bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C25-4: VALIDATION OF ACTIVITY MONITORS IN AND OUT-OF-THE LABORATORY ENVIRONMENT
Authors: Dreisbach Scott B , Rhudy Matthew B , Henriquez Brandon , Veerabhadrappa Praveen 
Published: January 2023

Objective:
Physical inactivity is an important risk factor for cardiovascular disease (CVD). Activity monitors track activity and health which can used to measure progress in CVD population. Fitness trackers may help motivate consumers towards a healthier lifestyle by providing feedback, tracking and accountability to maintain regular exercise. Before placing trust in these monitors, their validity and reliability must be determined both, within the laboratory and out-of-laboratory environment. The purpose of this study was to validate the step counts of Apple Watch and compare wrist-, hip- and ankle- worn Actigraphs, in and out-of-the-laboratory environment during treadmill and overground walking respectively, at different walking intensities using video monitoring of participants with manual counting of steps as a reference.

Design & method:
Apple Watch and wrist-, hip- and ankle- worn Actigraphs were used for this study. Participants walked on a set track on a flat, overground surface to mimic free-living conditions. Verbal instructions were provided to walk at three different stages (slow, moderate, fast). Subsequently, participants completed a 3-stage treadmill protocol using the calculated average velocity/stage from overground walking. Both conditions were recorded using a Canon VIXIA HF500 camcorder to observe the steps. All data was collected and analysed between 2017 and 2018.

Results:
Apple Watch, compared to Actigraphs, had the lowest errors (absolute: -2.32, -8.95, and -20.00steps; relative: -1%, -2% and -5%) during overground walking for all stages, and (absolute: -3.35 and -2.25 steps; relative: -1% and -1%) on the treadmill protocol for the moderate and fast stages.

Conclusions:
Apple Watch was an extremely accurate and credible consumer device that can be used by the general population for activity monitoring during overground and treadmill walking. Our study demonstrated the equivalence of step counts during overground and treadmill walking. Such simple, cost effective and precise monitoring could play a larger role to reduce the burden of CVD.
PS-C25-5: ASSOCIATIONS BETWEEN CARDIORESPIRATORY FITNESS AND CARDIOVASCULAR PARAMETERS DERIVED AT REST FROM FINGER PHOTOPLETHYSMOGRAM
Authors: Cox James R , Qasem Ahmad , Tan Isabella , Butlin Mark 
Published: January 2023

Objective:
Cardiorespiratory fitness has been shown to be correlated with cardiovascular complications and comparable to other conventional health parameters. Consequently, it can be a useful preventative and a practical first line of information for cardiovascular diseases, such as hypertension. Wearable devices have the capacity to provide a convenient assessment of individuals cardiorespiratory fitness. Despite its clinical relevance measures of cardiorespiratory fitness remain limited to commercial devices for exercise training purposes. This study investigates whether there is potential for cardiorespiratory fitness to be derived from indices measured at rest from a finger photoplethysmogram waveform.

Design and method:
Participants (n = 8, 4 females, 39 ± 17 years) first completed two questionnaires to provide two separate estimates of cardiorespiratory fitness. The first questionnaire by Jackson et al. (1990) provides an estimated maximum rate of oxygen (VO2max, gold standard measure of cardiorespiratory fitness) based on height, weight, age, and a subjective physical activity rating score. The second questionnaire by Radim et al. (2005) provides a metabolic equivalent parameter (MET) that has previously been shown to correlate with measured VO2max. Following 10 minutes of seated rest, 30 seconds of finger photoplethysmography was recorded. A 10-second snippet with high quality signal was extracted, and a generalised transfer function was applied to the signal to generate an uncalibrated central aortic waveform. Pulse pressure amplification (PPAmp), ejection duration (ED), subendocardial viability ratio (SEVR), heart rate (HR) and augmentation index corrected to a HR of 75 bpm (AIx75bpm) were then calculated for each cardiac cycle and averaged over 10 seconds. Correlation plots and stepwise linear regression were then performed on the estimated VO2max and MET with the derived parameters.

Results:
Average baseline estimated VO2max was 44 ± 10 ml/kg/min and estimated MET was 11 ± 2 (1 MET = VO2/3.5). Stepwise linear regression revealed AIx75bpm, SEVR and HR were the strongest predictors of estimated VO2max (model R^2 = 0.929, F = 17.44, p = 0.009). Only AIx75bpm and SEVR were strongly associated with estimated MET (model R^2 = 0.942, F = 40.5, p < 0.001). For both estimated VO2max and estimated MET, individual correlation plots for PPAmp and ED showed poor correlation.

Conclusion:
A selection of non-exercise derived central aortic parameters from finger photoplethysmography were correlated with cardiorespiratory fitness. This demonstrates that a finger photoplethysmogram signal obtained at rest, such as can be easily measured in wearable devices, may be useful in management and monitoring of cardiorespiratory fitness, and by association health, without the burden of performing rigorous exercise tests.
PS-C26-1: USEFUL MARKERS FOR RENAL PROGNOSIS IN HYPERTENSIVE EMERGENCIES WITH SEVERE RENAL DYSFUNCTION
Authors: Nakazato Rei , Mii Akiko , Sakai Yukinao , Iwabu Masato 
Published: January 2023

Background:
Hypertensive emergencies are poor prognosis conditions associated with rapid blood pressure (BP) elevation and various organ damage. The frequency of dialysis induction due to nephrosclerosis is high and early detection and appropriate therapeutic intervention are important.

Methods:
We selected 15 patients diagnosed as hypertensive emergencies with severe renal dysfunction (serum creatinine level > 2.5 mg/dL) admitted to our hospital between 2005 and 2019. These were divided into two groups: those who received a renal replacement therapy (RRT) after 3 years and those who were not received (non-RRT). The clinical features and laboratory data between the two groups were reviewed and compared retrospectively.

Results:
The median age was 48 years old and the male to female ratio was 3:1. All the patients lacked medical examination and regular checkups after diagnosis of hypertension. 33% of them were obese with body mass index > 25. Six patients resulted in end-stage renal disease and received RRT. On admission, about 80% had elevated plasma renin activity and serum aldosterone levels, while there were no cases of renal artery stenosis. Between two groups, there was no significant difference in serum creatinine levels. Serum LDH levels in the non-RRT group were higher than those in the RRT group. Serum potassium levels and platelet counts were lower, respectively. These data at post-antihypertensive treatment was improved significantly in the non-RRT group. Serum values of LDH, potassium, and platelet in the comparison of pre-and post-treatment data of the two groups showed significantly improved by two-way analysis of variance.

Discussion and Conclusion:
The mechanism of the onset of hypertensive emergencies is still unclear. Severe hypertension causes severe vascular injury and multiple organ damages. In our study, there were young or middle-aged adults and some of them were obese. Therefore, taking health-checkup is helpful for the prevention of the risk of hypertension and appropriate treatment. Higher LDH levels and decreased platelet counts in the non-RRT group suggested the development of severe endothelial damage with rapid BP elevation in the short term. Severe renal dysfunction in these cases can be improved to some extent by appropriate antihypertensive therapy. Furthermore, the lower potassium level suggested the aggravation of the renin-angiotensin-aldosterone system (RAAS) and early induction of RAS inhibitors would be beneficial for the maintenance of BP and renal protection. In conclusion, the value of serum LDH, platelet count, and serum potassium would be predictors of renal prognosis.
PS-C26-4: ASSOCIATIONS BETWEEN ARTERIAL STIFFNESS INDICES AND CHRONIC KIDNEY DISEASE CATEGORIES IN ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Kusunoki Hiroshi , Iwashima Yoshio , Kawano Yuhei , Ohta Yuko , Hayashi Shin Ichiro , Horio Takeshi , Shimizu Hideo , Shinmura Ken , Ishimitsu Toshihiko , Yoshihara Fumiki 
Published: January 2023

Background:
This study investigated the association between arterial stiffness indices and asymptomatic chronic kidney disease (CKD) risk categories in hypertensive patients by using oscillometric device.

Methods:
Arterial stiffness indices, including 24-hour brachial and aortic systolic blood pressure (SBP) and pulse wave velocity (PWV), were measured by an oscillometric Mobil-O-Graph device, brachial-ankle PWV (baPWV) by a volume-plethysmographic method, and renal resistive index (RI) by ultrasonography, in 184 essential hypertensive patients (66.0 ± 17.1 years, 47.3% male). CKD was categorized into 3 stages based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria, using a combination of estimated glomerular filtration and albuminuria.

Results:
The 24-hour aortic PWV (aPWV), baPWV, and RI increased with worsening severity of CKD risk category (all P < 0.01 for trend). Multivariate logistic regression analysis found that a 1 SD increase of nighttime aortic SBP (odds ratio [OR] 1.52), PWV (OR 4.80), or RI (OR 1.75) was an independent predictor of high or very-high CKD stage (all P < 0.05). After adjustment for potential confounders, day-to-night change in brachial SBP as well as in aPWV differed among groups (P < 0.05, respectively). In a multivariate regression model, day-to-night changes in aortic SBP and PWV, and RI were independently associated with day-to-night brachial SBP change.

Conclusions:
In hypertension, circadian hemodynamics in high CKD stage are characterized by higher nighttime values of aortic SBP and PWV and disturbed intrarenal hemodynamics. Further, the blunted nocturnal BP reduction in these patients might be mediated via disturbed intrarenal hemodynamics and circadian hemodynamic variation in aortic SBP and arterial stiffness.
PS-C26-6: HYPERTENSION DUE TO HYDRONEPHROSIS SECONDARY TO IGG4-RELATED DISEASE
Authors: Matsuoka Hiroki , Shimizu Hideaki , Kawada Kyogo , Naruse Yuki , Hayakawa Takuto , Goto Shuji , Kishima Yukari 
Published: January 2023

Background:
Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that is capable of affecting multiple organs. It can present as an inflammatory pseudotumor in various organs. Patients may present with normo- or hypertension (HT) and urinary tract obstruction (UTO). Hydronephrosis (HN) leads to HT by overloading vessels or activating the renin-angiotensin system.

Case presentation:
A 53-year-old man presented with a two week history of abdominal pain. At admission, his blood pressure (BP) was 208/112 mmHg. His physical examination was otherwise unremarkable. Laboratory data and imaging revealed post-renal azotemia. HN was identified due to a mass around the aorta causing bilateral ureteric compression. The right ureter was considered to be more recently compressed because the left kidney cortex was more extensively thinned compared to the right kidney, respectively. Insertion of a double J stent in the right ureter led to improve urinary output with an attendant reduction of weight of 7 kg. Renal function also improved substantially (serum creatinine 5.66 mg/dL at admission; 1.34 mg/dL post-stent insertion).
Initial treatment included intravenous nicardipine, followed oral nifedipine and telmisartan. With the above interventions, HT normalized to 132/71 mmHg in nine days. Finally, only telmisartan was required to maintain normal BP upon discharge.
Biopsies of a salivary gland, the lip, and a cervical lymph node were non-diagnostic. The abdominal mass was not biopsied. Urine cytology was negative for malignancy three times. Serum lactate dehydrogenase was within normal limits, whereas soluble interleukin-2 receptor was elevated at 1,730 U/mL. IgG4-RD was considered as the likely cause. In accordance with current international diagnostic criteria for IgG4-RD, there was: 1) no exclusion criteria, 2) elevated serum IgG4 level, 3) hypocomplementemia, and 4) circumferential soft tissue around the infrarenal aorta. Oral corticosteroid therapy was prescribed. At 40 days post-discharge, follow-up imaging showed a slight reduction in the size of the soft tissue mass. Hypocomplementemia also showed improvement.

Conclusion:
HT was induced by UTO secondary to suspected IgG4-RD. It is reported that HT due to IgG4-RD occur in over one third of cases. Pathophysiology of HT includes renal parenchymal disease and HN. Laboratory data at admission revealed that the plasma renin activity and plasma aldosterone concentration were normal. His BP was ameliorated after urinary output improved, despite using antihypertensive monotherapy. Thus, we suspected that volume overload due to UTO led to HT. We suggest that HN should be considered as a differential diagnosis for the cause of HT.
PS-C26-10: THE PROPKD SCORE IS ASSOCIATED WITH THE PROGRESSION OF RENAL INVOLVEMENT IN PATIENTS WITH POLYCYSTIC KIDNEY DISEASE TREATED WITH TOLVAPTAN
Authors: Moriyama Tomofumi , Taguchi Kensei , Kaida Yusuke , Ito Sakuya , Kodama Goh , Yokota Yunosuke , Nasu Makoto , Fukami Kei 
Published: January 2023

Background:
The PROPKD score has been proposed to evaluate the risk of the progression to end stage renal failure in patients with autosomal dominant polycystic kidney disease (ADPKD), based on gender (male: 1point), hypertension under 35 years old (2 points), urological event under 35 years old (2 points), and gene mutation (PKD1 truncating mutation: 4 points, PKD1 non-truncating mutation: 2 points, PKD2: 0 point). Although tolvaptan has benefits for renal involvement, whether PROPKD score could predict future renal involvement in patients with ADPKD treated with tolvaptan is unknown. Thus, we explored the effects of tolvaptan on the annual changes in total kidney volume (%TKV) and estimated glomerular filtration rate (%eGFR) according to the PROPKD score in these patients.

Methods:
32 ADPKD patients treated tolvaptan for at least a year were retrospectively analyzed (the mean observation period: 3.6 years). We examined the decline in renal function, %TKV by computed tomography, and gene mutation. The association between %eGFR and %TKV change before and after tolvaptan treatment, annual TKV change (%TKV) and PROPKD score was analyzed.

Results:
We identified gene mutations in ADPKD patients: PKD1 truncating mutation (n = 15), PKD1 non-truncating mutation (n = 5), PKD2 mutation (n = 6), and mutation not found (n = 6). Mean %TKV and eGFR were 1843 ± 986 ml and 54.7 ± 21.0 ml/min/1.73 m2, respectively. The mean PROPKD score was 3.3 ± 2.4 points and showed a significant negative correlation with %eGFR before and after tolvaptan treatment (p = 0.044/0.016), and no significant correlation with %TKV before and after tolvaptan treatment.

Conclusion:
The higher PROPKD score, the faster the decrease in %eGFR during tolvaptan therapy, suggesting that the PROPKD score may be useful as a predictor of the risk of progression to renal failure after tolvaptan introduction.
PS-C27-9: THE IMPORTANCE OF BP CONTROL IN AKI: THE KEY TO AN ESCAPE FROM RRT - NEW OPPORTUNITIES OR VAIN HOPES?
Authors: Kwiatkowska Marlena , Kawalec Malgorzata Twardowska , Malyszko Jolanta 
Published: January 2023

Objective:
Chronic kidney disease-CKD is associated with 18-fold increased cardiovascular risk, however data on acute kidney injury-AKI, in cardiovascular risk are limited. Hypertension (HT) is an overwhelming finding in CKD but again data on hypertension prevalence in AKI are very scarce. The etiology of HT AKI could be multifactorial thus BP control requires multidirectional, frequently aggressive, treatment and is one of the major challenge of nephrologists and hypertension specialists. The aim of the study was to assess blood pressure control in patients with AKI admitted to the nephrology department.

Design and method:
The retrospective analysis of 215 (mean age 58y) patients with AKI (N17) was made based on the medical documentation. The medical history, BP measurements body mass, diuresis, laboratory tests, the presence of peripheral edema and the echocardiography were taken. The kind of using hypotensive drugs and the connection between the number of them, the presence of volume overload and BP control, need for dialysis, were analyzed. Among patients with AKI 35% requires acute hemodialysis-HD, due to either clinical or biochemical indications.

Results:
AKI patients requiring HD were significantly older than patients treated conservatively group (Me = 67 vs. Me = 54y, p < 0,01) and had much higher both systolic and diastolic blood pressure values (p < 0.01 for both). The renal function was less present in AKI group requiring HD. The peripheral edema was observed significantly more often in HD group with uncontrolled BP (above 140/90 mmHg) (72,2% vs 35,7%, p < 0,05). The average amount of hypotensive drugs was 5 in HD and 3 in non-HD patients. The most used hypotensive drug was calcium channel blocker, diuretic and beta-blocker. Non-HD patients were treated with ACEi and ARB significantly wider (p < 0,05). There were no differences in echocardiographic parameters.

Conclusions:
There were the better BP and volume control in HD group. We confirmed the connection between BP control, volume status and the duration of dialysis, particularly in PD patients. Salt dietary restriction and the better volume control in PD patients are strongly recommended. ACEi should be used more widely, particularly in patients with the high risk of cardiovascular disease.
PS-C27-10: SHORT-TERM EFFICACY OF DAPAGLIFLOZIN FOR CHRONIC KIDNEY DISEASE PATIENTS
Authors: Nakai Kentaro , Hara Yuichiro , Inoue Megumi , Shukuri Tomoya , Hara Masatoshi , Nakagawa Kaneyasu , Tokumoto Masanori 
Published: January 2023

Background:
Dapagliflozin, a SGLT-2 inhibitor, has been reported to prevent renal and cardiovascular events. Dapagliflozin has been approved for use in chronic kidney disease (CKD) without diabetes, so that it has been widely used in CKD patients.

Methods:
This study was a single-center, retrospective, and longitudinal study consisting of 102 patients (75% male, mean age 61.5 ± 15.7 years, 30.3% diabetes), who were started dapagliflozin prescription at our department between April 2021 and March 2022. The efficacy of treatment on proteinuria, blood pressure and blood sample findings (hemoglobin, uric acid, phosphorus and creatinine) in the short term (64.1 ± 46.7 days) between initiation of treatment and the first return visit were compared in two groups: advanced CKD (eGFR under 30 mL/min/1.73 m2) and moderate CKD (GFR more than 30 mL/min/1.73 m2).

Results:
Advanced CKD patients were older (mean age 65.1 ± 14.7 years vs. 58.2 ± 15.9 years) and had more diabetes (45.8% vs. 16.7%) compared with Moderate CKD patients, but the sex ratio was similar between the two groups. Proteinuria did not change in Advanced CKD, but decreased significantly from 2.1 ± 2.1 g/gCr to 1.8 ± 2.0 g/gCr in Moderate CKD. Systolic blood pressure significantly decreased from 144.1 ± 15.0 mmHg to 136.6 ± 26.1 mmHg in Advanced CKD and tended to decrease from 140.0 ± 17.4 mmHg to 135.4 ± 18.2 mmHg in Moderate CKD. Hemoglobin increased significantly in Moderate CKD (from 14.2 ± 1.8 g/dL to 14.7 ± 1.8 g/dL) and uric acid decreased significantly (from 6.4 ± 1.4 mg/dL to 5.4 ± 1.3 mg/dL), but no significant change was observed in Advanced CKD. On the other hand, Advanced CKD patients showed a significant increase in serum phosphorus (from 4.0 ± 1.3 mg/dL to 4.3 ± 1.5 mg/dL) and serum creatinine (from 3.2 ± 1.6 mg/dL to 3.3 ± 1.8 mg/dL). Serum creatinine elevation above 0.3 mg/dL was found in 29% of Advanced CKD patients, but not in any Moderate CKD patients.

Conclusions:
Dapagliflozin may reduce blood pressure and improve anemia, proteinuria, and hyperuricemia in short-term treatment of moderate CKD patients, while acute exacerbation of kidney function should be considered in short-term treatment of advanced CKD patients.
PS-P07-6: ACCESS TO ESSENTIAL MEDICINES AND DIAGNOSTIC TESTS FOR HYPERTENSION AND HEART FAILURE IN MAPUTO CITY, MOZAMBIQUE
Authors: Jessen Neusa , Sharma Abhishek , Jones Jennifer , Auala Tangeni , Boladuadua Sainimere , Jingi Ahmadou , Ferrer Jose , Mocumbi Ana 
Published: January 2023

Objective:
To evaluate access (availability, price, affordability) to essential medicines (EMs) and diagnostic tests and technologies for management of hypertension and heart failure (HF) in Maputo City, Mozambique.

Design and method:
In a cross sectional survey, using a modified version of World Health Organization (WHO)/Health Action International methodology, data from a representative sample comprising 6 public and 6 private sector hospitals and 30 private sector retail pharmacies was collected. Upon reviewing WHO Model EM List (EML), Priority Medicines for Children and Women list, Mozambique National EML and guidelines, 50 EMs, including 14 WHO Core and 36 cardiovascular diseases (CVD) EMs were selected. Of those, data for 19 EMs (including different formulations and dosages) for management of hypertension and HF are presented here. Data on 19 diagnostic tests and 17 devices was collected from hospitals. Availability was calculated as percentage of surveyed facilities where a medicine or diagnostic tool was found on the day of survey. Median price ratio (MPR) refers to median consumer price of a medicine compared to respective international reference price (IRP). Medicines were considered unaffordable if to purchase a monthly supply, the lowest paid government worker had to spend more than one day wage.

Results:
Mean availability of anti hypertensive and HF medicines combined was far below WHO target (80%), both in private (retail: 35.0%, hospital pharmacies: 30.6%) and public sectors (hospital pharmacies: 27.8%). Only two surveyed medicines were available in over 80% of public-sector hospital pharmacies. Most (11/19) medicines were available in less than 50% of retail pharmacies.
Median MPR (range) of medicines was high [Lowest Priced Generic (LPG): 3.2 (0.98;19.84); Most Sold Generic (MSG): 4.8 (1.67;19.98)] compared to WHO recommendation (no one should pay greater than 4 times the IRP). LPG versions above that recommendation included amlodipine, enalapril, spironolactone.
The lowest paid worker, on average, would spend more than one day wage to purchase a monthly supply of most EMs.
Mean availability of CVD diagnostic tests and devices was lower in public (54.6% and 61.1%, respectively) compared to private (89.5% and 91.7%, respectively) sector.

Conclusion:
Access to EMs for management of hypertension and HF is very limited in Maputo City, characterized by high prices, low availability and affordability. Access to CVD diagnostic tests and devices is particularly low in public-sector. These data raise important concerns and may guide policies and interventions for improving access to cardiovascular care and serve as benchmark for future comparations.