bluuebunny/crossref_metadata_2025_split huggingface dataset:
EPIDEMIOLOGY AND ASSOCIATED RISK FACTORS OF ISCHEMIC STROKE TREATED AT THE UNIVERSITY HOSPITAL CENTER OF TLEMCEN (ALGERIA)
Authors: Abdrebbi Samira Benbekhti 
Published: May 2024

Objective:
Determine the epidemiological profile of ischemic strokes treated at the University Hospital center of Tlemcen and describe the associated risk factors.

Design and method:
Descriptive study with prospective collection, involving patients with ischemic stroke at the University Hospital center of Tlemcen. A questionnaire was administered by interview to patients. The data were entered and analyzed by Epi-info 6 software.

Results:
The study involved 184 patients with ischemic stroke treated at the University hospital center of Tlemcen. A female predominance was noted, affecting 96 women and 88 men (sex ratio (m/f): 0.9). The average age was 63.75±14.34 years; with age extremes of 15 and 93 years. Subjects aged over 65 represented 47.28% of cases. The socio-economic characteristics of the study subjects were: 78.8% of patients were married; 86.4% had a low level of education; 54.3% were unemployed, 18.5% retired and 27.2% civil servants. A low socio-economic level was noted in 67.6% of cases. The associated risk factors were distributed as follows: Hypertension was the major risk factor, found in 114 subjects, or 62% of cases; with an average duration of 05.27± 5.76 years, reaching a maximum of 30 years. Obesity (BMI >30 kg/m2) was found in 27.2% of cases, with an average body mass index (BMI)of 27.1± 4.4 kg/m2 with extremes of [16.8 -39.9]. Diabetes was found in 40 subjects, or 21.73% with average duration: 7.6± 8.8 years; going to a maximum of 35 years. Dyslipidemia: 28%; Tobacco: 26.1%; Heart diseases: 13%. The notion of hypertension in the family was noted in 51.1% of cases.

Conclusions:
Ischemic stroke is the most common neurological disorder. It's causes are multiple and vary in frequency. Primary prevention measures are necessary with management of risk factors, particularly hypertension, regardless of age.Other measures are essential for promoting the management of strokes, among others: the creation of a neurovascular unit dedicated to the management of strokes in an early and adequate manner and the establishment of a register of strokes, locally and nationally;
STATINS PREVENT THE DELETERIOUS CONSEQUENCES OF PLACENTAL CHEMERIN UPREGULATION IN PREECLAMPSIA
Authors: Tan Lunbo , Kluivers Ans C.M. , Cruz-lopez Edwyn O. , Broekhuizen Michelle , Chen Zhongli , Neuman Rugina I. , Schoenmakers Sam , Ruijgrok Liesbeth , Van De Velde Daan , De Winter Brenda C.M. , Van Den Bogaerdt Antoon J. , Lu Xifeng , Danser A.H. Jan , Verdonk Koen 
Published: May 2024

Objective:
Chemerin, an inflammatory adipokine, is upregulated in preeclampsia, and its placental overexpression results in preeclampsia-like symptoms in mice. Statins may lower chemerin.

Design and method:
Chemerin levels were determined in a prospective cohort study in women suspected of preeclampsia evaluating the predictive value of the soluble Fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio. Chemerin release was studied in perfused placentas and placental explants with or without the statins pravastatin and fluvastatin. We also addressed statin placental passage, and the effects of chemerin in chorionic plate and coronary arteries.

Results:
Serum chemerin was elevated in women with preeclampsia, and its addition to a predictive model yielded significant effects on top of the sFlt-1/PlGF ratio to predict preeclampsia and its fetal complications. Perfused placentas and explants of preeclamptic women released more chemerin and sFlt-1 and less PlGF than those of healthy pregnant women. Statins reversed this. Both statins entered the fetal compartment, and pravastatin's fetal/maternal concentration ratio was twice that of fluvastatin. Chemerin constricted plate arteries, and this was blocked by a chemerin receptor antagonist and pravastatin. Chemerin did not potentiate endothelin-1 in chorionic plate or coronary arteries. In explants, statins upregulated low-density lipoprotein receptor (LDLR) expression, which relies on the same transcription factor as chemerin, and NO release.

Conclusions:
Chemerin is a biomarker for preeclampsia, and statins both prevent its placental upregulation and effects, in an NO- and LDLR-dependent manner. Combined with their capacity to improve the sFlt-1/PlGF ratio, this offer an attractive mechanism by which statins may prevent or treat preeclampsia.
GENDER DIFFERENCES IN ARTERIAL STIFFNESS IN YOUNG PATIENTS WITH PRIMARY HYPERTENSION
Authors: Prelevic Vladimir , Jelakovic Ana , Gasparovic Kristina , Bazadona Danira , Radunovic Danilo , Josipovic Josipa , Jelakovic Bojan 
Published: May 2024

Objective:
Influence of sex hormones on regulation of arterial stiffness (AS) include different mechanisms where changes in extracellular matrix, smooth and endothelial cells, and influence on oxidative stress and chronic inflammation are highlighted. In women after puberty AS decreases what confirm selective and fluctuating effect of sex hormones, primarly estrogen. In older men, hypogonadism is associated with incresed AS, while testosterone replacement reduce pulse wave velocity (PWV). Our aim was to analyze difference in central hemodynamic parameters between men and women with stage 1 hypertension.

Design and method:
This study included 154 patients with the primary hypertnsion (69.5% women, mean age 38.5). In all of them we collected different data and antroplogical paramaters using medical records. Parameters of AS were measured with the office tonometric system (SphygmoCor) and 24h ambulatory blood pressure monitoring system using Mobil-o-Graph and Arteriograph, but also estimated PWV was calculated using validated equation (ePWV).

Results:
There were no statistically significant gender differences in PWV values measured in the office oCor, measured during 24 hours (using Arteriograph and Mobil-O-Graph), and ePWV. There were no statistically significant gender differences in the values of 24 hours systolic and diastolic central aortic pressure (CAP) (Arteriograph or Mobil-O-Graph). Women had significant higher office CAP Men, on average, had statistically significantly higher amplified pulse pressure (APP) values than women (144.20 vs. 128.94, t = 3.275, p < 0.01), while women had statistically significantly higher office augumentation index (AiX) values (t = -6.118, p < 0.001), as well 24 hours (Mobil- O-Graph (t = -5.940, p < 0.001;Arteriograph (t = -5.580, p < 0.001).

Conclusions:
Possible explanation of no statistically significant differences in PWV values between men and women is average age of our group. A possible gender difference in AiX can be consequence of the increased reflection of pulse waves, which is increased in women. Longitudinal study should be conducted with monitoring of patients at longer time intervals in order to determine the further hormonal influence on structure of the arteries and for the assesment of total CV risk.
INCREASED RISK FOR DEVELOPPING HYPERTENSION IN WOMEN AFTER PREECLAMSIA WITH ESTROGEN CONTAINING ORAL CONTRACEPTIVES
Authors: Polonia Jorge , Silva Jose A , Belchior Helena , Bertoquini Susana 
Published: May 2024

Objective:
High cardiovascular risk and hypertension (HT) are common in women with previous preeclampsia (PE). Some women (5%) show an increased risk of HT under hormonal contraceptives containing oestrogens (EC-OC). We retrospectively reevaluated previous data suggesting that women with previous PE were more prone to develop HT while receiving EC-OC after delivery.

Design and method:
We reexamined data from 49 women normotensives before pregnancy but with previous PE (PE-WO and 71 normotensive women (NT-WO) with normal BP levels during last pregnancy. BP of all women were <140/90 at least at 6 months after pregnancy. Diabetic (DM) or gestational diabetic were not included. Then all (ageing 25-38 yrs) received (at baseline) EP-OC. Revaluation was between at 3-4 yrs after.

Results:
At baseline, age was NT-Wo = 25.6 ± 4.3 and PE-Wo = 28.0 ± 4.2 yrs and for BP, NT-Wo = 124.4/77.2 ± 5.1/4.4 and PE-Wo = 125.3/77.6 ± 4.2/4.6 mm Hg (p>0.2 between groups). Under EP-OC, BP was significantly lower in NT-Wo = 125.9/77.3 ± 9.1/6.1 than in PE-Wo = 131.5/83.6 ± 11.7/6.9 mm Hg (p<0.01). After EP-OC, relative risk (RR) (Odds Ratio CI-95%) for developing HT (BP >=140/or 90 mmHg) in PE-Wo (10/49) vs NT-Wo (5/71) was 3.38 (1.08-10.63), p<0.03; RR for increasing systolic BP (SBP) >=15 mm Hg after EP-OC in PE-Wo (9/49) vs NT-Wo (4/71) was 3.38 (1.09-13.04), p<0.03 and RR for increasing >=10 mm Hg SBP after EP-OC in PE-Wo (17/49) vs NT-Wo (11/71) was 2.90 (1.22-6.93), p<0.04.

Conclusions:
Women with previous PE are at a 3.4 fold increased risk for development of HT after estrogenic containing oral contraceptives. Careful BP monitoring and alternative contraceptive methods other than EP-OC should be considered in women after PE while submitted to EP-OC.
NON-INVASIVE ASSESSMENT OF HEMODYNAMIC FORCES AND PRESSURE-VOLUME RELATION ANALYSIS IN TWIN PREGNANCY
Authors: Pellegrino Alessio , Toncelli Loira , Pasquini Lucia , Masini Giulia , Mecacci Federico , Pedrizzetti Gianni , Modesti Pietro Amedeo 
Published: May 2024

Objective:
This aim of the study was to prospectively investigate pattern of intraventricular Hemo-Dynamic Forces (HDF) associated with Left Ventricular (LV) function and remodeling in women with uncomplicated twin pregnancy.

Design and method:
Prospective, cohort study. Transthoracic echocardiography was performed on 35 women (aged 35.9±4.7 years) during gestation (<14 w, T1; 14–27 w, T2; >28 w, T3), and 6–7 months after delivery (T0). LV HDF were computed from echocardiography long axis data sets using a novel technique based on endocardial boundary tracking, both in apex-base (A-B) and latero-septal (L-S) directions. HDF distribution was evaluated by L-S over A-B HDF ratio (L-S/A-B HDF ratio).

Results:
At T1, L-S/A-B HDF ratio was higher than in T0 (p<0.05) indicating HDF misalignment. At T2, a slight impairment of cardiac function was then recorded with a reduction of Global Longitudinal Strain (GLS) and left ventricular End-Systolic Elastance (Ees) at pressure-volume relationship analysis versus T1 (both p<0.05). Finally, at T3, when HDF misalignment and LV contractility reduction (GLS and Ees) were all restored, a rightward shift of the End Diastolic Pressure-Volume Relationship (EDPVR) with an increase of ventricular capacitance were documented.

Conclusions:
In twin pregnancy, HDF misalignment in the first trimester precedes the slight temporary decrease in left ventricular systolic function in the second trimester; at the third trimester a rightward shift of the EDPVR was associated with a realignment of HDF and normalization of ventricular contractility indexes. These coordinated changes that occur in the maternal heart during twin pregnancy suggests the role of HDF in cardiac remodelling.
GESTATIONAL HYPERTENSION AND PERIPARTUM CARDIOMYOPATHY: EPIDEMIOLOGICAL, CLINICAL AND EVOLUTIONARY PROFILE IN THE REFERENCE HOSPITALS OF YAOUNDE
Authors: Ouankou Christian Ngongang , Mfeukeu-kuate Liliane , Njonnou Raoul Sylvain Simeni , Zangue Carrel Raspaïl Founou , Choukem Simeon Pierre 
Published: May 2024

Objective:
Peripartum cardiomyopathy (PPCM) is a rare primary dilated cardiomyopathy responsible for congestive heart failure. Our objectives was to derermine the clinical and prognosis of PPCM et the risk factors.

Design and method:
We carried out a prospective descriptive study over a period of six months. It was conducted in six reference hospitals in Yaounde. The study population was made of pregnant women with dyspnoea and women who had given birth with dyspnoea. Were included all pregnant or postpartum women (from the 32nd WA to the 5th months of postpartum) who had a LVEF <45% associated or not with left ventricle dilation. They were placed on treatment with a follow-up over 3 months, where they had a second cardiac ultrasound to highlight the evolutionary profile.

Results:
We enrolled 10 patients from 26 women who were pregnant or had given birth and presented with dyspnoea within 6 months. The average age was 25.9 ± 4.9 years (range: 16-33 years). The average parity was 1.6 ± 1.17 (extreme 0-3). Multiparas were the most represented. The history of gestational hypertension was the main predisposing factor found (50%); followed by multiparity (30%), the notion of twin pregnancy and advanced maternal age (20%). Heart failure was the clinical expression in 60% of cases. Sinus tachycardia was constant; followed by signs of left ventricular hypertrophy and repolarization disorders on ECG assessment. The echocardiographic pattern depicted a hypokinetic dilated cardiomyopathy (mean LVEDD 61.2 ± 8.6 mm) with an average systolic function of 27.1 ± 10.6%. The main complications were acute pulmonary edema (60%), thromboembolic events including pulmonary embolism (10%), ischemic stroke (10%) and one death (10%). The treatment mostly based on the use of diuretics, ACE inhibitors, beta-blockers, Aldactone (1/3 of the patients) without forgetting the anticoagulation made with Rivaroxaban(n=4) for some and aspirin (n=6); and bromocriptine (initiated in 3 patients).

Conclusions:
PPCM is a cause of heart failure during pregnancy. It primarily arises during the postpartum period regardless of maternal age. It is a serious disease due to its (important morbi-mortality rate) and its complications, both hemodynamic and thromboembolic.
DISTURBANCES OF UTEROPLACENTAL BLOOD FLOW DURING EXCESSIVE WEIGHT GAIN IN PREGNANT WOMEN WITH CHRONIC ARTERIAL HYPERTENSION
Authors: Kerimkulova Aiman , Medubayeva Madina , Latypova Natalia , Khodzhaeva Zulfiya , Markabayeva Akbayan , Nurpeissova Riza 
Published: May 2024

Objective:
To evaluate the effect of excess weight gain on the development of uteroplacental blood flow disorders in pregnant women with chronic arterial hypertension.

Design and method:
A retrospective study was conducted to observe 257 pregnant women with chronic hypertension (CAH) and 200 pregnant women without hypertension and other conditions leading to increased blood pressure (control group). The study was conducted on the basis of perinatal centers in Astana (Kazakhstan) for 2018-2019. The average weight gain during pregnancy and its possible impact on the development of UPC disorders were studied.

Results:
The main goal of managing pregnant women with arterial hypertension is to prevent the development of complications in the mother and fetus. One of the reasons for an unfavorable prognosis for the fetus is a violation of the uteroplacental circulation (UPC). When comparing pregnant women with CAH and the control group, a violation of UPC was detected in 28.1% and 1.0% of cases, respectively (p <0.001). The average age of pregnant women with CAH was 32.9±5.7 years, in the control group 31.6±5.6 (p=0.059). The average weight gain was found to prevail in the CAH group of pregnant women with CAH (16.86±3.68 kg) compared to the control group (12.91±2.36 kg, p=0.004). Using binary logistic regression, we analyzed the effect of excess weight gain on the development of UPC impairment. In the control group, excessive weight gain was observed in 21 (10.5%) pregnant women, only 2 (1.0%) in the group with normal weight gain (n=179) subsequently developed UPC. Of the 257 pregnant CAH women, 125 (48.7%) had excessive weight gain and 71 (27.6%) developed UPC abnormalities. However, 131 (50.9%) had normal weight gain and only 1 (0.4%) pregnant women with normal weight gain later developed a UPC disorder.

Conclusions:
To prevent disturbances of uteroplacental blood flow in pregnant women with chronic arterial hypertension, weight gain is important and therefore strict control of weight gain during pregnancy is necessary, compared with the control group.
PREGNANCY OUTCOMES IN WOMEN WITH UNTREATED AND TREATED HYPERTENSION IN THE CZECH REPUBLIC BETWEEN 2012-2022
Authors: Jan Vaclavik , Zdenek Ramik , Jarkovsky Jiri , Pohlova Radka , Jirova Jitka , Zouharova Anna 
Published: May 2024

Objective:
Arterial hypertension affects about 5-10% of pregnancies and has detrimental effects on pregnancy outcomes in both the mother and fetus. The study aimed to analyse the outcomes of pregnancy in women with untreated and treated arterial hypertension in pregnancy in the Czech Republic during the past decade.

Design and method:
Nationwide data on all births and abortions in the period 2012-2022 in the Czech Republic were obtained from the National Registry of Reproductive Health (NRRZ) and the National Registry of Reimbursable Health Services (NRHZS). Women who had the diagnosis I10 within one year before pregnancy and were prescribed any antihypertensive drug from selected ATC groups (C02, C03, C07, C08, C09) were classified as pre-existing hypertension. Women diagnosed with O13 or I10 during pregnancy were classified as pregnancy induced hypertension. Hypoxia in the new-born was defined as pH <7.1 or Apgar score <8 present after delivery. We used descriptive statistics to evaluate the outcomes.

Results:
There were total of 1,154,648 deliveries in the 11-year period. The proportion of women with hypertension in pregnancy was 8.24% and their mean age was 31±5 years. Mean age of women without hypertension was 30±5 years. 77,121 women (77.9%) had untreated hypertension, 21,094 (22.1%) women were treated with antihypertensive drugs during pregnancy. Women with treated hypertension (TH) had higher proportion of delivery by Caesarean section (43.8%) compared to women with untreated hypertension (UTH; 34.3%) and women without hypertension (NH; 23.9%). Women with TH and UTH also had higher proportion of pre-term deliveries in earlier gestational ages (please see the Table). Hypoxia in the new-born occurred in 10.6% women without hypertension, in 13.0% with UTH and 14.8% with TH.

Conclusions:
Women who require antihypertensive treatment during pregnancy have worse pregnancy outcomes than women with untreated hypertension and women without hypertension in pregnancy. The necessity of pharmacological treatment may be a proxy of more severe hypertension.
SEX RELATED DIFFERENCES IN BLOOD PRESSURE VARIABILITY IN HYPERTENSIVE PATIENTS: CV-PREVITAL STUDY
Authors: Croce Alessandro , Bilo Grzegorz , Pengo Martino , Soranna Davide , Sucapuca Richard , Amato Franca , Favè Marta , Marino Antonietta , Pellegrinelli Veronica , Molteni Serena , Nardin Elisa , Parisi Marco , Romeo Claudia , Losa Lorenzo , Saccà Angelo Maria , De Virgiliis Giorgia , Colella Chiara , Zambon Antonella , Ferrara Pietro , Parati Gianfranco 
Published: May 2024

Objective:
Blood pressure (BP) regulation is influenced by biological effects of sex chromosomes, sex hormones and reproductive events. Gender-associated BP differences in humans are well known, with men having higher BP than age-matched pre-menopausal women, while after menopause higher prevalence of hypertension was observed in women. Less information is available on gender differences in BP variability (BPV), a BP-related feature known to independently predict cardiovascular outcomes. Aim of this study was to assess the differences in BPV between genders in participants of an ongoing prospective cardiovascular prevention trial (CV-PREVITAL).

Design and method:
The study included hypertensive patients without previous major cardiovascular events who responded to the advertisement campaign in outpatient facilities of Istituto Auxologico Italiano. In addition to clinical history, physical examination, standard routine blood tests, EKG and conventional office BP measurement, 24-hour ambulatory BP monitoring (validated oscillometric device TM2430, A&D, Japan) was performed at baseline. Short-term (24-hour) BPV was assessed as daytime and night-time standard deviation (SD) or average real variability (ARV).

Results:
The sample included 581 patients, with a mean age of 61.3±8.6 years and balanced gender distribution. Women had slightly lower BMI and 24-hour DBP and slightly higher 24-hour SBP then men. In most cases BPV estimates were higher in women. Principal BP and BPV variables in male and female participants are reported in Table 1.
In multiple regression analysis gender remained independently associated with higher values of systolic (p<0.001 for day SD, p=0.022 for night SD and p=0.002 for ARV) and diastolic BPV (p<0.001 for day SD, p=0.004 for ARV 0.15, p<0.006) after adjusting for age, BMI, mean systolic and diastolic 24-hour BP and for 24-hour heart rate. We did not observe differences in BPV variables between pre- and postmenopausal women.

Conclusions:
In hypertensive patients female gender is independently associated with higher values of most short-term BPV estimates, regardless of menopausal status. Mechanistic and prognostic implications of this difference should be better understood.
NIGHTTIME ARTERIAL PRESSURE PHENOTYPES AND THEIR PROGNOSTIC VALUE IN PREGNANT WOMEN AS PREDICTORS FOR FUTURE MATERNAL AND NEONATAL EVENTS
Authors: Aguiar Tiago , Cruz Inês , Costa Carlos , Carvalho Simão , Pacheco Adriana , Carvalho Diana , Barbosa Eliana , Bastos José 
Published: May 2024

Objective:
We have previously demonstrated that some ambulatory blood pressure monitoring (ABPM) values can predict maternofoetal evens in hypertensive pregnant women. The analysis of the different nighttime blood pressure (BP) phenotypes in pregnant women is still an unknown topic.

Design and method:
A retrospective cohort study which followed a sequential number of 274 hypertensive pregnant patients (mean age of 32 years) from 2007 to 2022, who underwent ABPM made with a Spacelabs 90207. Data was collected and analysed in SPSS Statistics through different parametric tests. Nocturnal BP phenotypes were defined for both systolic and diastolic values as: reverse dipper (RD); non-dipper (ND); dipper (DP); and extreme dipper (ED). An event was defined as the composite endpoint of multiple adverse events: preeclampsia or eclampsia, foetal or neonatal death, prematurity, low weight at birth, gestational diabetes, and maternal death.

Results:
A Kaplan-Meier survival curve analysis was performed between systolic DP and ND groups, with ND showing a worse survival with a long rank of 11.331 (p<0.001); and for diastolic DP and ND groups, again with ND showing a worse survival with a long rank of 15.335 (p<0.001).
In a further systolic nocturnal phenotypes Kaplan-Meier analysis, RS (n=6) showed the worse survival, followed by ND (n=87), while DP (n=162) and ED (n=19) showed better survival, with a log rank of 8.4 (p=0.038). For the diastolic nocturnal phenotypes Kaplan-Meier analysis, ND (n=33) showed the worse survival, followed by DP (157), while ED (81) showed better survival, with a log rank of 21.3 (p<0.001). Diastolic RD showed no events, likely due to the small sample size (n=3). (Fig 1)

Conclusions:
This study further exemplifies the importance of ABPM in the evaluation of hypertensive pregnant women, both for its major role in diagnosis as well as prognostic value. Different nocturnal phenotypes show different survival rates, and patients without systolic or diastolic dipping seem to be at a major risk.