bluuebunny/crossref_metadata_2025_split huggingface dataset:
AORTIC INVOLVEMENT IN FIBROMUSCULAR DYSPLASIA: REPORT FROM ARCADIA-POL
Authors: Talarowska Paulina , Canning Caitriona , Persu Alexandre , Januszewicz4 Andrzej , Gornicka Barabra , Colgan Mary-Paula , Matsko Pavlo , Sasin Dawid , Sterlinski Ignacy , Kruk Mariusz , Szkamruk Katarzyna , Prejbisz Aleksander , Dobrowolski Piotr , Michalowska Ilona , Litwin Mieczyslaw , Januszewicz Magdalena 
Published: June 2023

Objective:
Fibromuscular dysplasia (FMD) affects the walls of medium-sized arteries. There are no described radiological characteristics pathognomonic of aortic FMD but pathological documentation of aortic FMD has been occasionally reported. The aims of this study were to investigate the characteristics of abdominal aorta in patients with FMD versus controls and to review the relevant literature.

Design and method:
We measured centreline abdominal aortic diameters on 136 patients with FMD (22 with focal disease) enrolled in the ARCADIA-POL study, 60 patients with carotid dissections but no evidence of FMD and 136 healthy controls.

Results:
The median abdominal aortic diameter did not differ between patients with FMD, patients with carotid dissections and no evidence of FMD and healthy controls. However, aortic diameter at the level of the diaphragm was smaller in patients with focal FMD compared to patients with multifocal FMD, patients with carotid dissections and healthy controls (ANOVA 0.015). Six patients with mid-aortic syndrome (MAS) were reported separately. All had radiological evidence of FMD in medium-sized aortic branches. In one in whom a sample of aortic wall was obtained, histology confirmed focal aortic FMD. A literature review found a further 31 reports of aortic histology with features of FMD.

Conclusions:
We found no difference in aortic diameters between individuals with or without FMD. Nevertheless, patients with focal FMD had smaller aortic diameters than those with multifocal FMD and controls. This represents another phenotypic difference between multifocal and focal FMD. Focal renal artery stenosis associated with MAS may represent an extreme presentation belonging to the same disease spectrum.
CAROTID-FEMORAL PULSE WAVE VELOCITY VARIABILITY: BEAT-TO-BEAT ASSESSMENT
Authors: Obeid Hasan , Tairi Amira , Fortier Catherine , Giudici Alessandro , Spronck Bart , Agharazii Mohsen 
Published: June 2023

Objective:
Variability of carotid pulse wave velocity (CFPWV) measurements may be related to measurement errors, but also to physiological beat-to-beat variations in pulse transit time (TT). We aimed to 1) evaluate beat-to-beat variability of CFPWV on simultaneous non-invasive carotid and femoral waveforms without signal artefacts, and 2) explore its clinical and hemodynamic determinants.

Design and method:
In 44 adult patients (47±18 years; 50% men; 32% hypertensive, 27% with chronic kidney disease, 9% diabetic and 5% with cardiovascular disease), three 10 seconds-long acquisitions of carotid and femoral pressure waveforms were performed using Complior Analyse. Raw data of the three recordings were extracted, checked to be artefact-free, concatenated, and subjected to a custom 2nd derivative-based foot detection algorithm. Mean, beat-to-beat standard deviation (SD), and coefficient of variation (CV) of CFPWV (80% of direct distance) and heart rate were determined. Regression analysis was used to identify determinants of CV of CFPWV.

Results:
44 ± 3 (mean ± SD) beats per individual were analysed, and the mean CFPWV was 7.7±2.6 m/s. The SD and CV of CFPWV were 1.2±0.8 m/s and 13.9±6.5%, respectively. In multivariable regression analysis, age (standardized ß = 0.470, p<0.001) and intra-individual SD of heart rate (ß = 0.430, p<0.001) explained 63% of changes in CV of CFPWV. Systolic/diastolic blood pressures were not significant determinants of CV of CFPWV.

Conclusions:
There is a variability in beat-to-beat pulse transit time that is not explained by poor signal quality, but by higher physiological variations of beat-to-beat transit time, which is explained by advancing age and beat-to-beat heart rate variability.
AMBULATORY BLOOD PRESSURE MONITORING IN PATIENTS WITH MEDIAL ARTERIAL CALCIFICATION
Authors: Gaspar Ludovit , Mesarosova Dasa , Filipova Slavomira 
Published: June 2023

Objective:
Several studies have shown that reduced ankle-brachial pressure index (ABI) is a reliable warning sign of increased cardiovascular risk. But also ABI values above 1.3 in the presence of medial arterial calcification (MAC) are associated with increased mortality due to cardiovascular causes. Aim of the study was in a group of patients with MAC using ambulatory blood pressure monitoring (ABPM) to document frequent occurence of arterial hypertension, with also frequent diurnal pattern loss, as significant factors in patients prognosis.

Design and method:
We examined 41 patients (25 men, 16 women) with identified MAC. Mean age 59 years (50-79 years). All patients have been treated for diabetes mellitus, type 2, most of them, 23 (56.1 %) with insulin. The mean duration of diabetes was 12.6 years. MAC was detected by the BOSO, ABI system 100 (Germany), using the oscillometric method of measuring blood pressure. ABI value was calculated as the ratio of the value of higher pressure in the leg to a higher pressure on the upper extremities. ABPM was performed with the Cardiosoft-Tonoport V, General Electric (USA).

Results:
35 patients (85,4 %) had arterial hypertension, most of them, 20 (48,8 %) grade 3 hypertension (according to ESC/ESH Guidelines). 14 patients (40 %) had a preserved diurnal rhythm (dipping), 18 (51.4 %) had it disturbed (non-dippers or risers). In 3 patients (8.6 %) we did not determine the diurnal sign for night vigil.

Conclusions:
In patients with MAC, we found a high prevalence of arterial hypertension, and a diurnal rhythm disorder was also very frequent. This fact may also contribute to the worsened cardiovascular prognosis of these patients. Therefore ABPM in patients with MAC is highly recommended, since subsequent cardiology management can improve their prognosis.
COFFEE CONSUMPTION RELATES TO A REDUCTION OF AORTIC STIFFNESS BUT NOT ON MICROCIRCULATION IN WELL-CONTROLLED HYPERTENSIVES
Authors: Zotti Francesca , Marozzi Marialuisa Sveva , Vacca Antonio , Rignani Federica , Gramegna Davide , Amodio Gianfranco , Santoro Giuseppe , Benedittis Lorenzo De , Schirosi Gabriella , Brosolo Gabriele , Catena Cristiana , Cicco Sebastiano , Sechi Leonardo A. , Nazzaro Pietro 
Published: June 2023

Objective:
Nutritional interventions potentially preventing hypertension-related organ damage are far to be fully defined. Coffee is one of the most used beverages all over the world. Many studies tried to define the optimal amount of coffee in order to understand whether coffee has a role in cardiovascular prevention. Thus, we evaluated vascular stiffness in well controlled hypertensives according to coffee consumption.

Design and method:
We evaluated well-treated 449 patients (225F, 224M, aged 62.56±11.49) with essential hypertension. All patients were checked for organ damage screening including carotid-femoral pulse wave velocity (cfPWV), Augmentation Index (AI), and ankle-brachial Index (ABI). To evaluate microcirculation, amydriatic retinography was performed. Arteriolar-to-Venular diameter Ratio (AVR). The number of coffee cups per day was asked during the visit. The median coffee consumption was 2 cups per day.

Results:
Patients were subdivided into three groups according to tertiles of cups consumed: Group 1, 0-1 cups 148 patients (87F, 61M; 63.66±12.94), Group 2, 2 cups, 159 patients (77F; 82M; 64.75±10.09), Group 3, >2 cups, 142 patients (60F; 82M; 58.96±10.54). No differences highlighted in BMI, in SBP/DBP, in cfPWV and in ABI. On the contrary, aortic stiffness evaluated as AI results significantly decreased in high coffee consumers compared to other groups (ANOVA p<0.0001). In particular, Group 3 was lower than Group 1 (Group 3 9.54±15.48 vs Group 1 17.49 ± 19.56, p<0.05) and (Group 3 9.54±15.48 vs Group 2 15.88 ± 16.57, p<0.05). AVR was higher in less coffee consumers compared to higher (Group 1 0.91 ± 0.10 vs group 3 0.87 ± 0.11, p<0.05), but no difference resulted between Group 2 and 3 or Group 1 and 2. Moreover, AVR did not correlate to Augmentation Index in any group.

Conclusions:
Coffee consumption may have a role in prevention of aortic remodelling and stiffness. Consumption of at least 3 cups of coffee per day reduces vascular stiffness and increase central vascular compliance, despite this effect is reduced in distal vascular circulation. Our findings need further analysis, mainly to the effects in distal/central hemodynamics due to different drug treatment.
RANDOMIZED PILOT STUDY ON THE EFFECTS OF SARCOCORNIA AS A SALTSUBSTITUTE IN ARTERIAL BLOOD PRESSURE AND VASCULAR FUNCTION INHEALTHY YOUNG ADULTS
Authors: Pereira Telmo , Caldeira Andreia , Caseiro Armando , Osorio Nadia , Silva Aida , Barroca Maria 
Published: June 2023

Objective:
Previous studies have shown that excessive salt intake is strongly associated with highblood pressure (HT), vascular dysfunction, and the overall risk of cardiovascular diseases. The aimof this study was to evaluate Sarcocornia effectiveness as a salt substitute, addressing its effect oncardiovascular function in healthy young individuals.

Design and method:
Thirty healthy participants, aged 18 to 26 years,were randomized into two groups: the control group (CG) and the intervention group (IG). The IGused Sarcocornia powder as a salt substitute for cooking, and the CG used regular salt, during a periodof 1 month. A baseline evaluation was performed before the participants started the interventionphase, and was repeated after a 30-day intervention period. Each evaluation included blood pressure (BP) measurement, carotid-femoral pulse wave velocity (PWV), and carotid pulse wave analysis(PWA), and blood samples were also collected for analysis. Sodium excretion was measured atbaseline and after intervention through spot urine collection and analysis, a method suitable forthis population but with known limitations.

Results:
Baseline parameters were similar between groups and were within normal range. Sodium excretion remained unchanged in the two evaluations in the CG, but significantly decreased after intervention in the IG. The reduction in sodium excretion in the IG was followed by a significant reduction in brachial and aortic systolic (-7.0± 0.9 mmHg and -5.6 ± 1.0 mmHg, respectively; p<.001) and diastolic (-5.9 ± 1.0 mmHg; p<.001) blood pressure, with no differences observed in the CG. Also in the IG, PWV decreased from 6.0 ± 0.6 m/s at baseline to 5.7 ± 0.6 m/s after intervention (p = .042), with no significant changes in the CG.

Conclusions:
This preliminary study conveys positive results in favor of Sarcocornia as a dietary substitute for regular salt, providing added evidence on the negative cardiovascular effects of high salt intake in young and healthy adults. The overall nutritional value of Sarcocornia, also known for its high phenolic content, may also add to the observed benefits.
DIETARY SODIUM/POTASSIUM INTAKE AND COGNITIVE IMPAIRMENT IN ELDERLY PATIENTS WITH HYPERTENSION: DATA FROM NHANES 2011-2014
Authors: Kou Chengkun , Zhao Xu , F Xin , Lin Xin , Wang Qiongying , Jing Yu 
Published: June 2023

Objective:
This study aimed to assess the relationship between dietary sodium/ potassium intake and cognition in elderly individuals with hypertension.

Design and method:
We designed a cross-sectional study based on the 2011–2014 National Health and Nutrition Examination Survey (NHANES). Cognitive performance was assessed using the Digit Symbol Substitution Test (DSST), Consortium to Establish a Registry for Alzheimer's Disease test (CERAD), and Animal Fluency Test (AFT). Multivariate logistic regression and restricted cubic spline (RCS) was used to assess the relationship between dietary sodium/ potassium intake and cognition.

Results:
After excluding participants with incomplete data, 1670 out of 2276 participants had confirmed hypertension. Compared with the lowest quartile of dietary sodium, the lowest weighted odds ratio (OR) of cognitive impairment in DSST was observed in Q4 (OR = 0.45, 0.29–0.70), and a similar trend was observed in AFT (OR = 0.34, 0.18–0.65). After adjusting the covariates, the lowest weighted multivariate adjusted OR of cognitive impairment in DSST were also observed in Q4 (OR = 0.47, 0.26–0.84) compared with the lowest quartile of dietary sodium. The RCS results showed that dietary sodium was U-shaped and associated with the risk of cognitive impairment in the DSST (Pnon–linearity = 0.0067). No significant association was observed between dietary potassium and cognitive performance.

Conclusions:
Too high and too low dietary sodium levels were associated with impairment of specific processing speed, sustained attention, and working memory for hypertension among the elderly in the United States. However, no association was observed between the dietary potassium intake and cognition.
CHIOS MASTIC IMPROVES NIGHT-TIME DIASTOLIC PRESSURE IN WELL-CONTROLLED PATIENTS WITH HYPERTENSION; PRELIMINARY RESULTS OF THE HYPER-MASTIC CLINICAL TRIAL
Authors: Kalafati Ioanna Panagiota , Korovesi Anastasia Areti Kyriazopoulou , Papaioannou Maria , Konstantaki Christina , Angelidakis Lasthenis , Pachi Vassiliki K. , Maneta Eleni , Bampatsias Dimitrios , Petropoulos Ioannis , Manios Efstathios , Smyrnioudis Ilias , Georgiopoulos Georgios , Dedoussis George V. , Stamatelopoulos Kimon 
Published: June 2023

Objective:
Chios mastic is a natural nutritional supplement consisting of several bioactive compounds and it possesses antioxidant and anti-inflammatory activities. Preliminary recent evidence suggests an anti-hypertensive effect of mastic. HYPER-MASTIC is a double-blind, randomized and controlled clinical trial, with the aim of investigating the additional effect of a three-month supplementation with Chios mastic on arterial hypertension of Greek patients with well-managed cardiovascular risk factors.

Design and method:
Patients with well controlled hypertension are being consecutively recruited and randomly allocated into three groups of supplements: 1500mg of mastic, 2800 mg of mastic and placebo in this ongoing study. For the current analyses, the two mastic groups were merged. Blood pressure measurements, using both office and 24h blood pressure measurement, and blood tests were performed at baseline and at 3 months. Flow-mediated dilatation (FMD) at the level of the brachial artery was measured in all patients as a measure of endothelial function. Patients reported no recent history of acute myocardial infarction or stroke and no history of heart failure. Herein, the preliminary results of the study are presented.

Results:
At the time of analysis, twenty one patients [48% females, age: 62 (14)] were consecutively recruited and randomized, with available data at 3 months. Thirteen volunteers were allocated to mastic and eight to placebo. No difference was found regarding age, sex distribution, BMI levels, personal or family history of hyperlipidemia and hypertension, diabetes mellitus type 2 and coronary artery disease between the two groups. Patients in the mastic group reduced their night-time diastolic blood pressure compared to placebo [-5 (10) vs -2.5 (16.3) mmHg | p = 0.025, respectively]. No other differences from placebo were observed on the effect of mastic on BP parameters. FMD dropped with time in the placebo group, whereas in the mastic group it was preserved [-1.2 (2.7) vs -0.2 (0.8) | pinteraction = 0.010].

Conclusions:
Chios mastic supplementation leads to improved night-time diastolic blood pressure and preserved endothelial function in patients with well-controlled hypertension, suggesting that it may incrementally exert anti-hypertensive and vasculoprotective properties over anti-hypertensive medication.
PROLONGED NOCTURNAL HYPOXEMIA PREDICTS WORSE PROGNOSIS IN PATIENTS WITH CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION UNDERGOING PULMONARY ENDARECTOMY
Authors: Xu Hang , Song Wu , Liu Sheng 
Published: June 2023

Objective:
Obstructive sleep apnea (OSA) and/or nocturnal hypoxemia is prevalent in patients with chronic thromboembolic pulmonary hypertension (CTEPH), yet the pathological determinants of adverse outcomes remain ambiguous. We aimed to investigate the prognostic significance of various sleep parameters for poor prognosis in patients with CTEPH undergoing pulmonary endarterectomy (PEA).

Design and method:
Consecutive patients diagnosed with CTEPH who underwent overnight cardiorespiratory polygraphy for the assessment of OSA were enrolled. Time-to-event analysis was performed investigating cardiorespiratory indices (eg, apnea-hypopnea index [AHI], time percentage with oxygen saturation below <90% [T90]) and clinical worsening using the log-rank test and multivariable Cox proportional hazard models adjusted for multiple confounders.

Results:
Of 71 operable CTEPH patients, 36 (50.7%) had OSA (AHI = 5 or above) and 32 (45.1%) had nocturnal hypoxemia (T90 no less than 30%). A 10% increase in T90 was associated with a nearly 27% greater risk of being classified as a high-risk group (odds ratio: 1.27, 95% confidence interval [CI] 1.07-1.50, P = 0.006), as quantified by mean pulmonary artery pressure over 46 mmHg. Over a median follow-up of 39.0 months, 19 (26.8%) patients experienced CW events. AHI did not predict a higher risk of incident CW (hazard ratio [HR]: 1.00, 95% CI: 0.93-1.06, P = 0.906). By contrast, Compared with normoxemic patients, patients with nocturnal hypoxemia had a higher cumulative incidence of CW (43.8% vs. 12.8%, log-rank P = 0.017). Notably, nocturnal hypoxemia was associated with an increased risk of CW events (HR: 3.27, 95% CI 1.17-9.13, P = 0.024), and these associations persisted even after covariate adjustment.

Conclusions:
Among patients with operable CTEPH, nocturnal hypoxemia quantified by T90 was a robust risk predictor of both short-term and long-term CW events. Investigation of nocturnal hypoxemic burden in CTEPH may aid in the early risk-stratification.
NOCTURNAL HYPOXIA INDEXES ARE ASSOCIATED WITH LEFT VENTRICULAR REMODELING AND DIASTOLIC DYSFUNCTION IN OBSTRUCTIVE SLEEP APNEA PATIENTS
Authors: Maiolino Giuseppe , Bisogni Valeria , Maggi Michael , Carlucci Silvia , Federici Giacomo , Soranna Davide , Zambon Antonella , Pengo Martino F. , Lombardi Carolina , Busetto Luca , Vettor Roberto , Parati Gianfranco 
Published: June 2023

Objective:
Echocardiography features of obstructive sleep apnea (OSA) are heart derangements as higher left ventricular mass index (LVMI) and left ventricular end-diastolic diameter, lower left ventricular ejection fraction (LVEF), and impaired diastolic function. The apnea/hypopnea index (AHI), the parameter currently used to define diagnosis and severity of OSA, poorly predicts cardiovascular damage, cardiovascular events, and mortality. Thus, we aimed to assess, if, in addition to AHI, other polygraphic indices of OSA presence and severity might serve as better predictors of echocardiographic cardiac remodeling.

Design and method:
We enrolled two cohorts of subjects referred for suspected OSA to the outpatient facilities of the IRCCS Istituto Auxologico Italiano, Milano, and of the Clinica Medica 3, Padova. All patients underwent home sleep apnea testing and echocardiography. Based on the AHI the cohort was divided into no-OSA (AHI<15 events/hour) and moderate-severe OSA (AHI> = 15 events/hour).
A stepwise multiple regression analysis was used to identify the covariates among age, gender, body mass index, past medical history, and polygrapic variables, independently associated to four echocardiographic variables, e.g., LVMI, LVEF, left ventricular end-diastolic volume (LVEDV), early and late ventricular filling velocity ratio (E/A).

Results:
We recruited 162 patients and found that compared to patients with no-OSA, those with moderate-severe OSA showed higher LV remodeling [LVEDV 48.4±11.5 ml/m2 vs. 54.1±14.0 ml/m2, respectively, p = 0.005] and lower LVEF (65.3±5.8 % vs. 61.6±7.8%, respectively, p = 0.002), whereas we could not find any difference in LVMI and E/A.
At multivariate linear regression analysis, the only polygraphic independent predictor of LVEDV was the percentage of time with SatO2 < 90% (↓ = 0.262), whereas, the independent predictors of E/A were AHI (↓ = -0.379) and oxygen desaturation index (↓ = -0.422).
None of the polygraphic variables was associated to LVMI and LVEF at multivariate linear regression analysis.

Conclusions:
Our study shows that nocturnal hypoxia-related indexes were associated with left ventricular remodeling and diastolic dysfunction in OSA patients. If confirmed in future studies with a wider sample of patients included, these results support the adoption of hypoxia indexes in the evaluation of OSA patients, particularly those at a greater cardiovascular risk.
CHREBP/ CHREBP BETA EXPRESSION MEDIATES THE PARADOXICAL EFFECT OF FRUCTOSE ON BODY WEIGHT OF FRUCTOSE-FED RATS BY BROWN ADIPOSE TISSUE ACTIVATION
Authors: Khashab Rawan , Sharabi Yehonathan , Shabtai Zehava , Grossman Ehud , Leibowitz Avshalom 
Published: June 2023

Objective:
Western diet fructose content is a neglected nutrition component, with significant devastating metabolic effects like metabolic syndrome (MeS) and obesity. The data suggest that Food-induced thermogenesis is a contributing factor for regulating body weight. Carbohydrate Responsive Element Binding Protein-beta (ChREBP beta) is recognized now as the regulator of fructose metabolism. Brown adipose tissue (AT) which plays essential role as a thermoregulatory organ, is recognized now also as an endocrine tissue that participates in glucose and lipids metabolism. ChREBP expression is associated with activating of BAT and improve metabolic status. On the other hand, increased ChREBP beta seems to have a deleterious metabolic effect on BAT.

Design and method:
Sprague-Dawley male rats, 8 weeks old were fed High Fructose Diet (HFRD) or match regular chow for 6 weeks (n = 8). Body weight (BW) and precise food intake were measured weekly. Brown (peri-aortic and interscapular, PA and IS respectively) and white (mesenteric) AT were collected for further molecular studies.

Results:
HFrD fed rats gain significantly less weight than the control group (from 236±2 to 397±8 vs. 233±2 to 430±9 gr. P<0.05) despite eating an equal food amount (28±1vs.29±1.5 g/rat/week). The expression of uncoupling 1 (UCP1) mRNA, a BAT activation marker, was significantly higher in BAT than in WAT. Fructose consumption increased its BAT expression compared to regular chow. However, the expression of ChREBP and ChREBP beta in BAT was significantly lower in HFrD fed rats.

Conclusions:
In the HFrD rat model of MeS, fructose consumption leads to lesser weight gain for the same caloric intake. This BW difference is accompanied by the activation of BAT in the HFrD group. This paradoxical effect may be regulated by decreased ChREBP/ChREBP beta expression in response to fructose.