bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-P10-6: IDENTIFYING A URINARY PEPTIDOMICS PROFILE FOR HYPERTENSION IN YOUNG ADULTS: THE AFRICAN-PREDICT STUDY
Authors: de Beer Dalene , Mels Catharina MC , Schutte Aletta E , Delles Christian , Samji Sheon M , Mullen William , Mischak Harald , Kruger Ruan 
Published: January 2023

Background and Aims:
Hypertension is one of the most important and complex risk factors for cardiovascular diseases. Identifying biomarkers in hypertension may lead to better strategies to understand the development of hypertension. Biomarker discovery through the use of peptidomics may also provide essential information for the prediction and prevention of premature CVD development.

Methods and Results:
We included 78 hypertensive (based on 24-hour ambulatory blood pressure) and 79 normotensive age (20–30-years old), sex and ethnicity (62% black and 48% white) matched participants from the African-PREDICT study. Urinary peptidomics were analysed with capillary electrophoresis time-of-flight mass spectrometry. Hypertension-specific peptide profiles were combined into a single summary multidimensional classifier. When comparing the peptide data between the normotensive and hypertensive groups, 354 peptides were nominally differentially expressed (Wilcoxon p-value less than 0.05). Nonetheless, only three peptides (ID10000 (SHANK1), ID8939 (unsequenced) and ID6841 (unsequenced)) remained significant after rigorous adjustments for multiple comparisons (maxT test) and were more abundant in the hypertensive compared to the normotensive group (all p-value less than 0.001). Furthermore, the 15 nominally most significant peptides (all p-value less than or equal to 0.0013) were combined into a unifying score which differed significantly between the groups (p-value less than 0.001) but had an insufficient prediction capability for hypertension.

Conclusion:
Apart from differential expression of single peptides in hypertensive adults, including ID10000 (SHANK1), no unifying urinary hypertension peptidomics profile was identified with a sufficient prediction capability. Our findings suggest that a downstream multimarker approach cannot reliably represent a complex multifactorial condition such as hypertension.
PS-P10-7: SEVENTY YEARS OF PHEOCHROMOCYTOMAS AND PARAGANGLIOMAS IN ARGENTINA
Authors: Aparicio Lucas S , de Miguel Valeria , Marín Marcos , Paissan Andrea , Sansó Gabriela , Lupi Susana , Barontini Marta 
Published: January 2023

In Argentina, data regarding Pheochromocytomas and Paragangliomas (PPGLs) are scarse.

Objective:
to describe demographic, biochemical and genetic characteristics of children and adults with confirmed PPGls.

Design and method:
Observational multicenter study of recruited participants surveyed from a retrospective cross sectional database from january 1953 until January 2022.

Results:
We included 486 patients (58.4% women) from 93 recruiting centers, mean age at diagnosis 38.3, 393 (80.9%) hypertensives, baseline office systolic/diastolic blood pressure 157.8/96.5 mmHg. Of all tumors, 382 (79.6%) were Pheochromocytomas, 67 (13.8%) paragangliomas and 11 (2.3%) mixed. The most prevalent cathecolamin secretion type was noradrenergic (35%), followed by adrenergic (30.6%) and mixed (20.3%). Local recurrence and mestastasis occured in 10% of subjects. The most common symptoms were headache (57%), sweating (57.5%) and palpitations (53.4%). In 147 patients with a genetic syndrome, we found 44 MEN2A, 7 MEN2B, 1 MEN1, 42 Von Hippel Lindau, 11 neurofibromatosis type 1, 32 PGL4, 6 PGL1, 2 MAX, 1 TMEM127, and 1 mosaic EPAS1/HIF2A. We found the genetic variant types in 102 patients.

Conclusions:
Our results are consistent with other publications from foreign databases. PPGls are rarely diagnosed in Argentina, and the genetic profile is lacking in three fourths of patients.
PS-R03-5: HYPOTENSIVE AND HYPERGLYCEMIC EFFECTS OF DIAZOXIDE IN A CASE OF INSULINOMA
Authors: Yamagishi Toshio 
Published: January 2023

Case report:
We report the case of sporadic insulinoma in a 70-year-old female with breast cancer and hypertension treated by irbesartan 100 mg and benidipine 8 mg, who presented with a 1-month history of episodic tremulousness, diaphoresis, increased hunger, confusion and fainting. Initial laboratory investigations showed low blood glucose (21 mg/dL) and high blood insulin (107 μU/mL) levels. The hypoglycemic symptoms were relieved greatly by glucose administration and Whipple's triad for insulinoma was met. An abdominal contrast-enhanced computed tomography scan showed a 12 mm, small, well demarcated, heterogeneously enhancing lesion within the tail of pancreas without dilatation of pancreatic duct. The site also showed a well-defined accumulation of boundaries on PET-CT. Patient was diagnosed with insulinoma. Since Patient did not initially wish to undergo surgery, blood glucose control was performed by taking diazoxide 225 mg, gradually reduced to 50 mg. Before and after taking diazoxide, blood glucose increased from 75 ± 40 mg/dL to 124 ± 35 mg/dL significantly (p < 0.05). On the other hand, blood pressure was significantly reduced from 141 ± 3/78 ± 3 mmHg to 126 ± 3/75 ± 3 mmHg. Benidipine was withdrawn to about 130/80 mmHg. Then, Patient changed her mind and underwent laparoscopic caudal pancreatic resection. Histopathological examination of the pancreatic mass confirmed neuroendocrine tumor (insulinoma). Patient had an uneventful recovery. Blood pressure re-increased above 140/90 mmHg and benidipine was resumed. Although diazoxide suppresses insulin secretion in the pancreas due to its KATP channel opening action and improves hypoglycemic attacks with insulinoma, it also acts on the KATP channel of vascular smooth muscle and show a hypotensive effect. It is important to pay close attention not only to blood glucose but also to blood pressure fluctuations when using diazoxide.
PS-R04-3: A CASE OF RESISTANT HYPERTENSION
Authors: Nakajima Yuya , Irie Junichiro , Nakamura Toshifumi , Kawano Yoshinaga , Ito Arata , Kinouchi Kenichiro , Kobayashi Sakiko , Meguro Shu , Itoh Hiroshi 
Published: January 2023

Background:
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg despite the use of three antihypertensive medications of different classes at the maximally tolerated doses, one of which is a diuretic. It is reported that approximately 10% of patients with hypertension have resistant hypertension, but the optimal management of resistant hypertension remains to be unclear.

Case presentation:
A 56-year-old Japanese woman visited our hospital because she presented high blood pressure of about 170/100 mm Hg even after the treatment by her primary physician. She had hypertension after giving birth at age 26 and her blood pressure was about 170/100 mm Hg. She was suspected of having secondary hypertension and the laboratory and imaging examination were conducted. The functions of the adrenal gland and thyroid were normal, and the renal artery stenosis and chronic kidney disease were excluded. She did not have NSAIDs, oral contraceptives, and herbal products. Although she had been intensively treated for hypertension, she suffered from a brain hemorrhage. Her systolic blood pressure has been still not controlled appropriately by 80 mg of nifedipine, 400 mg of the combination of sacubitril/valsartan, 2.5 mg of esaxerenone, 2 mg of trichlormethiazide, and 9 mg of bisoprolol transdermal patch daily.

Conclusion:
Because patients with resistant hypertension have a higher risk of stroke, kidney disease, and heart failure, the careful examination and intensive treatment are necessary.
PS-R04-4: A CASE OF PHEOCHROMOCYTOMA IN A 17-YEAR-OLD MALE
Authors: Liberato Jessa Mae Daranciang , Punzalan Jemely Metra 
Published: January 2023

Background:
Pheochromocytoma is a rare catecholamine secreting tumor arising from the adrenal medulla and produces signs and symptoms due to excessive catecholamine secretion from the tumor. It is a rare cause of secondary hypertension and a delay in recognition and treatment can present serious consequences to the patient.

Case Summary:
We present a case of a 17-year-old male with a history of hypertension for 4 years with episodic headache, palpitations, and sweating. He does not have any history of serious illnesses, hospitalizations, or trauma. He was not on any medications. He has a family history of hypertension. He does not drink alcohol, smoke cigarettes, or do any illicit drugs. Upon arrival to the ER, he was conscious, coherent with BP of 170/140mmHg, PR 111bpm, RR 26cpm, and afebrile.
Laboratory work-up showed proteinuria, elevated BUN and creatinine levels, hyponatremia, hypokalemia, and hypocalcemia. A 2D echocardiography showed left ventricular hypertrophy. The whole abdominal CT scan demonstrated a fairly defined hypodense mass in the left suprarenal measuring 4.8 x 6.4 x 4.7 cm. Pheochromocytoma was confirmed by biochemical tests that showed elevated plasma normetadrenaline and 24-hour urine metanephrine. The patient was initially started on an alpha-adrenergic blocker, Terazosin, and a beta-blocker, Propranolol. Blood pressure was still uncontrolled hence calcium-channel blocker, Nicardipine drip was also given to control the blood pressure. During surgery, they noted the mass to be 8x5 cm invading the superior pole to mid pole and renal hilum hence the patient underwent left open adrenalectomy with left radical nephrectomy. Immediately upon removal of the mass, the patient had a hypotensive episode, which was addressed immediately. The histopathologic finding showed no extension of the mass to the kidneys and it is consistent with pheochromocytoma. Blood pressure control without medication was achieved 13 days post-operatively. The patient is regularly monitored for the recurrence of hypertension due to the increased risk of recurrence. The patient is now living with a solitary kidney hence should also be followed up through.

Conclusion:
Although it is a rare condition, pheochromocytoma should be considered a differential diagnosis in young patients presenting with unexplained hypertension, headache, and palpitations. A multidisciplinary approach is the best way to achieve success in the management of a patient with pheochromocytoma.
PS-R04-5: A CASE OF SEVERE RENAL FAILURE WITH HYPERTENSIVE EMERGENCY WHO SUCCEEDED IN HEMODIALYSIS WITHDRAWAL BY STRICT CONTROL OF BLOOD PRESSURE
Authors: Kato Naoyuki , Mizumoto Teruhiko , Izumi Yuichiro , Kuwabara Takashige , Mukoyama Masashi 
Published: January 2023

Introduction:
Hypertensive emergency is a condition in which progressive and irreversible organ damages occur as a result of extremely elevated blood pressure. Although the prognosis for renal outcomes has been improved by advances in antihypertensive therapy, the cases who result in maintenance dialysis are still not uncommon. We herein report a case of hypertensive emergency who was successfully withdrawn from hemodialysis by intensive treatment.

Case presentation:
A 55-year-old woman, whose systolic blood pressure was 150–160 mmHg constantly for at least 2 years, was seen by her primary care physician due to nocturnal cough and respiratory distress. She exhibited marked hypertension (diastolic blood pressure, 120–130 mmHg) and renal dysfunction (serum creatinine (sCr), 2.76 mg/dL, baseline 0.5 mg/dL). She was diagnosed as hypertensive emergency and was treated with antihypertensive agents immediately. Despite the treatment, her renal function did not improve, so that she was transferred to our hospital for further examination and intensive treatment. While imaging examination revealed a right adrenal tumor, for which primary aldosteronism was suspected, endocrinological examinations showed high plasma aldosterone concentration with high plasma renin activity; therefore it was assumed that the hormonal changes were secondary to hypertensive emergency. Although funduscopic findings were relatively mild (KW-IIb), the condition was considered as accelerated-malignant hypertension caused by essential hypertension. A renal biopsy revealed extensive interstitial damage with onion skin-like lesions, which led to a diagnosis of malignant nephrosclerosis. While continuing strict antihypertensive management including the renin-angiotensin system blockade, hemodialysis was started on day 17 due to progressive renal dysfunction (sCr 9.27 mg/dL). Continuous intensive treatment gradually alleviated renal dysfunction, and hemodialysis was finally withdrawn on day 38. There was no further deterioration seen, and the patient was discharged on day 55. After discharge, her renal function was kept improved and her sCr was 2.5 mg/dL 6 months after the discharge.

Discussion and Conclusion:
Hypertensive emergency may cause irreversible kidney damage without appropriate antihypertensive therapy. In particular, acute tubular damages have been suggested to correlate with both systolic and diastolic blood pressures. Controlling blood pressure appropriately is crucial to protect kidneys against disease progression and even reverse kidney damage upon acute renal failure with hypertensive emergency.
PS-R05-8: THREE PATIENTS WITH CHRONIC KIDNEY DISEASE WHEREIN ANGIOTENSIN RECEPTOR NEPRILYSIN INHIBITOR WAS EFFECTIVE AGAINST HEART FAILURE AND HIGH BLOOD PRESSURE
Authors: Sato Eiichi , Tanaka Hiroaki , Sato Shohei , Degawa Manaka , Ono Takao , Lu Hongmei , Matsumura Daisuke , Nomura Mayumi , Moriyama Noriaki , Amaha Mayuko , Nakamura Tsukasa 
Published: January 2023

Background:
The efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI) for patients with an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73m2 have not been established. This paper reports three cases of low eGFR wherein ARNI was effective against heart failure and high blood pressure. Case: In case 1 (a woman in her 70 s), eculizumab was used to treat chronic kidney disease (CKD) because of an atypical hemolytic uremic syndrome. Surgery was performed for the exacerbation of chronic heart failure due to worsening mitral regurgitation. The postoperative course was stable. However, from the third disease day, her kidney failure exacerbated (eGFR decline from 16 to 10 mL/min/1.73 m2), heart failure flared up again (B-type natriuretic peptide [BNP] elevated from 500 to 1200 pg/mL), hemodialysis was performed, carperitide was added, and the diuretic stage was started. However, the drug could not be discontinued, and ARNI was initiated (50 mg once twice a day). Consequently, the eGFR was recovered (elevated from 10 to 18 mL/min/1.73 m2), the urine output was increased, and the heart failure was recovered (BNP declined from 1200 to 250 pg/mL). In case 2 (a man in his 80 s), CKD exacerbation due to diabetic nephropathy (eGFR of 18 mL/min/1.73 m2) led to heart failure, and hemodialysis therapy and ARNI (50 mg once two times a day) were initiated. Good diuresis became available, and hemodialysis could be withdrawn (BNP declined from 120 to 70 pg/mL, and the bodyweight from 95 to 75 kg). Since then, the urine output has been maintained, and peritoneal dialysis has been initiated and continued. In case 3 (a man in his 70 s), in whom 6 months had elapsed since the initiation of hemodialysis therapy for CKD caused by diabetic nephropathy, the dry weight was appropriate, but the blood pressure tended to increase (from 140/80 to 186/96 mmHg). Moreover, BNP levels had increased (BNP elevation from 70 to 180 pg/mL). When telmisartan 40 mg once a day was changed to ARNI (100 mg once a day) as an antihypertensive agent, the blood pressure was stabilized (from 186/96 to 140/80 mmHg), and the BNP decreased (BNP declined from 180 to 20 pg/mL). No adverse events were observed in all three cases. Discussion: These cases suggest that ARNI not only has diuretic effects but decreases blood pressure and BNP in patients with CKD, including those requiring dialysis. ARNI may be used relatively safely even in patients with reduced kidney function.
PS-B10-6: CAPILLARY-TO-ARTERIOLAR SIGNALLING, INFLAMMATION AND SMALL VESSEL DISEASE OF THE BRAIN
Authors: Evans Lowri Elizabeth , Taylor Jade , Dabertrand Fabrice , Pritchard Harry , Schiessl Ingo , Allan Stuart , Greenstein Adam 
Published: January 2023

Objective:
Chronic cerebral inflammation is thought to be a mechanism by which hypertension causes small vessel disease of the brain, leading to dementia. Mouse studies have demonstrated enhanced small resistance artery constriction and neurovascular uncoupling in hypertension. We wished to examine whether acute exposure to the predominant inflammatory driver in hypertension, interleukin-1β; (IL-1β;) could account for this dual vascular deficit.

Design and method:
Pressure myography of freshly isolated mouse posterior cerebellar pial arteries was used to assess contributions of the inwardly rectifying K+ 2.1 (KIR2.1) channel to vasodilation. In order to assess neurovascular coupling from a vascular perspective, we adopted a recently described approach: the Capillary to Parenchymal Arteriole (CaPA) preparation. In the CaPA preparation, penetrating arterioles (< 40ums) with attached capillary branches are isolated and pressurised. The capillary branch and arteriole are independently stimulated via a micropipette and arteriole diameter is recorded. This approach enables the retrograde hyperpolarising signal from the KIR2.1 channel, which propagates against the flow of blood in the brain, to be assessed both in terms of the extent of arteriole vasodilation and the speed of communication (video).
In order to assess the effects of perivascular inflammation on cerebrovascular function, we incubated (in culture medium) small pial arteries with IL-1β; for 24 hours prior to study on a pressure myograph rig. KIR2.1 function was assessed using 10 mM exogenous K+. Cerebral arterioles with attached capillaries were incubated with IL-1β; for 2 hours prior to CaPA study. We then examined the capillary-to-arteriolar signalling mechanism via application of 10 mM K+ to the capillary. We also assessed arteriolar tone and reaction to directly applied K+, NS309 and U46619.

Results:
Preliminary data suggests that sub-acute incubation with exogenous IL-1β; had no effects on the degree of pressure induced constriction of either the pial artery or the arteriole. CaPA preparation showed that the KIR2.1 capillary-to-arteriolar signalling was preserved as well as arteriolar responses to direct K+, NS309 and U46619 following IL-1β; exposure.

Conclusions:
Whilst chronic cerebral inflammation in the setting of hypertension results in cerebrovascular deficits, sub-acute exposure with IL-1β; does not appear to significantly impair cerebral microvascular function. Precisely how chronic exposure to inflammation in hypertension induces neurovascular uncoupling is the subject of ongoing investigation.
PS-B12-7: PERSISTENT REDUCTION IN RENAL RENIN FOLLOWING EARLY TREATMENT OF SPONTANEOUSLY HYPERTENSIVE RATS WITH LOSARTAN
Authors: Harrap Stephen , Suphapimol Vera , Byars Sean , De Vries Nathan , Prestes Priscilla , WilkinsonBerka Jenny , Charchar Fadi 
Published: January 2023

Objective:
Abnormalities of renin-angiotensin system (RAS) and renal function have been reported in young spontaneously hypertensive rats (SHR) and blood pressure (BP) can be permanently reset to lower levels after brief early treatment with RAS inhibitors. We sought to determine whether renal renin was affected long-term by early RAS blockade.

Design:
Male SHR were treated via minipump from 10–14 weeks of age with vehicle (Veh, n = 12) or losartan (Los, n = 14, 7.5 mg/kg/d). Four Veh and six Los SHR were culled at 14-weeks and the remaining animals at 20-weeks. To control for effects of low BP another group received hydralazine (HZ, n = 6, 1 mg/kg/d) from 10–20 weeks.

Methods:
At 14- and 20-weeks systolic BP was measured, and kidneys collected. Three micrometer paraffin sections of renal cortices were counterstained with hematoxylin for renin immunolabelling, assessed for each animal as the percentage of labelling in 200 glomeruli which displayed the afferent arteriole entering the glomerulus.

Results:
At 14-weeks the systolic BP (mean ± SEM) was significantly (P < 0.001 by ANOVA) lower in both the Los (145 ± 7 mmHg) and HZ (153 ± 7 mmHg) SHR compared with Veh (206 ± 6 mmHg). At 20-weeks, the same pattern persisted (Los: 187 ± 6 mmHg; HZ: (155 ± 4 mmHg; Veh: 220 ± 6 mmHg) (P < 0.001 by ANOVA). Renal renin immunolabelling increased dramatically during treatment at 14-weeks (44.8 ± 1.1%) compared with Veh (10.5 ± 1.7%) (P < 0.0001 by ANOVA). However, at 20-weeks renal renin was significantly lower in Los (7.7 ± 0.9%) (P < 0.05 by ANOVA) compared with Veh (11.9 ± 1.2%), while renal renin was significantly higher in HZ kidneys (18.0 ± 1.0%) than both Los and Veh kidneys (P < 0.01 by ANOVA).

Conclusions:
The persistently low BP in SHR following brief early treatment with losartan is associated with reduced renal renin. Normally one would expect activation of the renal RAS with lower BP, as observed with the hydralazine-treated SHR. These results suggest that long-term reduction in renal renin following brief early RAS blockade in SHR might cause the persistently reduced BP seen in these animals.
PS-B12-10: CLASSIC CARDIOVASCULAR PROTECTIVE SIGNALING IN ANGIOTENSIN II-INDUCED NOVEL PREECLAMPSIA RAT MODEL
Authors: Cui Huixing , Jin Li Yuan , Liu Jun Xian , Zhang Yin Hua 
Published: January 2023

Angiotensin II (Ang II)-induces vasoconstriction, in vivo perfusion has been shown to induce preeclampsia (PE) in pregnant rats. In this study, we aimed to examine the protein and mRNA expressions of endothelial and neuronal NOS (eNOS, nNOS) as well as angiotensin II type 2 receptor (AT2R) in normal pregnant and Ang II-induced PE rats.
Pregnant (8 weeks) and non-pregnant SD rats (8 weeks, GD-8) were infused with Ang II via an osmotic minipump (1 ug/kg/min), and the rats (GD-21) were sacrificed 13 days later. Pregnant and non-pregnant rats without Ang II were taken as sham controls. The fetal weight, crown-rump length and placental weight of PE rats were significantly lower compared to those without Ang II infusion. Immunohistochemistry results showed an approximately 30% increase in glomerular volume, suggesting morphological changes in the kidney and Ang II infusion exhibits a PE phenotype. Ang II infusion did not affect AT2R, AT1R and nNOS protein or mRNA expression in the uterus of non-pregnant or pregnant rats. However, eNOS mRNA expression was reduced in PE rats (p < 0.0001) although protein expression was not affected by Ang II infusion. However, in the placenta, AT1R and AT2R protein expression were not different in PE, but AT2R mRNA was decreased (p < 0.0001). eNOS protein was only expressed in fetal vascular endothelial cells, and eNOS protein expression was higher in PE rats (P = 0.001) but eNOS mRNA was decreased (p = 0.0096). Notably, strong nNOS expression was observed in placental trophoblast cell groups of sham and PE rats, and both mRNA and protein expression of nNOS was decreased in placental lysates of Ang II rats (respectively p = 0.0287 and p < 0.0001).
These results demonstrate that we have recapitulated the PE model of Ang II infusion in rats. The expression of nNOS was reduced, and the localization of nNOS in the trophoblast suggested a new functional remodeling in the fetal vasculature.
In the placenta, decreased expression of AT2R and nNOS may be a novel mechanism of impaired fetal development.