bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECTS OF SODIUM-GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON HEART FAILURE IN CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Alexandrou Maria Eleni , Tsitouridis Alexandros , Theodorakopoulou Marieta , Kamperidis Vasileios , Pella Eva , Sampani Erasmia , Xanthopoulos Andrew , Papagianni Aikaterini , Sarafidis Pantelis 
Published: June 2023

Objective:
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors significantly reduce the risk for hospitalizations for heart failure (HF) in patients with diabetes, and HF; findings in patients with chronic kidney disease (CKD) are not uniform. Objectives: We aimed to perform a meta-analysis exploring the effect of SGLT-2 inhibitors on HF events in patients with CKD and across subgroups defined by baseline kidney function.

Design and method:
A systematic search in major electronic databases was performed. Randomized controlled trials providing data on the effect of SGLT-2 inhibitors on the primary outcome, time to hospitalization or urgent visit for worsening HF in patients with prevalent CKD at baseline or across subgroups stratified by baseline estimated glomerular-filtration-rate (eGFR) were included.

Results:
Twelve studies (n = 89,191 participants) were included in the meta-analysis. In patients with CKD, treatment with SGLT-2 inhibitors reduced the risk for HF events by 32% compared to placebo (hazard ratio [HR] 0.68; 95%CI 0.63-0.73). Reduction in HF events with SGLT-2 inhibitors was more prominent in patients with eGFR<60 ml/min/1.73m2 (HR 0.68; 95%CI 0.62-0.74) than in those with eGFR> = 60 ml/min/1.73m2 (HR 0.76; 95%CI 0.69-0.83). Subgroup analysis according to type of SGLT-2 inhibitor showed a consistent treatment effect across all studied agents (p subgroup-analysis = 0.44). Sensitivity analysis including data from studies including only diabetic patients showed an even more pronounced effect in eGFR subgroup<60 ml/min/1.73m2 (HR 0.62; 95%CI 0.54-0.70).

Conclusions:
Treatment with SGLT-2 inhibitors led to a significant reduction in HF events in patients with CKD. These findings may change the landscape of HF treatment in patients with advanced CKD.
ANEMIA IN HYPERTENSIVE PATIENTS WITH CHRONIC RENAL FAILURE, WHAT ARE THE CHARACTERISTICS?
Authors: Nigassa Nawel Brikci , Bendiab Nabila Taleb 
Published: June 2023

Objective:
During chronic renal failure, the progressive impairment of kidney functions results in a set of manifestations, initially biological, then clinical. Anemia and high blood pressure are common complications during chronic kidney disease.
The aim of this study is to determinate the main characteristics of anemia in hypertensive patients with chronic kidney disease

Design and method:
This descriptive work is a retrospective cross-sectional study aimed at evaluating the iron status of 70 hypertensive chronic renal failure patients. The average age in this study was 65 years with a male predominance (51%).
In our study, 70 patients with chronic renal failure of all stages participated, hypertensive and anemic.
The count of the blood elements and the hemoglobin assay were done by optical measurement using the ADVIA® 2120i automaton. The assay of vit B12, folate and ferritin in the blood by enzymatic chemiluminescence.

Results:
In our study, the mean hemoglobin was 10.18 g/dl, In our series of hemodialysis patients, mean serum ferritin was 276±207.14 ng/ml. In our population, blood pressure averages are of the order of: 130.29 ± 22.33 mm Hg for PAS, and 69.86 ±10.16 mm Hg for DBP.
Regarding patients with chronic renal failure not on dialysis 43.5% of patients had serum ferritin low.
50% had normal ferritinemia, and 6.45% of patients had elevated serum ferritin.
Ford's study found 2.92% of patients with low serum ferritin, 25.05% had a normal level, and 72.02% had hyperferritinemia. At 26% of patients in our population, the blood pressure figures were > 140/90 mmHg, while 74% of patients reached the target .

Conclusions:
Chronic renal failure exposes to numerous hematological and cardiovascular type complications, which can themselves induce health problems, in addition Correction of anemia is not always beneficial for patients suffering from CKD in due to increased blood pressure.
Perform periodic biological and hormonal analyzes. Recommend lifestyle and dietary measures in all hypertensive patients, chronic renal failure. Carry out awareness campaigns with the general public for a better understanding of chronic kidney disease
EFFECT OF ORAL FLAVONOIDS ON ARTERIAL STIFFNESS IN CKD – A PILOT PROSPECTIVE STUDY
Authors: Haddad Nasra , Bagopoulou Natasa , Kontogiorgos Ioannis , Papatolios Thomas , Papadopoulou Evaggelia , Makridis Dimitrios , Tzimikas Stergios , Fountoglou Anastasios , Kalaitzidis Rigas , Karasavvidou Despoina 
Published: June 2023

Objective:
Flavonoids, the main category of polyphenols possess antioxidative and antihypertensive properties mediated through endothelial protection, renin-angiotensin-aldosterone and sympathetic system suppression. The aim of the study was to evaluate the effect of oral flavonoids administration in arterial stiffness indices and of oxidative stress markers in patients with Chronic Kidney Disease (CKD).

Design and method:
The enrolled patients received chocolate bars rich in polyphenols (200 mg) daily for a period of 3 months The patients underwent clinical examination and laboratory test arterial stiffness measurements with Sphygmocor. Markers of oxidative stress (total phenolic contents, total plasma antioxidant capacity, protein carbonyls) were also measured.

Results:
Sixteen patients were enrolled in the study, [median age 62.5 years (± 8,2), 14 patients (87,5%) were male]. Clinical characteristics, blood pressure measurements, arterial stiffness indices and markers of oxidative stress are summarized in table 1,2 and 3.
Peripheral systolic Blood Pressure (PSBP) was decreased by 13,56 mmHg (± 2,57), (p<0,001). Pulse wave velocity (PWV) and central pulse pressure (CPP) were significantly decreased (8,2 m/sec (5,1-9,22), vs 8,85 m/sec (6,7-11,75), (p<0,001) and 47,63 (36,5-60) versus [59,13 mmHg (43,5-69 respectively) at the end of the study], (p = 0,003). Markers of oxidative stress were also improved. A decreased in plasma proteinic carbonyls 52,54 nmol/ml ± 25,04 versus (73,50 nmol/ml ± 18,65, (p<0,001) was
observed while antioxidative capacity was increased 3,55% (1,15-6,38) versus 12,51% (6,26-17,66) (p = 0,013). Importantly no side effects were observed during the study period.

Conclusions:
In this pilot study, oral flavonoid supplementation in the dose of 200 mg may improve arterial stiffness indices and systolic blood pressure measurements and contribute to the improvement of antioxidative capacity in CKD patients.
FEATURES OF DAILY BLOOD PRESSURE IN PATIENTS WITH ARTERIAL HYPERTENSION WITH CHRONIC KIDNEY DISEASE
Authors: Duysewnbaeva Aziza , Srojidinova Nigora , Saidakbarova Feruza 
Published: June 2023

Objective:
To study the daily profile of blood pressure in patients with arterial hypertension (AH) with chronic kidney disease (CKD).

Design and method:
The study included 120 patients with AH I-III degree, who received inpatient treatment. CKD stages were determined according to glomerular filtration rate (eGFR), according to the modern KDIGO 2013 classification. Daily blood pressure profile (DAP) was assessed using the Medicom-combi device (Russia).

Results:
Among the examined patients, preserved renal function of CKD C1 was observed in 20.8% (n = 25); CKD C2 – in 50.8% (n = 61); CKD C3A – in 19.2% (n = 23); CKD C3B – in 9.2% (n = 11) p<0.001. CKD C4 and terminal stages were not detected. It was revealed that according to increasing of degree of CKD, values of the average daily SBP (p = 0.013) average daytime SBP (p = 0.04), mean night SBP (p = 0.001) significantly rises. The load index of elevated daytime and nighttime SBP was high in AH patients with lower eGFR values, p = 0.001. A normal daily profile of SBP/DBP had 28%/32% of patients of the 1st group vs 24.61%/37.70% of patients of the 2nd group vs 37.78%/21.73% of patients of the 3rd group vs 0% /0% of patients of the 4th group, SBP ⇙2 = 40.62 p<0.01; DBP ⇙2 = 47.21, p<0.001. The number of non-dippers in SBP was somewhat higher in the group of patients with CKD C3b: night reduction speed (NRS) SBP 40% in group 1 vs 49.1% in group 2 vs 52.17% in group 3 vs 54.54% in group 4 group ⇙2 = 9.35, p = 0.02. In the group of patients with CKD C3b, individuals with a daily profile of SBP/DBP night-pickers significantly prevailed: 32%/20% vs 14.75%/13.11% vs 13.04%/13.04% vs 45.45%/ 54.54% (in groups 1, 2, 3 and 4, respectively) in SBP ⇙2 = 32.47 p<0.001, in DBP ⇙2 = 64.25 p<0.001. There was a significant increase in patients with a daily profile of over-dipper according to DBP in patients with CKD C3b:0% vs 4.91% vs 13.04% vs 27.27% ⇙2 = 41.47, p<0.001.

Conclusions:
AH patients with CKD have more pronounced disturbances in the daily blood pressure profile, which contribute to an increased risk of developing complications of arterial hypertension.
DIFFERENCES IN ASSOCIATION OF EJECTION DURATION AND CAROTID-FEMORAL PULSE WAVE VELOCITY WITH TARGET ORGAN DAMAGE
Authors: Bai Yaya , Jia Huiying , Avolio Alberto , Qian Yi , Zuo Junli 
Published: June 2023

Objective:
Target organ damage (TOD is affected differently by cardiac and vascular function parameters such as ejection duration (ED) and carotid-femoral pulse wave velocity (cfPWV). This study aimed to quantify the relative differences in relationship of TOD with ED and cfPWV.

Design and method:
The study was conducted in 1254 patients (64.27% males) from Ruijin Hospital (December 2018 to August 2022). All participants provided urine and blood samples and information from medical records. cfPWV was measured using applanation tonometry and leg cuff waveforms (SphygmoCor, AtCor Medical, Sydney, Australia), and ED was obtained from waveform features. TOD was assessed in terms of left ventricular hypertrophy (LVH), microalbuminuria, chronic kidney disease (CKD), and abnormality of carotid intima-media thickness (CIMT).

Results:
Stepwise linear regression models of cfPWV and ED (individually or together) showed that cfPWV was positively correlated with left ventricular mass index (LVMI) (beta = 0.131, p 0.002) and Log (albumin-creatinine ratio, ACR) (beta = 0.123, p = 0.004), while ED was negatively correlated with LVMI (beta = –0.244, p < 0.001) and positively correlated with the estimated glomerular filtration rate (eGFR) (beta = 0.115, p = 0.003). When cfPWV and ED were added separately or together in multiple stepwise logistic regression models, cfPWV was associated with CKD [odds ratio (OR) = 1.240, 95% confidence interval (CI) 1.055–1.458, p = .009], while ED was associated with LVH (OR = 0.983, 95% CI 0.975–0.992, p < 0.001). In the control group with normal cfPWV (< 10 m/s) and normal ED (range 281-321 ms), LVH was significantly lower in patients with high ED (OR = 0.574, 95% CI 0.374–0.882, p = 0.011), but significantly elevated in those with high cfPWV and low ED (OR = 6.799, 95% CI 1.305–35.427, p 0.023).

Conclusions:
cfPWV was more strongly associated with renal damage, while ED was more strongly associated with cardiac dysfunction. As an index of arterial stiffness, cfPWV has an influence on wave reflection which can affect and ED, with a combined effect on LVH.
ASSOCIATION OF ARTERIAL STIFFNESS WITH LEFT VENTRICULAR FUNCTION AND THE IMPACT OF CARDIAC REHABILITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Joo Seungjae , Yoon Homin , Kang Bomin , An Soyeon , Boo Kiyoung , Lee Jaegeun , Choi Joonhyouk , Kim Songyi 
Published: June 2023

Objective:
Arterial stiffness has an important role in the pathophysiology of coronary artery disease and heart failure. The association of arterial stiffness with left ventricular (LV) function and the impact of cardiac rehabilitation in patients with acute myocardial infarction (AMI) were 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) and index (EAI) was calculated from stroke volume measured using LV outflow waveform. The exercise-based, outpatient cardiac rehabilitation (CR) program, which was composed of 8 to 12 visits during 4 weeks to 6 months, was provided, and the follow-up (F/U) echocardiographic study was done after 6 months.

Results:
Twenty-nine patients (age 58.7+/-10.2 years) with AMI were enrolled, but 8 patients denied CR program. At baseline, EAI was significantly associated with E’ (beta -0.379, P = 0.035) and LV global longitudinal strain (GLS) (beta 0.458, P = 0.014). F/U echocardiographic data showed decreased EAI (from 0.95+/-0.24 to 0.85+/-0.28 mmHg/ml/m2, P = 0.039), increased E’ (from 6.34+/-2.34 to 7.40+/-2.86 cm/sec, P = 0.032), and improved LV GLS (from -13.7+/-2.8 to -16.6+/-3.0%, P <0.001) in patients with CR program, but not in patients without CR program. Changes of EAI was significantly associated with changes of E’ (beta -0.396, P = 0.048).

Conclusions:
Arterial stiffness was associated with LV dysfunction in AMI patients. The CR improved the arterial stiffness and LV dysfunction.
CLINICAL INERTIA REGARDING LIFESTYLE CHANGES AND THE ADHERENCE TO THE ADVICE IN HYPERTENSIVE PATIENTS LIVING IN THE CROATIAN RURAL AREA DAMAGED BY AN EARTHQUAKE
Authors: Skelin Juraj , Prgomet Luka , Vuksan-Cusa Zrinka , Bosnic Klara , Jelakovic Bojan 
Published: June 2023

Objective:
Hypertension is a worldwide health issue that can heavily impact the patient's health and life expectancy if not treated. There are many habits in our day-to-day life that can help or hinder the treatment of hypertension.
Our objective was to describe the frequency of doctors’ advice regarding salt intake, weight loss and physical activity and the adherence of patients with hypertension to those suggestions in the rural population from the earthquake damaged area.

Design and method:
Our sample consists of 120 patients diagnosed with hypertension who participated in “The Silent Killer Hunt” project in this rural area. The patients were given a questionnaire which included questions about their doctors’ advice regarding salt intake, weight loss and physical activity and whether or not they took that advice.

Results:
Out of 120 patients, 66% were advised to reduce their salt intake and 91.4% of them implemented the advice; 46.6% of the patients who were overweight were given guidance to reduce their body weight and 72.9% were compliant, while out of the 53.4% who were not given advice, 78.2,% had a BMI>25 g/m2. Lastly, out of 58.4% of our participants who were given instructions to increase their physical activity, 94.9% had a BMI>25 kg/m2 and 71.2% were adherent. Out of the 41.6% who were not given advice, 78.6% had a BMI>25 kg/m2.

Conclusions:
Given how lifestyle changes can be a powerful tool in battling hypertension, our results show that the frequency of doctors giving advice regarding lifestyle changes is much lower than it should be, while the adherence of patients to the instructions given by their doctors is above average, especially regarding salt intake. This indicates that to reach better results, physicians need to give more focus to their communication with patients.
THE EFFECT OF LOW-CARBOHYDRATE DIET ON HYPERTENSIVE PATIENTS WITH OBESITY
Authors: Kim Hyun-Jin , Choi Jong Han , Cho Yoon Jeong , Ko Seung-Hyun , Chon Suk , Kang Jee-Hyun , Kim Kyoung-Kon , Kim Eun Mi , Kim Hyun Jung , Song Kee-Ho , Kim Kwang Il 
Published: June 2023

Objective:
Non-pharmacological treatment such as a healthy diet, is important for hypertensive patients as it has a effect of lowering blood pressure (BP). We aimed to evaluate the effect of low-carbohydrate diet (LCD) on hypertensive patients with obesity.

Design and method:
Four electronic databases (KoreaMed, Embase, Medline, and the Cochrane Library) were searched from their inception to June 2021. Randomized clinical trials evaluating LCD (<130 g/day or <26% of the 2000 kcal/day diet) and very low-carbohydrate diet (VLCD) (<20-50 g/day or <10% of the 2000 kcal/day) for at least 8 weeks in adults with hypertension were eligible. Studies in which more than 50% of patients taking antihypertensive drugs, or systolic blood pressure (SBP) of 140 mmHg or more or diastolic blood pressure (DBP) of 90 mmHg or more were included. Primary outcomes were change of SBP and DBP. The comparative diets were diets with calorie restriction equivalent to those of the intervention diets, and most were included in a calorie-restricted diet and a low fat diet.

Results:
From 18, 151 studies identified in the initial search results, 6 randomized studies were included in the final analysis. Compared to the control diet, decreased SBP (mean difference: -3.25; 95% CI -7.28, 0.77) is observed in LCD for a period of six months or less, with no statistically significant difference in more than six months to one year or less and more than one year (36-52weeks: mean difference -1.30; 95% CI -76.04, 3.44, and > 1year: mean difference -4.51, 95% CI -15.38, 6.37) (Figure). LCD did not effect on DBP compared to control diet. VLCD marginally decreased SBP compared with the control diet, but not lead to a significant difference in DBP.

Conclusions:
For obese adults with hypertension, LCD had no additional benefit in reducing BP and weight compared to calorie-restricted or low fat diets when maintained for one year or longer. There is insufficient evidence to support the beneficial effect of a LCD in adults with hypertension, and further studies are needed to evaluate the effect of LCD in hypertensive patients.
METABOLIC (TCPO2) AND HEMODYNAMIC DISCORDANCE IN PERIPHERAL VASCULAR EVALUATION OF POSTOPERATIVE STUMP NECROSIS. ABOUT TWO CASES AND LITERATURE REVIEW
Authors: Ouail Djamel Eddine , Tebbani Meriem 
Published: June 2023

Objective:
Amputation levels are discussed based on hemodynamic approach.
Transcutaneous oximetry (TcPO2) is a metabolic test of the local perfusion of peripheral tissues.
we report two cases of discordance between hemodynamic and metabolic tests in the evaluation of the level of amputation on stump necrosis.

Design and method:
study of two cases of amputation level decision using ABI, arterial doppler ultrasound and TcPO2

Results:
1st case: patient A D 52 years old, type 2 diabetic for 11 years, admitted 12 days after amputation of the left forefoot following a complication of the infectious and neuropathic diabetic foot. The clinical examination found an infected necrosis of the amputation stump, the ABI is at 1.22. The arterial Doppler ultrasound objective an atheromatous overload and a good arterial flow. The TcPO2 is 69 mmHg next to the stump, contrasting with a TcPO2 of 27 mmHg on the right. The decision was a necrectomy associated with an antibiotic therapy adapted to the antibiogram. The evolution was favorable.
2nd case: patient S B 71 years old, hypertensive for 20 years, paraplegic for 20 years following a spinal trauma. Hospitalized for management of acute ischemia of the lower limbs on paroxysmal AF. Doppler ultrasound performed in the context of the emergency was in favor of the total occlusion of the regular poplar and leg arteries. Rejected from revascularization, evolution under anticoagulant was marked by the appearance of dry gangrene of both feet. The preoperative evaluation was in favor of a TcPO2 of 41 mmHg on the left and 75 mmHg on the right. An amputation of the two forefeet was performed. The postoperative evolution was characterized by a necrosis of the left stump requiring a complementary gesture with good consequences.

Conclusions:
The two cases clearly demonstrate the discrepancy between the classic evaluation (anatomical and hemodynamic) and the metabolic evaluation (TcPO2)
The TcPO2 provides valuable assistance in deciding the level of amputation regardless of the diabetic, hypertensive, elderly patient profile….and regardless of the vascular profile; normal, PAD, post acute ischemia
The TcPO2 is essential before each amputation procedure independently of the hemodynamic evaluation.
METABOLIC PROFILE OF SUBJECTS WITH NAIVE ISOLATED SYSTOLIC HYPERTENSION
Authors: Papadakis Ioannis , Theodorakopoulou Vasiliki , Vougiouklakis George , Petrakis Emmanouel , Spentzouri Despoina , Mathioudaki Anna 
Published: June 2023

Objective:
Even though hypertension is an important contributor to cardiovascular disease (CVD), and its treatment has established mortality benefits, uncertainty lies in the management of isolated systolic hypertension (ISH). Although the association of ISH with CVD and mortality has been established, the metabolic characteristics of this population have not been adequately described. The aim of this study was to describe the metabolic profiles of patients with isolated systolic hypertension.

Design and method:
An observational study of patients attending the Hypertension Unit of the University Hospital of Heraklion, Heraklion, Greece, was performed.

Results:
In total, 809 hypertensive patients not on any anti-hypertensive treatment were identified. Among them, 44.7% were men; age was 55.6±12.5years, while 29.7% were smokers. Systolic blood pressure was 161.3±15.8mmHg and diastolic blood pressure was 96.1±11.3mmHg. Body mass index (BMI) was 31±5.3kg/m2, while 9.6% had type 2 diabetes mellitus (DM).
A comparison of subjects with ISH with the rest hypertensives, revealed that persons with ISH were older, had lower SBP and higher pulse pressure, while they also had lower total cholesterol and LDL, and were more likely to have DM even though they had a slightly lower BMI. On the other hand, they did not have any difference in terms of gender, smoking status, HDL, triglycerides, liver biochemistry, uric acid or prevalence of impaired fasting glucose.

Conclusions:
Subjects with ISH were older, with lower SBP, total cholesterol and LDL and higher pulse pressure and higher prevalence of DM.
ASSESSMENT OF MACROPHAGE INFLAMMATORY ACTIVITY ON VISCERAL ADIPOSE TISSUE IN HIGH-FAT DIET-INDUCED OBESE MICE BY 18F- FDG PET/CT
Authors: Pahk Kisoo , Kwon Hyun Woo , Yeo Jeong Seok , Kim Sungeun 
Published: June 2023

Objective:
Obesity induced inflamed visceral adipose tissue (VAT) secretes pro-inflammatory cytokines thereby promoting systemic inflammation and insulin resistance which further exacerbate obesity-related cardiovascular disease (CVD). Macrophages are the key players in the development of obesity-associated VAT inflammation. Extensive clinical studies have reported that 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can be used to evaluate the macrophage inflammatory activity on VAT in human beings. However, due to difficulty in human VAT biopsy, pathologic correlations were lacking and there was a few study on preclinical animal models. Here, we investigated whether 18F-FDG PET/CT could reflect the macrophage inflammatory activity on VAT in high-fat diet-induced obese mice.

Design and method:
Obese animal models were induced by a high-fat diet (60% fat) for 20 weeks using the male C57BL/6 mice. Insulin tolerance test was performed to evaluate the status of insulin resistance and C-reactive protein (CRP) was measured to assess the status of systemic inflammation. All animals underwent 18F-FDG PET/CT before sacrifice. Macrophage inflammatory activity was evaluated using the maximum standardized uptake value (SUVmax). Flow cytometry-, histological-, and molecular analyses were performed on harvested VAT.

Results:
All obese animals showed insulin resistance which resembled the human metabolic syndrome, a key pathophysiological process that contributes to increase CVD risk. VAT SUVmax was increased in obese mice and significantly correlated with the levels of CRP. Furthermore, VAT from obese mice showed increased macrophage infiltration, compared to normal mice.

Conclusions:
18F-FDG PET/CT could visualize and evaluate the macrophage inflammatory activity on obesity-driven inflamed VAT in obese mice model. Our preclinical study strongly supports the clinical application of 18F-FDG PET/CT in the assessment of VAT inflammation to patients who are vulnerable to CVD.