bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C02-4: QRS DURATION AS A PREDICTOR OF FUTURE ATRIAL FIBRILLATION IN END-STAGE RENAL DISEASE PATIENTS WITH PRESERVED LEFT VENTRICULAR SYSTOLIC FUNCTION
Authors: Chung Hyemoon , Lee Jung Myung , Woo Jong Shin , Kim Jin Bae , Kim Soo Joong , Ryu Sung Kee , Kim Weon , Kim Woo Shik 
Published: January 2023

Objective:
We investigated the echocardiographic and electrocardiographic predictors for future development of AF in patients with ESRD and preserved LV EF who had never diagnosed AF.

Design and method:
Atrial fibrillation (AF) is a common cause which leads to adverse cardiovascular outcome in patients with end-stage renal disease (ESRD). AF is common arrhythmia in patients with reduced left ventricular (LV) ejection fraction (EF). It is unclear the predictor of new AF in patients with preserved LV EF. We enrolled 226 patients with ESRD who has performed transthoracic echocardiography. We excluded the 1) 16 patients who has been received a diagnosis of AF, and 2) 19 patients with LV EF < 50%, and 191 patients (121 males, mean 62 ± 14 years years).

Results:
During a mean follow-up period of 885 ± 720 days, AF occurred in 20 (10.5%) patients. The patients with AF development was older (69 ± 12 vs. 61 ± 14 years, p = 0.023). There were no differences in history of hypertension, diabetes, stroke and coronary artery disease between two groups. In univariate Cox regression analysis, left atrial volume index (LAVI), right ventricular systolic pressure, age and QRS duration were associated with future AF events. After multivariate Cox regression analysis, age (HR: 1.015, 95% CI: 1.008–1.105, p value: 0.022) and QRS duration (HR: 1.025, 95% CI: 1.001–1.049, p value: 0.043) significantly predicted the future development of AF.

Conclusions:
QRS duration is well known predictor of cardiovascular outcome in patients with reduced LV EF. In this study, we demonstrated QRS duration predicted new AF events in ESRD patients with preserved LV EF.
PS-C02-6: A PROTOCOL PAPER FOR THE NEW HEALTH GUIDANCE INITIATIVES OF HEART FAILURE AGGRAVATION PREVENTION PROJECTS FOR URBAN RESIDENTS IN JAPAN
Authors: Nosaka Saya , Sakai Yukie , Watanabe Emi , Yasui Yuka , Maeda Saori , Kashima Rena , Teramoto Masayuki , Kokubo Yoshihiro 
Published: January 2023

Background:
At the end of 2021, Japan's ageing rate was 29.1%, the highest globally, and is steadily increasing. Heart failure is a terminal manifestation of various heart diseases, but there have been very few epidemiological studies of heart failure among residents in Japan. We have started a joint project with Suita city and its Medical Association to prevent heart failure, which implements the findings of the Suita study in urban area residents.

Objective:
The purpose of this project is to contribute to the prevention of heart failure as well as overall cardiovascular disease, cancer, and dementia by providing health guidance according to the level of heart failure.

Methods:
The examiners in this project agree to participate in the “Long-term Follow-up Study on Prognostic Factors for Heart Failure in Suita City Health Examination” at the time of their health examination in Suita from November 2020 to October 2022. Predict the onset of potential heart failure using a predictive tool that adds NT-proBNP to the risk score for coronary artery disease and atrial fibrillation. There are four groups of subjects: low, middle, and high risks. For high-risk people, we will provide medical cooperation as a treatment required. Subjects classified as middle risk will be given health guidance, and those classified as high risk will be recommended to consult a doctor. Those at middle risk are stratified into two categories: individual guidance and group guidance programs, according to their risk of potential heart failure. We developed the original textbook, “Lifelong Health Support 10.” Of the 26,267 participants in total (including 3,852 duplicates), 591 were given group guidance and 285 were given individual guidance (as of March 2022). Blood pressure and body composition are measured at the first interview in the individual guidance program, and lifestyle habits according to the lifelong health support 10 are checked. We set behavioral goals for each participant. At the time of 1 and 2 months later, a mail or letter support is provided, and after 3 months, blood pressure and body composition are measured and biochemical tests (HbA1c, LDL-c, NT-proBNP), and evaluation of lifestyle improvement. In the group guidance program, lifestyle checks and action goals are set at the time of initial guidance, and lifestyle improvement evaluations are conducted three months later. In both cases, the final review will be evaluated using the results of the health checkup items and risk scores for the following year.
PS-C02-8: ROLE OF STATIN THERAPY IN HYPERTENSION, PLEIOTROPIC EFFECT IN REDUCING NEW-ONSET AF AND ISCHEMIC STROKE
Authors: Pradnyana I Wayan Agus Surya , Antara I Made Putra Swi , Jagannatha Gusti Ngurah Prana , Kamardi Stanly 
Published: January 2023

Introduction:
Hypertension is considered the most important risk factor for stroke in the general population, is the most common comorbidity in patients with atrial fibrillation (AF), and is prevalent in approximately 80 to 90% of subjects with AF enrolled in recent clinical trials. Statin drugs have potent anti inflammatory and antioxidant effects that have the potential to prevent AF. Patients who had ischemic stroke complications due to episodes of AF are usually asymptomatic, thus primary prevention of AF in hypertensive patients is very important.

Objectives:
To determine the effectiveness of statin in reducing the incidence of new onset AF and ischemic stroke complications in hypertensive patients.

Methods:
We included 180 subjects in this retrospective cohort study using medical records at Sanglah General Hospital from 2018 to 2020. Subjects were divided into hypertensive subjects who were treated with a statin and hypertensive subjects who were not given statins, and we tracked the incidence of new onset AF. Pearson chi square test was used to determine the association of baseline characteristics, comorbidities, and medications, including statin, on the outcome of new onset AF, ischemic stroke, and side effects of statin. The progression of new onset AF between groups was also compared with the Kaplan Meier curve.

Results:
Our subjects who used statin were 39.4%, the mean age for all was 51.51+12.31 with 28,3% new onset AF, 7,2% ischemic stroke, and 2.2% all cause death. Statin in hypertensive patients significantly reduced the incidence of new onset AF (PR 0.174; 95%CI 0.079–0.38; P < 0.001) with a longer AF free period (19.16 + 2.57 vs 13.68 + 0.67 months; 95%CI 5.01–5.84; P = 0.014) and ischemic stroke free period (23.72 + 0.71 vs 16.57 + 1.06 month; 95%CI 5.01–5.84; P = 0.003), without any significant relationship with the adverse effect of statin. The incidence of AF was significantly high in hypertensive subjects with comorbid heart failure (HF) however, the AF free period remains longer if hypertensive patients with HF are given statin (19.16 + 2.57 vs 13.68 + 0.67 month; 95%CI 5.01–5.84; P = 0.014).

Conclusion:
Statin administration has the potential to be an effective treatment for primary prevention of the incidence of new onset AF and ischemic stroke in hypertensive patients without significant side effects.
PS-C03-5: REAL-WORLD DATA OF BLOOD PRESSURE IN DIALYSIS PATIENTS WITH AND WITHOUT DIABETES IN JAPAN USING THE WEB-BASED DATABASE
Authors: Sakuma Hirofumi , Matsuki Motoki , Hasebe Naoyuki , Nakagawa Naoki 
Published: January 2023

Objective:
Diabetic nephropathy was the most common primary disease among patients undergoing dialysis, and the number is growing each year. Despite advancements in dialysis technique, cardiovascular complications and mortality in dialysis patients with diabetes remain higher than in those without diabetes. Furthermore, hypertension is commonly known to contribute to the development of cardiovascular complications in dialysis patients, and we aimed to compare the systolic blood pressure (SBP) in dialysis patients with and without diabetes using the Web-based Analysis of Dialysis Data Archives (WADDA) system database.

Design and Methods:
From 2014 to 2020, we enrolled dialysis patients who had their predialysis SBP measured using the WADDA system 2.1. We classified SBP and evaluated its trends over time by gender, age, and presence of diabetes using the Japanese Society of Hypertension guidelines 2019 (JSH2019). Furthermore, we looked at the relationship between SBP and cardiovascular death in patients with and without diabetes.

Results:
Dialysis patients with diabetes (n = 168,227) had a mean age of 69.2 (11.7) years versus 69.4 (13.3) years, a mean predialysis history of 5.5 (5.3) years versus 9.4 (9.3 years), and a mean dialysis SBP of 156.6 (25.0) mmHg versus 147.9 (23.6) mmHg, respectively. Dialysis patients with diabetes had higher rates of cardiovascular complications than those without diabetes. From 2014 to 2020, the percentage and absolute values of hypertension were higher in dialysis patients with diabetes than across all age groups and in both men and women. Patients with cerebrovascular death had a higher rate of hypertension, but there was no difference in the rate of grade I and II hypertension between the two groups.

Conclusion:
We summarized the recent trends in SBP of Japanese dialysis patients with and without diabetes using the WADDA system. Dialysis patients with diabetes had higher SBP than those without diabetes in all age groups and in both men and women. As a result, optimal blood pressure management for dialysis patients with and without diabetes is important for the prevention of cerebrovascular death.
PS-C03-7: FUNDOSCOPIC EXAMINATION USING A SMARTPHONE CAMERA: A REVIEW OF EFFECTIVENESS AND FEASIBILITY IN DETECTING HYPERTENSIVE RETINOPATHY IN HYPERTENSIVE CRISIS PATIENTS
Authors: Chaichan Soramon , Laovirojjanakul Wipada , Kotruchin Praew 
Published: January 2023

Introduction:
In patients presented with hypertensive crises, a fundoscopic assessment is necessary because once hypertensive retinopathy is discovered, a hypertensive emergency is diagnosed, and intravenous antihypertensive medication is recommended. However, direct ophthalmoscopy is relatively underutilized, especially under the social distance regulation, which may result in delayed diagnosis and treatment. The novel method, namely, smartphone-based fundoscopy offers longer working distance and shorter doctor-patient contact time, however, there is limited data regarding its feasibility and effectiveness.

Objective:
We aimed to gather scientific evidence on the smartphone-based fundoscopy in terms of its effectiveness, accessibility, and trainability in detecting hypertensive retinopathy among hypertensive crisis patients in emergency room settings.

Methods:
A literature search was conducted on PubMed, Google Scholar, and the Cochrane Library for papers published from January 2010 to November 2021. Keywords including hypertensive crisis, hypertensive retinopathy, target organ damage, fundoscopic optic examination, direct ophthalmoscope, fundus images, smartphone fundoscopy, digital fundus camera, and COVID-19 were used. Full papers published in English and abstracts of non-English publications were all reviewed.

Results:
Eight studies out of 34 fulfilled our search criteria. Five observational studies confirmed the effectiveness of smartphone-based fundoscopy in obtaining fundus images adequate for interpretation compared with those from commercially available fundus cameras. Also, smartphone-based fundoscopy offers time-saving properties as it allows fundus examination to be effectively completed within 74 seconds compared to 130 seconds with a traditional direct ophthalmoscope. Two studies investigated the accessibility of smartphone-based fundoscopy and discovered that fundus images can be obtained by using 20 diopter condensing lenses with the video mode of the smartphone camera, which can be easily provided even at a primary level hospital due to their low cost. Another study reviewed the trainability of the smartphone-based fundoscopy in 137 undergraduate medical students which concluded that 75% of these students can identify the optic nerve within 20–25 minutes of face-to-face demonstration.

Conclusion:
With a greater diagnostic capability, accessibility, and trainability of smartphone-based fundoscopy makes it a potentially game-changing technique for detecting hypertensive retinopathy in hypertensive emergency patients, especially during the current COVID-19 pandemic, in which longer working distance and shorter doctor-patient contact time are both required.
PS-C04-2: LONGITUDINAL CONSTANCY OF VASCULAR AGEING PHENOTYPES AND FACTORS ASSOCIATED WITH THE PHENOTYPE CONSTANCY OVER TIME
Authors: Shiina Kazuki , Takahashi Takamichi , Takada Yoichiro , Fujii Masatsune , Nakano Hiroki , Matsumoto Chisa , Chikamori Taishiro , Tomiyama Hirofumi 
Published: January 2023

Background:
The concept of two phenotypes of vascular aging, healthy vascular aging (HVA) and early vascular aging (EVA) has been proposed.

Objectives:
To examine the: (1) constancy of these phenotypes over time; (2) validity of assuming that a constantly maintained phenotype reflects the rate of structural arterial stiffening; and (3) longitudinal associations between the vascular phenotypes and cardiovascular risk factors/heart rate (HR).

Methods:
The brachial-ankle pulse wave velocity (baPWV) was measured annually over a 16-year period in 4682 middle-aged Japanese subjects. The vascular phenotypes of 4682 middle-aged Japanese subjects were measured at the start and end of a 16-year study period, by measuring the arterial stiffness as a function of the age and blood pressure.

Results:
Of 4682 subjects, 158 (3.4%) showed constancy of the HVA phenotype, and 192 (4.1%) subjects showed constancy of the EVA phenotype throughout the study periods. The baPWV adjusted for the mean blood pressure differed significantly between the two groups. Elevated mean blood pressure, serum HbA1c levels and HR were significantly associated with constancy of the EVA phenotype, whereas only a low HR was significantly associated with constancy of the HVA phenotype.

Conclusions:
In middle-aged Japanese subjects with the HVA/EVA phenotype at the study baseline, while the phenotype changed during the study period in many subjects, phenotype constancy appeared to reflect the rate of structural arterial stiffening. Elevated blood pressure and abnormal glucose metabolism were associated with constancy of the EVA phenotype. On the other hand, HR was a robust marker of the presence/constancy of the HVA/EVA phenotype.
PS-C05-10: INDIVIDUALS WITH PRE-IMPAIRED GLUCOSE TOLERANCE (PRE-IGT) HAVE ALREADY ENDOTHELIAL DYSFUNCTION BUT WITH NO SIGNIFICANT IDENTIFIABLE CARDIOVASCULAR RISK FACTORS
Authors: Salmon Jeannine Ann Ong , Magbuhat Ann Lorraine , Sali Ruby Jane Guerrero , Purino Francis , Macindo John Rey , Asis Leilani Mercado 
Published: January 2023

Objective:
Pre-impaired glucose tolerance (pre-IGT), characterized as normoglycemia with hyperinsulinemia, is the earliest stage of dysmetabolism in type 2 diabetes mellitus (DM). C-peptide, which is equimolar to insulin, has been shown to cause intima-media thickening when present in increased amounts. This study aims to determine the prevalence of endothelial dysfunction among individuals with pre-IGT and to determine the cardiovascular risk factors for developing endothelial dysfunction.

Design and method:
We employed a cross-sectional analytical study of adult patients with risk factors for developing diabetes [first-degree relative with type 2 DM, obesity, history of gestational diabetes (GDM), and polycystic ovary syndrome (PCOS)]. Brachial artery flow-mediated dilatation (FMD) was performed on pre-IGT patients to test for the presence of endothelial dysfunction. Cardiovascular risk factors evaluated were age, 2-hr insulin and glucose level after 75 gms OGTT, BMI, lipids, and systolic and diastolic blood pressure. Binary logistic regression was used to determine the significant risk factors affecting endothelial dysfunction,

Results:
Of the 67 subjects, 41 had pre-IGT with a prevalence of 61%. Among the pre-IGT who had FMD studies (31/41), seven had FMD (+) with a prevalence of 22.58%. Although statistically not significant, FMD (+) vs. FMD (-) subjects were respectively, older (mean 28.86 (SD 4.34) vs. 25.96 years (SD 25.96), p = 0.112), more obese (mean (SD) 26.87 (4.36) vs. 25.18 kg/m2 (4.83), p = 0.257), had higher 2nd hr glucose and HbA1c (mean (SD) 2-hr glucose; 106.34 (13.36) vs. 105 mg/dL (17.55), p = 0.620, mean (SD) HbA1c; 5.30 (0.37) vs. 5.23% (0.37), p = 0.669), and higher total cholesterol and LDL (mean (SD) cholesterol; 182.13 (21.51) vs.177.07 mg/dL (20.70), p = 0.620, mean (SD) LDL; 105.68 (3.77) vs. 98.58 mg/dL (19.25), p = 0.357). Conversely, FMD (+) vs. FMD (-) subjects had respectively, lower values of the following; 2nd hour insulin levels (mean (SD) 101.32 (76.10) vs. 122.44 uIU/mL (101.83), p = 0.450), mean (SD) systolic BP (109.71 (11.40) vs.110.67 mmHg (13.10), p = 0.886), and mean (SD) diastolic BP (71 (9.11) vs. 74.13 mmHg (10.60), p = 0.683). Similarly, the difference was not statistically significant. Comparative analyses also yielded no significant difference in the demographics (family history, GDM, PCOS) of the two groups.

Conclusion:
Endothelial dysfunction is already present among individuals with pre-IGT. The study did not demonstrate any significant difference in the previously reported cardiovascular risk factors contributing to endothelial function abnormality.
PS-C06-1: ELEVATED PULSE PRESSURE AND SERUM INSULIN ARE INDEPENDENTLY ASSOCIATED WITH DIABETIC RETINOPATHY IN DIABETIC WOMEN WITH OR WITHOUT SYSTEMIC HYPERTENSION
Authors: Olatunji Victoria Ayodeji , Olarinoye John Kola , Olatunji Lawrence Aderemi , Olorundare Olufunke Esan 
Published: January 2023

Objective:
Diabetic retinopathy (DR) is a major cause of vision loss, creating a low quality of life in patients. High blood pressure and serum insulin levels are known to be associated with DR. Though incident diabetic eye disease is reportedly related to systolic blood pressure (SBP), the potential importance of pulse pressure (PP) is not clear. The present study aimed at determining the association between pulse pressure, serum insulin levels and diabetic retinopathy in type 2 diabetes (T2DM) with or without systemic hypertension.

Design and Method:
Cross-sectional hospital-based study involving type 2 DM female patients with (n = 70) or without systemic hypertension (n = 36). The groups were matched for age, sex and BMI. Anthropometric measurements were taken, fasting blood glucose, glycated hemoglobin, serum insulin, and lipid profile were determined.

Results:
The mean values for weight and BMI were comparable between the groups, however, DBP, SBP, PP and serum insulin were significantly higher in the hypertensive diabetics. Using multiple regression (stepwise) analysis, there was a strong relationship between PP and DR in hypertensive diabetics (β = 2.239, p < 0.000, R2 = 0.143) while serum insulin showed a strong relationship with DR in patients with only T2DM (β = 2.190, p < 0.000, R2 = 0.253). Receiver operating characteristics (ROC) curve showed that PP with area under the curve (AUC) of 0.746 in hypertensive diabetics and serum insulin with AUC of 0.784 in patients with only T2DM were the most efficient predictors of DR respectively.

Conclusions:
The findings in the present study indicate that elevated PP and serum insulin could be reliable independent predictors of DR in T2DM female patients with or without systemic hypertension respectively.
PS-C07-7: EFFECTS OF PSYCHOLOGICAL STRESS AND PHYSICAL ACTIVITY ON AMBULATORY BLOOD PRESSURE AND PULSE RATE VARIABILITY
Authors: Tomitani Naoko , Kanegae Hiroshi , Hoshide Satoshi , Kario Kazuomi 
Published: January 2023

Objectives:
Physical activity and psychological stress during daily life contribute to ambulatory blood pressure (BP) variability. This study aims to investigate the effects of physical activity and psychological stress on daytime BPs measured by ABPM.

Methods:
This study is a post-hoc analysis using ABPM data from a comparison study of ambulatory BP measured by a wrist watch-type wearable BP monitoring device and an ABPM device. ABPM was performed at 30-min intervals for 24 h using a TM-2441 device (A&D Co., Tokyo), an oscillometric device with an upper-arm BP-cuff. This device is also equipped with a high-sensitivity actigraph that can detect fine-scale physical movements of the wearer in three directions. Physical activity was calculated as the sum of the actigraphically measured physical activity over the 5 min before each ABPM measurement. Study participants were asked to write a self-report diary of their general situation (i.e., location, emotion, and body position) corresponding to each BP measurement at least 10 times while awake.

Results:
From 50 outpatients (mean age 66.1 ± 10.8 years, 60.0% male, 98.0% hypertensive patients), 1580 daytime BP readings were taken by ABPM. Of these, 642 BP readings had corresponding diary information. In the mixed effect model analysis including physical activity, significant systolic BP (SBP) elevation associated with physical activity was observed in both a dataset of 1580 BP readings (2.9 ± 0.9 mmHg, P = 0.001 for light physical activity; and 2.9 ± 1.4 mmHg, P = 0.045 for moderate physical activity) and a dataset of 642 BP readings (2.5 ± 1.2 mmHg, P = 0.043 for light physical activity; and 4.2 ± 2.0 mmHg, P = 0.036 for moderate physical activity). In the analysis of 642 BP readings using the model including physical activity and situational factors from diary information, SBP was significantly higher during negative emotions than during positive emotions (7.4 ± 2.5 mmHg, p = 0.003), while the SBP change to physical activity decreased and was not statistically significant. On the other hand, pulse rate was unchanged by negative emotions, but was increased for physical activity.

Conclusions:
Daytime BP measured by ABPM was elevated to a greater extent by psychological stress than by physical activity. BP elevation without corresponding pulse rate increase might be influenced by psychological stress. Simultaneous monitoring of BP and physical activity might detect BP elevation caused by psychological stress.