bluuebunny/crossref_metadata_2025_split huggingface dataset:
ECHOCARDIOGRAPHIC AND ELECTROCARDIOGRAPHIC PREDICTORS OF NEW ATRIAL FIBRILLATION IN END-STAGE RENAL DISEASE PATIENTS WITH PRESERVED LEFT VENTRICULAR SYSTOLIC FUNCTION
Authors: Chung Hyemoon 
Published: May 2024

Objective:
We investigated the echocardiographic and electrocardiographic predictors for future development of AF in patients with ESRD and preserved LV EF who had never diagnosed AF.

Design and method:
Atrial fibrillation (AF) is a common cause which leads to adverse cardiovascular outcome in patients with end-stage renal disease (ESRD). AF is common arrhythmia in patients with reduced left ventricular (LV) ejection fraction (EF). It is unclear the predictor of new AF in patients with preserved LV EF. We enrolled 226 patients with ESRD who has performed transthoracic echocardiography. We excluded the 1) 16 patients who has been received a diagnosis of AF, and 2) 19 patients with LV EF < 50%, and 191 patients (121 males, mean 62 ± 14 years)

Results:
During a mean follow-up period of 885 ± 720 days, AF occurred in 20 (10.5%) patients. The patients with AF development was older (69 ± 12 vs. 61 ± 14 years, p=0.023). There were no differences in history of hypertension, diabetes, stroke and coronary artery disease between two groups. In univariate Cox regression analysis, left atrial volume index (LAVI), right ventricular systolic pressure, age and QRS duration were associated with future AF events. After multivariate Cox regression analysis, age (HR: 1.015, 95% CI: 1.008-1.105, p value: 0.022) and QRS duration (HR: 1.025, 95% CI: 1.001-1.049, p value: 0.043) significantly predicted the future development of AF.

Conclusions:
QRS duration is well known predictor of cardiovascular outcome in patients with reduced LV EF. In this study, we demonstrated QRS duration predicted new AF events in ESRD patients with preserved LV EF.
DIAGNOSING WHITE COAT HYPERTENSION AMONG SOLDIERS AT STRESSFUL DUTIES – IS THERE AN ALTERNATIVE TO 24 HOUR ABPM?
Authors: Rapoport Vladimir , Lenkovsky Ori , Nidam Naomi Nakash , Angel-korman Avital , Leiba Adi 
Published: May 2024

Objective:
White Coat Hypertension (WCH) is defined as elevated office blood pressure (BP) readings with a normal blood pressure during ambulatory blood pressure monitoring (ABPM). We recently established a dedicated “fast track” clinic for diagnosis of hypertension among soldiers.
We assumed that WCH might be highly prevalent among these examinees, whose blood pressure is measured in a stressful, non-standardized, military setting.
Since home BP for diagnosing of WCH is not feasible among most military personnel, we aimed at comparing possible alternatives: standardized hospital clinic BP, aortic (central) BP measurement or 24-hour ABPM.

Design and method:
We estabished a dedicated hypertension clinic, in which soldiers who are off duty for a long weekend (Thursday-Sunday) undergo full hypertension workup during 2 consecutive work days. The workup consists of standardized clinic BP, measured by an experienced medical technician, central BP measurement and 24-hour ABPM as well as echocardiography, renal ultrasound, renal artery doppler, fundoscopic exam, blood and urine tests.

Results:
During 2023, 56 examinees were seen in our clinic.
Thirty-five of those (68.6% men, median age 20) were referred due to repeated elevated BP in a military setting (BP>=140/90mmHg), but no clear diagnosis of hypertension.
Sixteen of these patients (45.7%) were diagnosed as WCH by 24-hour ABPM. Standardized office BP measurements done by a medical technician unmasked the white coat effect (WCE) in 5 patients (31.2% of WCH). Central (aortic) BP measurements followed the standardized BP measurements and were within normal limits in patients with normal standardized brachial BP measurements. Similarly, central BP was elevated in those with elevated standardized brachial BP measurements.

Conclusions:
WCH is more common among women, elderly and obese and occurs in up to 30% of subjects with elevated blood pressure. We found a prevalence of 45.7% among young examinees, most of whom were men.
Standardized clinic BP measurements unmasked 31.2% of WCH cases, possibly, as they were performed by a technician and not a physician. However, 24 hour ABPM is mandatory in order to diagnose WCH. Central BP measurement adds no value as compared to brachial BP.
ANALYSIS OF DETECTION RATE OF EARLY EVENING ELEVATED BLOOD PRESSURE IN HYPERTENSIVE PATIENTS BY AMBULATORY BLOOD PRESSURE MONITORING
Authors: Ma Zhiyi , Zhang Yuqing , Xu Yang 
Published: May 2024

Objective:
The aim of the study is to investigate the detection rate of early evening elevated blood pressure (EEE) in treated and untreated hypertensive patients by ambulatory blood pressure monitoring.

Design and method:
From February 1, 2020 to February 28, 2023, the total of 1413 hypertensive patients underwent ambulatory blood pressure monitoring in 13 medical institutions through the National 13th Five Year Plan Major Cooperation Group for Chronic Disease Prevention and Control (Research on the Application of Lifestyle and Nutritional Intervention Techniques and Strategies for Obesity and Hypertension, No. 2016YFC1300100). Among them, 1026 patients had taken antihypertensive drugs and 387 patients had not taken antihypertensive drugs. EEE is defined as average systolic blood pressure is higher or equal to 135mmHg or average diastolic blood pressure is higher or equal to 85mmHg from 6PM to 10PM.

Results:
1. The detection rate of EEE in treated hypertensive patients was 60.4% (620 patients), while the detection rate of EEE in untreated hypertensive patients was 70.5% (273 patients); 2. The detection rate of daytime hypertension in treated hypertensive patients was 55.8% (573 patients), while the detection rate of daytime hypertension in untreated hypertensive patients was 71.6% (277 patients); 3. The detection rate of nighttime hypertension in treated hypertensive patients was 81.2% (833 patients), while the detection rate of nighttime hypertension in untreated hypertensive patients was 87.6% (339 patients); 4. The detection rate of whole-day hypertension in treated hypertensive patients was 69.3% (711 patients), while the detection rate of whole-day hypertension in untreated hypertensive patients was 80.9% (313 patients); 5. The detection rate of morning hypertension in treated hypertensive patients was 61.1% (627 patients), while the detection rate of morning hypertension in untreated hypertensive patients was 72.9% (282 patients).

Conclusions:
In this study, the detection rate of EEE in treated hypertensive patients did not significantly decrease compared to those untreated patients, while the detection rate of EEE was similar to that of morning hypertension. It is necessary to conduct further research to reveal the correlation between EEE and cardiovascular diseases.
PERIPHERAL TH1 AND TH17 CELLS AND IL17-A IN PERITONEAL DIALYSIS PATIENTS ACCORDING TO DIPPING PROFILE – A CROSS-SECTIONAL STUDY
Authors: Grilo João , Coutinho Joana , Barreto Inês , Chorão Raquel , Filipe Rui Alves , Fonseca Mafalda , Santos Catarina Reis 
Published: May 2024

Objective:
Despite technical advances, hypertension (HT) in peritoneal dialysis (PD) patients remains highly prevalent, with 24-hour ambulatory blood pressure monitoring (ABPM) allowing for a better understanding of the blood pressure profile. Recent studies suggest a close relationship between T helper (Th)1 and Th17 cells and non-dipping HT. In this setting, we aimed to evaluate the relationship between dipping profile and peripheral Th1 and Th17 cells and IL-17A levels in chronic PD patients.

Design and method:
Cross-sectional study of 26 PD patients with history of HT and 10 healthy controls. Peripheral blood frequencies of TCD4+, TCD8+, Th1 and Th17 cells were quantified by flow cytometry and IL-17A concentrations measured by enzyme-linked immunosorbent assay. All patients were examined by ABPM on the same day as the blood collection.

Results:
Table 1 summarizes patient characteristics. The frequency of Th1 cells in PD patients was lower than in healthy controls (p=0.001). A lower percentage of Th17 cells was also observed, although not statistically significant (p=0.061). According to ABPM, 10 PD patients were classified as dippers and the remaining as non-dippers. There were no significant differences in age, PD duration, office systolic and diastolic pressures, body mass index, lipid profile and hemoglobin A1c between dippers and non-dippers. All patients with diabetic nephropathy (n=7) were non-dippers. The average number of prescribed anti-hypertensive medication classes in dipper patients was 2.20 ± 1.14 and in non-dippers was 2.81 ± 0.91. Non-dippers presented lower frequencies of Th17 cells than dippers (p=0.018), and frequencies were also lower than the observed in healthy controls (p=0.008). These differences were not accompanied by a significant difference in IL-17A levels across the three groups. Both dipper and non-dippers had lower frequencies of Th1 cells when compared to the controls.

Conclusions:
Non-dipping is a frequent characteristic in PD patients, although higher frequencies of Th1 and Th17 cells, as well as IL-17A levels were not documented in these patients. Whether these cells may be the link between immunity and poorer blood pressure control in PD patients should be further evaluated in larger cohorts.
WHITE-COAT AND MASKED HYPERTENSION IN HEMODIALYSIS PATIENTS
Authors: Leonidou K , Georgianos P , Kollias A , Vaios V , Divanis D , Roumeliotis S , Varouktsi G , Tsinari A , Stergiou G , Zebekakis P , Liakopoulos V 
Published: May 2024

Objective:
Unlike the general population or patients with earlier stages of chronic kidney disease, there are no clear diagnostic criteria for white-coat and masked hypertension in the hemodialysis population. In the present study, we aimed to estimate the prevalence of these 2 BP phenotypes using routine predialysis BP recordings in combination with 44-hour ambulatory BP monitoring (ABPM).

Design and method:
In a cohort of 70 hemodialysis patients, hypertension was assessed with 2 methods: (i) the average of routine predialysis BP recordings over 6 consecuitive dialysis sessions; (ii) ABPM over an entire 44-hour interdialytic period (BP measurements at 20-minute intervals; Microlife WatchBP O3 device). The thresholds of 140/90 mmHg and 130/80 mmHg were used to define abnormal predialysis and ambulatory BP, respectively.

Results:
Study participants (45 males and 25 females) had a mean age of 65.3±13.3 years and a median dialysis vintage of 15 months. The prevalence of hypertension was 88.6% by predialysis BP recordings and 90% by ABPM. In all, 61 patients were being treated with an average of 1.5±0.6 antihypertensive medications daily. In all, 51.4% of patients had either normotension or adequately controlled hypertension confirmed by the 2 different BP monitoring techniques, whereas 18.6% of patients had uncontrolled hypertension confirmed by both techniques. The prevalence of white-coat hypertension was 24.3% and the prevalence of masked hypertension was 5.7%. A 2-week averaged routine predialysis BP at the threshold of 140/90 mmHg provided 77.8% sensitivity and 30.8% specificity for the diagnosis of an average 44-hour ambulatory BPequal or higher than 130/80 mmHg. The agreement between these 2 techniques for the identification of patients with adequately controlled hypertension was poor (k-statistic: 0.378, P<0.001).

Conclusions:
This study shows that in approximately 30% of hemodialysis patients, there is lack of concordance between routine predialysis BP recordings and ABPM for the determination of BP control status. Routine predialysis BP recordings, even when averaged over 6 consecutive dialysis sessions, are inaccurate estimates of the actual BP load, as assessed by ABPM.
TRV027 REDUCES BLOOD PRESSURE IN SHR AND RESTORES VENTRICULAR HYPERTROPHY BY AFFECTING CONNEXIN 43 PATHWAY
Authors: Fan Xin , Yu Jing 
Published: May 2024

Objective:
Hypertension is one of the common causes of cardiovascular diseases. Angiotensin II (AngII) plays a crucial role in hypertension and hypertension-induced cardiac hypertrophy. Whether TRV027, an AngII type 1 receptor biased agonist, could lower blood pressure and treat hypertensive cardiac hypertrophy is unknown.

Design and method:
Spontaneously hypertensive rats and Wistar-Kyoto rats were selected as the study subjects. Some SHRs were giving TRV027. H9c2 cells were selected as the in vitro study subjects to explore the mechanism of action of TRV027.

Results:
When compared to the WKY group, the SHR group displayed a pronounced increase in blood pressure. However, after giving subcutaneous pump of TRV027, blood pressure exhibited a marked reduction. Based on the Doppler ultrasound data, prior to the intervention, the SHR group had higher values for LVAWs, LVAWd, LVPWs, and LVPWd when contrasted with the WKY group. Moreover, the left ventricular mass in the SHR group also increased significantly (P<0.05). After the intervention with TRV027 in the SHR group, all the above-mentioned cardiac Doppler parameters were lower than those in the SHR group. HE staining of cardiac sections revealed a slight disarray in myocardial arrangement and significant myocardial hypertrophy in the SHR group. Compared with the WKY group, the level of Cx43 in the heart tissue of the SHR group was decreased, and the phosphorylation of MAPK and ERK2 was increased. After administration of TRV027, the expression levels of these proteins were restored. In the cell intervention, the expression level of Cx43 was significantly decreased, the phosphorylation levels of MAPK and ERK2 were increased, and the levels of MHC and ANP were increased in the AngII intervention group. After the intervention of TRV027 the expressions of Cx43 and MAPK/ERK pathways and MHC and ANP were restored. When Cx43 inhibitor was given to H9C2 cells,along with the decrease of Cx43 expression, the phosphorylation levels of MAPK and ERK2 were increased, while the levels of MHC and ANP were significantly increased.

Conclusions:
TRV027 lower blood pressure in SHR and ameliorate cardiac hypertrophy induced by hypertension. This effect is likely achieved through the Cx43 pathway.
BLOOD PRESSURE CLASSIFICATION USING BRACHIAL VERSUS CENTRAL HYPERTENSION PHENOTYPES AND ASSOCIATION WITH LEFT VENTRICULAR MASS – FINDINGS FROM THE I24ABC CONSORTIUM
Authors: Danninger Kathrin , Weber Thomas , Wassertheurer Siegfried , Protogerou Athanase , Sharman James E. , Sala Enrique Rodilla , Ortner Stefan , Athanasopoulou Elpida , Hametner Bernhard , Mayer Christopher , Li Yan , Pascual Jose Maria , Karachalias Fotis , Stergiou George , Bahous Sola Aoun , Zhang Yi , De La Sierra Alejandro 
Published: May 2024

Objective:
Brachial and central systolic blood pressure (BP) is different, which may have implications for BP classification and cardiovascular risk stratification. We investigated the association between BP phenotypes, based on brachial versus central SBP, and left ventricular mass, an important intermediate endpoint in hypertension.

Design and method:
In all centers, 24-hour blood pressure (24hBP) was measured with the same validated oscillometric upper arm device (Mobil-O-Graph, I.E.M., Germany), using a transfer function and ARCSolver algorithms for determination of central pressures (using mean/diastolic BP calibration). Hypertension phenotypes were defined according to average 24h brachial BP as normotension (NTN), isolated systolic (ISH) and diastolic (IDH) hypertension, and systolic/diastolic hypertension (SDH), using brachial 130 and 80 mm Hg as systolic and diastolic threshold, respectively. Brachial BP phenotypes were further subdivided based on central 24h SBP (threshold for central hypertension was 135 mmHg). Left ventricular mass was determined by echocardiography, and indexed to body surface area (LVMi).

Results:
Overall, 2378 participants from 21 centers worldwide, connected in an academic research consortium, were included. Based on 24h brachial BP, 43.9%, 7.0%, 22.0% and 27.1% were classified as NTN, ISH, IDH, and SDH, respectively. The fraction of discordantly elevated central SBP in brachial NTN and IDH was 10.4% and 5.2%, respectively, and the fraction of discordantly normal central SBP in brachial ISH and SDH was 15.1% and 28.1%, respectively. Sex-differences were most striking in brachial NTN with elevated central SBP (male predominance), and brachial SDH with normal central SBP (female predominance). LVMi was higher in all brachial BP phenotypes, if central SBP was elevated (as compared to normal; see Table).

Conclusions:
Discordant BP classification based on central systolic BP is not uncommon and to some degree sex-specific. Measurement of central SBP likely adds to risk stratification in all brachial-BP based phenotypes, due to the stronger relationship with LVMi.
HYPERTENSION PHENOTYPES BASED ON BRACHIAL AND AORTIC 24HR SYSTOLIC PRESSURE AND THEIR ASSOCIATION WITH HYPERTENSION PHENOTYPES BASED ON BOTH BRACHIAL AND AORTIC 24HR SYSTOLIC PRESSURE AND THEIR ASSOCIATION WITH LEFT VENTRICULAR HYPERTROPHY: FINDINGS FROM THE I24ABC CONSORTIUM
Authors: Athanasopoulou Elpida , Weber Thomas , Wassertheurer Siegfried , Sharman James E. , Argyris Antonios , Sala Enrique Rodilla , Jankowski Piotr , Muiesan Maria Lorenza , Giannattasio Cristina , Wilkinson Ian , Hametner Bernhard , Orter Stefan , Mayer Christopher , Li Yan , Pascual Jose Maria , Danninger Kathrin , Karachalias Fotis , McEniery Carmel , Pucci Giacomo , Blacher Jaques , Stergiou George , Gomes Marco Antonia Mota , McDonnell Barry , de la Sierra Alejandro , Piskorz Daniel , Agharazii Mohsen , Bahous Sola Aoun , Perl Sabine , Zhang Yi , Nemcsik Janos , Gkaliagkousi Eugenia , Protogerou Athanase ,   the international24 hour Aortic Blood pressure Consortium (i24ABC)
Published: May 2024

Objective:
To describe the prevalence of systolic hypertension phenotypes based on simultaneous 24hr ambulatory blood pressure monitoring (ABPM) of the brachial (br) and aortic (ao) systolic pressure, as well as their association with left ventricular hypertrophy (LVH), using data from the international 24hr aortic blood pressure consortium (i24ABC).

Design and method:
Participants with 24hr br & ao ABPM (Mobil-O-Graph, IEM Germany) and echocardiography data from 21 centers worldwide were analyzed and categorized into the following 4 phenotypes: sustained [br & ao] systolic normotension (SSN), isolated br systolic hypertension (IbrSH), isolated ao systolic hypertension (IaoSH), and sustained [br & ao] systolic hypertension (SSH). These phenotypes were generated using 2 different calibration (C) methods and various proposed 24hr ao systolic pressure cut-off values (mmHg) (C1: systolic /diastolic pressure [120 and 114]; C2: mean/diastolic [135 and 132]).

Results:
We analysed 2367 individuals (49.5 ± 16.1 years, 54.5% men, 55.8% hypertensives). Depending on both cut-off values as well as on calibration method the phenotypes prevalence ranged: IaoSH 5.8% - 24.2%; IbrSH: 0.2% - 8.7%; SSN: 41.9% - 60.3%; SSH: 29.2% - 33.9%. In comparison to the SSN and after adjustment for age, sex and diastolic blood pressure: the SSH phenotype had 2.4 to 3.2 times more often LVH (statistically significant irrespectively of calibration and cut-off); the IaoSH had 1.7 to 2.4 times more often LVH (statistically significant with both C1 and C2); the IbrSH had 2.1 times more often LVH only with C1 and 120 mmHg cut-off.

Conclusions:
Individuals with the novel herein defined phenotype of 24hr IaoSH constitute a non-neglectable percentage of the population that cannot be identified by brachial arm ABPM, possibly carrying high cardiovascular risk as suggested by the more frequent LVH. Outcome studies are needed to verify these results.
24 HOUR ISOLATED AORTIC SYSTOLIC HYPERTENSION AND HYPERTENSION MEDIATED ORGAN DAMAGE: DATA FROM THE SAFAR STUDY
Authors: Athanasopoulou Elpida , Karachalias Fotios , Yofoglou Lazaros , Kanatas Panagiotis , Weber Thomas , Danninger Kathrin , Blacher Jacques , Manios Efstathios , Protogerou Athanase , Argyris Antonios 
Published: May 2024

Objective:
To describe the prevalence of systolic hypertension phenotypes according to simultaneous 24hr brachial systolic pressure (br) and aortic (ao) ambulatory blood pressure monitoring (ABPM) and their association with carotid and left ventricular damage, using data from the NoninvaSive Aortic ambulatory blood pressure monitoring for the detection of tARrget organ damage (SAFAR) study.

Design and method:
Participants with 24hr br & ao ABPM (Mobil-O-Graph, IEM Germany), carotid ultrasound and echocardiography data were analyzed and categorized into 4 systolic hypertension phenotypes: sustained systolic br & ao normotension (SSN), isolated br systolic hypertension (IbrSH), isolated ao systolic hypertension (IaoSH) and sustained br & ao systolic hypertension (SSH); using 2 different calibration peripheral waveform methods and different 24hr ao systolic proposed cut-off values (i.e., 120mmHg or 114mmHg for type 1 calibration; 135mmHg or 132mmHg for type 2 calibration [mean/ diastolic pressure]). We examined the prevalence of these phenotypes and their associations with carotid and cardiac damage.

Results:
Out of 1024 participants (55.0 ± 13.1 years, 58.1% males, 60.4% hypertensives) with ABPM, 684 (53.5 ± 12.4 years, 57.7% males, 61.0% hypertensives) had carotid and 423 (55.4 ± 14.3 years, 57.4% males, 60.3% hypertensives) had echocardiography data. IaSH ranged from 3.7% to 23.0% of the population depending on the calibration and the applied cut-off; (SSN: 37.0% – 56.3%, IbrSH: 0.6% – 9.5%, SSH: 30.5% – 39.4%). In comparison to SSN and IbrSH, IaoSH phenotype (only by calibration 2 - but independently of the applied cut-off) had significantly higher common carotid intimal-medial thickness, cross-sectional area and left ventricular mass. Irrespectively of the type of calibration and applied cut-off, SSH had consistently the highest carotid and cardiac damage.

Conclusions:
Individuals with 24hr IaoSH constitute a non-neglectable percentage (3.7% to 23.0%) of the population with otherwise normal 24hr br pressure, possibly carrying high cardiovascular risk. Further mortality outcome studies are needed to verify these results.