bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C16-7: ASSOCIATION OF ELECTROCARDIOGRAM FINDINGS WITH MORTALITY IN COVID-19 PATIENTS
Authors: Aquino Achilles , Lopez Marian 
Published: January 2023

Objective:
The COVID-19 virus has greatly debilitated a lot of patients in the Philippines. Baseline demographic characteristics and other parameters such as baseline electrocardiographic (ECG) findings were investigated to act as predictors for mortality among admitted patients who are RT-PCR positive for COVID. This study aims to determine the association of baseline ECG findings including both normal and abnormal variants such as those suggestive of acute cardiac injury and hypertrophy with mortality of these patients.

Design and method:
This is a retrospective study of patients admitted from March 2020 to May 2021 who were diagnosed to have COVID-19 thru an RT-PCR swab. Inclusion criteria include a recorded baseline ECG. Demographic characteristics were also included. Patients were divided according to their ECG findings as normal and abnormal. Among those with abnormal ECG findings, they were further subdivided into those with ischemic changes, hypertrophy, and miscellaneous (bundle branch blocks).

Results:
A total of one hundred thirty-six (136) patients were included in this study. Among the abnormal ECG findings obtained, the miscellaneous group particularly those with right bundle branch block was noted to be associated with mortality (OR = 4.86, 95% CI 1.04–22.7, p = 0.044). Other ECG findings such as ischemic changes and hypertrophy showed no significant association.

Conclusion:
Among the different classifications of ECG findings, those with baseline ECG findings of right bundle branch block showed a positive association with mortality. Other parameters such as demographic features are also noted to have no association with mortality. Further investigation and a higher population number are suggested to further conclude these findings.
PS-P01-4: PREDICTORS FOR REVERSIBILITY OF MILD COGNITIVE IMPAIRMENT OVER 9 YEARS IN GENERAL POPULATION (TANUSHIMARU COHORT STUDY)
Authors: Morikawa Nagisa , Enomoto Mika , Fukami Ako , Sato Hiromi , Adachi Hisashi , Fukumoto Yoshihiro 
Published: January 2023

Backgrounds:
Prevention of dementia by preventing mild cognitive impairment (MCI) is very important, because the treatment for dementia has not been established. It is known that some of MCI convert to normal cognitive function, although its pathophysiology has not been elucidated. Currently, evidences of predictors for the cognitive reversibility are scarce, however, promoting cognitive improvement is necessary to prevent dementia. Therefore, we investigated the predictors of reversible MCI in a general population.

Methods:
We conducted medical interview, physical and blood tests and Mini-Mental State Examination (MMSE, 30 points) to assess cognitive function as a longitudinal cohort study in Tanushimaru in Japan in 2009 and 2018. Our study subject was 376 participants with MCI, which was defined as 24–27 points of MMSE, in 2009. Reversible MCI, which means MMSE score improvement to more than 28 in 2018, was defined as an outcome. Univariate and multivariate logistic regression analyses were used to analyze the association between life style factors in 2009 and reversible MCI. Traditional cardiovascular risk factors including were used as covariates.

Results:
Of the 376 subjects, 211 (56.1%) had reversible MCI. In fully adjusted logistic regression analyses, reversible MCI was significantly associated with higher body mass index (p = 0.003), history of alcohol intake (p = 0.009), taking lipid-lowering medication (p = 0.008), and less domains of impaired cognition in MMSE in 2009 (p = 0.01). The odds ratios (95% confidence interval) were 1.14 (1.05–1.24), 2.2 (1.2–3.8), 2.6 (1.3–5.3), and 0.62 (0.43–0.90).

Conclusion:
This study suggests some features of reversible MCI. Especially, we found that a possibility of a protective effect of lipid-lowering drugs on cognitive function. Further studies are needed to clarify the association.
PS-P02-3: DIETARY RISK FACTORS FOR HYPERTENSION- INSIGHTS FROM THE TESCO 1.0 DATASET
Authors: Pimenta Dominic , Yilmaz Dilsan , Anyim Martin , Taubel Jorg 
Published: January 2023

Background:
Tesco published an open-source dataset containing area-aggregated product purchase information from 420m transactions across 16m individual Clubcard users in the Greater London area, at a borough level. This dataset is presented as a typical product purchase for each borough, divided into 220 individual datapoints.

Purpose:
We wanted to explore dietary correlates with the prevalence of hypertension, utilising the London Borough wide Quality and Outcomes Framework (QOF) for GP reported hypertension diagnoses.

Methods:
The Tesco 1.0 dataset (2015) was accessed on 1/11/21 and all data downloaded. Hypertension data was accessed from the QOF reporting database (gpcontract.co.uk) for the last year available presented by Borough (2017). HYP001: the number of established hypertension patients as a total of registered patients, and HYP006: the % of hypertensive patients with a reading < 150/90 mmHg were selected, representing the prevalence and control of hypertension respectively. To explore for relevant associated factors, the average deprivation index (IMD) for each borough was accessed from Public Health England, and demographic data accessed from the Greater London Authority database. Univariable correlation using Spearmans Rho was calculated in using scipy in Python (3.0) and significance value of < = 0.01.

Results:
Highly significant risk factors for hypertension were the consumption of sugar, carbohydrate and sweets. Diabetes mellitus and obesity prevalence were also highly correlated with hypertension. Salt consumption was not a significant risk factor. Highly significant protective factors included consumption of eggs, fish, fruit and vegetables.

Conclusions:
The Big Data approach of utilising supermarket data allows a unique insight into dietary habits at a population level. We have demonstrated here an unexpected finding, the consumption of sugar and carbohydrate are highly significant risk factors for hypertension prevalence, while salt consumption is not. While not the first time the sugar versus salt question has been asked, this is the first time it has been answered in this manner.
PS-P05-6: CAROTID INTIMA-MEDIA THICKNESS IS ASSOCIATED WITH PREVALENCE OF ATRIAL FIBRILLATION
Authors: Yamamoto Maki , Enomoto Mika , Fukami Ako , Morikawa Nagisa , Sato Hiromi , Adachi Hisachi , Fukumoto Yoshihiro 
Published: January 2023

Objective:
Carotid intima-media thickness(IMT) is one of the useful marker for atherosclerosis and increased IMT predicts for cardio-vascular disease(CVD). Prevalence of atrial fibrillation(AF) is increasing with age, and the elderly have complications such as CVD and AF. We investigated whether IMT was related with prevalence of AF.

Methods:
We performed a health check-up in Tanushimaru in 2018. A total of 1368 subjects were measured IMT by using ultrasonography, and were examined electrocardiography and echocardiography.

Results:
Mean IMT was 0.72 ± 0.21 mm, 18 subjects (1.3%) had AF. The characteristics of age (p < 0.001), systolic blood pressure (p < 0.001), LDL-cholesterol (p = 0.0026), E/A ratio (p < 0.001), Left ventricular end-diastolic diameter (p = 0.0199), Left Atrial Dimension (p < 0.001) and prevalence of AF (p < 0.001) were significantly associated with the IMT quartiles. After adjustment for age and sex, the significances of factors were remained.

Conclusion:
This study demonstrated that increased IMT was associated with prevalence of AF. A prospective study is needed to examine whether increasing IMT predicts for incidence of AF.
PS-R02-7: PAROXYSMAL ATRIAL FIBRILLATION IN A PATIENT WITH HYPERTENSION: A CASE REPORT
Authors: Kabaklic Amela , Sinigoj Petra , Hitij Jana Brguljan 
Published: January 2023

Objective:
To present the association between arterial hypertension and concomitant arrhythmias.

Summary:
The report examines a case of a 74-year-old female patient with known arterial hypertension. She presented with wide blood pressure (BP) fluctuations, with surges of very high BP during the last three months. She also experienced palpitations, dyspnea and chest pain. BP measurements ranged from 116/67 mmHg in the office to 235/103 mmHg at home. She had been taking telmisartan 40 mg once-daily (OD), lercanidipine 10 mg OD and bisoprolol 5 mg OD regularly for several years and her BP was previously well controlled.
Considering the discrepancy between BP measurements in the office and at home, we decided against changing her regular therapy. Therefore, the patient was advised to continue current antihypertensive treatment and additionally take captopril 25 mg and/or sublingual nitroglycerin when systolic BP was above 150 mmHg.
Further diagnostics was performed. Transthoracic echocardiogram was normal, except for moderately enlarged left atrium. Pulmonary embolism and obstructive coronary artery disease were excluded. 24-hour Holter ECG revealed that the patient had symptomatic paroxysmal AF with rapid ventricular response (Figure 1a). There were also some sinus pauses and short periods of sinus bradycardia immediately after the cessation of AF paroxysm (Figure 1b).
To reduce AF-related symptoms and improve the quality of life, the patient was referred to catheter ablation. Pulmonary vein isolation was successfully achieved with no periprocedural complications. Due to borderline sinus bradycardia, bisoprolol was temporarily discontinued and later reintroduced in a lower dose. After the procedure, she was regularly taking telmisartan 40 mg OD, lercanidipine 10 mg OD, bisoprolol 1.25 mg OD, a direct oral anticoagulant and a statin. 24-hour ambulatory blood pressure monitoring was performed. A 24-hour mean BP was 112/66 mmHg, mean day-time BP was 115/69 and mean night-time BP was 108/62 mm Hg (Figure 1c). There was no excessive fluctuation in BP. Furthermore, no increases in HR were noted that would suggest recurrence of AF paroxysms.

Conclusion:
The patient, who was referred to our outpatient hypertension clinic due to uncontrolled hypertension, was diagnosed with symptomatic paroxysmal AF. By means of a successful AF catheter ablation, we eliminated the excessive BP fluctuations. AF and hypertension are closely related, and the appearance of AF can lead to poor BP control. An appropriate treatment for AF in patients with hypertension contributes to better control of the hypertension itself.
PS-R02-8: RUPTURED SINUS OF VALSALVA ANEURYSMS: A CASE SERIES OF THE 3-YEAR EXPERIENCE IN THE PHILIPPINE GENERAL HOSPITAL
Authors: Cheng Paula Victoria Catherine Young , Bongcawil Roxanne Yen , Manalaysay Amanda Mae Ramos , Laforteza Stephanie Obillos , Uy Celia Catherine , Magno Jose Donato , Punzalan Felix Eduardo 
Published: January 2023

Introduction:
Sinus of Valsalva aneurysms (SOVA) are rare conditions in which a portion of the aortic root dilates due to a weakness of the aortic wall, which can eventually lead to rupture, leading to a shunt from the aorta into any one of the cardiac chambers. Some patients can present asymptomatically and are diagnosed incidentally, while others can present with precipitous courses with symptoms of chest pain, palpitations, and heart failure. When left untreated, these patients have poor prognosis.

Case Description:
A total of 6 patients are presented in this case series. These patients were seen in the Philippine General Hospital from 2018–2020. The patients had varied characteristics, with ages ranging from 24–57 years old. Most of the patients were males. Presenting symptoms are also varied, with dyspnea as the most common symptom, and a murmur as the most common sign. The most commonly involved sinus is the right coronary sinus draining into the right ventricle, with half of the patient presenting with concomitant ventricular septal defects. Five out of the six patients underwent successful open repair of their ruptured SOVAs and were eventually discharged.

Discussion:
Early identification of the cardiac lesion is important to clinch the diagnosis and plan for eventual definitive management. Imaging studies such as transthoracic echocardiogram are needed to visualize the defect, which is classically described as a windsock deformity. Transesophageal echocardiography may present clearer images to assess the anatomy better preoperatively. Medical management is usually done to bridge the patient to more definitive therapy, either through endovascular closure if the anatomy permits it, or through surgical repair. Urgent and timely repair is needed to ensure improved survival in these patients.
PS-BPB01-8: IMPACT OF DIFFERENT DIURETIC TYPES ON ARTERIAL STIFFNESS AND CALCIFICATION IN A RAT MODEL OF CHRONIC KIDNEY DISEASE
Authors: Agharazii Mohsen , Larivière Richard , Ung Roth-Visal , Picard Sylvain , de Souza Dailson N , Richard Darren E , Mac-Way Fabrice 
Published: January 2023

Introduction:
We reported that antihypertensive therapy with a hydrochlorothiazide (HCTZ)-based regimen aggravates arterial stiffness and vascular calcification in a rat model of chronic kidney disease (CKD) with mineral and bone disorder (MBD). In this study, we investigated whether the aggravation of arterial stiffness and vascular calcification in CKD-MBD rats is induced by HCTZ and whether these abnormalities could also occur with other types of diuretic currently used in clinic.

Methods:
In rats with renal mass ablation-induced CKD, MBD was generated by a Ca/P-rich diet and calcitriol supplementation. The animals were divided into 4 groups; 1) CKD-MBD control; 2) CKD-MBD + HCTZ (thiazide diuretic, 5 mg/kg/d); 3) CKD-MBD + Chlorthalidone (thiazide-like diuretic, 5 mg/kg/d), and; 4) CKD-MBD + Furosemide (loop diuretics, 10 mg/kg/d). At week 6, hemodynamic parameters including systolic and mean blood pressure (SBP and MBP), pulse pressure (PP) and pulse wave velocity (PWV) were determined. The thoracic aorta was harvested to assess vascular calcification.

Results:
SBP was reduced by all types of diuretic in CKD-MBD rats. Contrary to chlortalidone nor furosemide, HCTZ treatment led to a reduction of MBP, but an increase in PP and PWV in CKD-MBD rats (p < 0.05). As expected from these hemodynamic changes, medial calcification in the thoracic aorta was significantly greater in CKD-MBD rats treated with HCTZ as compared to all the other groups of rats (p < 0.05).

Conclusion:
In rats with CKD-MBD, antihypertensive therapy with the thiazide diuretic HCTZ, but not other types of diuretic, exacerbated arterial stiffness and vascular calcification despite a reduction in SBP. The deleterious effect of HCTZ in CKD-MBD rats may have major clinical impact as this diuretic is widely use in patients with CKD that often develop MBD.
PS-BPB06-7: NOVEL MOLECULAR MECHANISMS OF CARDIO-RENAL INTERACTION MEDIATED BY INCREASED SERUM MODIFIED NUCLEOSIDES ASSOCIATED WITH RENAL FAILURE
Authors: Nagayoshi Yu , Yamamura Ryosuke , Kaneko Hitomi , Kakizoe Yutaka , Nishiguchi Kayo , Nakagawa Terumasa , Adachi Masataka , Miyasato Yoshikazu , Izumi Yuichiro , Kuwabara Takashige , Tomizawa Kazuhito , Mukoyama Masashi 
Published: January 2023

Objective:
The number of patients with chronic kidney disease (CKD) continues to rise by population aging. Moreover, CKD patients progress to end-stage renal failure and require renal replacement therapy. Many cohort studies have shown that impaired renal function itself is a risk factor for the development of cardiovascular disease, rather than comorbidities such as diabetes or hypertension. However, the molecular mechanisms are not fully understood. We focused on chemical modifications in RNA and their pathophysiological significance. Previously, we have shown that modified nucleosides, the metabolites of modified RNA, have unique physiological effects. For example, we reported that N6-methyladenosine is a true ligand for the A3 adenosine receptor, and that 1-methylguanosine promotes Zika virus replication in the host. In addition, it was found that a number of modified nucleosides are present in serum and excreted into extracellular spaces like urine. Therefore, we hypothesized that the decreased urinary excretion of modified nucleosides upon renal failure may cause abnormally high levels of modified nucleosides in the blood, which may exert detrimental effects on the heart and vasculature.

Methods and Results:
First, serum samples were collected from 210 CKD patients, and the correlation between serum modified nucleoside levels and eGFR was investigated. The results showed that several modified nucleosides such as 5-methylcytidine and pseudouridine were inversely correlated with renal function (r2 = -0.76, p < 0.0001; r2 = -0.78, p < 0.0001, respectively). Moreover, we found that 1-methylinosine was inversely correlated with renal function and positively correlated with BNP, a typical marker for heart failure (r2 = -0.82, p < 0.0001 vs. eGFR; r2 = 0.41, p = 0.010 vs. BNP). Next, to explore the possibility of cardiovascular injury associated with this elevation of 1-methylinosine, we examined its effect on vascular endothelial cells. We found that the addition of 1-methylinosine significantly increased cell proliferation using cultured human aortic endothelial cells (p = 0.004, n = 6).

Conclusions:
Through this study, we found that multiple modified nucleosides are significantly elevated in serum of CKD patients. Furthermore, the elevation of 1-methylinosine in serum can induce abnormal proliferative signals in vascular endothelial cells, which may thereby lead to endothelial damage. In conclusion, these results suggest that the elevated blood levels of modified nucleosides could be a novel marker for vascular injury, and might become a potential target for drug intervention in the cardio-renal interaction.
PS-BPB09-5: BROWN ADIPOSE TISSUE DYSFUNCTION PROMOTES METABOLIC DISORDER IN A FAILING HEART.
Authors: Yoshida Yohko , Shimizu Ippei , Minamino Tohru 
Published: January 2023

Objective:
Low body temperature predicts poor clinical outcomes in patients with heart failure, however, underlying mechanisms and pathological implications are largely unknown. Brown adipose tissue (BAT) was initially characterized as a heat generating organ, and studies suggest it has crucial roles for maintaining systemic metabolic health. The purpose of this study was to determine whether alteration of BAT function contributes to development of heart failure.

Design and method:
We generated two murine heart failure models, thoracic aortic constriction (TAC) and myocardial infarction (MI). We analyzed cardiac function, thermogenic response, and pathological findings in the hearts of these mice. We also performed comprehensive metabolomic analyses in the heart, BAT, and plasma samples from sham- and TAC-operated mice.

Results:
We found murine models with TAC or MI induced BAT dysfunction, and this led to a significant reduction in body temperature. Chronic activation of adrenergic signaling induced apoptosis in brown adipocytes, and surgical denervation of sympathetic nerves innervating BAT improved thermogenic response and cardiac systolic dysfunction. Gain of BAT function model, generated with BAT implantation into peritoneal cavity, improved thermogenesis and ameliorated cardiac dysfunction in TAC. In contrast, systolic function was reduced in genetically BAT dysfunctional model, and this associated with poor survival rate in this model. Metabolomic analyses showed that BAT dysfunction led to an increase of choline and its downstream metabolite, trimethylamine N-oxide (TMAO) that promoted metabolic dysfunction in the failing heart. TMAO administration resulted in a significant reduction in phosphocreatine or ATP level in cardiac tissues, and this was mediated by the suppression of complex IV activity in mitochondria. Genetic or pharmacological inhibition of TMAO production ameliorated cardiac dysfunction during left ventricular pressure overload. Dilated cardiomyopathy patients had lower body temperature, and this associated with an increase in circulating choline and TMAO level.

Conclusions:
Alteration of BAT function contributes to the development of heart failure via increased TMAO. Our findings suggest that maintenance of BAT homeostasis and reducing TMAO production could be potential next-generation therapies for heart failure.
PS-BPB10-3: MOLECULAR INSIGHT INTO SALT-SENSITIVITY; THE ROLE OF ATF3 AND THE GENERATION OF TUBULAR SPECIFIC KO MICE. (2)
Authors: Mouri Satoshi , Machida Kosho , Maeda Kazuki , Matsumoto Kento , Kino Tabito , Saigo Sae , Minegishi Shintaro , Sugawara Takuya , Uchida Kotaro , Arakawa Kentaro , Chen Lin , Sugiyama Michiko , Tamura Koichi , Ishigami Tomoaki 
Published: January 2023

Objective:
Atf3 is transcriptionally activated according to intracellular Na concentrations. We found about 1.6 fold to 2.5 fold gene expression enhancements in kidney of Nedd4 2 C2 KO mice due to oral salt intakes and diuretics treatments. Aim of this study is to elucidate significance of Atf3 gene for salt-sensitivity by dietary salt loading and furosemide treatment for tubular specific Atf3 KO mice examining blood pressure, body weight, urine volume, water intake with genetic analyses.

Methods:
We performed metabolic cage experiments for male Ksp-cre (minus) Atf3 flox/flox mice (N = 5) and male Ksp-cre (+) Atf3 flox/flox mice (N = 10) with 7–8 wks old for subsequent protocol. After 1 week habituation period, experiments were done for 3 days normal salt intake, 5 days high salt intake, and 5 days high salt intake with furosemide treatment (40 mg/kg, ip), respectively. We measured blood pressure by tail cuff methods at day 0, day 8, and day 12. During experimental periods, body weight, water intake and urine volumes are measured daily.

Results:
We could not find significant differences among body weight, water intake and urine volume between two groups. After high oral salt intake and intra-peritoneal furosemide injection, we found blood pressure of cre (+) Atf3 flox/flox mice were significantly higher than cre (minus) Atf 3 flox/flox mice. (p < 0.001, 119.6 ± 1.4 mmHg vs 112.8 mmHg) Additionally, we found significant expression change of both classic renin and alternative renin in tubules between two groups by quantitative RT PCR and immunohisto chemistry imaging for kidney.

Conclusions:
Tubular-specific Atf3 KO mice have elevated blood pressure sensitive to salt and furosemide treatment. Because furosemide treatment might induce enhancement of intra-cellular Na ion concentration, Atf3 gene is responsible for adaptations for intra-cellular Na concentration change through tubular renin expressions.