bluuebunny/crossref_metadata_2025_split huggingface dataset:
ARTERIAL STIFFNESS ESTIMATED BY BRACHIAL OSCILLOMETRY PREDICTS PROGRESSION TO HYPERTENSION IN PATIENTS WITH NORMAL AMBULATORY BLOOD PRESSURE
Authors: Rodilla Enrique , Mendizabal Andrea , Jimenez Iratxe , Canales Sergio , Roldan Alicia , Perez Leticia , Catalan Marta , Saez Maria Carmen , Ferrer Anna , Pintos Santiago , Fernandez Monica , Morro Santiago , Chorda Jose , Costa Jose Antonio 
Published: June 2023

Objective:
There is growing evidence that arterial stiffness can precede hypertension (HTN). This study aimed to assess the predictive value of Pulse Wave Velocity, estimated by brachial oscillometry (ePWV), for incident HTN in patients with initially normal ambulatory BP measurement (ABPM) after one year of follow-up.

Design and method:
This retrospective, observational, longitudinal study included all consecutive patients referred to a HTN Unit with suspected naïve HTN, without prior pharmacological treatment. EVA was defined according to ePWV exceeding the 90th percentile of its age group (Mobil-O-Graph, IEM®). Incident HTN was defined as ABPM at follow-up > 130/80 mmHg or prescription of antihypertensive medication. Standard clinical tests and ABPM were performed at baseline and after 12 months.

Results:
223 consecutive patients with ABPM <130/80 mmHg entered the study, with 155 women (69.5%), a mean age of 47.9 years (±13.5), mean office BP of 128/73 (±13/8), mean ABPM of 118/73 (±7/5) mmHg and mean estimated PWV of 7.74 m/s (±1.7). At baseline, 51.1% of patients showed EVA. At follow-up, after a mean time of 1,1 years, 114 participants presented elevated ABPM. After adjustment for age, gender and ambulatory BP, presence of EVA at baseline was associated with progression to HTN at follow-up (OR:2,5;IC:1,4-4,6;p = 0.003). Furthermore, the pattern of PWV-EVA and incident HTA according to age were superimposable (Image). Arterial stiffness defined as ePWV > 10 m/s was also significantly associated with incident HTN, but showed a completely different distribution in age compared with incident HTN. Of note, arterial stiffness at follow-up was mainly determined by EVA at baseline (OR:6.1;IC:3.2-11.6;p = 0.001), but not by BP traits.

Conclusions:
Arterial damage, characterized as early vascular aging according to estimated PWV by brachial oscillometry, doubles the probability of sustained HTN one year after initial assessment in naïve patients with normal ABPM at baseline, independently of ambulatory and or office blood pressure at baseline. On the other hand, the main determinant of arterial stiffness at follow-up was elevated ePWV at baseline, but not blood pressure traits.
FISETIN ENHANCES PPAR GAMMA EXPRESSION TO PREVENT VASCULAR SMOOTH MUSCLE CELL SENESCENCE VIA MTORC2-AKT-FOXO3A SIGNALING PATHWAY
Authors: Kim Seul Gi , Sung Jin Young , Kang Young Jin , Choi Hyoung Chul 
Published: June 2023

Objective:
Cellular senescence is caused by diverse stimuli and is contributed to cardiovascular diseases such as atherosclerosis, coronary heart disease, and hypertension. Several studies have indicated that PPAR gamma is mainly a key mediator in lipid metabolism and adipocyte differentiation. In addition, PPAR gamma has a protective effect in vascular biology and regulates the inflammation and reactive oxygen species (ROS). Nevertheless, the anti-aging mechanism of PPAR gamma has not been elucidated in vascular smooth muscle cell (VSMC). Although mTORC2 is involved in the cellular senescence and autophagy, there are significantly fewer studies than mTORC1. Therefore, we focused on mTORC2 function and then aimed to investigate the correlation between PPAR gamma and mTORC2, and to identify the anti-aging mechanism in VSMC.

Design and method:
To generate the oxidative stress-induced VSMC senescence, we treated with hydrogen peroxide (H2O2). The anti-aging effect and underlying mechanism of fisetin were evaluated by Western blot analysis, senescence-associated beta-galactosidase (SA-beta-gal) staining, flow cytometry, immunofluorescence analysis, and immunoprecipitation analysis.

Results:
We found hydrogen peroxide (H2O2) induced not only PPAR gamma translocation from nuclear to cytosol but also mTORC2 activation with VSMC senescence. We determined mTORC2 activation contributed to the senescence by suppressing FoxO3a-autophagy signaling pathway. Furthermore, the double knockdown of mTORC1 and mTORC2 decreased the cellular senescence and increased the autophagy activation more than single knockdown. However, fisetin acted as a PPAR gamma activator, leading to the inhibition of VSMC senescence through mTORC2-Akt (Ser473)-FoxO3a signaling pathway which is related to autophagy.

Conclusions:
These results demonstrate PPAR gamma is associated with cellular senescence and fisetin has anti-aging effect via PPAR gamma activation and mTORC2 inhibition. Moreover, mTORC2 signaling pathway could regulate autophagy, which suggests mTORC2 is considered a significant target for preventing cellular senescence and aging-related disease.
ASSOCIATION BETWEEN HOUSEHOLD SOLID FUEL USE AND RISK OF SARCOPENIA: DATA FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
Authors: Chen Chao-Lei 
Published: June 2023

Objective:
Few studies have examined the effects of air pollutants on the risk of sarcopenia, especially air pollution from indoor settings. We aimed to explore the cross-sectional and longitudinal associations of household solid fuel use for cooking and heating, separately and simultaneously, with risk of sarcopenia.

Design and method:
Cross-sectional and follow-up data from the China Health and Retirement Longitudinal Study (CHARLS) were used. Multivariable-adjusted generalized linear models and Cox proportional hazards regression models were performed to estimate the odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CI), respectively. We also calculated the extent of interaction or joint relations of sociodemographic and behavioral factors and household fuel use with sarcopenia.

Results:
11,494 (median age: 57.0 years; 47.4% males) and 7,483 (median age: 57.0 years; 46.9% males) participants were included in the cross-sectional and follow-up study, respectively. After fully adjusting for covariates, both using solid fuels for cooking and heating were positively associated with incident sarcopenia in the longitudinal analyses, with hazard ratio (HR) (95% CI) of 1.56 (1.28-1.89) and 1.26 (1.04-1.52), respectively. When comparing to those using clean fuels for both cooking and heating, participants using solid fuels for both cooking and heating were more likely to have incident sarcopenia [HR (95% CI):1.52 (1.19-1.93)]. In addition, compared with those persistently used clean fuel for cooking, significantly higher risk of new-onset sarcopenia was found in participants persistently used solid fuels [HR (95% CI):2.05 (1.55-2.71)]. Moreover, significant multiplicative and/or additive interactions were observed between age, smoking status and solid fuel use for cooking with risk of sarcopenia (all P for interaction < 0.05). Similar results were found in the cross-sectional analyses.

Conclusions:
Household solid fuel use was significantly associated with higher risk of sarcopenia. In addition, ageing and smoking had synergetic effects with burning solid fuels for increasing the risk of sarcopenia. Our results highlighted the importance of taking multi-pronged measures from both aspects of air pollution and health behavior to prevent sarcopenia and promote healthy ageing.
ATRIAL FIBRILLATION AND MORTALITY RISK IN HYPERTENSIVE PATIENTS ACCORDING TO CARDIORESPIRATORY FITNESS
Authors: Pittaras Andreas , Grassos Charalampos , Faselis Charles , Tsimploulis Apostolos , Doumas Michael , Lovic Dragan , Papavasiliou Maria , Manolis Athanasios J. , Kokkinos Peter 
Published: June 2023

Objective:
Atrial fibrillation (AF) is associated with increased risk of mortality. Epidemiologic evidence strongly supports an inverse and graded association between cardiorespiratory fitness (CRF) and mortality risk. The impact of CRF status on mortality risk in hypertensive patients with AF has not been assessed. The aim of the study was to evaluate the association between CRF and mortality risk in hypertensive patients with AF.

Design and method:
We identified 24,171 hypertensive patients (mean age 67.5±9.0 yrs), with documented AF who completed an exercise treadmill test (ETT) between years 1999 to 2020, with no evidence of ischemia. We established 5 fitness categories (quintiles) based on age-specific peak metabolic equivalents (METs) achieved: Least-fit (4.0±1.1 METs; n = 8,857); Low-fit (6.4±1.1 METs; n = 6,103); Moderate-fit (7.8±1.1 METs; n = 4,256); Fit (10.0±0.9 METs; n = 3,803) and High-fit (12.6±1.6 METs; n = 1,152). We used multivariable Cox proportional hazard models to estimate hazard ratios (HR) and 95% confidence intervals [CI] for mortality across CRF categories. The models were adjusted for age race, gender, resting blood pressure, comorbidities, and medications.

Results:
During follow-up (median = 8.8 years; 224,138 person-years), 10,499 individuals died (46.8 events per 1,000 person-years). The risk for stroke was 14% lower for each 1-MET increase in exercise capacity (HR = 0.86, CI: 0.85-0.87; p<0.001). When considering CRF categories, mortality risk was 27% lower for the Least-Fit individuals (HR = 0.73; CI: 0.70-0.77) and declined progressively with increased CRF to approximately 45% t0 60% for Moderate-fit and Fit, and 67% (HR = 0.33; CI: 0.29-0.37) for High-Fit individuals.

Conclusions:
Increased CRF was inversely related to mortality in hypertensive patients with AF. The association was independent of comorbidities and graded.
RENIN-ANGIOTENSIN-ALDOSTERONE BLOCKADE AND ITS PREDICTION OF LATE RECURENCE OF ATRIAL FIBRILLATION AFTER RADIOFREQUENCY ABLATION
Authors: Labr Karel , Mieresova Marie 
Published: June 2023

Objective:
Hypertension is one of the main triggers of atrial fibrillation. Patients with hypertension have 1.7 times higher risk of developing atrial fibrillation. Opinions differ on the use of RAAS blockers in atrial fibrillation. The aim is to evaluate the effect of RAAS blockers in the prevention of atrial fibrillation on the post-ablation prognosis of the patient.

Design and method:
A retrospective analysis of 221 patients who underwent radiofrequency ablation of atrial fibrillation at the First Department of Internal Medicine - Cardioangiology of St. Anne's University Hospital in Brno from 1 January to 31 December 2019 was performed. Recurrence within the first three months was designated as early, and in the following months as late.

Results:
The median age of the study population (N = 221) was 63 years, with 67.4% of men. According to pre-ablation transesophageal echocardiography, the mean left atrial dimension was 45.3mm and left ventricular ejection fraction was 59.8%.
Among the comorbidities, hypertension (63.3%) and dyslipidaemia (41.6%) were the most common, followed by diabetes mellitus (14.0%), ischemic heart disease (7.2%), history of stroke (6.3%), chronic obstructive pulmonary disease (5.0%). 33.0% had a history of nicotinism.
Among the baseline antihypertensive groups, beta-blockers were the most represented (69.2%) followed by angiotensin-converting enzyme inhibitors (37.5), angiotensin-receptor blockers (20.4%), calcium channel blockers (32.1%) and diuretics (32.1%). There was not a significant difference in the representation of each group of antihypertensives between the populations.
n the group of patients treated with ACEis/ARBs (57.9%), the mean blood pressure resulting from pre- and post-ablation measurements was the same 149/81mm Hg. No significant differences in left atrial size or capture of early or late postablation recurrence (HR 1.26, 95% CI 0.84-1.90, p = 0.265) were detected in the RAAS inhibitor group relative to patients without ACEis/ARBs in therapy.

Conclusions:
Conventionally administered ACEis/ARBs before ablation procedure did not lead to a reduction in the detection of late postablation recurrence of atrial fibrillation. Despite the documented benefit of RAAS blocker therapy in atrial fibrillation patients, their routine administration before ablation procedure aimed at improving postablation prognosis was not evaluated as justified.
ATRIAL FIBRILLATION CAUSED BY ISOLATED TRICUSPIDE REGURGITATION
Authors: Chamtouri Ikram , Jomaa Walid , Hamda Khaldoun Ben 
Published: June 2023

Objective:
Atrial fibrillation (AF) may be the cause or the consequence of funcionnal tricuspide regurgitation (TR). Predectifs factors of AF occurence secondary to TR and its prognosis are unclear
Aim: to invastigate predective factors of AF induced by severe TR and its prognosis.

Design and method:
All patients presented isolated moderate to severe TR with sinus rythm were enrolled prospectively in this study. A follow-up at 6 to 12 months was performed in all patients by clinical examination, electrocardiogramm and echocardiography.

Results:
Among 182 patients prensenting moderate to severe isolated TR with sinus rythm, 113 (62%) presented AF at 6 to 12 months follow-up. Predective factors of AF onset were female gender, chronic kidney failure, anemia and the presence of right bundle branch block (RBBB) at electrocardiogram. Right ventricle dysfunction and rehospitalization were significantly higher in patients experienced AF with no difference in mortality at follow-up.

Conclusions:
AF induced by isolated TR is not rare. It is associated with female gender and anemia. Prognosis of patients with TR is worsen by AF onset leading to a high prevalence of right ventricule dysfunction. AF should be early screened and treated .
ATRIAL FIBRILLATION AND LEFT VENTRICLE SYSTOLIC FUNCTION IN MODERATE HYPERTENSIVE PATIENTS WHO COME TO THE EMERGENCY ROOM DUE TO INADEQUATE CONTROL OF BLOOD PRESSURE
Authors: Solé Ricardo Cabrera , Turpin Caridad , Estephan Erick Luekpe , Aguilera Manuel 
Published: June 2023

Objective:
To determine the percentage of cases of atrial fibrillation (AF) and left ventricular systolic function (LVEF) documented in hypertensive patients (PH) who come to the emergency room due to poor blood pressure control and those who do not attend.

Design and method:
From July 2020 to July 2021, we have studied 100 patients with hypertension, 60 women and 40 men with an average age of 72±8 years, who have previously been diagnosed and treated for hypertension. Of these PH, 22 had gone to the emergency room due to poor control of the BP. All underwent a standard echocardiogram and ABPM within 6 months of being seen in consultation with the cardiology specialist. The following parameters were measured: systolic and diastolic blood pressure (TAS, TAD), left ventricle systolic function (LVEF), left atrial size (LA) -The results were compared between those who went to the Emergency Department (PHER) and those who did not attend (PH) and we showed them.

Results:
TABLE:

Conclusions:
The PH that come to the Emergency Department have higher blood pressures and a higher frequency of atrial fibrillation, although the LVEF does not present significant differences. The size of the LA is also larger in the worst controlled patients, which indicates that we should follow this PH group more closely because of the important risk they have.
COMPARATIVE STUDY OF CENTROID DEFUZZIFICATION AND MAXIMUM DEFUZZIFIER MODEL MEAN OF MAXIMA ALGORITHM FOR CORONARY ARTERY DISEASE DIAGNOSIS
Authors: Fajar Rifaldy , Bern Roy , Mendoza Dewz , Kurnia Nana 
Published: June 2023

Objective:
Cardiovascular, especially coronary artery disease (CAD), is the number one cause of death globally. Every year, more people die from cardiovascular disease than any other disease. There are several factors and symptoms of coronary artery disease that are easily recognized. To find out the severity of CAD, a diagnosis of CAD is needed to facilitate medical treatment. This study aims to explain the diagnostic process for CAD using a fuzzy system and to determine the accuracy of the fuzzy system.

Design and method:
This study uses a fuzzy system to diagnose the severity of coronary artery disease. Input variables used in the study were gender, age, pulse, systolic blood pressure, cholesterol, blood sugar, triglycerides, electrocardiogram (ECG), chest pain, shortness of breath, and cough. In making the system, 90 data were used which were then divided into two types of data, namely 70 training data and 20 testing data. The fuzzy inference system used in this study is the Mamdani inference system which uses centroid defuzzification and maximum defuzzifier mean of maxima (MOM). This defuzzification process is used to diagnose types of coronary artery disease, namely: CAD level 1 (Asymptomatic), CAD level 2 (Angina Pectoris), and CAD level 3 (Acute Myocardial Infarction).

Results:
The results of the research on the application of the fuzzy system for diagnosing coronary artery disease were the accuracy of the defuzzification centroid method of 98.5% for training data and 95% for testing data, while for the MOM defuzzification method, the accuracy level of training data was 98.5% and 90% for testing data.

Conclusions:
Based on the research results, it can be concluded that the centroid defuzzification method is better than the MOM defuzzification system for the coronary artery disease diagnosis system, so, it can be said that by using a fuzzy system with centroid defuzzification, the probability of correctly diagnosing one patient is 95%.
A CLINICAL RISK PREDICTION TOOL FOR CARDIOVASCULAR EVENTS FOLLOWING RESPIRATORY INFECTIONS
Authors: Lee Joseph , Wright-Drakesmith Cynthia , Koshiaris Constantinos , Hobbs Richard , Sheppard James 
Published: June 2023

Objective:
The risk of cardiovascular (CVD) events increases for four weeks following a respiratory infection. This short-term increase in risk may be an opportunity for clinical intervention, providing one could predict the risk of infection-related CVD. We therefore sought to develop and validate a risk prediction model for use in patients with respiratory infections in primary care.

Design and method:
We used routinely collected data from two UK general practice databases, provided by Clinical Practice Research Datalink (CPRD). We used cohorts of patients without pre-existing CVD, starting from their first respiratory infection after the age of 40. We followed patients for 28 days. Our outcome was a composite of cerebral and cardiac events. We used logistic regression to develop risk prediction models in CPRD Aurum, and validated it in CPRD Gold. We selected predictors by asking clinicians to prioritize a list of potential predictors. This model uses ten variables.

Results:
The development cohort comprised 3.8 million patients with respiratory infections, and 7,081 CVD events in the following 28 days (0.18%). The validation cohort comprised 2.6 million patients with infections, and 6,868 events (0.26%). In external validation, we estimated a C statistic of 0.86. Using a 1% threshold of risk as a cut off, the positive predictive value was 3% (3.2 to 3.4%), with a negative predictive value close to one.

Conclusions:
It is possible to predict risk of primary infection-related CVD. Identifying patients at greatest risk of infection-related CVD opens up possibilities for further research applications.
BASELINE CARDIAC BIOMARKER ANALYSIS FROM THE BASEL POSTPARTUM HYPERTENSION REGISTRY
Authors: Socrates Thenral , Piattini Leana , Strobel Noémie , Schaffhauser David , Schumacher Christina , Mayr Michael , Vischer Annina , Burkard Thilo 
Published: June 2023

Objective:
Postpartum hypertension (PPHT) is defined by elevated blood pressure measurements after birth of more than 140 mmHg systolic and more than 90 mmHg diastolic, that persist or develop directly after pregnancy and is associated with adverse cardiovascular and renal outcome. Aim of the current analysis was the evaluation of different prognostic cardiac and stress related biomarkers like cardiac troponin T (cTnT), N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) and growth differentiation factor 15 (GDF-15) in the setting of PPHT.

Design and method:
Enrollment for the prospective observational Basel Postpartum Hypertension Registry began in June 2020 at the University Hospital Basel. Women with preexisting hypertension, hypertensive disorders of pregnancy (HDP), and de novo postpartum hypertension were enrolled and followed up in structured management program. Clinical history and lab values were collected out of the electronic health records. Additional blood samples were stored for further evaluation. The present analysis contains biomarker analysis of a subset of 58 out of 288 patients using blood samples taken within one week of giving birth. Serum samples were analyzed for detectable levels of cTnT, NT-proBNP and GDF-15 at the department for Laboratory Medicine at University Hospital Basel using electrochemiluminescence immunoassay Elecsys on the Cobas e 801 platform (Roche Diagnostics, Rotkreuz, Switzerland).

Results:
Mean age of the patients from whom we measured biomarkers at baseline was 34±4.7. Mean troponin was 8.5 ng/l ±2.2 with normal cuttoffs for this age group being 14ng/l and sex specific cutoffs at 9ng/l. NT-proBNP was 229.86ng/l ±80.4, with 125ng/l being the normal cut off in an acute disease setting. Mean GDF-15 was 1895.8ng/l ±323.5 with correlating normal values in healthy populations in the same age range being 564 ± 223 ng/l.

Conclusions:
This first biomarker analysis shows a trend of elevated NT-proBNP and GDF-15 which are associated with cardiovascular disease or stress. Cardiac troponin T was not elevated in most of the patients, but in a subset of 13 patients. Further analysis and long term outcome correlations remains to be established and may be part of the follow-up analyses of the Basel PPHT cohort.