bluuebunny/crossref_metadata_2025_split huggingface dataset:
CARDIOVASCULAR RISK SCORE MAY BE USEFUL IN STRATIFY DEATH RISK IN HOSPITALIZED COVID19 PATIENTS
Authors: Cicco Sebastiano , Mozzini Chiara , Marozzi Marialuisa , De Fazio Giuditta , Carella Rossella , Vacca Antonio , Cariddi Christel , Pappagallo Fabrizio , Solimando Antonio G. , Ria Roberto 
Published: June 2022

Objective:
COVID–19 induce a robust systemic inflammation. Patients with cardiovascular disease (CVD) present an increased death risk. Many efforts are spent to identify possible predictors of negative outcomes. CVD score are useful tools in evaluation of risk of cardiovascular events Aim: We evaluated oxygenation and characteristics in COVID–19 according to cardiovascular risk stratification performed using Framingham (FRS) and Atherosclerotic cardiovascular disease (ASCVD) risk scores.

Design and method:
We evaluated retrospectively 155 COVID–19 patients (110 males, aged 67.43 ± 14.72 yrs). All patients underwent to a complete physical examination, chest imaging, laboratory tests, and blood gas analysis at the time of diagnosis. Seventeen patients died (10 males and 7 females, aged 74.71 ± 7.23 yrs) while the remaining 138 patients (100 males, aged 66.07 ± 15.16 yrs) were alive at discharge.

Results:
No differences there were in Hb, C–reactive protein nor in d–dimers between the two groups. Compared to alive, died group presents a significant increase in white blood cells (p < 0.05) and d–dimers (p < 0.05). No difference there were in pCO2, SO2, and in alveolar arteriolar oxygen difference (A–aDO2). On the contrary, in died patients there is an increased pO2 (p < 0.05) and a decreased ratio between oxygen inspired and pO2 (P/F; p < 0.05). Died patients have increased both in FRS (27.37 ± 5.03 vs 21.33 ± 9.49, p < 0.05) and ASCVD (40.18 ± 20.36 vs 21.47 ± 17.23, p < 0.05). FRS, but not ASCVD, presents a negative correlation to P/F (r–0.42, p < 0.05) in died while no correlation was found in alive. No other correlation has been found with blood gas parameters or in the phlogosis parameters evaluated in the two groups. ROC curve analysis showed a good performance in prediction of death for both scores (AUC FRS 0.71, ASCVD 0.77) with a good sensitivity (FRS 76.92%, ASVCD 75.00%) and specificity (FRS 65.00%, ASCVD 81.13%).

Conclusions:
CVD is a major risk factor for death in COVID–19 patients. The increase risk relates to a reduced lung capacity but it is not related to alteration in gas exchange. CV risk results independent from inflammatory state we found. CVD risk score may be useful to stratify patients at admittance for a better treatment.
COVID-19 IMPACT ON THE PREVALENCE OF SUBCLINICAL HYPERTENSION AMONG PRACTICALLY HEALTHY MEDICAL STUDENTS
Authors: Yufereva Yulia , Shevchenko Oleg , Ginzburg Leonid , Zakirzyanov Artem , Shevchenko Alex 
Published: June 2022

Objective:
Silent arterial hypertension is not rare among young adults suffering chronic distress like medical students. COVID-19 pandemic with increased fears and anxiety, social isolation, distant learning, and decreased ACE2 receptor activity could boost hypertension and other cardiovascular risk factors.
The study was aimed to compare the frequency of subclinical hypertension in cohorts of ‘apparently healthy’ young adults revealed before the COVID-19 pandemic and two years after its onset.

Design and method:
Medical students without any known diseases or apparent signs of ‘health problems’ enrolled. 24-hour BP monitoring and test questioning with “International Physical Activity Questionnaire” and “The Perceived Stress Scale-10” were performed in ‘pre-COVID’ November and December of 2019 (Group 1) and the same months of ‘peak-COVID’ of 2021 (Group 2).

Results:
A total of 160 students aged 19 to 26 years were enrolled (group 1, n = 74; group 2, n = 86). The groups did not differ with respect to gender, age, body mass index (BMI) or physical activity (table). The proportion of participants with high perceived stress level (24 and more points) was higher in group 2 vs group 1 (58.1% vs 11.2%, p < 0.001). Masked hypertension prevalence and average values of systolic and diastolic blood pressure (SBP and DBP) did not differ between groups, however daytime and nighttime BP load index was significantly higher in group 2 vs group 1 for both SBP and DBP.

Conclusions:
Despite the absence of significant differences in the mean BP variables, when compared with similar group from ‘pre-COVID’ period, ‘apparently healthy’ students examined after two years of the COVID-19 pandemic had significantly worsened day and night BP load indexes. These changes correlated with the increase of perceived stress levels.
CARDIOPULMONARY EXERCISE TEST AND ECHOCARDIOGAPHIC FINDINGS IN HOSPITALISED POST SARS-COV-2 PATIENTS: THE EFFECT OF ARTERIAL HYPERTENSION
Authors: Kariori Maria , Fragoulis Christos , Chrysochoou Christina , Leontsinis Ioannis , Mantzouranis Emmanoyil , Iliakis Panagiotis , Konstantinidis Dimitrios , Konstantinou Konstantinos , Andrikou Ioannis , Kalos Theodoros , Grigoriou Kalliopi , Tsioufis Konstantinos 
Published: June 2022

Objective:
There is little data concerning the impact of arterial hypertension (HTN) on the cardiopulmonary status and right ventricle (RV) function of patients with SARS-Cov-2 infection. The purpose of our study was to investigate whether HTN affects the functional status of hospitalized for SARS-Cov-2 patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the first day of infection.

Design and method:
Subjects who were hospitalized and survived Covid-19 infection were divided into two groups according to history of HTN. All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol evaluating all parameters. Echocardiographic findings including right ventricle strain were analyzed using an offline program.

Results:
A total population of 52 hospitalized Sars-Cov-2 patients with a mean age of 57 ± 11.5 years were evaluated 3 months after the symptoms onset. Males amounted to 51.9 %. History of coronary artery disease was recorded in 15.4% of them. In hypertensive subjects, age (63 ± 8 vs. 52 ± 11 years, p < 0.001), BMI (29.9 ± 4.6 vs. 27.1 ± 5.8 kg/m2, p:0.03) and BSA (2.1 ± 0.25 vs. 2 ± 0.9 m2, p:0.04) were significantly higher. When analyzing cardiopulmonary test parameters, only maximum systolic blood pressure ((SBP, mmHg), 190 ± 21 vs.171 ± 26, p: 0.02) at peak and during the 1st minute of recovery (180 ± 23 vs. 157 ± 27 mmHg, p: 0.005) were higher comparing to normotensive subjects. Furthermore, diameter of left atrium ((LA, mm), 42 ± 6 vs.38 ± 6 p: 0.009), left ventricle ejection fraction ((LVEF,%), 48 ± 11 vs. 57 ± 6, p:0.004) and the absolute mean value of right ventricle strain ((RVLS, %), 9.1 ± 4 vs. 12.7 ± 5.4, p:0.04) differed significantly between two groups. Using linear regression analysis adjusted for age, gender, HTN, coronary heart disease and LVEF, HTN

Conclusions:
Our study highlighted negative impact of HTN both in right and left ventricle functionality, implying HTN as a negative independent predictive factor for right ventricle strain in patients hospitalized for SARS-Cov-2.
IMPACT OF HYPERTENSION AS AN ADDITIONAL RISK FACTOR IN CARDIORESPIRATORY STATUS OF POST SARS-COV-2 INFECTED SUBJECTS
Authors: Kariori Maria , Fragoulis Christos , Polyzos Dimitrios , Leontsinis Ioannis , Grigoriou Kalliopi , Drogkaris Sotirios , Manta Eleni , Tatakis Fotis , Zammanis Ioannis , Kouremeti Maria , Siafi Eirini , Konstantinidis Dimitrios , Dimitriadis Kyriakos , Thomopoulos Costas , Tsioufis Konstantinos 
Published: June 2022

Objective:
Few data have been published regarding the holistic approach of post-Covid patients, examining physical health. The purpose of our study was to examine the impact of arterial hypertension in the cardiopulmonary status of post-covid patients 3 months after the first day of infection.

Design and method:
All participants who recovered Covid-19 infection underwent cardiorespiratory exercise using either Bruce or modified Bruce protocol where all parameters were evaluated and transthoracic echocardiogram. The population was separated into two groups based on history of hypertension. Group I (n = 29) included hypertensive subjects and Group II (n = 75) included normotensive subjects.

Results:
A total of 104 patients were assessed 3 months after the onset of COVID-19 symptoms. We recorded a mean age of 49 ± 15 years, 50.5% of them were males, 8.7% had a history of coronary heart disease. Hypertensives had higher BMI (29.24 ± 24 vs 26.64 kg/m2, p < 0.01) and BSA (2.09 ± 0.25 vs. 1.95 ± 0.58, p = 0.001). They were hospitalized in higher percentage comparing to normotensives (72.4% vs. 41.3%, p < 0.01). Left atrial diameter (41 ± 6 vs. 35 ± 5.5 mm, p < 0.001) was significantly larger in hypertensives. Furthermore, A wave (79 ± 21 vs. 58 ± 18 cm/s, p < 0.001) and ratios of E/A (1.01 ± 0.42 vs. 1.28 ± 0.44, p < 0.01) and E/E’ (7.3 ± 3.7 vs. 5.9 ± 4.3, p < 0.01) differed between two groups. Finally, LVEF (%) was significantly impaired in hypertensive comparing to normotesive subjects (53 ± 13% vs. 59 ± 7%). This finding was depicted in lower maximum oxygen consumption (VO2 22 ± 4.5 vs.28 ± 8 ml/kg/min, p < 0.001), metabolic equivalents (METS) at peak, 9.1 ± 3 vs. 14 ± 20, p < 0.001), maximum heart rate (maxHR 147 ± 17 vs. 165 ± 21 bpm, p < 0.001) and HR1st minute recovery (123 ± 28 vs. 138 ± 21 bpm, p: 0.02) comparing to normotensive. Systolic blood pressure (SBP, 180 ± 29 vs. 165 ± 25mmHg, p: 0.02) during the 1st minute of recovery was higher in hypertensives. Finally, the duration of exercise was significantly lower in patients with hypertension (7.3 ± 2.7 vs. 9 ± 4 min, p:0.02)

Conclusions:
the current study highlighted the negative impact of hypertension in the ability to exercise. Regardless of the disease severity, post-covid patients need a comprehensive approach for rehabilitation including the modification of risk factors like hypertension and obesity.
ASSOCIATION BETWEEN DEPRESSION DISORDER AND INCIDENTAL HYPERTENSION IN COVID 19 POSITIVE PATIENTS
Authors: Koh Jong Hoon , Kang Min Jong 
Published: June 2022

Objective:
Although the association between depression disorder and cardiovascular diseases has been well recognized. but an effect of depression for incident hypertension are scarce.

Design and method:
300 men and 390 women aged over 40 without hypertension or cardiovascular diseases. Depressive disorder was assessed using Beck’s depression inventory (BDI) ranged 0 to 63 and was considered if BDI score over 16. Hypertension was defined as SBP over 140 and/or DBP over 90 mmHg or the use of antihypertensive medication. We calculated incidence rates (IRs) per 100 person-year for incident hypertension were calculated and incidence rate ratios (IRRs) and its 95% CIs.

Results:
COVID 19 positive patients with depressive symptoms had a significantly higher incidence of hypertension in women compared to men with depressive symptoms. In the logistic regression analysis, the presence of depressive symptom was significantly associated with incident hypertension with COVID 19 positive independently of age, body mass index, education level, and current smoking and drinking status.

Conclusions:
COVID 19 positive patients with Depressive symptoms were highly associated with the incidence of hypertension among middle aged women.
ARTERIAL HYPERTENSION FOLLOWING COVID-19
Authors: Delalic Didi , Jug Juraj , Varahabhatla Vamsi , Prkacin Ingrid 
Published: June 2022

Objective:
The aim of this study was to determine the frequency of newly verified or worsened existing hypertension in patients who had COVID-19.

Design and method:
In this case-control study which lasted from May 2021 to December 2021, 108 patients (49 males, 59 females) who have had COVID-19 were analyzed at the Emergency department in Clinical Hospital Merkur, a tertiary care center in Zagreb, Croatia. In order to be categorized as a COVID patient, a positive PCR test at a single point in time was required. According to the accepted definitions of COVID-19 and its manifestations in respect to time from a positive PCR test, the patients were divided into two groups: acute COVID patients (PCR test positive < 30 days ago) and post-acute COVID patients (PCR test positive > 30 days ago). Additionally, the post-acute group was subdivided into the following groups: sub-acute (30–90 days from positive PCR test), chronic (90–180 days from positive PCR test), and “long COVID” (>180 days from positive PCR test). Patients’ age, history, BMI, laboratory values, and antihypertensive therapy were recorded.

Results:
Out of 108 patients studied, 13 (12.04 %) had either newly verified (8) or worsened existing (5) arterial hypertension. Among those, the median time from a verified SARS-CoV-2 infection to onset of symptoms was 90 days. When divided into groups, 5 were in the acute, 3 in the sub-acute, 4 in the chronic, and 1 in the “long COVID” group. Compared to the rest of the study population, patients presenting with arterial hypertension had significantly higher systolic (median 155 vs. 126 mmHg, p = 0.004) and diastolic (median 90 vs 80 mmHg, p = 0.02) blood pressure and were non-significantly younger (median 48 vs 58 years, p = 0.067).

Conclusions:
Arterial hypertension following COVID-19, either newly verified or worsened existing, is a relatively common (12.04% of our patient pool) occurrence and more effort should be directed into evaluating patients’ blood pressure values following COVID-19 in order to make a timely diagnosis and start proper treatment early.
THE FEATURE OF ATRIAL FIBRILLATION OCCURRENCE AND PROGRESSION IN PATIENTS WITH ARTERIAL HYPERTENSION, WHO HAVE UNDERGONE COVID-19
Authors: Hazarapetyan Lusine , Grigoryan Svetlana , Zeveian Parunak 
Published: June 2022

Objective:
COVID-19 pandemic has a rather negative effect on patients with cardiovascular pathology. AH is one of the main reasons for the remodeling process in AF patients and makes a significant contribution to the development of heart structural changes.
The aim of this study is to identify the feature of AF occurrence and progression in patients with AH, who have undergone COVID-19.

Design and method:
In this study where enrolled 91 patients with AH and non-valvular paroxysmal/persistent AF, who have undergone COVID-19 (first group). As a control group 109 patients with AH and AF, but without have undergone COVID-19 were also examined (second group). The database consisting of indices that characterize the clinical, hemodynamic and structural-functional state of the heart, were analyzed by SPSS 13.

Results:
The obtained results showed that in the first group patients were significantly older than in the second group (mean age 71.6 ± 7.4 vs. 61.6 ± 6.4 years, p < 0.001). Resting heart rate was significantly higher in patients from first group in comparison with second group (86.6 ± 6.2 vs. 76.9 ± 7.8 beat/min, p < 0.01). In first group body mass index of patients was significantly more than in second group (33.9 ± 1.5 vs. 31.6 ± 1.8 kg/m2, p < 0.05). In the first group the prevalence of patients with uncontrolled AH were statistically significantly higher, than in the second group (54% vs. 23%, p < 0.001). In those patients the doses of antihypertensive medications taken were either increased or the antihypertensive treatment were revised. Moreover, in the first group the frequency of hypertensive crises was nearly twofold higher (31% vs. 17%, p < 0.001). It was revealed that the left atrium diameter in patients of the first group was significantly greater than in the second (44.3 ± 1.4 vs.41.2 ± 1.1 mm, p < 0.05); but systolic and diastolic dysfunction did not significantly differ in both groups.

Conclusions:
The obtained results indicate that in patients with AH who have undergone COVID-19, the onset of AF has some features, namely; uncontrolled AH, frequent hypertensive crises, tachycardia, overweight and older age. As well as left atrium more large dilation compared with second group that did not undergo a viral infection.
ARTERIAL HYPERTENSION IN PATIENTS WITH LONG DURATION TYPE 1 DIABETES MELLITUS
Authors: Chalakova Tatiana , Tsochev Kaloyan , Yotov Yoto , Bocheva Yana , Valchev Georgi , Usheva Natalya , Iotova Violeta 
Published: June 2022

Objective:
Prognosis in Type 1 diabetes mellitus (T1DM) patients is constantly improving and the role of other cardiovascular risk factors, e.g. hypertension is gradually increasing. The effective management of both conditions is important for the prevention of cardio-vascular diseases (CVD).
Aim: to assess the blood pressure (BP) in patients with long-duration T1DM compared to controls and to evaluate arterial hypertension (AH) management in them.

Design and method:
A study of 124 patients of T1DM at a mean age 42.68 ± 10.4 years, 53% males, with a median duration of T1DM 24 years and mean HbA1c 8.42 ± 1.75% and 59 age- and sex matched controls. BP was measured twice with a calibrated sphygmomanometer and the mean of both measurements was used. AH was defined as BP> 140/90 mm Hg or history of AH or on antihypertensive treatment.

Results:
The mean systolic BP (SBP) in T1DM patients was significantly higher than in controls – 128.17 ± 18.87 vs 121.13 ± 1.26, p = 0.008, with no interaction with gender. Diastolic BP was not significantly higher – 80.28 ± 10.02 vs 77.98 ± 10.72, p = 0.16. AH was twice more prevalent in T1DM patients than in controls – 67 (54%) and 17 (27%), resp. (p = 0.001). It was due to already known hypertension - 51 (41%) vs 12 (20%), p = 0.001 while incident AH cases were equally found in T1DM and controls – 15 (25.4%) vs 4 (25%). Control of AH < 140/90 mmHg was achieved in only 35.8% of the patients with T1DM and in 37.5% of the controls, while BP< 130/80 mm Hg was even less frequent in both categories – 13.4% vs 12.5% (p = NS). Untreated were 24 (29%) of all hypertensive participants, combination treatment was prescribed in 32 (39%) and monotherapy – in 26 (32%). ACE-inhibitors were the preferred antihypertensive class, followed by beta-blockers, ARBs, diuretics, and CCBs.

Conclusions:
SBP is significantly higher in T1DM patients than in their healthy peers, irrespective of gender. The prevalence of AH is higher in diabetic patients with long duration even at still relatively younger age. The BP control is far from optimal in the studied population which requires more aggressive management to prevent CVD occurrence.
ASSOCIATION BETWEEN SERUM LEVELS OF CYSTATIN C AND NATRIURETIC PEPTIDES
Authors: Vasilkova Volha , Mokhort Tatsiana , Yarets Yulia , Korotaeva Ludmila 
Published: June 2022

Objective:
Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease, independent of creatinine-based renal function measurements. The aim of our study was to evaluate the association between the levels of natriuretic peptides (BNP and NTproBNP) and serum cystatin C in patients with diabetes.

Design and method:
A total of 449 patients with type 1 and type 2 diabetes, aged 34 to 84 years, were examined. All patients underwent standard clinical and laboratory examination, with an assessment of the levels of BNP and NTproBNP. Renal function was assessed based on the levels of serum creatinine, glomerular filtration rate, which was calculated according to the CKD-EPI formula, and albuminuria, which was assessed as albumin/creatinine ratio (A/C). An echocardiographic examination was conducted according to the standard protocol with the calculation of dimensional, volume and speed characteristics.

Results:
57% DM patients had BNP and NTproBNP levels exceeding the diagnostic values of BNP > 35 pg/ml and/or NTproBNP > 125 pg/ml. The levels of BNP and NTproBNP positively correlated with the levels of homocysteine, uric acid, IL-6, C-reactive protein, high-sensitivity C-reactive protein, A/C, creatinine, cystatin C, TNF-alpha, chemokines (MIG, RANTES), growth factors (FGF-23, VEGF-A) (p < 0.05). According to logistic regression analysis, predictor for increased proBNP was cystatin C, rather than creatinine (ß = 7,216, p = 0,042). ROC analysis determined the diagnostic significance of cystatin C for the prediction of increased NTproBNP. Thus, when the level of cystatin C (AUC-0.798) was 0.96 mg/l, the sensitivity and specificity for increased NT-proBNP concentration were 81% and 69%, respectively.

Conclusions:
Cystatin C might be an independent predictor of increased levels of natriuretic peptide in patients with diabetes.
THE ROLE OF URINARY EXOSOMAL SODIUM CHLORIDE COTRANSPORTER IN SUBTYPING PRIMARY ALDOSTERONISM
Authors: Kong Linghui , Tang Xiaofeng , Kang Yuanyuan , Dong Lei , Tong Jianhua , Xu Jianzhong , Wang Ji-Guang , Shen Weili , Zhu Limin 
Published: June 2022

Objective:
Adrenal venous sampling (AVS) is recognized as the gold standard for subtyping primary aldosteronism (PA), but its invasive nature and technical challenges limit its availability. A recent study reported that sodium chloride cotransporter (NCC) in urinary exosomes is a promising marker for assessing the biological activity of aldosterone and can be treated as a potential biomarker of PA. The current study was conducted to verify the hypothesis that the expression of NCC and its phosphorylated form (pNCC) in urinary exosomes are different in various subtypes and genotypes of PA and can be used to select AVS candidates.

Design and method:
A total of 27 patients with PA were enrolled in the study.Patients with LI > = 4 and < 4 were classified into high LI (hLI) and low LI (lLI) groups, respectively. Urinary exosomes were isolated from spot urine samples using ultracentrifugation. NCC and pNCC expressions were tested in patients diagnosed with PA who underwent AVS. Sanger sequencing of KCNJ5 was performed on DNA extracted from adrenal adenoma.

Results:
Compared with the lLI group, the hLI group had higher levels of 24 h urinary aldosterone (28.6 ± 11.8 vs 14.9 ± 4.6, P = 0.0002) and supine PAC (314 ± 115 vs 163 ± 53, P < 0.0001) on admission (Table 1). In addition, the pre-saline infusion test (pre-SIT) supine PAC (after correction of hypokalemia) in the hLI group was higher than that in the lLI group (342 ± 172 vs 224 ± 59, P = 0.0141). pNCC was more abundant in the urinary exosomes in the high lateralization index (hLI, > = 4) group (1.64 folds, P = 0.0080) than in the low LI (lLI, < 4) group (Figure 1). Carriers of the somatic KCNJ5 mutations, compared with non-carriers, had more abundant pNCC expression in urinary exosomes (1.99 folds, P = 0.0399) (Figure 2).

Conclusions:
The expression of pNCC in urinary exosomes in patients with PA with various subtypes and genotypes was different. They can be used as biomarkers of AVS for PA subtyping.