bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-B02-3: FGF23 EXACERBATES CARDIAC FIBROSIS IN DOCA-SALT HYPERTENSIVE MICE THROUGH LOCALLY ABNORMAL VITAMIN D METABOLISM
Authors: Saito Tomohiro , Mizobuchi Masahide , Kato Tadashi , Shikida Yasuto , Ogata Hiroaki , Koiwa Fumihiko , Honda Hirokazu 
Published: January 2023

Backgrounds:
Fibroblast growth factor 23 (FGF23) is associated with cardiovascular disease in patients with chronic kidney disease (CKD), but the mechanisms underlying the effect of FGF23 on cardiac function remain to be investigated. Herein, we studied the effect of continuous intravenous (CIV) FGF23 loading in a deoxycorticosterone acetate (DOCA)-salt mouse model that has mild CKD and hypertension, and heart failure with a preserved ejection fraction (HFpEF).

Design and method:
Wild type male mice (n = 16) were allocated randomly to four groups: normal control (NC), vehicle-treated DOCA-salt mice (V), FGF23-treated DOCA-salt mice (F), and FGF23 and calcitriol-treated DOCA-salt mice (C). The DOCA-salt mice received agents by CIV for ten days via an infusion mini-pump, uninephrectomized, and cardiac changes were evaluated in these mice.

Results:
DOCA-salt mice that received FGF23 showed a marked increase in serum FGF23 (249 pg/mL in V, 1416 pg/mL in F, and 1261 pg/mL in C) than NC (51 pg/mL). Echocardiography in these DOCA-salt mice revealed HFpEF. These mice also showed exacerbation of myocardial fibrosis area (7.0% in V, 13.2% in F, and 3.8% in C) concomitant with an inverse and significant correlation with Cyp27b1 expression (r = -0.79, P < 0.01). Calcitriol treatment attenuated the FGF23-induced cardiac fibrosis (F vs. C, P < 0.01) and improved diastolic function (early-to-atrial wave ratio in doppler echocardiography, 0.7 in F vs. 2.0 in C; P < 0.01) via inhibition of transforming growth factor (TGF)-beta signaling. Protein expression levels of TGF-beta was significantly higher in F (1.32-fold to NC; P < 0.01) than in NC, and significantly lower in C (0.96-fold to NC; P < 0.05) than in F. This effect was independent of systemic and local FGF23 levels.

Conclusions:
These results suggest that CIV FGF23 loading induced cardiac fibrosis concomitantly with locally abnormal vitamin D metabolism, and this might have contributed to HFpEF progression in the DOCA-salt mice model. Thus, cardiac toxicity of FGF23 may be partly due to vitamin D inactivation in cardiac tissue. Calcitriol has cardioprotective effects by mediating TGF-beta signaling, independently of local and systemic FGF23 levels.
PS-B02-6: CHANGES OF THE EXTRACELLULAR MATRIX AND INTERCELLULAR COMMUNICATION IN THE RAT HEARTS WITH VOLUME-PRESSURE OVERLOAD AND MODULATION BY CARDIOPROTECTIVE DRUGS
Authors: Sykora Matus , Kratky Vojtech , Tribulova Narcis , Kopkan Libor , Bacova Barbara Szeiffova 
Published: January 2023

Objective:
Pathogenesis of heart failure (HF) and hypertension with a focus on extracellular matrix (ECM) and communication in the heart is still a current scientific topic that calls for new findings.

Design and method:
We used as experimental model normotensive (HSD) and hypertensive (TGR) rats with aortocaval fistula (ACF) supplemented with an ACE inhibitor (ACEi)(15weeks, 6 mg/L) and an AT1 receptor blocker (ARB)(15weeks, 200 mg/L). At the end of the experiments, serum and myocardial tissue samples of the right and left ventricles were taken for biometric, biochemical, gene, protein and microscopic analyzes.

Results:
We observed an increase in the cardiac weight index after ACF, left and right ventricles in HSD and TGR rats. ACEi and ARB have normalized this condition to a greater extent. Due to ACF, serum concentrations of ANP and TBARS were increased in the blood serum of both strains. ACF increased hydroxyproline levels in right ventricular levels in HSD and TGR rats and left ventricular TBARS in TGR rats. In addition, ACF increased mRNA collagenI, and collagenI protein expression in the left and right ventricles of HSD rats. In contrast, ACF reduced Cx43 and pCx43 protein levels in the left and right ventricles of both strains, SMAD2 expression in the right ventricle in HSD and TGR rats. ACF also suppressed MMP-2 protein expression in both cardiac ventricles in HSD rats and PKCepsilon protein expression in both heart chambers of both strains. Hypertension caused a slight decrease in the protein expression of Cx43, pCx43 and PKCepsilon and an increase in the expression of PKCdelta in cardiac ventricles of both rat strain. Hypertension further increased and collagenI in TGR rats in the left and right ventricles of the heart. Microscopic analyzes showed that ACF induced cardiomyocyte hypertrophy as well as decreased activity of enzymes involved in ACF energy metabolism. An interesting finding was that the signaling pathways involved in cardiac remodeling were more normalized by the ARB, while proteins involved in intercellular communication by ACEi.

Conclusions:
Based on the results obtained from the experiment, it can be stated that the right ventricle is more significantly affected by ACF and the results of analyzes in TGR indicate adaptation, attenuated responses to the parameters we observed. Supported by: APVV-21-410, VEGA-2/0158/19.
PS-C02-1: BENEFIT OF RANOLAZINE ADDED TO ANGIOTENSIN RECEPTOR BLOCKERS PLUS MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY FOR VENTRICULAR EXTRASYSTOLES TREATMENT IN HYPERTENSIVE PATIENTS
Authors: Paterno Carlos Alberto 
Published: January 2023

Objective:
Ranolazine is an anti-ischaemic agent with additional electrophysiological properties by inhibiting the cardiac late Na+ current and reducing the Ca2+ overload; it does not produce a change in heart rate or blood pressure. This study aimed to know if Ranolazine was added to Angiotensin Receptor Blockers plus Mineralocorticoid Receptor Antagonists (ARB+MRA) therapy in hypertensive with normal kidney function can reduce or avoid ventricular extrasystoles without the use of antiarrhythmics drugs such as flecainide or propafenone.

Design & Methods:
For developing this study, one first group of 45 hypertensive patients was entered, females 17 with an average age of 64.8 (SD 14.0) and males 28 with an average age of 68.4 (SD 12.8) in a regime of ARB+MRA therapy. All patients were assessed with a 24hs-monitoring Holter, pre and post Ranolazine (375/500 mg, 2xd), with an average therapy time-length on females-males by 12.4 (SD 10.0) - 12.8 (SD 12.0) months. Also, the second group of 73 patients was registered, females-males (43–30) with an average age (SD) 67.1 (12.2) - 66.8 (13.5) assessed with a 24hs-monitoring Holter only once at 12.2–16.7 months after ARB+MRA+Ranolazine therapy. All patients achieved normal levels of the central hemodynamic parameters, principally augmentation index (surrogate value of arterial stiffness) and end-systolic pressure measured with applanation tonometry (SphygmoCor System-PVX AtCor-Australia) used according to standard methods.

Results:
In the pre-and post-treatment group of females-males were observed ventricular extrasystoles a mean of 2610–5004 which were reduced to a mean of 12.5–1464, respectively, with a highly statistically significant difference (p > 0.001).
In the post-treatment group, the average of ventricular extrasystoles on females-males was found 15.0–37.4. Interestingly, during ARB+MRA+Ranolazine therapy patients which had not registered anyone ventricular extrasystoles, in the first group were found females-males 8/17 (47%) - 7/28 (25%), and in the second group 14/43 (33%) - 6/30 (20%), respectively.

Conclusion:
The combination of ARB+MRA therapy normalized the augmentation index and the end-systolic pressure, stabilized the curve volume/pressure reduce the stress of ventricular-arterial coupling, and can avoid the onset of atrial fibrillation, also so it would allow added Ranolazine to perform a beneficial antiarrhythmic action avoiding or reducing the appearance of the ventricular extrasystoles.
PS-C02-2: THE USE OF HYDROCHLOROTHIAZIDE FOR THE TREATMENT OF HYPERTENSION INCREASES THE CARDIOVASCULAR RISK ACCORDING TO THE CENTRAL HAEMODYNAMIC PARAMETERS
Authors: Paterno Carlos Alberto 
Published: January 2023

Objective:
The chronic use of the diuretic hydrochlorothiazide (Hct) can activate the neurohormonal system, increasing metabolic risk factors it is potentially arrhythmogenic; and can stimulate the escape of aldosterone, even during Angiotensin Receptor Blockers (ARB) treatment. Aldosterone is a hormone with dangerous effects on the cardiovascular system, from arterial/myocardium stiffness to sodium and water retention; also, is involved in the production of reactive oxygen species and endothelial dysfunction. Psoriasis is a systemic disease that exemplifies the intersection of inflammation, immune dysregulation; and accelerating cardiovascular disease. This study aimed to know if the hydrochlorothiazide added to ARB therapy for the treatment of hypertension can produce a deleterious effect on the cardiovascular system similar to psoriasis, and compare the different responses of ARB therapy alone, according to the measuring of the Central Hemodynamic Parameters (CHP).

Design & Methods:
For this cross-sectional retrospective study data were collected from 994 patients divided into three groups, both sexes. One group of patients with psoriasis female-male (F-M) (65–57) average age (SD) 55.7 (14.7) - 52.1 (12.5). A second group, in the regime of ARB therapy, F-M (237–217) average age (SD), 62.6 (12.8) - 58.5 (13.6). In the third group, during ARB+Hct therapy, F-M (253–165) average age (SD) was 65.2 (11.2) - 61.9 (12.6). For this study were entered anthropomorphic measures, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Heart Rate, CHP, and the Difference between observed values and normal levels of Augmentation Index (Diff-AIx), the surrogate value of arterial stiffness, assessing with a validated device employing the high-fidelity technique of applanation tonometry according to standard methods (SphygmoCor-PVX). All patients had a therapy time length of more than 6 months. The presence in brief phases of atrial fibrillation was in 24hs-Holter monitoring in the 3 groups were registered.

Results:
Data of SBP, DBP, Central Aortic Pressure, End-Systolic Pressure, Mean Arterial Pressure and Diff-AIx were highest among the groups with ARB+Hct and psoriasis, and ARB therapy with a statistically significant difference, while between the group psoriasis and ARB+Hct was not found a statistically significant. The highest percentage of patients with phases of atrial fibrillation during 24hs-Holter monitoring were found in the group ARB+Hct (13.6%) than ARB therapy (7.5%) with a statistically significant (p < 0.001).

Conclusions:
The chronic use of Hydrochlorothiazide for hypertension treatment produces deleterious action on hemodynamics and cardiovascular parameters and can increase the development of atrial fibrillation.
PS-C03-9: A COMPARATIVE STUDY OF SELF-VITAL MEASUREMENTS AND TELEMEDICINE IN THE TREATMENT OF HYPERTENSION: RATIONALE AND PROTOCOL
Authors: Yatabe Junichi , Yatabe Midori Sasaki , Ishida Kazuya , Yano Yuichiro , Nishiyama Akira , Node Koichi , Goto Rei , Yabuki Takashi , Hashimoto Shigeatsu 
Published: January 2023

Background:
There has been a series of reports on the effectiveness of ICT-based telemedicine in the treatment of hypertension. However, sufficient evidence has not been obtained in Japan. In this study, we will clarify how push-type communication through the combination of vital data measurements including home blood pressure (HBP) obtained by IoT devices and online visits (telemedicine) affects blood pressure management.

Setting:
Multicenter, open-label, randomized, prospective intervention study

Methods:
This study (Fukushima Medical University Ethics Committee Permission no. 2021–292, now registering in jRCT) is an investigator-initiated 6-month clinical trial, which will recruit 234 patients to be randomized in Aizuwakamatsu area, Fukushima, Japan. During the whole study, HBP, body weight and physical activity data will be collected through the internet using smartphone App (OMRON CONNECT and TELEMEDEASE). This study includes 3 arms; 1: Vital data measurement without any feedback (control), 2: Vital data measurement with telemonitoring and feedback from health care professionals such as registered nurse, 3: In addition to telemonitoring and feedback, patients can engage in consulting physicians through telemedicine and receive prescription via mail when needed. Eligible patients are asymptomatic patients with hypertension who are aged 40–75 years old and can measure HBP and use smartphone App. The primary endpoint is percentage of patients achieving antihypertensive goal (mean morning and night systolic HBP < 125 mmHg). Examples of secondary endpoints include medical economics and safety of telemedicine for treatment of hypertension.

Anticipated Medical Contributions:
The expected outcome is that application of telemedicine on self-measurement of vital data including HBP will be superior to vital data monitoring alone in the treatment of hypertension to improve cardiovascular outcome.
PS-C03-10: PRACTICE OF TELEMEDICINE CONCERNING ATRIAL FIBRILLATION DETECTED BY APPLE WATCH
Authors: Takai Kohichi , Yoneyama Akio , Hammarlund Hampus , Miyake Yoshinori , Nakanishi Takeshi , Sawada Ryousuke , Yatabe Junichi , Taguchi Kenta 
Published: January 2023

Background:
Atrial fibrillation affects nearly 60 million adults worldwide. Atrial fibrillation is associated with a high risk of cardiovascular morbidity, therefore early detection of atrial fibrillation is important for improving patient outcomes. Apple Watch has an ECG which can detect atrial fibrillation but users do not always contact a doctor. We report in-depth interviews with users who detected atrial fibrillation with Apple Watch.

Methods:
In this research, participants wearing an Apple Watch received real-time electrocardiograms via their smartphone, and received telemedicine guidance from our smartphone application. This research was a single arm study with 489 participants conducted with the goal of evaluating the effectiveness of telemedicine by using Apple Watch. In a three-month experiment, 412 participants measured more than once and 89 participants measured once a day on average. 20 participants experienced atrial fibrillation which was detected by their Apple Watch. Finally, five participants connected to a Telehealth doctor, who based on the data from the Apple Watch and the patient's symptoms was able to give appropriate medical guidance.

Results:
We carried out in-depth interviews with four participants who detected atrial fibrillation. Two participants did not understand the detection. Afterwards they received an explanation of atrial fibrillation from the person in charge of the experiment via email, after which the participants applied for telemedicine. The other two participants were familiar with atrial fibrillation and did not apply because they had existing medical history and subjective symptoms.
In addition, we conducted a questionnaire survey about telemedicine from the 20 participants who detected their atrial fibrillation. 95% of questionnaire respondents were aware of telemedicine, which was free in this experiment. However, 53% of questionnaire respondents did not understand the risks and basic information about atrial fibrillation. Moreover, 47% of questionnaire respondents selected that they were not going to contact a doctor if they do not have subjective symptoms.

Conclusions:
Early detection of atrial fibrillation is important for patients, but people do not always get in connect with an online doctor. We confirmed that one of the reasons is lack of knowledge about atrial fibrillation and another is lack of subjective symptoms.
PS-C04-5: ASSOCIATIONS BETWEEN INTERARM SYSTOLIC BLOOD PRESSURE DIFFERENCE AND HYPERTENSIVE ORGAN DAMAGES IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Ohara Maiko , Koike Tsutomu , Yamazaki Hidenori , Kinugawa Koichiro , Tomoda Fumihiro 
Published: January 2023

Objective:
Several studies and meta-analyses have reported that interarm systolic blood pressure difference (IAD) in the upper limbs is associated with risks such as all-cause mortality and cardiovascular diseases. However, few results have examined the usefulness of IAD as an index of arteriosclerosis in patients with essential hypertension (EHT). We investigated the relationship between IAD and vascular structures and evaluated the usefulness of IAD as an index of hypertensive organ damages in EHT patients.

Design and method:
In 71 untreated EHT patients (48 males, average age 56 ± 13 years) without chronic kidney disease (urinary albumin excretion less than 300 mg / g of creatinine and estimated glomerular filtration rate 60 mL / min / 1.73m2 or more), blood sampling, 24-hour urine collection, and 24-hour blood pressure monitoring were performed. Next, as cardiovascular structural indices, Next, as indicators of vascular structure, the intima media thickness of carotid artery (IMT) was measured by ultrasonography, and the cardio ankle vascular index (CAVI) and ankle brachial index (ABI) were measured by using the Vascular Screening System VaSera VS-1000 (Fukuda Denshi, Tokyo, Japan) device. The absolute value of the difference between the left and right blood pressure measured at the same time was defined as IAD.

Results:
IAD was not associated with age, BMI, or systolic and diastolic blood pressure in 24-hour blood pressure monitoring. IAD increased accompanying with a decrease in creatinine clearance (r = -0.25, p < 0.05). IAD correlated positively with IMT (r = 0.24, p < 0.05) and negatively with ABI (r = -0.45, p < 0.01), whereas it did not associate with CAVI. Furthermore, in multiple regression analysis using any of IMT, ABI and creatinine clearance as objective variables, and conventional risk factors for atherosclerosis and IAD as explanatory variables, IAD became an independent determinant factor for IMT, ABI and creatinine clearance.

Conclusions:
In EHT patients, IAD was associated with decreased renal function and vascular abnormalities. IAD was considered to be a useful index as an initial screening for latent hypertensive organ damages in EHT patients.
PS-C05-7: ASSOCIATION OF VENTRICULAR-ARTERIAL COUPLING WITH LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Kang Bomin , Yoon Homin , An Soyeon , Beom Jongwook , Boo Kiyoung , Lee Jaegeun , Choi Joonhyouk , Kim Songyi , Joo Seungjae 
Published: January 2023

Objective:
Ventricular-arterial coupling (VAC) has an important role in the pathophysiology of coronary artery disease and heart failure. The association of VAC with left ventricular (LV) function in patients with acute myocardial infarction (AMI) was investigated in this study.

Design and Method:
Echocardiographic indexes of LV volumes, systolic function, and diastolic function were measured in the usual way. Effective arterial elastance (Ea) was calculated from stroke volume measured using LV outflow waveform. Effective LV end-systolic elastance (Elv) was obtained using the single-beat method. Central aortic pressure waveform was recorded using the applanation tonometry. Characteristic impedance (Zc) of aortic root was calculated after Fourier transformation of both aortic pressure and flow waveforms.

Results:
Eight-five patients (age 58.5 ± 10.6 years) with AMI were enrolled. They were grouped as patients with reduced EF (rEF, < 50%; n = 27) and preserved ejection fraction (pEF, ≧ 50%; n = 58). In patients with rEF, Ea (2.14 ± 0.55 vs. 1.84 ± 0.51 mmHg/mL; P = 0.017) and VAC (1.18 ± 0.22 vs. 1.02 ± 0.22; P = 0.002) were increased, but peripheral and central systolic blood pressure, Elv and Zc were not different. In multiple linear regression analysis, VAC was significantly associated with E” velocity (beta -0.36, P = 0.001) and Zc (beta 0.33, P = 0.019), but neither with EF nor left ventricular longitudinal strain. The association between VAC and E” velocity was significant in patients with pEF (beta -2.64, P = 0.011), but not in patients with rEF.

Conclusions:
VAC was associated with LV diastolic dysfunction in AMI patients with pEF, but not with rEF.
PS-C06-8: CONCOMITANT HYPERTENSION INFLUENCES CASPASE-8 LEVELS IN COPD PATIENTS
Authors: Tverezovskyi Volodymyr , Kapustnyk Valeriy , Shelest Borys 
Published: January 2023

Introduction:
Cardiovascular diseases are common in chronic obstructive pulmonary disease (COPD) patients with hypertension (HTN) having leading places, contributing to higher hospitalization and mortality rates. Oxidative stress, chronic hypoxia and hypoxemia induce systemic inflammation, leading to apoptosis development. Active apoptosis processes lead to forced violations in respiratory tract and influence the course of COPD. To the best of our knowledge, little data is available on assessment of caspase-8 (Cas-8) activity in hypertensive COPD patients.

Aim:
To investigate association of Cas-8 levels in COPD patients depending on presence of concomitant hypertension.

Methods:
93 COPD matched by gender and age patients were enrolled to the study: 47 non-hypertensive (62.0 [52.3; 65.8] years; 29.8% females) in main group and 46 hypertensive (60.0 [58.0; 62.8] years; 37.0% females) in comparison group. COPD and HTD diagnosis was made according to respective GOLD and ESC guidelines. Spirometry was used to assess FEV1/FVC ratio. Cas-8 was assessed by ELISA.

Results:
Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the main group was 142.5 [140.0; 150.0] mm Hg. and 85.0 [80.0; 90.0] mm. Hg respectively; and 120.0 [115.0; 120.0] mm Hg. and 80.0 [75.0; 80.0] mm Hg.
Hypertensive COPD patients showed significantly (p < 0.001) higher Cas-8 levels than non-hypertensive: respectively: 3.7 [3.5; 3.8] ng/ml vs. 3.3 [2.8; 3.7] ng/ml. While FEV1/FVC ratio was significantly higher in the COPD only group than in COPD+HTN patients: 73.0 [71.0; 77.0] % vs. 72.0 [69.0; 75.0] %, p = 0.014.
Increase in Cas-8 levels was significantly (p < 0,001) associated with presence of HTN in univariate analysis: 0.406 [95.0% CI 0.225–0.578] ng/ml. In adjusted (for age, gender and FEV1/FVC ratio) model presence of concomitant HTN was significantly (p < 0.001) associated with increase in Cas-8 levels for 0.306 [95.0% CI 0.128–0,484] ng/ml.

Conclusion:
Concomitant hypertension can aggravate apoptosis in COPD patients, which leads to worsening of the course of the diseases. Our study showed significant association of increased Cas-8 levels with the presence of hypertension in both non-adjusted and adjusted linear models.