bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C12-4: OPEN-ANGLE GLAUCOMATOUS OPTIC DAMAGE ASSOCIATED WITH DAYTIME AND NOCTURNAL DIPS IN BLOOD PRESSURE
Authors: Melgarejo Jesus D , Eijgen Jan Van , Wei Dongmei , Maestre Gladys E , Aswad Lama A Al , Mena Luis J , Vanassche Thomas , Janssens Stefan , Verhamme Peter , Keer Karel V , Stalmans Ingeborg , Zhang ZhenYu 
Published: January 2023

Background:
Impaired ocular perfusion pressure via systemic hypoperfusion plays a pivotal role in the pathogenesis of open-angle glaucoma (OAG). Extreme dips in mean arterial pressure (MAP) during 24-h are associated with OAG, however, whether this is driven by diurnal or nocturnal dips remains undocumented. We aimed this study to investigate the association of OAG damage with daytime and nocturnal dips in MAP.

Methods:
We conducted a retrospective longitudinal study that included 110 primary OAG patients who underwent 24-h ambulatory blood pressure monitoring. OAG damage was defined as changes in mean deviation (MD) of visual field tests during follow-up. MAP variability independent of the mean (VIMmap) was computed for daytime and nighttime. Dips were the five daytime and three nighttime lowest drops in MAP. We also calculated the night-to-day ratio and defined low diurnal and nocturnal MAP levels. We applied mixed models to evaluate changes in MD (expressed as decibels [dB]) during follow-up in relation to diurnal and nocturnal variability and dips in MAP.

Results:
The mean age was 64.0y (53% women). The median follow-up was nine years. In adjusted mixed models, every + 3 mmHg increase in daytime VIMmap was associated with a -2.57 dB longitudinal change in MD (P < 0.001). The longitudinal changes in MD associated with daytime dip measures ranged from -2.56 dB (95% confidence interval [CI], -3.61 to -1.51; P < 0.001) to -3.19 dB (95% CI, -4.53 to -1.84; P < 0.001). For nighttime measures, the MD changed -0.71 dB (CI, -1.24 to -0.17; P = 0.009) per every -5 decrease in the nighttime MAP level. Nocturnal MAP level < 74 mmHg and every 0.05 decrease in the night-to-day ratio were related to -7.23 (P = 0.003) and -0.96 (P = 0.011) changes in MD. Nighttime VIMmapP and nocturnal dips were not associated with changes in MD (P > 0.097).

Conclusions:
Extreme daytime dips in MAP relate to OAG damage independently of the MAP level. Whereas, the association between OAG damage and nocturnal measures is driven by the nocturnal MAP level rather than variability or dips in MAP. The assessment of diurnal patterns in MAP might offer an opportunity to understand the pathogenesis of OAG. This is also critical as the perfusion pressure to the eyes is physiological 30% lower than at the brachial level in the standing or sitting positions. Therefore, a physiological lower perfusion pressure combined with extreme diurnal dips in MAP would exacerbate the hypoperfusion state in the optic nerve, leading to further glaucoma damage.
PS-C12-10: “CHRONOBIOLOGY” THE NEW PARADIGM OF CLINICAL APPROACH
Authors: Sagam Dinesh Reddy 
Published: January 2023

1) Definition: Chronobiology is the study of biological rhythms. Over the past few decades, chronobiology has developed into a multidisciplinary field.
2) The suprachiasmatic nucleus (SCN) is a bilateral structure located in the anterior part of the hypothalamus. It is the central pacemaker of the circadian timing system and regulates most circadian rhythms in the body.
3) Why your circadian rhythm matters? Our circadian rhythm matters in all parts of our life. For eg: if your sleep times are off, your hunger could be off or your eating times. We often see people who are sleep deprived either their hunger goes up or down. And the time when they get hungry changes.
4) How to tell it is time to reset our circadian rhtym ?
You might need to reset your circadian rhythm:: if you have trouble falling asleep, staying awake in the evening, waking in the morning, focusing on daily tasks and responsibilities.
5) Our circadian rhythms evolve over time. As we age, our circadian timing gets earlier. People in their 50 s, 60 s and 70 s may start to want go to bed earlier and wake up earlier. If you were a night owl as a teenager, you could be a morning person when you are an older adult.
6) Small Study at LMR Hospital:

TARGET PEOPLE 1) ELDERLY PEOPLE WITH HYPERTENSION 2) MID AGED PEOPLE BOTH MALE AND FEMALE 25-40 YEARS WITH BORDERLINE HYPERTENSION

Observations:
1) In a group of 1000 elderly people with HTN correction in 1 hour of sleep cycle has improved their quality of life by 60 to 70 percent and thereby reducing the dose of antihypertensives. 2) In middle aged females and males of 1000 people (age 30–40) with prehypertension timely sleeping, avoiding nighttime electronic gadgets tv, increased physical activity almost avoided the need for the antihypertensives.

Conclusions:
A very small variation in the circadian rhythm will have great impact on our health. For eg:: 1 hour deprivation of sleep may increase the stroke risk from 40 % to 80 % and thereby increasing mortality rate. It is very important to note that even in clinical trials of many drugs, circadian rhythm should also be taken in to consideration. for eg:: dippers and non dippers in population.

9) Goal of this Entire Study:
Doctor treating the patients accordingly to the biological clock will give the chance for getting excellent results without increasing the dose of medication.
PS-C13-5: SPECTRUM OF ECG ABNORMALITIES SEEN AT THE FIRST VISIT OF PATIENTS TO A CARDIOLOGY CLINIC IN ENUGU, NIGERIA
Authors: Nwigwe Scholastica Ijeoma , Okwulehie Vincent , Okonkwo Alex , Oguanobi Nelson , Ejim Emmanuel Chukwudi 
Published: January 2023

Objective:
Hypertension, heart failure and chest pain are among the commonest indications for referral of patients to cardiologists in Nigeria. Often times these patients present at advanced stages of the illnessess, when cardiovascular complications are already present. It is therefore not surprising that many patients referred to the cardiologists in Nigeria present for the first time with significant ECG abnormalities. We set out to find the common ECG abnormalities seen at the first presentation of patients at a cardiology clinic in Enugu, Nigeria.

Design and Method:
The case notes of all the patients referred to the Cardiology clinic of Kenechukwu Specialist Hospital, Enugu from January 2012 to April 2022 were retrospectively reviewed. Data obtained from the case notes included age, gender, indication for referral, pulse, blood pressure and ECG findings at first presentation. Data was analyzed using SPSS version 22.0.

Results:
A total of 356 patients aged 15–100 years were referred to the clinic within the period under review, made up of 223 males (62.6%) and 133 females (37.4%). The mean age of the patients was 55.21 ± 16.8 years.
The commonest indications for referrals were hypertension (65.4%), breathlessness (8.4%), and chest pain (6.5%).
The commonest structural abnormalities on ECG were left atrial abnormality (19.4%), left ventricular strain pattern (9.8%), and old infarcts (7.9%). The commonest rhythm abnormalities were atrial fibrillation (2.8%), atrial flutter (0.8%), complete heart block (0.6%).
First degree atrioventricular block was the commonest conduction abnormality (10.4%), followed by left anterior hemiblock (5.1%) and complete right bundle branch block (4.8%).

Conclusion:
A good number of patients referred to specialist cardiology clinics in Nigeria are hypertensive, and present with significant electrocardiographic abnormalities at the time of first assessment. This may be explained by the asymptomatic nature of hypertension which makes a lot a patients seek medical attention only when they have symptoms. These symptoms are often from the complications of hypertension, some of which may be produce significant abnormalities on ECGs.
PS-C14-1: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS OF PDE5 INHIBITOR SILDENAFIL IN THE TREATMENT OF HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Sun Runmin 
Published: January 2023

Background:
The results of clinical trials of phosphodiesterase (PDE) 5 inhibitors for the treatment of HFpEF patients are inconsistent. Thus, we undertook a meta-analysis to evaluate the clinical value of sildenafil for HF with preserved EF (HFpEF) patients.

Methods:
Relevant studies were searched and identified in the PubMed, Cochrane Library and EMBASE databases. We searched randomized controlled trials (RCTs) that compared PDE5i with placebo in HFpEF and extracted relevant clinical data.

Results:
Six RCTs enrolling 471 HFpEF patients were included in the meta-analysis. Compared with placebo, sildenafil was not significantly associated in death (OR = 1.12, 95%CI: 0.06 to 19.40), adverse events (OR = 2.55, 95%CI:0.67 to 9.62) . Also, sildenafil therapy had no impact on the patient's six-minute walk test, PASP, E/e’, peak VO2, NT-proBNP but improved at PVR(SMD = -1.04, 95% CI = -1.96 to -0.13) significantly compared to placebo in HFpEF patients. Whereas, if only the RCT study with HFpEF combined with pulmonary hypertension is included, sildenafil therapy was associated with a marked improvement in E/e’ (SMD = -0.745, 95% CI = -1.24 to -0.25) in HFpEF patients combined with pulmonary hypertension.

Conclusions:
Compared with placebo, sildenafil therapy was associated with the improvement of diastolic function in HFpEF patients combined with pulmonary hypertension, while sildenafil treatment of HFpEF patients does not increase death or rehospitalization.
PS-C14-2: QUANTITATIVE METHODS FOR ASSESSING CONTRACTILE RESERVE IN PATIENTS WITH DIASTOLIC HEART FAILURE
Authors: Tselov Nikolay Valeriev , Tsonev Svetlin , Marinov Rumen , Slavchev Boris , Zlatancheva Galina , Hristova Krasimira 
Published: January 2023

Aim:
The effectiveness of isometric handgrip exercise on changes of cardiovascular hemodynamical parameter in patients with diastolic heart failure is unknown. We assessed the effect of several hemodynamic parameters and it changes during handgrip maneuvers in patients with different stages of diastolic heart failure during chemotherapy and their improvements after 4 months follow up (4mFU) treatment with single pill combination of ACE inhibitor ACE) and beta blocker(BB).

Methods:
The study population included 65 patients female / mean age of 45 ± 12 years/ 55 with breast cancer and undergoing chemotherapy / 30 pts with HFpEF and 25 pts with HFmrEF / and 10 pts with HFnEF and without chemotherapy. The effect of handgrip maneuver on hemodynamic parameters were studied by speckle tracking echocardiography. Following maximal squeeze by 100%, during the next 3 minutes patients were instructed to apply pressure at 50%. The global longitudinal strain were extracted by 3, 4 and 2 chamber apical view images on 70 fr/s and MAP and HR were performed at basal level, 1st, 2nd and 3rd minutes during handgrip stress test. The contractility /force/ of LV were also calculate as ratio SBP / ESV. Patients with HFmrEF and HFpEF received for 4 months treatment with single pill combination ACE (perindorpril)/ BB (bisoprolol) 5/5 mg.

Results:
Heart rate(HR) and mean arterial pressure(MAP) increased significantly after handgrip maneuver / from 75 ± 6 beats /min to 101 ± 12 beats/ min, 109 ± 15 mmHg to 118 ± 19mmHg, p < 0,05 /. Pulmonary artery systolic(s) and diastolic (d) pressure(PAP),pulmonary capillary wedge pressure (PCWP), cardiac index(CI), LVEF did not change significantly(p > 0,5) after handgrip maneuvers. On the other hand, LV force (SBP/ ESV ratio),MAP and HR decreases significantly (p < 0,01) in group with HFmrEF. In same group were found significantly decreased GLVLS at 2nd and 3rd minutes during stress- test comparable with other 2 groups with HFpEF and HFnEF. After 4mFU and treatment with 5/5 mg doses combination of ACE / BB were found improvement in parameters: HR /p < 0,001/, MAP /p < 0.01/ and contractile reserve as well as LV force /p < 0, 01/ and GLVLS /p < 0,001/.

Conclusion:
Cardiovascular response to handgrip maneuver may be a marker of failure to respond to compensatory mechanisms. Patients with good LV reserve had a rise in stroke work with little or no change in LVEDP. Patients with poor contractile reserve had a fall in stroke work reserve together with a substantial rise in LVEDP. It is concluded that the stress imposed by sustained handgrip provides a simple test for evaluation of LV contractile reserve in patients, who will develop cardiotoxicity during chemotherapy treatment. The treatment with combination with small doses ACE/BB is a big challenge in patients with HFmrEF and HFpEF to improve the contractile reserve.
PS-C14-4: PROLONGED QT AND ITS RELATION TO LEFT HEART SYSTOLIC FUNCTION IN HYPERTENSIVE PATIENTS
Authors: Pham Duong Hai , Nguyen Hoai Thi , Nguyen Huy Anh 
Published: January 2023

Background:
The aim of this study is to assess the prevalence of prolonged QTc in people with hypertension and its relation to left heart systolic function (evaluating by EF) in this group of patients.

Method:
The study was cross-sectional in design. Subjects were recruited from patients hospitalized in Cardiology Department, Hue University of Medicine and Pharmacy Hospital from May/2020 to Feb/2021, patients were diagnosed with hypertension according to ISH 2020 criteria and indicated to perform echocardiogram in order to evaluate their left heart systolic function (manifest as EF) and other related indices. Prolonged QTc was defined as QTc > 450 ms in females and > 460 ms in males. A p-value of < 0.05 was considered statistically significant.

Results:
Among 187 patients who agreed to participate in the research, 133 patients were qualified with all inclusion and exclusion criteria. 41 of them (30.8%) had prolonged QTc, while the remaining 92 (69.2%) had normal QTc interval. Patients with prolonged QTc had significantly higher prevalence of lower ejection fraction (EF), higher LVMI, besides, they also had higher prevalence of being diagnosed with heart failure, peripheral edema, dyspnea, higher mean heart rate (HR), longer PR interval compared to patients with normal QTc.

Conclusion:
This study demonstrated high prevalence of prolonged QTc in patients with hypertension. In the mentioned group, prolonged QTc has relation to left heart systolic function. In addition, affected patients also had significantly higher prevalence of factors associated with bad prognosis.

Keywords:
QTc, QT interval, hypertension, LVMI, EF, systolic dysfunction, Hue University of Medicine and Pharmacy Hospital.
PS-C14-9: DIFFERENTIAL DIAGNOSIS OF HYPERTROPHIC CARDIOMYOPATHY AND HYPERTENSIVE HEART DISEASE
Authors: Nurbay Zhanar , Tuleutaev Rustem , Zhakaev Maksat , Bagramov Akan , Ibragimov Timur , Daniyarova Laura , Konisbekova Akzhan , Abzaliev Kuat , Muzaev Vladimir , Sultanov Galymzhan , Ishakbaeva Guzel , Nagimatullaeva Aigerim 
Published: January 2023

Objective:
To conduct a differential diagnosis of hypertrophic cardiomyopathy and hypertensive heart.

Material and Methods:
The study included 40 patients with hypertrophic cardiomyopathy without left ventricle outflow tract obstruction, mean age 57.3 ± 9.5 years, 26 women and 30 patients with hypertensive heart, mean age 49.0 ± 8.7 years, 21 men.

Results:
The diagnosis of hypertrophic cardiomyopathy was established on the basis of clinical and anamnestic data, electrocardiography and echocardiography, genetics, upon detection of left ventricle myocardial hypertrophy with a maximum wall thickness of > 15 mm without dilatation of its cavity in the absence of other heart diseases. Hypertensive heart was diagnosed in patients with left ventricle myocardial hypertrophy > 12 mm due to hypertension. Hypertonic disease was detected according to the data of 24 hour blood pressure monitoring when systolic blood pressure > 135 mm Hg was recorded during wakefulness, diastolic > 85 mm Hg. The patients of both groups were comparable in terms of gender and age. Left ventricle myocardial mass index, interventricular septum thickness in diastole in patients with hypertrophic cardiomyopathy significantly exceeded those in patients with hypertensive heart. The thickness of the posterior wall of the left ventricle was almost the same in both groups. The maximum pressure gradient in hypertrophic cardiomyopathy at a load of 9 to 22 mm Hg. According to blood pressure monitoring data, arterial hypertension was detected in 65% of patients with hypertrophic cardiomyopathy. The degree of arterial hypertension was higher in patients with hypertensive heart. Exercise tolerance in patients with hypertension was higher than 111.0 ± 22.2. The maximum systolic blood pressure at the peak of physical activity in hypertrophic cardiomyopathy was significantly lower than in hypertensive heart 159.6 ± 21.1 and 196 ± 7.9 mmHg. Dyspnea as a reason for discontinuation of the test was more often observed in hypertrophic cardiomyopathy, 39% and 5%. In 26% of patients with hypertrophic cardiomyopathy, frequent ventricular extrasystole occurred at the height of the load, and no rhythm disturbances were recorded in patients with hypertensive heart.

Conclusion:
According to echocardiography data, there was no significant difference; systolic blood pressure at the height of the load in patients with hypertensive heart was significantly higher. Despite the above differences between patients with hypertrophic cardiomyopathy and hypertensive heart, it is not possible to single out an absolute sign that allows for a differential diagnosis. Important is the history of the disease, complaints and genetic analysis to identify mutations in hypertrophic cardiomyopathy.
PS-C14-11: COFFEA ARABICA SEEDS EXTRACT HAS ANTIHYPERTENSIVE AND CARDIOPROTECTIVE EFFECTS IN L-NAME-INDUCED HYPERTENSIVE RATS
Authors: Singh Amit Kumar , Pandey Abhay Kumar 
Published: January 2023

Objective:
A large percentage of the adult population worldwide is affected by hypertension, which is the most common cardiovascular disease. Essential hypertension is primarily caused by an absence of nitric oxide (NO), which leads to endothelial dysfunction. This study examined whether Coffea Arabica seeds extract (CA) was effective against L-NAME-induced hypertension and oxidative stress in wistar rats.

Method:
Approximately 40 mg/kg of L-NAME, a non-specific nitric oxide inhibitor, was administered to male Wistar rats to induce hypertension in them, while CoQ10 served as a standard anti-hypertensive agent. L-NAME was administered orally to all of the other groups along with the CA extract for three weeks. A direct cannulation procedure was used to measure hemodynamic parameters after the treatment. The lipid profile, kidney and cardiac functions along with markers of oxidative stress were examined, as well.

Result:
It has been found that L-NAME increases blood pressure, depletes NO, causes oxidative imbalance, and damages cardiac and kidney function in animals. As compared to control and L-NAME groups, the CO-treatment group had significantly lower levels of cardiac markers than the L-NAME only group. The CA treatment of hypertensive rats significantly reduced the levels of angiotensin converting enzyme (ACE) and mineralocorticoid receptor expression. It was found that when L-NAME and CA extract were administered concurrently, all injuries were prevented without affecting the heart rate or raising the blood pressure.

Conclusion:
This study confirms the antihypertensive action of Coffea Arabica seeds extract and indicates its protective properties in a L-NAME induced hypertension model in rats, most likely due to the presence of antioxidant potential and by inhibiting inflammation in the tissues.
PS-C15-8: SUPER HYPERTENSION OR VERY SEVERE HYPERTENSION IN A SUB-SAHARAN COUNTRY: EPIDEMIOLOGICAL, CLINICAL, THERAPEUTICAL AND EVOLUTIVE PATTERNS
Authors: Christian Ngongang Ouankou , Oriane Chendjou Kapi Leana , Liliane Mfeukeu Kuate , Raoul Simeni Njonnou Sylvain , Yannick Fogang Fogoum , Jerome KAZE Francois , Pierre CHOUKEM Simeon 
Published: January 2023

Backgroung:
To describe the epidemiological, clinical, therapeutical and evolutive patterns of super hypertension in Yaounde University Teaching Hospital.

Methodology:
This study is an observation cohort over a period of 9 months (January 2016 to September 2016). We recruited from members of the public who accepted voluntary blood pressure screening offered in various localities in Yaounde, and were aged 18 years or over.

Results:
Of a total of 6.519 people, 1.875 (28.8%) presented a high blood presure. Amongst them, 37 presented a super hypertension (a systolic blood pressure 250 mmHg and/or diastolic blood pressure 150 mmHg in presence or not of complications), corresponding to a prevalence of 2% of all hypertensive patients. Our cohort comprised 33 of these individuals who accepted the invitation to participate in the study. The mean age was 49.3 years, with a sex- ratio of 0.7. Twenty-three (70%) of the patients were known hypertensive for a mean time of 10 years, out of 9% were regularly rewieved, but none on medications. The mean of cardiovascular risk factors was 7, with 91% who had an excess salt intake. Dyspnea and headache were the main symptoms. The means systolic blood pressure and diastolic blood pressure were respectively 244.9 mmHg and 144.8 mmHg. Twenty-six (78.8) patients were either overweight or obese. We noticed a fundoscopy stage II or III in 21.1% of the cases. Seventy percent of the cases had left ventricular hypertrophy on electrocardiogram and 18.2 on echography. Complications were noticed on admission in 60.6% of all cases, mainly signs of renal failure. Acute kidney injury occurred in 15.15% of the cases during follow-up. The average rate of blood pressure control over 6 months was 3%. The main cause of poor blood pressure control was lack of therapeutic compliance. We noticed refractory high blood pressure in 4 (12.1%) cases and registered one death at the 3rd month of follow up due to acute kidney injury.

Conclusion:
Super hypertension is a yout s pathology. The early detection reduces significantly the high morbi-mortality. However, its efficient management needs minimal additional resources.