bluuebunny/crossref_metadata_2025_split huggingface dataset:
“SEEK, AND YOU WILL FIND” - IMPLICATIONS OF PULMONARY HYPERTENSION DIAGNOSIS AND TREATMENT OF PATIENT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND LEFT HEART FAILURE
Authors: Wilk-sledziewska Katarzyna , Zimnowski Mateusz , Czajkowski Mateusz , Anikiej Katarzyna , Piotrowska Weronika , Zbroch Aleksandra , Wawierna Julia , Zdanska Adrianna , Wysocka Anna , Malinowska Dominika , Baranowska Magdalena , Cabaj Marta , Gawryluk Mateusz , Nazarko Weronika , Panas Zuzanna , Zbroch Edyta 
Published: May 2024

Objective:
The case report presents a patient with multimorbidity. A diagnosis of pulmonary hypertension was made during multiple hospitalizations due to bad compliance. The objective of this case report is to describe the difficulties involved in diagnosing pulmonary hypertension in a patient with chronic obstructive pulmonary disease and left heart failure.

Design and method:
Case report of patient with pulmonary hypertension, chronic obstructive pulmonary disease, left heart failure and multiple comorbidities.
Observation of the patient's health condition during many hospitalizations led to further diagnosis of pulmonary hypertension and forced the modification of current treatment.

Results:
Patient went through many hospitalizations because of bad compliance to chronic obstructive pulmonary disease and left heart failure pharmacotherapy.
The patient was hospitalized in our ward for chest pain. He also presented combination of nonspecific symptoms such as dyspnoea (including resting dyspnoea), exercise intolerance and peripheral oedema. Chest x-ray showed signs of pneumonia. Therefore, the diagnosis of pulmonary hypertension was not made during the first hospitalisations. Echocardiography was planned to exclude chronic coronary syndrome. It revealed patent ductus arteriosus, right ventriculum and pulmonary trunk dilation, tricuspid regurgitation and high probability of pulmonary hypertension (mean pulmonary artery pressure 46,5mmHg), without regional cardiac wall dysfunction. The next hospitalization was scheduled, during which cardiac catheterization was performed (pulmonary capillary wedge pressure 14,5 mmHg) and precapillary pulmonary hypertension was confirmed. After many consultations, excluding other causes, such as thromboembolic changes, chronic obstructive pulmonary disease was considered the most likely cause of precapillary pulmonary hypertension. Treatment of basal diseases has been modified, off-label treatment with sildenafil was started, and then due to ineffective treatment (deterioration of the patient's condition resulted in a transition from WHO functional class II to III) the patient was qualified for the bosentan clinical drug treatment program.

Conclusions:
Diagnosis of pulmonary hypertension can be difficult when symptoms of diseases from other systems are overlapping. This case shows the necessity of watchful observation of patients with multimorbidity, but also difficulties in maintaining good medical compliance. Pulmonary hypertension is still a rare diagnosis, but we should stay alerted about it.
HYPERURICEMIA AND ITS RELATIONSHIP WITH METABOLIC DISORDERS IN HYPERTENSIVE PATIENTS
Authors: Srojidinova Nigora , Duysenbaeva Aziza , Khafizova Lola 
Published: May 2024

Objective:
To study the prevalence of hyperuricemia and its role in the development of metabolic disorders in hypertensive patients.

Design and method:
We analyzed 188 hypertensive patients. 109 were female and 79 were male, for a mean age of 62.8±10.2 years. Uric acid, glucose, creatinine, and blood lipids were determined using the RANDOX Daytona autoanalyzer (UK). Microalbuminuria (MAU) in the morning urine was determined using a quantitative enzymatic method. Hyperuricemia was established when the level of uric acid was >7 mg/dl in men and >5.7 mg/dl in women. Statistical analysis was conducted using SPSS 24.0.

Results:
Patients were divided into two groups: the first group consisted of patients with hyperuricemia (n = 103), and the second group consisted of patients with normal levels of uric acid (n = 85). The average level of uric acid in the 1st group was 7.44±1.33 mg/dl, and in the 2nd group, it was 5.06±0.98 mg/dl, p<0.00001. The compared groups were comparable in terms of age, office SBP, and DBP. Body mass index (BMI) and waist circumference (WC) also did not differ between groups: BMI-32.96±5.84 kg/m2 vs 31.24±5.00 kg/m2, p = 0.44; OT-105.44±13.75 cm vs 102.76±12.06 cm, p =0.16. Patients with hyperuricemia had a significantly higher level of MAU: 63.24±104.06 vs. 39.33±36.42 mg/l, p = 0.044. Patients with hyperuricemia had more pronounced dyslipidemia. Thus, total cholesterol was significantly high in group 1: 198.31±49.41 mg/dl vs. 181.75±49.1 mg/dl, p = 0.04, and LDL-C was 111.83±42.46 mg/dl vs. 100.56±37.99 mg/dl, p = 0.04. TG and HDL-C did not differ between the groups. TG: 223.39±130.76 vs. 189.69±122.18, p = 0.057. HDL-C: 41.92±13.54 mg/dl vs. 43.30±12.87 mg/dl, p = 0.48. Patients with hyperuricemia had a significantly high level of glucose compared with patients with normal levels of uric acid: 9.71±04.35 mmol/l vs. 6.51±3.06 mmol/l, p = 0.0001. The creatinine level was also high in patients with hyperuricemia: 98.45±36.75 μmol/l vs. 85.06±17.21 μmol/l, p = 0.003.

Conclusions:
Hyperuricemia should be considered as an additional cardiovascular risk factor in patients with hypertension. Hyperuricemia is associated with another metabolic disorders in hypertensive patients.
URIC ACID SIGNIFICANTLY CORRELATES WITH THE PRESENCE OF LOW-VOLTAGE AREAS AT THE ENDOCARDIAL MAPPING IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION
Authors: Maloberti Alessandro , Baroni Matteo , Fortuna Matteo , Tognola Chiara , Algeri Michela , Intravaia Rita Cristina My , Leidi Filippo , Colombo Valentina , Ciampi Claudio Mario , Carbonaro Marco , Gigli Lorenzo , Mazzone Patrizio , Giannattasio Cristina , Garofani Ilaria 
Published: May 2024

Objective:
Interest in the role of atrial substrate in maintaining Atrial Fibrillation (AF) is growing. Fibrosis is the culprit in the electrical derangement of the myocites. Many cardiovascular risk factors are known to be linked to atrial scarring; among them Uric Acid (UA) is emerging. The purpose of our study is to evaluate whether UA is associated with atrial fibrosis in AF patients.

Design and method:
81 patients who underwent radiofrequency transcatheter ablation for nonvalvular AF at the cardiological department of the Niguarda Hospital were enrolled. UA levels were analysed before the procedure as well as known predictors of atrial fibrosis. High density electroanatomic mapping of the left atrium was performed and patients were divided according to the presence or not of areas of pathological substrate (bipolar voltage < 0.5 mV in sinus rhythm).

Results:
19 patients showed a pathological atrial substrate. The population of patients with pathological atrial substrate was older (64.7±1.6 vs 58.2±10.9 years, p=0.032) and had more often a persistent phenotype of AF (84.3 vs 35.8%, p<0.001). UA levels were significantly higher in the pathological group (6.8±1.9 vs 5.3±1.4, p<0.001) as well as the prevalence of hyperuricemia (26.5 vs 6.5%, p=0.021). The association between uric acid and pathological atrial substrate remains significant even after correction for confounding factors (age, left ventricular dysfunction, valvular disease, AF phenotype and furosemide use).

Conclusions:
In a population of patients who underwent atrial fibrillation's ablation, higher uric acid's levels were significantly associated with pathological left atrium's substrate at electro-anatomical mapping.
INADEQUATE CARE OF HYPERTENSION AND OTHER NON-COMMUNICABLE DISEASES DURING THE COVID-19 PANDEMIC IN SOUTH AFRICA
Authors: Peer Nasheeta , Mashiane Tshephang , Sureshkumar Sugitha , Oris Michel , Mwangi Kibachio Joseph , Kengne Andre -Pascal 
Published: May 2024

Objective:
In the setting of an already overburdened healthcare system, South Africa has a high burden of hypertension and other non-communicable diseases (NCDs), and the country experienced a high COVID-19 caseload. The aim of this study was to examine the perceptions and experiences of 1) healthcare professionals (HPs) on the preparedness of health systems to provide NCD care and of NCD management during the COVID-19 pandemic, and 2) people living with NCDs (PLWNCDs) on the care they received for hypertension and other NCDs during the COVID-19 pandemic in South Africa.

Design and method:
Across the country, we recruited a convenience sample of 1) HPs who worked in healthcare management i.e., public health officials and healthcare workers who provided care and engaged with patients in any healthcare capacity, and 2) PLWNCDs with at least 1 NCD. Questionnaires included quantitative and open-ended follow-up questions. Quantitative analyses were conducted using SPSS. The qualitative open-ended questions were evaluated using content analysis with inductive reasoning.

Results:
There were 31 HPs and 79 PLWNCDs (59 with hypertension) included in this cross-sectional study. HPs perceived COVID-19 care to be adequate, while NCD care was poor during the pandemic. There were service disruptions including for emergency and specialised NCDs care. Strategies for the care of non-COVID-19 illnesses during the pandemic were absent. This would have serious long-term consequences for PLWNCDs and the healthcare system. Perceptions of inadequate hypertension and other NCD care were reiterated by PLWNCDs; 49% felt they received ’very little’ or no adequate care. 18% had a scheduled appointment cancelled. Additionally, many PLWNCDs (52%) felt anxious, lonely, or frightened during the pandemic and 15% felt their mental health had deteriorated. The utility of digital health in future was positively perceived by both HPs and PLWNCDs and may be able to improve health provision during crises.

Conclusions:
Policies are required 1) so that NCD care will not be overlooked during future crises and 2) to encourage PLWNCDs to timeously access healthcare services during such periods. Such strategies may incorporate digital health apps to improve care and target the mental healthcare needs of PLWNCDs.
THE INFLUENCE OF CORONAVIRUS INFECTION ON THE DEGREE OF NOCTURNAL BLOOD PRESSURE ELEVATION IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Abdullayeva Go’Zal , Atoyeva Munisa , Yusupova Khafiza , Masharipov Shukhrat , Khamidullayeva Gulnoz 
Published: May 2024

Objective:
effect of COVID19 on the degree of nocturnal decrease in blood pressure (BP) initially and in dynamics against the background of antihypertensive therapy (AHT) in patients with arterial hypertension (AH).

Design and method:
Studied 74 male and female patients with I-III degree of AH according to the classification (ESH/ESC, 2018). Age was 53.54±1.92 years, duration of AH was 8.61 years. were divided: group I - AH patients who had undergone COVID19 no more than one month before inclusion in the study (n=42) and 2nd group - AH patients who had not undergone COVID19 (n=32). The diagnosis of COVID19 was confirmed by PCR test. All patients at the stage before treatment and 6 months of therapy had their office BP measured according to Korotkoff method, in order to study the daily arterial pressure profile (DAPP) we performed daily monitoring arterial pressure (DMAP) (BR-102 plus recorder (SCHILLER, Switzerland)). The daily rhythm of blood pressure was determined based on the degree of nocturnal decrease in SBP (DND SBP). An DND of 10 to 20% was considered optimal. All patients were prescribed two-component or three-component AHT.P<0.05. The results are presented as μ±SD.

Results:
2nd group in SBP (DND SBP), which initially amounted to 5.31±5.88% in dynamics - 11.6±3.81% (p<0.001). Whereas in 1stgroupDND SBP was initially 4.8±5.8% and over time – 6.3±4.4% (p > 0). In 1stgroup the number of non-dippers predominated - 53.8%, night pickers were 15.40%, dippers - 30.8%. A similar picture was observed in 2ndgroup: 50.0%: 20.0%: 30.0%. (ξ2=0.086, p=0.958). No overdippers were identified in both groups.in 1stgroup of patients the number of non-dippers increased significantly, amounting to 77%, dippers decreased to 23%. On the contrary, in 2ndgroup of patients, the number of non-dippers and non-dippers decreased slightly to 40%, and the number of dippers significantly increased by 2 times, amounting to 60% of patients. At the same time, the intergroup difference approached significance (ξ2= 3.23, p = 0.072).

Conclusions:
The previous COVID19 made a negative contribution to the antihypertensive effectiveness in terms of the dynamics of the degree of nocturnal reduction in blood pressure.
THE EFFECT OF COVID-19 ON NOCTURNAL BLOOD PRESSURE ELEVATION IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Atoeva Munisa , Abdullaeva Guzal , Yusupova Khafiza , Masharipov Shukhrat , Khamidullaeva Gulnoz 
Published: May 2024

Objective:
to evalute the effect of COVID-19 on the degree of nocturnal decrease in blood pressure (BP) against the background of antihypertensive therapy (AHT) in patients with arterial hypertension (AH).

Design and method:
74 male and female patients with I-III degree of AH(ESH/ESC, 2018) were studied. The mean age of patients was 53.54±1.92 years,duration of AH was 8.61 years. 2 groups of patients were identified: I – patients with AH who had suffered COVID19, (n=42) and 2nd group – patients with AH who had not suffered COVID-19 (n=32). All patients before and 6 months of therapy measured office BP and DBPM. The daily rhythm of blood pressure was determined based on the degree of nocturnal decrease in SBP (DND SBP). Based on the DND SBP data, patients were divided into: “dippers”, “non-dippers”, “over-dippers”, “night pickers”. All patients were prescribed dual or triple AHT. The results are presented as M±SD.

Results:
Significant improvement in the circadian rhythm of BP with a high degree of reliability in 2nd group of patients initially amounted to 5.31±5.88% in dynamics - 11.6±3.81% (p<0.001). In 1nd group DND SBP initially was 4.8±5.8% versus– 6.3±4.4% (p > 0.01). In 1st group of patients, the number of non-dippers predominated - 53.8%, while night pickers were 15.40%, dippers - 30.8%. A similar picture was observed in group II of patients: 50.0%: 20.0%: 30.0%. Intergroup differences were not significant (χ2=0.086, p=0.958). Analysis of the dynamics of DND SBP in both groups during therapy revealed that 1st in group of patients the number of non-dippers increased significantly, amounting to 77%, while the number of dippers decreased to 23%. On the contrary, in group II of patients, the number of non-dippers and non-dippers decreased slightly to 40%, and the number of dippers significantly increased by 2 times, amounting to 60% of patients. At the same time, the intergroup difference approached significance (χ2 = 3.23, p = 0.072)

Conclusions:
The previous COVID-19 made a negative contribution to the antihypertensive effectiveness in terms of the dynamics of the degree of nocturnal reduction in BP.
RENAL DENERVATION RESULTS IN SUBSTANTIAL NOCTURNAL BP REDUCTION IN PATIENTS WITH A REVERSED DIPPING PATTERN
Authors: Mahfoud Felix , Schlaich Markus , Narkiewicz Krzysztof , Ruilope Luis , Williams Bryan , Schmieder Roland , Mancia Giuseppe , Sharif Faisal , Ribichini Flavio , Fahy Martin , Böhm Michael 
Published: May 2024

Objective:
We characterized patients with reverse blood pressure (BP) dipping pattern and uncontrolled hypertension (HTN) at baseline referred for radiofrequency renal denervation (RF RDN), and their subsequent BP changes.

Design and method:
Patients with HTN were enrolled into the Global SYMPLICITY Registry (GSR) DEFINE and underwent RF RDN. Patients were grouped into different BP dipping patterns defined by night/daytime BP ratio: dippers (ratio 0.9 or below), non-dippers (ratio 0.9 to 1.0 or below), reverse dippers (ratio >1.0). Baseline characteristics and BP changes through 3yrs were compared between groups based on dipper patterns. Statistical significance was defined as p<0.05.

Results:
As of March 2023, 3331 patients with uncontrolled BP were enrolled, 2276 of whom had 24-h BP measures and could be categorized by dipping patterns. Majority of the patients were non-dippers (44.3%), followed by dippers (34.6%) and reverse dippers (21.1%). Reverse dippers (n=480) were the oldest (62±12yrs; p=0.0024), more likely to have cardiac disease (54.2%; p<0.0001), diabetes (48.1%; p<0.0001) and renal disease (38.9%; p<0.0001). Reverse dippers had the highest baseline 24-h ambulatory systolic BP (SBP) (156±19mmHg; p<0.0001) and nighttime SBP (163±21; p<0.0001). In contrast, they had the lowest daytime SBP (153±19mmHg; p<0.0001) and heart rate (66±11bpm; p<0.0001). Reverse dippers were prescribed the most antihypertensive drugs (5.2±1.7; p=0.0058).
3yrs after RF RDN, significant overall 24-h ambulatory SBP reduction from baseline was observed within all dipping patterns, and the largest reduction was observed within reverse dippers (-11.8±25.1mmHg; Figure), particularly in the nighttime (-21.1±23.8mmHg).

Conclusions:
Reverse dippers with uncontrolled HTN referred for RDN were prescribed more antihypertensive drugs and had more comorbidities compared to patients with other dipping patterns. After RF RDN, significant SBP changes from baseline were observed irrespective of dipping status. The largest BP reduction was observed in nighttime BP in patients with reverse dipping pattern. RF RDN may offer an effective adjunctive therapy to drugs to lower nighttime BP patients with a reverse dipping pattern, who have the highest risk of cardiovascular events.
LONG-TERM PROGNOSIS OF THE DEVELOPMENT OF HEART FAILURE WITH LOW EJECTION FRACTION IN ACUTE CORONARY SYNDROME IN YOUNG AND MIDDLE-AGED PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Zbyshevskaia Elizaveta , Butaev Tamerlan , Wang Zheming , Makeeva Tatiana 
Published: May 2024

Objective:
To determine the prognosis and dynamics of the development of heart failure with low ejection fraction (HFrEF) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) in young and middle-aged patients with arterial hypertension (AH) and type 2 diabetes mellitus (DM)

Design and method:
The study included 191 hypertensive patients aged 36-59 years with ACS after PCI. Group 1 - 76 patients with hypertension in combination with DM, group 2 - 115 patients with hypertension without DM. In 35 (46%) people of the 1st group and in 56 (48.7%) of the 2nd group, myocardial infarction (MI) of the anterior wall of the left ventricle (LV) was determined. The incidence of non-anterior MI (posterior and lateral walls) of the LV was 54% and 51.3% respectively. Patients in both groups were comparable. Observation was carried out for 12±1 months. Ejection fraction (EF), indices of LV end-systolic volume (LVESVI), LV end-diastolic volumes (LVEDVI), and index of impaired local contractility (ILCI) were determined over time.

Results:
On the first day after PCI, LVEF <40% (36%, 27-39%) in 14 of 76 (18.4%) in group 1; LVESVI - 43 ml/m2 (40-48 ml/m2); LVEDVI - 77 ml/m2 (67-87 ml/m2); ILCI 1.81 (1.63-2.0). After 12 months, LVEF decreased to 33% (28-39%) in 26 of 76 (34.2%) patients. The progression of HFrEF was indicated by an increase in initial LVESVI by 29-30% and LVEDVI by 23-35%. In group 2, on the first day after myocardial reperfusion in 8 out of 115 (7%) patients, LVEF was 38% (37 - 39%), LVESVI 44 ml/m2 (40-46 ml/m2), LVEDVI 69 ml/m2 m2 (64-76 ml/m2), ILCI 1.75 (1.13-1.88). After 12 months, HFrEF was detected in 10 of 115 (8.7%) patients with an increase in initial LVESVI values by 28%, LVEDVI by 31% and a decrease in LVEF to 36% (35-39%) (p = 0.0242).

Conclusions:
In young and middle-aged patients with hypertension in combination with DM, during the first 12 months after MI, in 34.2% of cases, there is a significant deterioration in the course of HFrEF, which requires an early decision on the timing of complete myocardial revascularization.
DETERMINANTS AND ASSOCIATIONS OF COMMON CAROTID INTIMA-MEDIA ROUGHNESS IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES
Authors: Kyriakoulis Konstantinos , Menti Ariadni , Komnianou Aikaterini , Ntousopoulos Vasileios , Stathopoulou Panagiota , Theodosiadi Aikaterini , Stergiou George , Kollias Anastasios 
Published: May 2024

Objective:
Carotid atherosclerosis, including increased intima-media thickness (IMT) and plaque, is associated with increased cardiovascular (CV) risk. The role of the irregularity of the carotid intima-media surface in terms of total CV risk has been insufficiently investigated. This study investigated determinants and associations of common carotid intima-media roughness in patients with type 2 diabetes and hypertension.

Design and method:
Adults with type-2 diabetes and hypertension were evaluated with (i) 24h ambulatory blood pressure (ABP) monitoring (20 min intervals, Microlife WatchBPO3), (ii) carotid ultrasonography for the calculation of the common carotid IMT (use of automated software that allows the calculation of the average value of multiple measurements), carotid plaque score (CPS), and standard deviation (SD) of the common carotid intima-media (derived for the multiple measurements performed for the calculation of the IMT), and (iii) ultrasound estimation of left ventricular mass index (LVMI).

Results:
Ninety-five individuals were analyzed [age 66.3±8.9 years, 61 men, body mass index (BMI) 30.8±4.8 kg/m2, HbA1c 6.6±0.8%, 24-hour ABP (systolic/diastolic) 123±13/69.4±7.3 mmHg, IMT 0.83±0.16 mm, SD IMT 0.07±0.03 mm, CPS 5.5±4.8 mm]. SD IMT was correlated with IMT (r=0.49, p<0.001), nighttime systolic ABP (r=0.21, p<0.05), 24h weighted SD of systolic ABP (r=0.26, p<0.05), CPS (r=0.30, p<0.01) and LVMI (r=0.39, p<0.001). In stepwise multivariable regression analysis with age, nighttime systolic ABP, 24h weighted SD of systolic ABP, total number of IMT measurements and IMT as independent variables, the SD IMT was determined by IMT (β=0.08, p<0.001) and 24h weighted SD of systolic ABP (β=0.003, p<0.05).

Conclusions:
These preliminary data suggest that in patients with type-2 diabetes and hypertension, carotid intima-media roughness is determined by IMT and the variability of 24h systolic ABP, and is associated with the severity of carotid atherosclerosis and left ventricular hypertrophy.
ARTERIAL HYPERTENSION AND INSULIN RESISTANCE IN OBESE PATIENTS
Authors: Papanastasiou Anastasios , Tsounis Dimitrios , Skoufis Fotios , Krallis Ioannis , Karkamanis Achilleas , Pitsariotis Thomas , Lapatsani Maria , Tsiachri Maria , Karinos Dimitrios , Kalpakos Dionisios , Bouras Georgios 
Published: May 2024

Objective:
Diabetes and Hypertension are two of the most common conditions connected to obesity, the development of cardiovascular disease and higher mortality rates. However, the relationship of these two conditions remains unclear. Obesity is an independent risk factor for insulin resistance, a hallmark of prediabetes. The aim was to study insulin resistance in obese hypertensive patients.

Design and method:
120 obese outpatients (BMI>30, 57% males) without Diabetes Mellitus (DM) when included in the study, where compared to 80 obese hypertensive patients (56% males), without DM. Homeostatic Model Assessment for Insulin Resistance Index (IR-HOMA) was used as an insulin resistance marker.

Results:
Hypertensive and obese patients showed a significant increase of IR-HOMA (5,17 vs 3,2 p=0,022), as well as increased fasting glucose, insulin and HBA1c levels, in contrast to obese normotensive patients.

Conclusions:
Hypertension may be another independent risk factor for DM in obese patients.