Authors: Joo Hyung Joon , Oh Seungmi , Hong Soon Jun , Yu Cheol Woong , Kim Yung Hyun , Kim Eung Ju 
Published: May 2024

Objective:
Amlodipine is the most widely prescribed calcium channel blocker (CCB) for hypertension. Lercanidipine, a newer CCB, is reported to exhibit fewer side effects, such as peripheral edema, and is believed to have beneficial effects on myocardial ischemia and congestive heart failure. However, its impact on major adverse cardiovascular events (MACE) has not been comprehensively explored. This study aims to elucidate the clinical efficacy of Lercanidipine in the prevention of major adverse cardiovascular events to that of Amlodipine.

Design and method:
A retrospective cohort study was conducted by analyzing electronic health records from three tertiary hospitals in Korea. We identified patients who were administered Lercanidipine (n = 2,182) or Amlodipine (n = 45,458) for a minimum of 30 days from January 1, 2017, to November 30, 2021. The incidence of MACE, including cardiovascular death, myocardial infarction, stroke, heart failure hospitalization, and coronary revascularization, was assessed over a three-year follow-up period. A total of 4,680 Amlodipine and 1,570 Lercanidipine patients were evaluated, with propensity score matching at a ratio of 1:3 after excluding those with end-stage renal disease.

Results:
Patients in the Lercanidipine cohort had a higher prevalence of low socioeconomic status, diabetes, hyperlipidemia, and chronic kidney disease. The usage of more than three antihypertensive drugs was more common in this group. The cardiovascular risk estimated by SCORE2/SCORE2-OP was also higher in the Lercanidipine cohort. After the propensity score matching, the incidence of MACE was numerically lower in the Lercanidipine group (2.8%) compared to the Amlodipine group (4.1%), but the difference was not statistically significant (p = 0.11). No differences in blood pressure control were observed over the follow-up period.

Conclusions:
In patients with higher cardiovascular risk profiles, Lercanidipine was preferred to Amlodipine. The study found that Lercanidipine had comparable efficacy to Amlodipine in preventing cardiovascular events.