bluuebunny/crossref_metadata_2025_split huggingface dataset:
FIRST COMPREHENSIVE ECHOCARDIOGRAPHIC ASSESSMENT IN PATIENTS WITH VASCULAR EHLERS-DANLOS SYNDROME WITH OR WITHOUT CELIPROLOL THERAPY AT THE MAXIMUM RECOMMENDED DOSE
Authors: Buso Giacomo , Paini Anna , Agabiti-rosei Claudia , Bertacchini Fabio , Stassaldi Deborah , Capellini Sara , Aggiusti Carlo , Salvetti Massimo , De Ciuceis Carolina , Ritelli Marco , Venturini Marina , Colombi Marina , Muiesan Maria Lorenza 
Published: May 2024

Objective:
Vascular Ehlers-Danlos syndrome (vEDS) is an inherited connective tissue disorder characterized by arterial fragility. Celiprolol is a beta1-adrenoceptor antagonist with partial beta2 agonist activity that has been shown to reduce rates of vascular events in this setting, though the underlying mechanisms are not yet fully understood. Moreover, few data on echocardiographic assessment are available in patients with vEDS.

Design and method:
Twenty patients with genetically confirmed diagnosis of vEDS followed at our Institution were divided into two groups (10 patients each) according to whether or not they were on celiprolol therapy at the maximum recommended dose (400 mg daily) for at least 12 months. Both groups were compared to 10 healthy individuals matched for sex, age, body mass index (BMI), and office blood pressure values. Each participant underwent transthoracic echocardiography with tissue Doppler analysis for a comprehensive evaluation of cardiac structure and function.

Results:
Mean age was 35 years and mean BMI was 21.6 kg/m2. Female sex was prevalent (60%). Left ventricular (LV) internal diameter values tended to be lower in patients with untreated vEDS than in healthy controls, though this difference was not statistically significant (4.33 vs 4.74 cm, respectively; p=0.053). Similar data were observed for LV mass index (56.9 vs 68.6 g/m2; p=0.093), stroke volume (56.6 vs 71.6 mL; p=0.068), and E/A ratio (1.26 vs 1.66; p=0.082), whereas an opposite trend was observed for e’ lateral (13.2 vs 12.2; p=0.096). No statistically significant difference was found between groups in terms of other parameters of LV mass, systolic and diastolic function. A normal LV geometry was found in all the cases. Indices of mechano-energetic efficiency and ventricular-arterial coupling were also similar between groups. No patient presented with aortic root dilation, mitral valve prolapse, valve insufficiency of more than mild degree, or valve stenosis of any degree.

Conclusions:
Our study suggests that patients with vEDS have normal cardiac mass and geometry, as well as normal systolic and diastolic function. Celiprolol therapy does not seem to significantly influence such aspects. Future studies on larger cohort of patients should confirm these aspects.
UNCONTROLLED HYPERTENSION AS A RISK FACTOR FOR POOR OUTCOME AFTER MYOCARDIAL INFARCTION
Authors: Bogicevic Zorana , Tasic Danijela , Ogarevic Sladjana Bozovic , Arsic Milan , Petrovic Masa , Tasic Nebojsa 
Published: May 2024

Objective:
The Republic of Serbia exhibits a disproportionately high incidence of cardiovascular diseases (CVDs), particularly among the sub-45 demographic. Early-onset hypertension (HTA) is considered to be one of the most significant factors in myocardial and vascular damage, and a possible contributor for myocardial infarction (MI). This study aims to delineate the contributory role of HTA in MI onset in patients aged below 45.

Design and method:
The retrospective cohort study included 224 patients aged 45 years or younger, who were diagnosed and treated for MI at the Institute for Cardiovascular Diseases “Dedinje” from January 1, 2020, to November 1, 2023. The cohort, predominantly male (83%), had a mean age of 40.27 ± 4.65 years. For comparative analysis, patients were grouped based on the presence of early onset of HTA and subsequently compared based on MI characteristics and severity of clinical presentation. Statistical analysis was done by IBM SPSS Statistics version 23, for confidence interval <0.05.

Results:
HTA was observed in 68.3% of the cohort (mean age 40.7 ± 4.3 years), with 26.8% reporting suboptimal HTA management. Concomitant risk factors included obesity (75.9%) and smoking (67.9%). ST-segment elevation myocardial infarction (STEMI) was present in 79.9% of cases. A subset of 17 patients presented with MI in the absence of obstructive coronary artery disease. Mean ejection fraction (EF) after MI did not differ to the level of statistical significance in the HTA group versus non-HTA group, 42.68±9.7% and 44.93±10.4%, respectively (p=0.116). However, patients with poorly controlled HTA exhibited a markedly reduced EF (mean EF=39.88%, p=0.012). A low statistical correlation was observed between HTA and the number of affected coronary arteries (r = 0.106).

Conclusions:
While HTA did not significantly correlate with the severity of coronary artery disease, and was rarely an isolated CVD risk factor, its presence, particularly in uncontrolled HTA, was associated with poorer MI outcomes and myocardial damage. Further research and longitudinal patient follow-up are planned to comprehensively evaluate prognostic factors im patient with MI and uncontrolled HTA.
DECIPHERING THE NOVEL ROLE OF ERDOSTEINE IN PREVENTION OF MYOCARDIAL ISCHEMIA-REPERFUSION INJURY IN RAT
Authors: Bhardwaj Priya , Verma Vipin Kumar , Mutneja Ekta , Prajapati Vaishali , Bhatia Jagriti , Arya D S 
Published: May 2024

Objective:
Myocardial ischemia-reperfusion injury (MIRI) is caused by thrombotic obstruction of the coronary artery subsequently leading to heart failure. Despite the availability of improved prognosis, MIRI is a foremost cause of morbidity and mortality worldwide. In this study, we investigated the therapeutic potential of Erdosteine (a mucoactive antioxidant molecule, with multifaceted pharmacological properties), to attenuate myocardial infarction in rat model of MIRI.

Design and method:
This study was conducted in adult male Wistar rats (n=40), randomized into five groups: Sham, IR-C (disease control), Erdosteine (80 mg/kg; s.c.) + IR, Telmisartan (10 mg/kg; orally) +IR and Erdosteine (80 mg/kg) perse groups. Erdosteine and telmisartan were administered for 28 days as a pre-treatment. On the 29th day, animals were subjected to LAD coronary artery occlusion for 1 h followed by reperfusion for 45 minutes. The cardioprotective potential was assessed through measurement of hemodynamic parameters, biochemical markers (MDA, GSH, SOD), cardiac injury markers (CK-MB and LDH), inflammatory markers (IL-6, TNF), histopathological evaluation, TUNEL assay and immunohistochemistry analysis (Bax, caspase 3, Bcl2). Further, the underlying mechanism was evaluated using immune-blotting of MAPK, Nrf-2/HO-1, and Akt/p-Akt. The statistics analysis was performed by one-way ANOVA followed by Turkey-Kramer post hoc tests.

Results:
Erdosteine and telmisartan pretreatment improves hemodynamic parameters by preserving MAP, ±LVdP/dt, and HR as compared to the IR-C group. Pretreatment markedly restored the levels of antioxidants (GSH and SOD) and decreased peroxidation marker (MDA) compared to the IR-C group. Also, the pretreatment significantly prevented the damage following IR injury as compared to the IR-C group when investigated through cardiac injury markers and histopathological evaluation. Erdosteine profoundly reversed the expressions of Bcl2/BAX ratio, in comparison to the IR-C group indicating its anti-apoptotic effect when reconfirmed through TUNEL assay. Erdosteine pretreatment preserved the levels of NF-kB, TNF, and IL-6 following IR challenge. Erdosteine pretreatment restores FABP, Nrf-2, and Hsp27.

Conclusions:
Erdosteine protects the myocardial cell membrane from peroxidation and inhibits oxidative burst and inflammation through NF-kB pathway activation. Erdosteine attenuates MIRI injury in rats preserving the MAPK and Nrf-2 signaling cascade.
NIGHTTIME BLOOD PRESSURE DIPPING PATTERNS AND MORNING SURGE IN RELATION TO DAYTIME ACTISENSITIVITY DETECTED BY AN ALL-IN-ONE MULTISENSOR BLOOD PRESSURE MONITORING DEVICE
Authors: Tomitani Naoko , Hoshide Satoshi , Kario Kazuomi 
Published: May 2024

Objective:
Ambulatory blood pressure (BP) fluctuates affected by physical activity and the BP response against physical activity (actisensitivity) differs by individuals. This is the first study to investigate whether the daytime actisensitivity evaluated by a multisensor all-in-one BP monitoring device affects the nighttime BP dipping status and morning BP surge.

Design and method:
Twenty-four-hour ambulatory BP monitoring (ABPM) with simultaneously monitored physical activity was performed in the HI-JAMP study participants. Actisensitivity was calculated as the slope of the regression line between daytime systolic BP (SBP) and log-transformed physical activity over 5-min prior to corresponding each BP reading. Data from 2,692 patients (mean age 69.9 ± 11.9 years; mean body mass index 24.8 ± 4.1 kg/m2, 53.6% male) were analyzed.

Results:
Patients with hyper reactivity (upper 10 percentile of actisensitivity) had high prevalence of extreme dipper and exaggerated morning surge, while patients with negative reactivity (lower 10 percentile of actisensitivity) had higher nighttime BP and nighttime riser pattern. These results remained significant even after adjusting for 24-hr physical activity. The differences of diurnal BP variability by actisensitivity were augmented in the patients>75 years.

Conclusions:
Actisensitivity detected by a multisensor all-in-one BP monitoring device in daily life determined nighttime dipping patterns and morning surge in BP. Especially in the elderly hypertensives with actisensitivity at both extreme ends, the abnormal diurnal BP variability was augmented, suggesting a possible increased risk of cardiovascular events.
INCIDENCE OF HYPERTENSION ASSOCIATED WITH POLY-ADP-RIBOSE POLYMERASE (PARP) INHIBITORS IN COMBINATION WITH ANTIANGIOGENIC DRUGS: A META-ANALYSIS
Authors: Ma Jie , Li Caie , Wang Wenjuan , Fan Xin , Yu Jing 
Published: May 2024

Objective:
poly-ADP-ribose polymerase(PARP) inhibitors have demonstrated significant anti-tumor activity in a variety of tumors, such as ovarian cancer, and some studies have found that PARP inhibitors combined with anti-angiogenic drugs have achieved significant results in the treatment of ovarian cancer compared with single drugs. While there are few studies on the vascular safety of the combination of PARP inhibitors and anti-angiogenic drugs. Therefore, We conducted a meta-analysis to assess the incidence of hypertension in patients with ovarian cancer treated with PARP inhibitors in combination with anti-angiogenic agents.

Design and method:
We reviewed PubMed, Embase, Cochrane Library and Web of Science databases to identify relevant randomised controlled trials published from inception to November 10, 2023, without language restrictions. Randomised controlled trials (RCTs) of patients with Ovarian Cancer treated with PARP inhibitors in combination with anti-angiogenic inhibitors in the experimental group, as well as available data on treatment-induced increases in blood pressure.

Results:
Five studies were selected for the final analysis, The incidence of PARP inhibitors plus anti-angiogenic agents related hypertension from 38.8% to 79.5%, compared from 0% to 59.9% in the control groups, PARP inhibitors plus anti-angiogenic agents therapies significantly increased the risk of hypertension (random-effects, OR = 10.38; P =0.04).

Conclusions:
PARP inhibitors combined with antiangiogenic inhibitors increase the risk of hypertension.
HIGH PREVALENCES OF NOCTURNAL HYPERTENSION AND ISOLATED NOCTURNAL HYPERTENSION IN LONG-STANDING VIRALLY SUPPRESSED PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS
Authors: Kositanurit Weerapat , Suksiriworaboot Tanawin , Nakornchai Gahn , Avihingsanon Anchalee , Chattranukulchai Pairoj 
Published: May 2024

Objective:
Nocturnal hypertension (NH) and isolated nocturnal hypertension (INH) have emerged as residual risks for adverse cardiovascular events. Little is known about the prevalence among virally suppressed people living with human immunodeficiency virus (PLHIV) without a known history of hypertension (HT).

Design and method:
A cross-sectional study was conducted among virally suppressed PLHIV without a known history of HT who had normotensive office blood pressure (BP). All participants underwent 24-hour ambulatory blood pressure monitoring (ABPM). Blood pressure phenotypes were analyzed according to the 2023 ESH guidelines for the management of arterial HT. Normotension was defined as a 24-hour average BP <130/80 mmHg, NH as a nighttime BP greater than or equal to 120/70 mmHg, INH as NH but with normal both office BP (<140/90 mmHg) and daytime BP (<135/85 mmHg), and non-dipping as a drop of nighttime systolic/diastolic BP <10% compared to daytime systolic/diastolic BP.

Results:
A total of 83 participants were included with a mean age of 52.5±7.8 years (61.4% women). The mean duration of viral load suppression was 14.2±5.9 years. Overall, 67 participants (80.7%) were confirmed normotension by ABPM. The prevalences of NH and INH were 29% and 18.1%, respectively. Around half of the participants had non-dipping systolic BP (56.6%) and non-dipping diastolic BP (49.4%). Moreover, non-dipping diastolic BP was a significant predictor of NH in multivariable logistic regression analysis (OR 9.54, 95%CI 1.05-86.29; p=0.045).

Conclusions:
In this long-standing, well-suppressed PLHIV with normotensive office BP, the prevalences of NH and INH were high. Non-dipping diastolic BP might be a good predictor of NH in this population.
INFLUENCES OF BEDREST DECONDITIONING ON ORTHOSTATIC HYPERTENSION RISK
Authors: Hönemann Jan -NIKLAS , Moestl Stefan , De Boni Laura , Hoffmann Fabian , Heusser Karsten , Mulder Edwin , Tank Jens , Jordan Jens 
Published: May 2024

Objective:
Orthostatic hypertension defined as systolic blood pressure (SBP) increase of more than 20 mmHg when standing up with hypertensive upright SBP heralds increased cardiovascular risk. The phenomenon is caused by sympathetic overactivation and occurs in conditions associated with poor cardiopulmonary fitness or hypovolemia. We hypothesized that head-down tilt bedrest, which induces cardiopulmonary deconditioning, hypovolemia, and sympathetic activation increases the likelihood of experiencing orthostatic hypertension.

Design and method:
We pooled data from two strict head-down tilt bedrest studies, the 60 days AGBRESA study (n=24, 8 women/ 16 men, 33.3±9 years) and the 30 days SANS countermeasure study (n=47, 20 women/ 27 men, 35±9 years), which both included healthy persons on no medications. In both studies, participants were on controlled sodium diets and caloric intake was adjusted to maintain body weight. Before and immediately after bedrest, we measured supine and upright blood pressure and heart rate during head-up tilt testing. We measured plasma volume using carbon monoxide rebreathing before and after bedrest.

Results:
Supine SBP was 128±9 mmHg before and 133±10 mmHg after bedrest (p<0.0001). While 5 minutes standing, SBP changed 2±8 mmHg before and 3±8 mmHg after bedrest (p=0.5825). 1 out of 67 participants fulfilled diagnostic criteria of orthostatic hypertension before and 3 out of 57 after bedrest. Supine heart rate was 69±11 bpm before and 79±15 bpm after bedrest (p<0.0001). With standing, heart rate increased 21±12 bpm before and 39±16 bpm after bedrest (p<0.0001). Plasma volume decreased by 367±348 ml with bedrest (p<0.0001).

Conclusions:
We conclude that in most healthy persons, cardiovascular deconditioning and volume loss associated with long-term bedrest are not sufficient to elicit orthostatic hypertension. There may be a smaller subgroup of susceptible individuals.
LOW-RENIN VERSUS NON-LOW RENIN HYPERTENSION: A COMPARISON OF CONTROL IN A SPECIALIST CLINIC
Authors: Travis Reece , Keogh Morgan , Faconti Luca 
Published: May 2024

Objective:
A significant proportion of hypertensive individuals display a low-renin profile and are commonly referred as subjects with low-renin-hypertension (LRH) phenotype. LRH is associated with a significant increase in cardiovascular events but it is debated whether it is more difficult to treat than non-low-renin hypertension (NLRH). Here, we investigated the prevalence of LRH and blood pressure (BP) control at 3 and 12 months in specialist centre in the UK.

Design and method:
Consecutive hypertensive subjects not on treatment with beta-blockers and centrally acting drugs were recruited from the hypertension outpatient service at Guy's and St. Thomas’ Hospital, London. Anthropometric variables, biochemistry assessment and BP measurement were evaluated in a baseline visit following which subjects were classified as LRH if renin concentration was < 5mU/L. Clinical data at 3 and 12 months were then used to assess BP control.

Results:
205 patients ((mean±SD) age 44±13 years, 61% male) of whom 92% on pharmacological treatment were recruited. Prevalence of LRH was 28% and the two groups (LRH/NLRH) were similar in age, gender, body mass index, prevalence of diabetes and dyslipidaemia. Subjects with LRH (n=59) had higher systolic BP values compared to NLRH (156±23 mmHg vs 147±20 mmHg, P=0.013) whilst the difference was non-significant for diastolic BP (94±14 mmHg vs 91±14 mmHg, P=0.175). Decrease in systolic BP values were greater in LRH compared to NLRH at 3 months and 12 months (10.8±2.9 mmHg vs 5.1±1.6 mmHg and 13.1±3.4 mmHg and 6.3 ±1.7 mmHg respectively, both P< 0.05). with BP values at 12 months similar between the two groups (144±20/88±11 mmHg vs 141±16/89±12 mmHg for LRH and NLRH respectively, P=0.375, Figure 1). Treatment at 12 months differed in the two groups, with LRH patients more likely to be prescribed diuretics (39% vs 25%) and less likely to be prescribed ACE-i/ARB (39.0% v 61.4%), both P<0.05.

Conclusions:
LRH phenotype is common among patients evaluated in a specialist centre for hypertension. Despite higher BP values at the time of the encounter, LRH patients achieve similar levels of BP control compared to NLRH at 3 and 12 months during the follow up.
IMPACT OF NON-DIPPER PATTERN ON LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN, IN HYPERTENSIVE PATIENTS. NACIM DAHMANI1, NABILA SOUFI TALEB BENDIAB2, MOUHAMED SOUFIANE LOUNES1
Authors: Dahmani Nacim 
Published: May 2024

Objective:
Several studies have shown that the non-dipper blood pressure pattern, defined by a nocturnal decrease in blood pressure (BP) of less than 10% at the 24-hour ambulatory blood pressure monitoring (ABPM), is associated with an increase in cardiovascular risk and risk of target organ damage, however, there are few data on the non-dipper effects on the longitudinal strain overall studied by 2D speckle tracking. The aim of this study is to evaluate the impact of nocturnal dipper/non-dipper pattern on the global longitudinal systolic (GLS) of left ventricle by means of two-dimensional speckle tracking echocardiography (2D STE), of hypertensive patients under treatment or not.

Design and method:
This is a cross-sectional descriptive study conducted over a period of 20 months, from November 2021 to June 2023. The study included a total of 382 patients with arterial hypertension, enrolled consecutively. All participants were subjected to clinical evaluation, biological examination, 24-hour ambulatory blood pressure monitoring and echocardiography with GLS. The patients were divided into dippers and non-dippers, according to the percentage reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at night. The study sought to analyze the relationship between these nocturnal profiles and GLS.

Results:
179 patients (46.90%) are non-dippers. The non-dippers had a significantly lower GLS value than the dippers (-19.45 ±2.03 vs -18.2 ±2.17, P < 0.001). The multivariate linear regression confirmed this independent relationship of the GLS and the non-dipping (β = -0.157, P=0.013), however, we do not find independent relationships between the non-dipping and the diastolic function on the one hand and the non-dipping and the LV geometry on the other hand.

Conclusions:
This study shows that non-dipping is associated with subclinical systolic dysfunction of the LV, as shown by the decrease in the GLS studied by 2D Speckle-Tracking, in hypertensive non-dippers patients.
THE PHENOTYPE OF ESSENTIAL HYPERTENSION WITH A HIGH LEVEL OF RENIN AND A HIGH LEVEL OF ALDOSTERONE
Authors: Cho Jungsun , Ihm Sang -Hyun , Kim Kyunghee 
Published: May 2024

Objective:
Over the years, considerable efforts have been made to divide the large, heterogeneous groups of individuals with essential hypertension into smaller, homogeneous subgroups based on hormonal responses to biological stimuli. This classification has included low-renin hypertension and non-modulators, in which changes in sodium intake do not produce the expected reciprocal changes in the adrenal gland (aldosterone) with normal or high levels of renin. In never treated essential hypertensive patients, we aim to evaluate the hypertensive phenotype according to renin and aldosterone levels.

Design and method:
Consecutive patients (n=782) with never treated hypertension were enrolled between August 2009 and July 2021. All enrolled patients underwent ambulatory blood pressure monitoring and laboratory tests, including renin and aldosterone levels, and were evaluated for cardiovascular events during a median follow-up of 5 years, excluding patients with primary aldosteronism.

Results:
Patients were divided into four groups based on renin and aldosterone levels:
High renin and aldosterone (n=216), low renin and high aldosterone (n=161), high renin and low aldosterone (n=163), low renin and aldosterone (n=212). The high renin and high aldosterone group was younger and had lower urine Na/K ratio and higher heart rate than those of other groups in this study.

Conclusions:
Other than low-renin hypertension or nonmodulators, high renin and aldosterone hypertension could be one of the phenotypes of essential hypertension. In addition, renin and aldosterone levels could be helpful in understanding the phenotypes of essential hypertension.
RELATIONS BETWEEN WHITE COAT EFFECT OF BLOOD PRESSURE AND ARTERIAL STIFFNESS
Authors: Cao Rong , Sun Gang , Yang Xiaomin 
Published: May 2024

Objective:
The aim of this study was to analyze the relationship between brachial-ankle pulse wave velocity (b-a PWV) and white coat effect (WCE), that is the difference between the elevated office blood pressure (BP) and the lower mean daytime pressure of ambulatory BP, in a mixed population of normotention, untreated sustained hypertension, sustained controlled hypertension, sustained uncontrolled hypertension, white coat hypertension, white coat uncontrolled hypertension.

Design and method:
A total of 444 patients with WCE for systolic BP (54.1% female, age 61.86±13.3 years) were enrolled in the study. Patients were separated into low white coat effect (< 9.5 mm Hg) and high white coat effect (>=9.5 mm Hg) according to the median of WCE.

Results:
The subjects with a high WCE showed a greater degree of arterial stiffness than those with a low WCE for systolic BP values (P< .05). The b-a PWV were 17.2±3.3m/s and 18.4±3.4 m/s in low WCE and high WCE, respectively. The b-a PWV increased with the increase of WCE, showing a positive correlation between them (P< .05 for non-linearity). The significant association between the high WCE and the b-a PWV was confirmed by the results of multiple regression analysis after adjusting for confounding factors (beta=0.78, 95% Cl 0.25-1.31, P=. 004). Similar results were observed in subgroups.

Conclusions:
In conclusion, WCE is significantly associated with arterial stiffness. More research is needed to determine the WCE and target organ damage.