bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term decline of renal function in patients with resistant and non-resistant arterial hypertension
Authors: Ramik Z , Vaclavik J , Kocianova E , Kamasova M , Kvapil T , Jelinek L 
Published: October 2022

Abstract

Background
The negative effect of arterial hypertension on renal function is well known. Until present, the detrimental effect of resistant arterial hypertension (RAH) on kidneys was not clearly defined.

Purpose
To assess the deterioration of renal function in patients with RAH in comparison to patients with non-resistant arterial hypertension (AH) during a long term follow-up.

Methods
We retrospectively reviewed records of 307 patients followed between May 2007 and January 2019 in an Hypertension Excellence Centre of a tertiary hospital. In all patients we assessed basic demographic characteristics, co-morbidities, laboratory findings, secondary causes of AH, medication, blood pressure including ambulatory blood pressure monitoring, studies and invasive procedures (CT, MRI, coronarography). We statistically evaluated differences in both groups and compared the decline of renal function.

Results
160 patients had resistant and 147 patients non-resistant hypertension. Patients were followed for a mean of 6 years. Patients with RAH were older (58.1±10.8 years vs. 51±13 years), more frequently diabetics (39.3% vs. 8.7%), had more frequent exposure to diagnostic studies and invasive procedures (86,5% vs. 64%).
Age at baseline visit and diabetes mellitus were established as statistically significant independent risk factors. Linear mixed effect model adjusted to age and diabetes demonstrated that patients with RAH have increased decline of renal function than patients with AH: patients with AH had mean increase of creatinine +0.24 μmol/l per year, while patients with RAH + 2.12 μmol/l per year (P=0.005). Similarly the decrease of eGFR in patients with AH was −0.66 compared to −1.5 mL/s/1.73 m2 per year in patients with RAH (P=0.005).
Figures 1 and 2 show the difference in mean slope of creatinine and eGFR in patients with resistant and non-resistant hypertension (based on linear mixed effect models)).

Conclusion
Patients with resistant hypertension had faster decline of renal function in comparison to patients with non-resistant hypertension independently on age and diabetes. Further studies are needed to determine the key factors affecting renal function decline in both subgroups.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): University Hospital Olomouc, Palacky University Olomouc, Faculty of Medicine, Czech Republic
Pericardial fat from a single horizontal long axis cardiac magnetic resonance cine image: a validation study against three-dimensional cardiac computed tomography
Authors: Zamani S K , Aldiwani H , Razipour A , Wei J , Kwan A C , Berman D S , Dey D , Bairey Merz C N , Nelson M D 
Published: October 2022

Abstract

Background
Excess fat accumulation around the heart (i.e., pericardial fat) is positively associated with cardiovascular disease. Pericardial fat is composed of two distinct depots: (1) epicardial fat, which is a metabolically active adipose tissue located between the heart and the pericardium, and (2) paracardial fat, which is the fat deposit in the mediastinum outside of the parietal pericardium. Both depots are visible on the horizontal long axis cardiac magnetic resonance (CMR) cine (i.e., four chamber view), offering an attractive opportunity to quantify pericardial fat from standard CMR cine images.

Purpose
To validate pericardial fat area measured from a single horizontal long axis CMR cine against whole-heart volumetric non-contrast cardiac computed tomography (CT) measurements.

Methods
To accomplish our goal, we leveraged 25 cases from the Women's Ischemia Syndrome Evaluation – Coronary Vascular Dysfunction Continuation cohort who underwent both cardiac MRI and cardiac CT within a median of 35 days apart. For MRI, pericardial fat area was measured from a single high resolution steady state free precession cine image in the horizontal long axis imaging plane using commercially available software (CVI42 V5.13.5, Circle Cardiovascular Imaging, Figure 1A). For CT, pericardial fat volume was measured using a fully automated deep learning algorithm (QFAT 2.0, Figure 1A).

Results
Fat area measured from a single horizontal long axis cine image was closely related to fat volume measured by three-dimensional cardiac CT, with strong correlations for epicardial fat (R2=0.72, p&lt;0.01, Figure 1B), paracardial fat (R2=0.80, p&lt;0.01, Figure 1C), and pericardial fat (R2=0.91, p&lt;0.01, Figure 1D).

Conclusions
Measuring pericardial fat area, and its constituent parts, from a single horizontal long axis cine image is both feasible and strongly related to reference standard pericardial fat volume by cardiac CT.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): National Institutes of Health
Statins benefit in androgen levels and target organ damage in hypertensive males with erectile dysfunction
Authors: Angelis A , Aggeli K , Dimitroglou I , Aznaouridis K , Ioakeimidis N , Georgakopoulos C , Zisimos K , Koukos M , Verveniotis A , Synodinos A , Lekoudi E , Alexopoulou K , Tsiamis E , Vlachopoulos C , Tsioufis K 
Published: October 2022

Abstract

Background
Statins may benefit cardiovascular physiology by cholesterol independent or pleiotropic actions. Target organ damage (TOD) amplifies cardiovascular risk in essential hypertension and endogenous testosterone (TT) exhibit vasoprotective effects. Erectile dysfunction (ED) is frequent in hypertensive middle aged men when androgen levels typically fall, impairing thus quality of life.

Purpose
To investigate the effect of statins in TT and TOD in hypertensive middle aged men with ED, independently of cholesterol levels.

Methods
248 hypertensive ED males (mean age: 57 yo) with no history of diabetes mellitus or overt cardiovascular disease enrolled the study. Of those 95 (38%) were on statin therapy for treatment of dyslipidemia. There were all screened for the presence of microalbuminuria, defined as urinary albumin loss 30–300 mg in a 24 h urine volume collection. TT, total cholesterol (Tchol) and low density lipoprotein (LDL) levels were measured on blood samples taken before 09:00 am. All individuals underwent a non invasive evaluation of the carotid-femoral pulse wave velocity (PWV), estimation of central pressures and augmentation index (AIx) a parameter of wave reflection amplification (Sphygmocor device). ED severity was assessed by the SHIM-5 score (range: 0–25) and higher values indicate a better erectile ability.

Results
In bivariate analysis statin use was positively related to TT (p&lt;0.05 – Figure 1) and negatively to microalbuminuria, Tchol and LDL (p&lt;0.005). Moreover TT was negatively related to PWV, AIx, microalbuminuria (all p&lt;0.005) and positively to the SHIM-5 score (p: 0.003). By linear regression analysis association of TT to statins remained significant after correction for age, BMI, PWV, AIx, Tchol and LDL levels.

Conclusions
Statin therapy benefits endogenous testosterone in hypertensive middle aged men with ED and so lessens TOD and enhances erectile ability independently of cholesterol levels. In such population group pleiotropic effects of statins may help restoring androgen levels, decrease cardiovascular risk and ameliorate quality of life.

Funding Acknowledgement
Type of funding sources: None.
Increased cancer incidence in children after cardiac catheterization within the first 8 years of life, a single center experience between 1999 and 2013
Authors: Scholtissek H , Sheho N , Spix C , Kretschmer A , Hager A , Ewert P , Meierhofer C , Stern H 
Published: October 2022

Abstract

Background
Children with congenital heart disease are exposed to ionising radiation early in their lives when tissue sensitivity for radiation is highest. This might provoke DNA fractures and cancer development. Our first study with an observation period from 1980–1998 showed a 4.4-fold increased cancer risk for children who had at least one cardiac catheterization in the first year of life.

Objectives
This study aimed to reassess the risk of cancer for children who underwent at least one cardiac catheterization between 1999 and 2013 with a follow-up of seven years.

Methods
This retrospective, single-center study included 2765 children who underwent at least one cardiac catheterization before eight years of age between January 1999 and December 2013. 1688 received their first cardiac catheterization in the first year of life, 1074 between first and eighth year of life. Catheterization and patient data were obtained from our database, and cancer diagnoses up to age 15 were matched with German Childhood Cancer Registry. For each tumor patient and for each of the 60 randomly selected control patients cumulative effective radiation doses were calculated.

Results
37667.16 person-years were evaluated. A total of ten patients developed a malignant tumor, while 5.82 were expected (SIR 1.72; CI 0.82–3.16; p=0.0722). Eight of these ten tumors developed in patients who received their first cardiac catheterization in the first year of life, while 3.99 were expected (SIR 2.0; CI 0.71–3.62; p=0.1095). The cancer group performed an average of 3.7 cardiac catheterizations per patient, with a mean cumulative effective dose of 24,79mSv. In the control group consisting of 60 patients, 2.1 cardiac catheterizations were performed per patient with an average cumulative effective dose of 21.04mSv. Three of the ten tumor patients have chromosomal abnormalities. The cancers observed are two leukemia, two lymphoma, two CNS tumors, one osteosarcoma, two nephroblastoma and one hepatoblastoma.

Conclusion
There is still an increased risk of cancer development for children with congenital heart disease exposed to ionizing radiation early in life. However, due to technical development and increased sensitivity to this fact, we observed a decrease in cancer disease compared to our previous study with catherization between 1980 and 1998.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Stiftung Kinderherz
Epicardial adipose tissue of atrioventricular grooves is a reliable and early MRI biomarker of the effect of metabolic diseases on atrial myocardium
Authors: Bialobroda J , Bouazizi K , Zarai M , Kachenoura N , Clement K , Aron-Wisnewsky J , Hatem S , Redheuil A 
Published: October 2022

Abstract

Introduction
Epicardial adipose tissue (EAT), the visceral adipose tissue surrounding the heart, is implicated in a host of cardiovascular diseases playing a transducer role between systemic metabolic conditions and the myocardium, as illustrated by higher risk of atrial fibrillation in patients with diabetes or obesity. MRI affords comprehensive and non-invasive insights into myocardial structure, function and tissue properties. However, the clinical usefulness of whole atrial EAT is limited by its challenging measurability in clinical routine in several imaging modalities, including MRI.

Purpose
We hypothesized that atrioventricular groove epicardial adipose tissue (GEAT) which can be measured routinely based on established anatomic landmarks may be: 1) a relevant surrogate of atrial EAT and 2) a relevant imaging biomarker to characterize atrial alterations in patients with varied degrees of metabolic disorders.

Methods
Ninety-nine patients from the METACARDIS cohort (EU FP7) who had MRI, all in sinus rhythm and without overt clinical heart disease, were divided into 4 groups based on distinct metabolic profiles: metabolic syndrome (MS, n=24), severe obesity (SO, BMI ≥35 kg/m2, n=17), type-2 diabetes (T2D, n=41) and healthy controls (n=17). Atrioventricular groove EAT volume was measured from cine SSFP MRI images in four-, three-, two-chamber and short-axis views; atrial EAT volume was measured from four- and two-chamber views. Native T1-mapping values of EAT at the anterior atrioventricular groove excluding the coronary vessels were measured from the MOLLI sequence (basal short-axis slice).

Results
We found a high correlation between GEAT and atrial EAT volumes (r=0.96; p&lt;0.0001) indicating that GEAT may reflect global atrial EAT volume. Next, we compared GEAT volume across study groups and found an increased GEAT volume in the 3 groups of patients with metabolic diseases compared to controls, with a significantly higher volume in MS (4.7±1.5 ml), SO (4.1±1.2 ml), and T2D (3.7±1.1 ml) than in Controls (2.6±0.6 ml; p≤0.001, p≤0.01, p≤0.05, respectively). In addition, T2D patients had lower native T1 values within GEAT compared to healthy controls (250±26 ms versus 280±31 ms; p≤0.01).

Conclusion
Atrioventricular groove EAT can be easily measured from conventional cine SSFP MRI images and could be used as a surrogate of global atrial EAT. Both volume and properties of GEAT are related to the metabolic status of patients. Furthermore, given its pure epicardial origin and pericoronary distribution, GEAT appears as a relevant biomarker of metabolic impacts on atrial myocardium.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Annee-recherche, Agence Regionale de Sante Ile-de-France
Impact of unemployment on cardiovascular mortality in united states: a nationwide county-level analysis 2010–2019
Authors: Sayed A , Aldosoky W , Khalid N , Diab M , Elsaiey A , Dar T , Abohashem S 
Published: October 2022

Abstract

Background
Unemployment has been linked with a myriad of adverse health outcomes; however, its population-level impact on cardiovascular mortality (CVM), particularly amongst various demographic subgroups, remains understudied.

Purpose
To determine the impact of county unemployment levels on CVM rates, in overall and between different demographic subgroups.

Methods
We utilized the CDC WONDER database tool to retrieve county-level CVM rates for U.S. counties between 2010 and 2019. The County Health Rankings project was used to retrieve data on unemployment levels in each county as well as other characteristics used in an adjusted multivariate model. Generalized linear mixed models using Poisson regression were used to estimate the impact of unemployment on county-level CVM using relative (incidence rate ratios; IRR) and absolute (additional yearly deaths; AYD) measures.

Results
From 2010 to 2019, a total of 2904 U.S. counties (64.2% white; 50.81% female) with data available on CVM and unemployment levels were analyzed. In a multivariate model adjusted for demographic composition, CV risk, socioeconomic, environmental, and healthcare-access factors, unemployment was significantly associated with higher levels of CVM (IRR: 1.026; 95% CI: 1.018 to 1.033; 6.00 AYD). The relative impact of unemployment was strongest in elderly Blacks (IRR: 1.051; 95% CI: 1.029 to 1.074), middle-aged whites (IRR: 1.050; 95% CI: 1.032 to 1.067), and middle-aged females (IRR: 1.046; 95% CI: 1.018 to 1.075). The absolute impact of unemployment was highest in elderly Blacks (AYD: 94.70), elderly Whites (AYD: 35.30), and elderly females (AYD: 32.70). On a relative basis, the impact was more pronounced in the middle-aged (IRR: 1.030; 95% CI: 1.015 to 1.044) compared to the elderly (IRR: 1.022; 95% CI: 1.014 to 1.030), females (IRR: 1.026; 95% CI: 1.017 to 1.036) compared to males (IRR: 1.022; 95% CI: 1.014 to 1.031), and Blacks (IRR: 1.036; 95% CI: 1.016 to 1.057) compared to Whites (IRR: 1.030; 95% CI: 1.022 to 1.038).

Conclusion(s)
Unemployment is significantly associated with county-level CVM, and this impact is most pronounced in vulnerable demographic subgroups, namely females and Blacks. Efforts to reduce unemployment levels may significantly lower the burden of cardiovascular disease, particularly in groups most strongly affected by health disparities.

Funding Acknowledgement
Type of funding sources: None.
Sex and gender influence on cardiovascular health in sub-saharan Africa: findings from Ghana, Gambia, Mali, Guinea, and Botswana
Authors: Dev R , Favour-Ofili D , Raparelli V , Behlouli H , Azizi Z , Kublickiene K , Kautzky-Willer A , Trinidad Herrero M , Pilote L , Norris C M 
Published: October 2022

Abstract

Background
Sex and gender-based differences in cardiovascular health (CVH) has been explored in the context of high-income countries. However, these relationships have not been examined in low- and middle-income countries. There is an upsurge of cardiovascular diseases (CVDs) in sub-Saharan Africa (SSA). Irrespective of biological sex, gender-related factors could be the precursor of these conditions.

Purpose
To examine the associations between biological sex, gender-related variables, and CVH risk factors in SSA countries.

Methods
We conducted a retrospective analysis of the World Health Organization's “STEPwise approach to surveillance of risk factors for non-communicable disease” or “STEPS” survey, conducted in adults aged 18–69 years from Ghana, Gambia, Mali, Guinea, and Botswana. The surveys were conducted between 2006 and 2014. The main outcome was CVH, as measured by a composite measure of STEPS-HEART health index (smoking, hypertension, diabetes, obesity/overweight, and daily consumption of fruits and vegetables), values ranging from 0 (worst) to 5 (best or ideal). Multivariable logistic regression was applied to determine the gender-related factors related to poorer CVH (index less than 4). Two-way interaction between the sex and gender-related factors were tested by including an interaction term in bivariate models.

Results
Data included 15,356 adults (61.4% females, mean age 36.9 years). The prevalence of hypertension (21.6% vs. 13.8%) and overweight/obesity (48.3% vs. 27.5%) was higher among females as compared to males. Females were more likely to be unemployed (17.3% vs. 9.7%) or reported unpaid work (36.8% vs. 15.2%). Overall, females showed worse CVH than males (OR female = 0.95, 95% CI: 0.91–0.99). Being married was associated with better CVH compared with being single, more so for males (OR male = 1.09, 95% CI: 0.96–1.24, p interaction &lt;0.01). Males with unpaid work (OR male = 1.28, 95% CI: 1.12–1.47) had better CVH than their unpaid female counterparts (OR female = 1.08, 95% CI: 1.01–1.17).

Conclusion
This study highlights an alarmingly high prevalence of CVD risk factors, mainly overweight/obesity and hypertension among females in SSA population. Being female was associated with poorer CVH given the disproportionate burden of hypertension and overweight/obesity. Gender-related factors such as marital status and unpaid work were associated with better CVH in males compared to females. With the rising prevalence of CVDs in SSA, it will be important to consider the gender-related factors while implementing preventive programs and creating effective health policies.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The GENDER– NET Plus ERA-NET Initiative (project ref. number: GNP-78): The Canadian Institutes of Health Research (GNP-161904)
Mortality and predictors of death in women and men with congestive heart failure with preserved, mildly reduced, and reducedejection fraction
Authors: Barretto A , Del Carlo C H , Ramos Neto J A , Abreu A B , Scipioni A R , Mansur A P 
Published: October 2022

Abstract

Background
Congestive heart failure (CHF) is one of the leading causes of death from cardiovascular disease and years lived with disability. Studies showed that women had better survival than men despite higher hospitalizations in women. However, little is known about differences in mortality and predictors of death in women and men with heart failure with preserved (HFpEF), mildly reduced (HFmrEF), and reduced ejection fraction (HFrEF).

Methods
From February 2017 to September 2020, we analyzed the mortality and the predictors of death in women and men with CHF (Framingham criteria). Baseline data included clinical characteristics and echocardiographic findings. Statistical analyses were performed with the Kaplan-Meier (K-M) method and the Cox proportional hazards methods to analyze death rates and search for predictors of death for women and men.

Results
We studied 12,015 patients, mean of 63.8±14.3 years, 6637 (55%) males. Females were older (64.9±14.8 vs. 62.8±13.8 years; p&lt;0.0001), had a higher baseline mean left ventricular ejection fraction (LVEF) (49.8±18.9% vs. 42.6±15.4%; p&lt;0.001), and a lower left ventricular diastolic diameter (LVDD) (54.1±9.0 vs. 60.1±9.6 mm; p&lt;0.001). Over a 3-years follow-up period, 1543 (23.2%) men and 1051 (19.5%) women of the cohort died (K-M: log-rank p&lt;0.0001). Cumulative incidence of death was higher in men (K-M: log-rank p=0.0002) with HFrEF but similar for HFmrEF and HFpEF (Figure 1). Cox regression for death adjusted for age, ischemic, idiopathic, hypertension, Chagas, valve, previous myocardial infarction, diabetes, previous stroke, chronic kidney disease (CKD), atrial fibrillation, and LVEF showed that CKD, previous stroke, and diabetes were the main predictors of death for all phenotypes of LVEF in women and men.

Conclusion
Women had a better prognosis than men inHFrEF but similar mortality for HFmrEF and HFpEF. Control of diabetes and preventing stroke and CKD could significantly reduce the death rate in women and men with all CHF phenotypes.

Funding Acknowledgement
Type of funding sources: None.
Myocardial function and myocardial work in young adults born very preterm or with extremely low birthweight – a regional cohort study
Authors: Engan B , Omdal T R , Greve G , Vollsaeter M , Leirgul E 
Published: October 2022

Abstract

Background
Preterm birth and low birthweight have been associated with increased risk of cardiovascular disease and heart failure at young adult age. However, clinical studies of myocardial function have reported diverging results. Echocardiographic strain analyses allow detection of subclinical early stages of cardiac dysfunction, and non-invasively estimation of myocardial work derived from left ventricular pressure-strain loops provides additional information on cardiac function.

Purpose
We aimed to compare systolic and diastolic myocardial function including measures of myocardial work in young adults born very preterm (&lt;29 weeks of gestation) or with extremely low birthweight (&lt;1000 g) (PB/ELBW) and term-born age-and gender matched controls.

Methods
63 PB/ELBW and 64 controls born in Norway in the periods 1982–1985, 1991–1992, and 1999–2000 were examined with echocardiography. Left ventricular (LV) ejection fraction, LV global longitudinal strain (GLS), traditional diastolic parameters and left atrial longitudinal strain were measured. Myocardial work was estimated by the echocardiographic software from LV pressure-strain loops after determination of GLS and construction of a LV pressure curve derived from brachial cuff pressure recording and timing of mitral valve opening and closure.

Results
The PB/ELBW with mean age 27 years (standard deviation (SD) 6), mean birthweight 945 g (SD 217) and mean gestational age 27 weeks (SD 2) had LV systolic function mainly within normal range. Only four (&lt;1%) had EF &lt;50%, but 12 (19%) had borderline impaired GLS &gt;−18% or impaired GLS &gt;−16%. Mean GLS in PB/ELBW (−19.7% (95% confidence interval (CI): −20.4, −19.1)) was impaired compared to controls (−20.4% (95% CI: −20.9, −20.0)), p=0.01. Lower birthweight was correlated to more impaired GLS (Pearson correlation coefficient −0.2). Estimated means of EF, measures of diastolic function, left atrial reservoir strain, global constructive and wasted work, global work index and global work efficiency was similar in PB/ELBW and controls.

Conclusions
The young adults born preterm or with extremely low birthweight had LV systolic function mainly within normal range, but GLS was impaired compared to controls, and lower birthweight was associated with more impaired GLS. Diastolic function and global work index were similar compared to controls.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Western Norway Health Authority