bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ROLE OF CARDIOVASCULAR MAGNETIC RESONANCE IMAGING IN NONINVASIVE ASSESSMENT OF PULMONARY HYPERTENSION SEVERITY
Authors: Kazimli Aygun , Ryzkov Anton , Berezina Aelita , Naymushin Alexandr , Moiseeva Olga 
Published: June 2023

Objective:
Pulmonary hypertension characterized by structural and mechanical changes in pulmonary vascular bed. Invasively calculated pulmonary artery (PA) stiffness indeces are associated with mortality in pulmonary hypertension (PH). CMRI-derived pulmonary artery distensibility (PAD) index reflects vascular remodeling in patients with pulmonary PH. The aim of the study was to evaluate the relationship between noninvasive PAD index and invasive PA stiffness indeces and basic determinants of PH severity.

Design and method:
We included 48 pts with PH (mean age 42.8± 14.7 yrs, m:f = 13:35): 27 idiopathic pulmonary arterial hypertension pts, 5 pts scleroderma PAH, 6 corrected congenital heart disease and 10 with inoperable CTPEH. All pts underwent 6-min walk test (6MWT), right heart catheterization (RHC), ECHO, CMRI, cardiopulmonary exercise testing (CPX). PA stiffness index and elastic modulus were calculated using data from RHC and CMRI. Pulmonary artery distensibility index (%) were derived from cross-sectional images of the main PA on cardiac magnetic resonance imgaging.

Results:
We revealed increased PA stiffness index 6.1 (4.6–10.2) and elastic modulus 424 mm Hg (254-678), decreased PAD index in PH pts 10% (9 –16.5). There was a significant negative correlation between PAD index and PA stiffness index (r = –0.90; p < 0.0001), so we derived the formula to calculate the invasive PA stiffness using noninvasive PAD index: PA stiffness index = 102.4/ PAD index. There was also a negative correlation between PAD and elastic modulus (r = –0.91; p < 0,0001). Patients with decreased PAD index < 20 % had higher NT-proBNP level (1558 (738-4341) versus 306 (178-370); p<0.05), also ECHO signs of RV systolic dysfunction:lower TAPSE (1.7 ±0.4 cm versus 2.0±0.4 cm; p = 0,04), tricuspid annular systolic velocity (10±2 versus 12±1 cm/sec; p = 0,007), global RV myocardial deformation (13±4% versus 21±5%; p = 0,001) and RV fractional area change ( 24±7%; p = 0,02) and reduced cardiac output which were determined by RHC (4.0 ± 1.1 versus 4.9 ±1.2 l/min; p < 0,05).

Conclusions:
Noninvasive CMRI-derived PA distensibility index strongly correlated with PA stiffness indeces, and may be used for noninvasive assessment of PH severity.
ROLE OF UBIQUITINYLATION MODIFICATION OF SIRTUIN 3 IN HYPERTENSION-ASSOCIATED CARDIOMYOCYTE INJURY
Authors: Sun Runmin , Wang Qiongying , Yu Jingle 
Published: June 2023

Objective:
The present study was designed to investigate whether mitochondrial dysfunction and oxidative stress in HTN-injured cardiomyocytes are associated with SIRT3 ubiquitination and whether SIRT3 deubiquitination can ameliorate the related cardiomyocyte injury.

Design and method:
The human cardiomyocyte AC16 cell line was selected as the study target. The SIRT3-K288R cell line construction was verified by immunoprecipitation and the effect of Ang-II on SIRT3 class ubiquitination was explored; the expression of SOD2, Acetyl-SOD2 (MnSOD), protein acetylation level, inflammatory vesicles NLRP3, etc. in different subgroups were determined by Western Blot to explore the ubiquitination-like modifications and SIRT3 deacetylation in HTN-related cell injury

Results:
(1) Immunoprecipitation results showed that the level of SIRT3 class ubiquitination was reduced after SIRT3-K288R transfection; compared to the control group, the level of SIRT3 class ubiquitination was increased in the presence of AngII; (2) Western Blot results showed that compared to the HTN cell injury model, the cardiomyocytes in the SIRT3-K288R intervention group had increased Acetyl- SOD2/SOD2 levels were increased (p < 0.05) and protein acetylation levels were decreased in the SIRT3-K288R intervention group compared with the HTN cell injury model, indicating that SIRT3 deubiquitination increased the deacetylation effect on mitochondria and increased cellular antioxidant stress enzyme activity; (3) Western Blot results showed that compared with the HTN cell injury model, cardiomyocytes in the SIRT3-K288R intervention group NLRP3 and NOX4 levels were significantly reduced, indicating that SIRT3 deubiquitination could improve the inflammatory response to Ang-II-related cell injury.

Conclusions:
In the HTN-associated cell injury model, the level of SIRT3 class ubiquitination was significantly increased, and the removal of ubiquitination modification by viral transfection could improve oxidative stress, protein acetylation levels and associated inflammatory responses in HTN-injured cardiomyocytes, indicating that SIRT3 class ubiquitination may play an important mechanism in HTN-associated cell injury, and reducing SIRT3 class ubiquitination modification may be a possible direction for future research.
EPIDEMIOLOGY OF CARDIOVASCULAR MORTALITY IN PATIENTS AGED UNDER 60 IN THE CARDIOLOGY DEPARTMENT FROM SEPTEMBER 2019 TO AUGUST 2022
Authors: Alassane Ngaide Aliou , Diaba Gaye Ngone , Salvador Mingou Joseph , Tening Diouf Marguerite , Diarra Sene Mame , Rassoul Diop Khadim , Youssou Diouf , Abdoul Kane 
Published: June 2023

Objective:
The objectives of our study were to study the cardiovascular mortality of the active population, to analyze the epidemiological, clinical, paraclinical aspects, the complications and to determine the etiological aspects related to this mortality.

Design and method:
This was a descriptive and analytical retrospective study over 3 years from September 2019 to August 2022 in patients aged at least 15 and at most 60 years old hospitalized and deceased in the cardiology department of the General Idrissa POUYE hospital in Dakar. The data was recorded on a survey sheet and entered into the EPI Info 7.2.5.0 software, and the analysis carried out by the R. Studio software version 2022.12.0 + 353 and Excel 2019. The significance threshold retained was a p value < 0.05.

Results:
Our study enrolled 73 dead patients, either a specific mortality of 8.8% and a proportional mortality of 39%. The predominance was male with a male/female sex ratio of 1.2. The average age was 44 years old. The cardiovascular risk factors found were dominated by physical inactivity (76.7%), hypertension (28.8%) and smoking (21.9%). Physical examination found signs of heart failure in 63% of cases. Biology noted above all anemia (59%), impaired renal function (25%) and high troponin in 87% of cases. The electrocardiogram essentially found arrhythmias (46.6%). The chest X-ray mainly showed cardiomegaly (49.3%), pleuro-pneumonopathy (33%). Echocardiography showed altered LVEF (81%), PAH (78%) and kinetic disorders (40%). Coronary angiography, performed in 4 patients, showed 2 bi-truncal lesions, 1 mono-truncular and 1 tri-truncular. The most used treatments were diuretics (63%), amines (47.9%), AVKs (42%), BBs (36%), ACE inhibitors or ARA2 (31%). Thrombolysis was performed in 5 SCA and 4 PE and angioplasty in 4 patients. The analytical study shows that the data most related to mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvular disease, pulmonary embolism (p = 0.034), hypertension (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemia, bed rest (p = 0.001), morbid obesity (p = 0.001) and infection with COVID-19 (p = 0.017).

Conclusions:
The predominance of ischemic heart disease, pulmonary embolism and valvular heart disease in premature mortality statistics should encourage strengthening cardiovascular prevention.
24-HOUR AMBULATORY BLOOD PRESSURE MEASUREMENT USING A PULSE ARRIVAL TIME BASED BLOOD PRESSURE MODEL BY A PROTOTYPE WEARABLE SENSOR
Authors: Heimark Sondre , Hove Christine , Stepanov Alexey , Boysen Elin Sundby , Gløersen Øyvind , Bøtke-Rasmussen Kasper Gade , Gravdal Hans Jacob , Narayanapillai Kesi , Larstorp Anne Cecilie K. , Seeberg Trine M. , Waldum-Grevbo Bård 
Published: June 2023

Objective:
Methods to enable cuffless blood pressure (BP) have gained widespread interest. If proven to be comparable to standard cuff measurements and more accepted by patients, these methods can improve hypertension care. We investigated accuracy and patient acceptability of a pulse arrival time (PAT) based model using a prototype cuffless device on the chest compared to standard 24-hour ambulatory blood pressure monitoring (24hABPM).

Design and method:
PAT was calculated using the electrocardiogram (ECG) and photoplethysmography (PPG) sensors incorporated in the chest belt. The model to predict BP from PAT was developed from a general population cohort during isometric exercise induced BP changes. Ninety-four normotensive and hypertensive adults underwent simultaneous 24hABPM with the prototype chest belt sensor and a validated cuff-based oscillometric device on the non-dominant arm. PAT-based BP predictions were compared to reference BPs using 2-minute time windows corresponding to reference measurements. Statistical analyses were performed using Stata® v. 17.0 (Statacorp., Texas, USA) with continuous data presented as means (SD) and compared using paired t-test. Correlation analysis and agreement were evaluated by Bland-Altman plots.

Results:
Mean age (SD) was 48.1 (14.3) years and 48 % had a prior hypertension diagnosis. Comparisons between reference and PAT-based mean 24-hour, daytime and nighttime BP showed that the PAT-based model generally overestimated BP (Table). The largest difference was seen during nighttime; the mean difference (SD) was 19.6 (22.2) mmHg and 17.0 (12.2) mmHg for systolic BP (SBP) and diastolic BP (DBP). Ninety-five % limits of agreements were [-29.8, 36.0 mmHg] and [-23.9, 63.0 mmHg] for daytime and nighttime SBP. The prototype sensor was reported to be more comfortable and less disturbing during daily activities and sleep compared to the reference device during 24hABPM (Figure).

Conclusions:
The present study demonstrated that a general PAT-based BP model significantly overestimated 24hABPM in normotensive and hypertensive subjects. The largest discrepancy was observed during nighttime. Although the PAT-based model did not provide accurate measurements of BP, the potential of cuffless BP technology is promising due to patient acceptability.
RARE CASE OF BUERGER'S DISEASE WITH ACUTE FULMINANT PROGRESSION TO DIGITAL ISCHAEMIA DESPITE AGGRESSIVE MEDICAL TREATMENT
Authors: Cangco Noe , Fang Jun-Tao , Lo Francis Albert , Borja Annamarie , Sule Ashish 
Published: June 2023

Objective:
This case presents an unusual presentation of Buerger's disease.

Design and method:
We report a rare clinical presentation of TAO that may be of diagnostic clinical challenge at the onset.

Results:
Buerger's disease, also known as thromboangiitis obliterans (TAO), is a non-atherosclerotic, segmental inflammatory disease affecting small to medium-sized arteries and veins in the limbs. It is a rare disease seen mostly in young male smokers below 45 years of age. Disease course is typically gradual, progressing from claudication symptoms to rest pain eventually ischemic ulcers and gangrene. It is rare for patients to present with ischemic pain with rapid worsening in days.
This is an interesting case of a 52-year-old male with no known past medical history who presented with digital ischemic rest pain. Initial investigations revealed mildly elevated inflammatory markers, while imaging studies showed thrombosis of bilateral radial and ulnar arteries, with dampened photoplethysmography. He was assessed to be unsuitable for endovascular intervention, consequently was treated medically with anticoagulants, statin, and prostaglandin analogue. He subsequently showed clinical improvement, with no compromise of his hand circulation, and was able to return to work. We report a rare clinical presentation of TAO that may be of diagnostic clinical challenge at the onset. Asians may be affected above the age of 50 years with acute fulminant progression to ischaemia and digital gangrene despite of aggressive medical treatment.

Conclusions:
Buerger's disease, or thromboangiitis obliterans (TAO), is a rare condition that presents a diagnostic challenge to many clinicians. Asians may be affected above the age of 50 years with acute fulminant progression to ischaemia and digital gangrene in spite of aggressive medical treatment.
THE EFFECTS OF MOTIVATIONAL INTERVIEWING ON HYPERTENSION MANAGEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Huang Xinghe , Xu Nuo , Wang Yuyu , Sun Yixin , Guo Aimin 
Published: June 2023

Objective:
Motivational interviewing is a patient-centered, directive counselling method designed to enhance behavior changes and has been widely applied in chronic disease management. However, the effectiveness of motivational interviewing on hypertension management has been not yet conclusive. This systematic review aimed to examine the effects of motivational interviewing-based interventions on hypertension management.

Design and method:
We conducted a systematic literature search in the following databases: PubMed, Embase, CINHAL, Cochrane Central Register of Controlled Trials, PsycINFO, and Web of Science from inception to 25 July, 2022. Randomized controlled trials involving adults diagnosed with hypertension and including motivational interviewing in the treatment interventions were included. Study selection process, data abstraction, and risk of bias assessment were completed independently by two researchers. When feasible, meta-analyses were conducted to estimate the pooled effects using Review Manager (Version 5.4).

Results:
In total, 14 studies with 5122 participants were included. Compared with no or minimal additional intervention, motivational interviewing-based intervention showed greater reduction in systolic blood pressure (MD: -5.28, 95% CI: -8.70, -1.86, P = 0.002) and diastolic blood pressure (MD: -2.34, 95% CI: -4.05, -0.63, P = 0.007) (Figure). Compared with the lower intensity intervention, motivational interviewing-based intervention produced statistically significant effect on reducing systolic blood pressure (MD: -2.72, 95% CI: -5.34, -0.10, P = 0.040); while there was no significant effect on reducing diastolic blood pressure (MD: -0.47, 95% CI: -2.21, 1.28, P = 0.600) (Figure). Qualitative synthesis suggests that motivational interviewing may improve medication adherence, self-efficacy, and quality of life, but the evidence was uncertain.

Conclusions:
Patients with hypertension could benefit from motivational interviewing-based interventions in blood pressure control. Motivational interviewing could be applied as a promising intervention strategy among patients with hypertension. Future research is warranted to evaluate the effects of motivational interviewing on improving medication adherence and psychological well-being.
IMPACT OF CARDIAC REHABILITATION PROGRAM IN ANXIETY AND DEPRESSION. A CASE-CONTROL STUDY
Authors: Costa Carlos Manuel Ol , Carvalho Simao Pedro , Jesus Ana Gomes Tania , Albuquerque Nelson Ferreira , Bastos Jose Mesquita , Neves Ana Briosa 
Published: June 2023

Objective:
The association of depression with increased mortality is widely demonstrated in patients with cardiovascular disease (CVD). Depression and anxiety are common in this group and may adversely affect cardiovascular outcomes. The Hospital Anxiety and Depression Scale (HADS) englobes two scales (HASD-D for depression and HADS-A for anxiety) and is a 14-item tool to measure anxiety and depression symptoms in medical patients, which was shown to be an excellent tool when assessing the psychological well-being of patients undergoing cardiac rehabilitation. This study aims to evaluate whether entry into a rehabilitation programme is associated with a lower HADS score.

Design and method:
Single center, cross-sectional case-control study comparing a screening anxiety and depression score – Hospital Anxiety and Depression Score (HADS) - in patients submitted to a Cardiac Rehabilitation (CR) program with a matched control group. Each patient in the study group was matched by sex, age and primary pathology to an individual in the control group. The selection bias was reduced by the selection of control patients in our institution previously to the implementation of the CR program.
Descriptive analysis was performed using means and standard deviation (SD), medians and Interquartile range (IQR) for continuous data, and frequencies and percentages for qualitative variables. HADS Score was compared between groups using Independent-Samples T Test in SPSS® software.

Results:
We studied a total 36 patients (18 CR patients and 18 matched controls), 72.2% were men, and the mean age of patients was 55.2 years. Upon comparison, the patients in the CR group had a statistically significantly lower HADS Score compared with matched non-CR patients (2.7 vs 3.5, p<.05) (Table 1).

Conclusions:
This study suggests that inclusion into a cardiac rehabilitation programme helps to reduce the HADS scores of post-MI patients.
EFFECT OF KIDNEY TRANSPLANTATION ON INDICES OF CARDIORESPIRATORY FITNESS ASSESSED WITH CARDIOPULMONARY EXERCISE TESTING: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Pella Eva , Alexandrou Maria-Eleni , Boutou Afroditi , Theodorakopoulou Marieta , Sampani Erasmia , Dipla Konstantina , Zafeiridis Andreas , Sarafidis Pantelis 
Published: June 2023

Objective:
Patients with kidney failure often present with reduced functional cardiovascular reserve and exercise intolerance. Kidney transplantation is the optimal treatment for patients with end-stage kidney disease as it is associated with longer survival and improved quality of life compared to hemodialysis or peritoneal dialysis.

Design and method:
This is a systematic review and meta-analysis of studies using cardiopulmonary-exercise-testing (CPET) to examine the cardiorespiratory fitness of patients with kidney failure before and after kidney transplantation. The primary outcome was differences in pre- and post-transplantation values of peak oxygen uptake (VO2peak). Literature search involved PubMed, Web of Science and Scopus databases, manual search of article references and grey literature. Quality assessment was undertaken with Newcastle-Ottawa-Scale.

Results:
From 379 literature records initially retrieved, 6 studies (207 participants) were included in final meta-analysis. A marginal, but not significant, improvement was observed in oxygen consumption during peak exercise compared to pre-transplantation values (standardized mean difference [SMD]: 0.32, 95%CI -0.02; 0.67). Oxygen consumption at anaerobic threshold (VO2AT) was significantly improved after kidney transplantation (weighted MD [WMD]: 2.30 ml/kg/min, 95%CI 0.50; 4.09), whereas no significant changes were observed in maximum heart rate (WMD: 10.45 bpm, 95%CI -3.97; 24.86). In subgroup analysis, consistent results were shown between patients having undergone transplantation preemptively and those after dialysis initiation (p-value for subgroup differences = 0.95). Of note, a trend for improvement in VO2peak was observed when pooling data reported from follow-up assessments undertaken at least 3 months post-transplantation surgery (SMD: 0.17, 95%CI -0.03; 0.38), but not earlier (WMD: -0.03 ml/kg/min, 95%CI -4.28; 4.23).

Conclusions:
Several major indices of cardiorespiratory fitness tend to improve after kidney transplantation compared to pre-transplantation values. This finding may represent another modifiable factor contributing to better survival rates of kidney transplant recipients compared to patients undergoing dialysis.
COMPARISON OF INFLUENCE OF OFFICE PULSE WAVE VELOCITY AND 24-HOUR AMBULATORY RECORDING OF AORTIC PULSE WAVE VELOCITY ON TARGET DAMAGE IN HYPERTENSION
Authors: Chao Huijuam , Wang Qian , Avolio Alberto , Zuo Junli 
Published: June 2023

Objective:
Arterial stiffness, as measured by pulse wave velocity (PWV), is a significant determinant of target organ damage (TOD). The aim of this study was to assess the potential use of office PWV and 24-hour PWV for prediction of subclinical TOD in a hypertensive cohort.

Design and method:
We evaluated associations of TOD with office carotid-femoral pulse wave velocity (O-cf-PWV) by radial tonometry (SphygmoCor) and 24-hour ambulatory PWV measurements (24h-PWV, including day-PWV and night-PWV) by brachial oscillometry (Mobil-O-Graph 24h PWA Monitor) in 636 hospital inpatients (age 54 ± 13 years, 465 males) with primary hypertension. Subclinical TOD was defined as left ventricular hypertrophy (LVH) obtained by echocardiography, carotid intima-media thickness (IMT) >0.9mm and chronic kidney disease (CKD) including urine albumin/creatinine ratio (ACR) >3.5 mg/mmol in females and >2.5 mg/mmol in males or estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2.

Results:
After adjusting for confounding factors, both O-cf-PWV and 24h-PWV or night-PWV showed significant association with LV mass index (p<0.05). Only day-PWV was associated with eGFR (p = 0.039). When O-cf-PWV and 24h-PWV, including other confounding factors, were forced into the same logistic regression model, only O-cf-PWV (OR = 1.117, 95% CI:1.009-1.236, p = 0.033) remained significant determinants of increased LVH. Each 1 m/s increase in 24-h-PWV and day-PWV was associated with decreased risk of eGFR (odds ratio [OR] = 0.340 and 0.43, respectively). Only each increase in night-PWV was associated with risk of carotid IMT > 0.9 mm (OR = 1.360, 95% CI: 1.004 -1.843, p = 0.047). For ACR, neither 24-h-PWV nor O-cf-PWV was significant.

Conclusions:
O-cf-PWV improved prediction of LVH compared to ambulatory 24h-PWV under ambulatory conditions. Day-PWV may improve prediction of eGFR decline.
ARTERIAL STIFFNESS ASSESSED BY SYSTEMIC VERSUS REGIONAL INDICES: DETERMINANTS AND DIAGNOSTIC AGREEMENT
Authors: Kyriakoulis Konstantinos , Kollias Anastasios , Ntousopoulos Vasileios , Theodosiadi Aikaterini , Menti Ariadni , Stathopoulou Panagiota , Ntineri Angeliki , Stergiou George S. 
Published: June 2023

Objective:
Arterial stiffness is closely associated with aging and hypertension and may improve the stratification of cardiovascular risk in patients with hypertension. This study investigated the determinants and the diagnostic agreement of systemic (brachial-ankle pulse wave velocity [baPWV]) and regional (carotid distensibility coefficient [DC]) arterial stiffness indices.

Design and method:
Adults referred to a hypertension outpatient clinic were subjected to: (i) triplicate office blood pressure (BP) measurement using a validated professional oscillometric upper-arm cuff device Microlife WatchBP Office, (ii) baPWV measurements using an automated oscillometric device Microlife WatchBP Office Vascular, and (iii) DC and carotid intima-media thickness (cIMT) measurements with carotid ultrasound.

Results:
Data from 136 participants were analyzed (mean age 60±12 [SD] years, 71% males, body mass index 28±4 kg/m2, 83% hypertensives, 12% diabetics, 16% smokers, baPWV 14±2 m/sec, DC 24±9 10-3/kPa). There was a moderate negative association between baPWV and DC (r = -0.37, p<0.01). baPWV was positively correlated with age (r = 0.64, p<0.01), systolic office BP (r = 0.27, p<0.01) and cIMT (r = 0.29, p<0.01), while DC was inversely associated with age (r = -0.37, p<0.01), systolic office BP (r = -0.48, p<0.01), and cIMT (r = -0.29, p<0.01). In multivariable linear regression models (independent variables: age, sex, systolic office BP, cIMT, diabetes), age and systolic office BP appeared to be significant determinants of baPWV (beta = 0.12/0.05, respectively) and DC (beta = -0.32/-0.27, respectively). The agreement between the two methods in identifying individuals with increased arterial stiffness (1st quartile of DC distribution and 4th quartile of baPWV distribution) was fair (agreement 71%, kappa = 0.22, p<0.05).

Conclusions:
These results suggest that although these two methods for assessing arterial stiffness are correlated and determined by similar variables, their agreement in identifying individuals with increased arterial stiffness is fair, implying that they may provide complementary information.