bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-BPC02-2: CLINICAL IMPACTS OF ENDOTHELIUM-DEPENDENT FLOW-MEDIATED VASODILATION ASSESSMENT ON PRIMARY ALDOSTERONISM
Authors: Watanabe Daisuke , Morimoto Satoshi , Morishima Noriko , Ichihara Atsuhiro 
Published: January 2023

Objective:
Primary aldosteronism (PA) is defined as autonomous aldosterone production from the adrenal glands and represents the most common and treatable cause of hypertension. Also, it is well known that the incidence of cardiovascular morbidity is higher among patients with PA than among those with essential hypertension (EH). Histologically, PA is divided into two major subtypes, aldosterone-producing adenoma (APA) and bilateral idiopathic hyperplasia (IHA). However, the nature of vascular function in PA patients remains to be determined. The aim of this study was to determine the vascular function and investigate the implications of vascular function assessments in the patients with PA.

Design and Method:
All patients were diagnosed with PA according to the guidelines of the Japan Endocrine Society. Flow-mediated dilation (FMD), as an index of endothelial function, and cardio-ankle vascular index (CAVI), as an index of arterial stiffness, were retrospectively compared between 42 patients with APA, 37 patients with IHA, and 42 patients with EH. These values were also compared with background factors, KCNJ5 mutation and clinical outcome in terms of blood pressure reduction after adrenalectomy in the APA group.

Results:
No differences were found among the three groups (APA, IHA and EH) with regard to age, sex, duration of hypertension, body mass index, blood pressure, renal function and hemoglobin A1c. FMD was significantly lower in the APA group (4.8 ± 2.1%) and IHA group (4.1 ± 1.9%) than in the EH group (5.7 ± 2.1%). CAVI did not differ significantly among APA, IHA and EH groups (7.9 ± 1.3, 7.8 ± 1.0, 7.8 ± 1.1, respectively). Although no significant correlations were seen between FMD and background factors (i.e. age, body mass index, renal function, glucose and lipid metabolic parameters, and hormonal data) in the IHA group, FMD correlated negatively with BMI and plasma aldosterone concentration in the APA group (rs = -0.313, rs = -0.342, respectively). No significant difference in FMD (4.8 ± 1.4%, 4.5 ± 2.1%, respectively) or CAVI (8.1 ± 1.8, 8.0 ± 1.1, respectively) was seen between the KCNJ5-mutant group and the wild-type group. A cut-off FMD of 4.3% was selected for complete clinical success after adrenalectomy, offering 78% sensitivity and 80% specificity.

Conclusions:
Patients with PA displayed impaired endothelial function. Complete clinical success after adrenalectomy was associated with preserved endothelial function. This study provides a better understanding of FMD assessment in patients with PA.
PS-BPC02-3: EVALUATION OF VASCULAR FUNCTION FOR PREDICTION OF RENAL PROGNOSIS IN JAPANESE PATIENTS WITH LIFESTYLE-RELATED DISEASES.
Authors: Masuda Shiho , Hara Tomoyo , Yamagami Hiroki , Mitsui Yukari , Kurahashi Kiyoe , Yoshida Sumiko , Otoda Toshiki , Yuasa Tomoyuki , Nakamura Shingen , Kuroda Akio , Endo Itsuro , Matsuhisa Munehide , Abe Masahiro , Aihara Ken ichi 
Published: January 2023

Background:
Since chronic kidney disease (CKD) is associated with the development of serious cardiovascular diseases such as stroke, coronary artery disease and heart failure, prevention and early diagnosis of CKD are important clinical issues. Many risk factors including diabetes, hypertension, dyslipidemia, obesity, and cigarette smoking are known to be involved in the development of CKD; however, there is no available biomarker that can predict the progression of CKD at an early stage. Although it has been reported that glomerular endothelial injury causes development of CKD, it remains unclear whether evaluation of vascular endothelial function can predict renal prognosis. Therefore, in the present study, we examined the association between vascular endothelial function and longitudinal eGFR change in patients with lifestyle-related diseases.

Methods:
We retrospectively evaluated 341 Japanese patients (176 males and 165 females; mean age, 63.87 ± 12.02 years) with lifestyle-related diseases in whom baseline vascular function was evaluated by flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV) and in whom 24-month longitudinal eGFR values were recorded after vascular testing at Tokushima University Hospital and Anan Medical Center, Tokushima Japan. The association between values of FMD and eGFR slope and the association between values of baPWV and eGFR slope were statistically analyzed. Statistical significance was set at p < 0.05.

Results:
Single regression analysis showed that value of FMD was positively associated with eGFR slope in females (p < 0.001) and non-smoking males (p = 0.033) but not in smoking males (p = 0.133). Multiple regression analysis including confounding factors demonstrated that the value of FMD remained a contributor against annual eGFR decline in females (p = 0.002) and non-smoking males (p = 0.046) but not in smoking males (p = 0.266). On the other hand, the value of baPWV had no significant association with eGFR slope regardless of sex and smoking.

Conclusions:
In patients with lifestyle-related diseases, FMD value can be used for prediction of renal prognosis represented by the eGFR slope in females and non-smoking males. Thus, early comprehensive intervention for improving vascular endothelial function might lead to a better renal prognosis in female and non-smoking male patients with lifestyle-related diseases.
PS-BPC03-6: USING A SIMPLE FIXED-RATIO BASED ALGORITHM MINIMIZES VARIABILITY IN OSCILLOMETRIC BLOOD PRESSURE DERIVATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Ringrose Jennifer , Smith Kevan , Jalali Afrooz , Khinda Harsimran , Wirzba Isaac , Ameh Hannah Ehce , Bello Aminu , Braam Branko , Padwal Raj 
Published: January 2023

Objective:
Oscillometric device accuracy may be decreased, and variability may be increased, in patients with chronic kidney disease. The objective of this study was to compare three oscillometric algorithms to identify which minimizes oscillometric blood pressure variability in chronic kidney disease.

Design & Methods:
Sixty patients with chronic kidney disease were studied. Thirty were on hemodialysis (HD group) and thirty had stage 3 chronic kidney disease (Stage 3 CKD). Baseline demographics and medical comorbidities were recorded. The mean of 3 readings from the Omron HEM 907XL device was used to provide a control (reference) blood pressure. Three oscillometric waveforms were also collected using a computer-based system, processed, and used to derive blood pressure by each of three algorithms: 1. simple fixed-ratio; 2. initial binning according to mean arterial pressure and then application of different fixed ratios within each bin (binning method); and 3. binning plus linear regression to incorporate the influence of additional oscillometric waveform characteristics (binning regression method). The mean of three blood pressure determinations from each algorithm was calculated and compared to the Omron mean, with variability assessed by calculating the standard deviation of the difference compared to the Omron.

Results:
Mean age in the overall group (± SD) was 65.6 ± 13.7 years (HD 63.4 ± 16.3 years; Stage 3 CKD 65.9 ± 10.7 years), percent female in the overall group was 42% (HD 37%; Stage 3 CKD 47%), and mean arm circumference overall was 31.5 ± 4.7 cm (HD 30.8 ± 4.4 cm; Stage 3 CKD 32.2 ± 5.0 cm. Hypertension was present in 82% of participants (HD 80%; Stage 3 CKD 83%). Mean Omron blood pressure was 136.9 ± 25.4/72.7 ± 15.8 mmHg. Compared to the Omron, the systolic/diastolic results for each algorithm were 134.4 ± 20.5/75.0 ± 12.9 for fixed ratio, 128.5 ± 19.8/71.4 ± 12.0 for binning, and 127.7 ± 18.7/70.2 ± 8.8 for binning regression (Table 1).

Conclusions:
An oscillometric algorithm based on simple fixed-ratio minimized variability in patients with chronic kidney disease. Manufacturers of devices designed for blood pressure measurement in this population should consider incorporating this approach into their algorithm-based blood pressure derivation.
PS-BPC07-4: RENOPROTECTIVE EFFECTS OF SGLT2 INHIBITORS AND RELATED FACTORS IN CHRONIC HEART FAILURE PATIENTS WITH DIABETES
Authors: Horio Takeshi , Yokouchi Go , Matsumoto Naoki , Fukuda Kohei , Yoshimura Ryutaro , Fujiwara Ryosuke , Matsuoka Yujiro , Sakamoto Yuya , Fujimoto Kohei , Kasayuki Noriaki 
Published: January 2023

Objective:
Large-scale clinical trials have shown that sodium-glucose cotransporter 2 (SGLT2) inhibitors have beneficial effects on not only cardiovascular and renal outcomes but also the preservation of renal function in patients with diabetes mellitus and/or chronic kidney disease. However, the effect of SGLT2 inhibitors on renal function in heart failure remains to be fully elucidated. The present study investigated whether SGLT2 inhibitors exert renoprotective effects in chronic heart failure patients with diabetes, by comparing serial changes in estimated glomerular filtration rate (eGFR) for years before and after SGLT2 inhibitor administration. In addition, if SGLT2 inhibitors had a favorable effect on renal function, we examined what cardiac/hemodynamic and noncardiac factors were involved in its effect.

Design and method: Methods:
From 83 outpatients with chronic heart failure and type-2 diabetes mellitus taking both SGLT2 inhibitors and loop diuretics, 50 patients whose eGFR levels were continuously measured for more than 6 months both before and after administration of SGLT2 inhibitors were selected. In this longitudinal observational study, eligible patients were retrospectively followed up before and after SGLT2 inhibitor administration. Clinical data such as body weight, blood pressure, heart rate, blood (hematological and biochemical) parameters, echocardiographic parameters, and medical treatment were collected at respective ends of the follow-up periods before and after SGLT2 inhibitor administration. All eGFR values were separately plotted before and after the initiation of treatment with SGLT2 inhibitors along the time course axis and the slope of the linear regression curve was calculated as an annual change in eGFR.

Results:
The mean follow-up periods before and after SGLT2 inhibitor administration were 2.6 and 1.9 years, respectively. Changing rates of eGFR per year were significantly improved after treatment with SGLT2 inhibitors (mean ± SD, -5.78 ± 7.67 to -0.43 ± 10.81 mL/min/1.73m2/year, p = 0.006). The daily doses of loop diuretics were not altered after SGLT2 inhibitor administration. Body weight decreased and hematocrit and hemoglobin increased by SGLT2 inhibitor administration, but neither change was not associated with the change in eGFR slope before and after SGLT2 inhibitor administration. While, the decrease in inferior vena cava diameter was significantly correlated with the improvement of eGFR decline slope after SGLT2 inhibitor administration (r = -0.428, p = 0.004).

Conclusions:
This study demonstrated that long-term treatment with SGLT2 inhibitors ameliorated annual decline in eGFR in Japanese patients with chronic heart failure. The observed renoprotective effect may have been mediated by improved venous congestion.
PS-BPC08-6: CLINICAL AND BIOCHEMICAL OUTCOMES OF PATIENTS WITH ALDOSTERONE-PRODUCING ADENOMA AFTER RADIOFREQUENCY ABLATION THERAPY AT KEIO UNIVERSITY HOSPITAL: 2022 REPORT
Authors: Kozuma Takahide , Kobayashi Sakiko , Nakamura Toshifumi , Kinouchi Kenichiro , Yokota Kenichi , Miyashita Kazutoshi , Kurihara Isao , Takase Kei , Nakatsuka Seishi , Itoh Hiroshi 
Published: January 2023

Objectives:
Total adrenalectomy of an affected adrenal gland is the standard therapy of aldosterone-producing adenoma (APA), a curable subtype of primary aldosteronism. However, the APA is occasionally inoperable in cases with bilateral adenomas or high-risk patients under general anesthesia. Computed tomography (CT)-guided radiofrequency ablation (RFA) of the adrenal gland is a less invasive, cortical-sparing therapy, and may become a treatment of choice for such cases. A multicenter clinical trial of RFA was conducted in patients with APA in Japan from 2015 to 2016. To establish its long-term efficacy and safety, the study subjects enrolled in Keio University Hospital have been annually followed up. Following the progress report at ISH 2018, here we update clinical and biochemical outcomes of this cohort of patients 6 years after the RFA treatment.

Methods:
Follow-up medical interviews, blood pressure measurements, blood tests, and urinalysis were done annually. In addition, at least one CT scan was performed since 2018. Data on antihypertensive medication, blood pressure, hormone and electrolyte levels, urinary albumin, and tumor size were collected and analyzed.

Results:
10 cases of APA were treated with RFA between June 2015 and March 2016. As of April 2022, 6 cases were successfully followed up. Of these patients, the aldosterone-to-renin ratio (ARR) remained normalized in 5 cases (83%), albeit above the upper limit in 1 case (17%). In this particular patient, serum potassium level remained normalized and antihypertensive medication was not needed. Antihypertensive medication was needed in 1 case (17%), while urinary albumin levels were improved in all cases. Of note, follow-up CT scan showed that the tumor was undetectable in 1 case (17%), reduced in size in 3 cases (50%) and unchanged in 2 cases (33%). None of the cases have developed adrenal insufficiency since the RFA.

Conclusion:
The follow-up study on APA patients 6-year after the RFA revealed no cases of recurrence. RFA is likely to be effective and safe in patients with APA.
PS-BPC10-3: DETERMINATION OF AORTIC STIFFNESS USING TWO ESTABLISHED ALGORITHMS
Authors: Tairi Amira , Obeid Hasan , Fortier Catherine , Pare Mathilde , Cote Nadege , Philibert Emy , Garneau Charles Antoine , Goupil Remi , Agharazii Mohsen 
Published: January 2023

Objectives:
Arterial stiffness is a risk factor for cardiovascular disease. Aortic stiffness is assessed by determination of pulse wave velocity using pulse transit time and the distance between carotid and femoral arteries. Transit time is obtained by using the foot-to-foot method to define the transit time through intersecting tangents algorithm or the point of maximal upstroke during systole (2nd derivative). Millasseau et al have proposed a formula for converting transit time between methods using SphygmoCor (intersecting tangents) and the Complior Analyse (2nd derivative). Based on a mathematical modeling of the proposed formula, there is discrepancy between values of pulse wave velocities, especially in subjects with higher aortic stiffness. The objective is to directly compare the two methods using the same pressure waveforms obtained by the newer generation of Complior Analyse and using Millasseau formula.

Design and Methods:
In a cross-sectional study of heterogeneous subjects, aortic stiffness was assessed by the Complior device which uses 2nd derivative. The pulse waveforms were extracted and used for the analysis by custom MATLAB algorithm for intersecting tangents, and the results were compared to the formula proposed by Millasseau.

Results:
The preliminary results of the first 24 patients (men: 71%; mean age: 61 ± 18 years) show that Millasseau formula underestimates the transit times values by about 19% in comparison with the transit times obtained by the intersecting tangents method using MATLAB software (50 ± 19 ms vs 62 ± 19 ms; P < 0.001). This results in an overestimation of the pulse wave velocities values by about 30% (13.8 ± 3.8 m/s vs 10.6 ± 2.7 m/s; P < 0.001).

Conclusions:
Our preliminary results allow us to conclude that the values of pulse wave velocities obtained with Millasseau formula overestimate values as compared to the values obtained by intersecting tangents method. Increasing the number of subjects will allow us to examine the possibility of a more reliable formula for converting transit times between methods.
PS-BPC10-5: ASSOCIATION BETWEEN KIDNEY FUNCTION AND CIRCULATING EPHA2 IN PATIENTS WITH HYPERTENSION
Authors: Murakoshi Maki , Iwasawa Takumi , Kato Kazunori , Gohda Tomohito , Suzuki Yusuke 
Published: January 2023

Objective:
We have previously demonstrated that high circulating levels of progranulin (PGRN) were negatively associated with estimated glomerular filtration rate (eGFR). PGRN binds to Ephrin type-A receptor 2 (EphA2). Recently, it has been reported that circulating EphA2 levels serve as a biomarker of kidney function decline in patients with diabetic kidney disease. Therefore, we investigated its level correlates with traditional renal measures, eGFR and ratio of proteinuria to creatinine (UPCR), in patients with hypertension.

Design and method:
EphA2 ELISA for human serum was developed and validated. The serum levels of EphA2 were measured in 80 patients with hypertension. The subjects were stratified according to the eGFR: normal kidney function (eGFR > 60 mL/min/1.73m2, n = 16), and declined kidney function (CKD; eGFR < 60 mL/min/1.73m2, n = 64).

Results:
Validation of the in-house EphA2 ELISA showed good recovery and linearity and no cross-reactivity with other Eph receptors. The levels of EphA2 were significantly higher in CKD group compared to normal kidney function group, and correlated significantly with eGFR (r = -0.83) and UPCR (r = 0.61).

Conclusions:
The high circulating EphA2 level has potential application as a clinical biomarker for presence of CKD in patients with hypertension.
PS-BPC11-3: INVESTIGATION OF THE EFFECT OF VISCERAL FAT ON THE CHRONIC KIDNEY DISEASE DEVELOPMENT AND PROGRESSION IN MEDICAL CHECKUP PARTICIPANTS
Authors: Miyasato Yoshikazu , Oba Koji , Masuda Izuru , Mukoyama Masashi 
Published: January 2023

Objective:
Many factors including obesity were reported as risk factors for development and progression of chronic kidney disease (CKD). However, there is a possibility that the effects of risk factors on the progression of renal dysfunction in CKD patients and the development of CKD are different. We aimed to evaluate the relationships of visceral fat area (VFA) and changes in kidney function in medical checkup participants stratified by the presence of CKD for investigation of the effect of visceral fat on CKD development and progression.

Design and method:
Study design: Retrospective cohort study. Setting: Routine medical checkups at two medical examination centers in Takeda Hospital Group. Participants: Subjects who underwent VFA measurements during medical checkups in 2012. The follow-up period was from April 2012 to March 2018. Exposures: VFA (≧ 100 cm2). Main outcomes: Changes in estimated glomerular filtration rate (eGFRcr). Statistical analysis: The relationships between VFA and eGFRcr were evaluated using a linear mixed effects model in the participants stratified by the presence of CKD. We defined CKD as eGFR < 60 mL/min/1.73 m2 in this study.

Results:
Analysis was performed on total 2,753 subjects (age [mean ± SD] 50.3 ± 10.0 years). The non-CKD group was composed of 2,516 subjects (age 49.5 ± 9.67 years, 1,277 men, 1,239 women), and the CKD group was composed of 237 subjects (age 59.5 ± 8.48 years, 142 men, 95 women). In the total subjects the VFA ? 100 cm2 group exhibited a larger annual difference in eGFRcr compared to the < 100 cm2 group (-0.24 mL/min/1.73 m2, p = 0.03). Although the difference of annual eGFRcr change in the non-CKD group was not statistically significant, VFA? 100 cm2 was associated with larger annual declines in eGFRcr in both CKD and non-CKD groups as compared to VFA < 100 cm2 (-0.64 mL/min/1.73 m2, p = 0.01, and -0.20 mL/min/1.73 m2, p = 0.10).

Conclusions:
In the CKD group VFA ≧ 100 cm2 was significantly associated with a greater annual decline in eGFRcr. This significant difference of eGFRcr decline in the CKD group suggests the effect of visceral fat as a modifiable risk factor for CKD progression.
PS-BPC12-4: HYPERTENSION IN CAMEROONIAN RURAL AND URBAN PYGMIES AND BANTUS OF THE SOUTHERN REGION
Authors: Hako Yves , Bika Claude , Okala Cecile , Dissongo Jean II , Degaute Jean Paul , Kabangu Jean Rene Mbuyamba , Van de Borne Philippe , Lemogoum Daniel 
Published: January 2023

Objective:
To determine the prevalence of hypertension and associated risk factors among rural and urban pygmy and Bantu dwellers of southern Cameroon

Design and Methods:
In this cross-sectional cluster sampling survey, we examined 100 traditional pygmies (TP) living in equatorial forest in Kavabousse village under hunter-gatherer subsistence mode, 100 traditional Bantus (TB) living in Bidjouka village closed to Kavabousse (rural area); and 100 contemporary pygmies (CP) and 100 contemporary Bantus (CB) both living in the same urban environment in Kribi city. Trained observers recorded in each participant lifestyle and socio-demographic data, and clinical parameters. Brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in triplicate using an automatic sphygmomanometer (Omron 705 CP). Hypertension was defined as SBP/DBP > or = 140/90 mmHg.

Results:
As compared to Bantus, Pygmies were younger (38 ± 16 vs 45 ± 17 years, p = 0.0001), with lower body mass index (22.7 ± 3.3 vs 24.9 ± 4.6, p < 0.0001). Age-adjusted SBP and DBP were lower in Pygmies than in Bantus (p < 0.0001), however within group SBP and DBP were similar among rural and urban individuals. Age-adjusted prevalence of hypertension was lower in pygmies than Bantus globally (7.5% vs 21.5% p = 0.0001), and in rural and urban areas: 4% vs 19% and 11% vs 24 %, respectively, both p < 0.01). In pygmies taken separately, the age-adjusted prevalence of hypertension was lower in TP than in CP (4% vs 11%). In the whole study population, multivariate logistic regression analysis revealed that hypertension was independently associated with urban area (OR = 2.15, 95%CI: 1.14–4.05), Bantu status (OR = 2.17, 95%CI: 1.09–4.34), age > or = 50 years (OR = 2.15, 95%CI: 1.14–4.05), and abdominal obesity (OR = 0.20 95%CI: 0.09–0.46) (all p < 0.05). In pygmies taken separately, multivariate logistic regression analysis shown that age > or = 50 years (OR = 3.83, CI95%: 1.33–11.36) and urban area (OR = 3.33, CI95%: 1.04–11.11) (both p < 0.05) were independent determinants of hypertension.

Conclusion:
This study reveals that hunter-gatherer lifestyle is associated with lower prevalence of hypertension as illustrated in TP. Hypertension is more common in Bantus and CP, and is largely attributable to their westernized lifestyle and the growing urbanization of rural area.