bluuebunny/crossref_metadata_2025_split huggingface dataset:
MET235THR POLYMORPHISM IN THE AGT GENE AS THE DEVELOPMENT FACTOR OF SEVERE PREECLAMPSIA
Authors: Kurbanov Bakhodir 
Published: June 2022

Objective:
Every year, as a prediction risk of developing preeclampsia, experts are attracted by polymorphisms of some genes involved in the regulation of vascular tone and endothelial function.
The purpose - to establish the features of Met235Thr polymorphism in the AGT gene in the development of severe preeclampsia.

Design and method:
We examined 139 pregnant women in the third trimester of gestation which were divided into 2 groups: The main group - 56 pregnant women with severe preeclampsia. The control group is 83 conditionally healthy women. The age of the pregnant women was 19–37 years.
The material for the study was DNA samples from pregnant women.
Isolation of DNA from blood and PCR analysis were performed with kits of reagents and test systems from Ampli Prime Ribot-prep.

Results:
The shares of the Thr allele, being at very close levels in values, were insignificantly less in the control group, where they were 36.9%, versus 38.4% among patients with severe preeclampsia.
The detection rate of the homozygous wild Met / Met genotype of the Met235Thr polymorphism of the AGT gene was also insignificantly higher in the control group, being at the level of 43.0% (x2 = 0.15; p = 0.70; RR = 0.92; 95% CI: 0.33–2.54; OR = 0.87; 95% CI: 0.42–1.79), which was insignificantly higher than among patients with severe preeclampsia 39.5%.
The heterozygous Met / Thr genotype, also relatively evenly distributed between the groups, was insignificantly less frequently detected in the control group, amounting to 40.2% (x2 = 0.20; p = 0.67; RR = 1.1; 95% CI: 0.41–2.97; OR = 1.18; 95 % CI: 0.58–2.41), versus 44.2% among patients with severe preeclampsia.
The homozygous mutant Thr / Thr genotype, also being at a comparable level, prevailed statistically insignificantly in the control group (16.8%), relative to the group of patients (16.3%) (x2 = 0.01; p = 0.94; RR = 0.97; 95% CI: 0.25–3.72; OR = 0.96; 95% CI: 0.38–2.44)

Conclusions:
We can conclude that the Met235Thr polymorphism in the AGT gene in women with severe preeclampsia has clinical prognostic significance.
COURSE OF PREECLAMPSIA IN CHRONIC KIDNEY DISEASE (CKD)
Authors: Alekseeva Maria , Demyanova Ksenia , Kozlovskaya Natalya , Korotchaeva Yulia , Chegodaeva Ayana , Apresyan Sergey , Kobalava Zhanna 
Published: June 2022

Objective:
The aim of the study is to analyze the incidence and characteristics of PE in patients (pts) with CKD.

Design and method:
A retrospective analysis of 60 case histories of pregnant women with CKD 1–4 stages followed in the nephrology center for pregnant women from 2018–2021 was carried out. 20 of them developed PE: CKD 1 – 7/23 (30,4%), CKD 2 – 3/10 (30%), CKD 3 – 7/23 (30,4%), CKD 4 – 3/4 (75%), then the course of their pregnancy was analyzed. Indicators of proteinuria (PU) and blood pressure (BP) were assessed at the time of the first visit to the center and further, at the time of PE.

Results:
In the group of pts with PE and CKD (n = 20), the mean age was 29.3 (± 6) years. The causes of CKD were: glomerulonephritis - 13 (65%); tubulointerstitial nephritis 2 (10%); aHUS 2 (10%) and one each - polycystic kidney disease, diabetic nephropathy, APS-associated nephropathy. The mean term of gestation at the time of first visit to the dedicated center was 15.5 weeks. The mean RU was 1.4 (± 0.8) g/l. Arterial hypertension had 9 pts.The mean BP at the first visit was: SBP 129 (± 15)/DBP 85 (± 10) mm. Hg. PE before 34 weeks of gestation developed in 13 (65%) pts, and the mean term for the development of PE was 31.8 weeks [24; 38]. The mean BP at the moment of PE was 139 (± 16.6)/89 (± 10) mm Hg, so in 45% (n = 9) of cases, BP did not meet the criteria for PE. The majority of women showed an increase in PU 3,6 ± 2,9 g/l. The mean value of the sFLT1/PLGF ratio in PE was 135, that for a given gestational term (31.8 weeks) corresponds to severe ischemic damage to the placenta.

Conclusions:
We believe that the main features of PE in pts with CKD are its earlier onset and lower blood pressure values than those provided by modern criteria for PE. In this regard, it is important to monitor the angiogenic coefficient in dynamics in pregnant women with CKD.
BLOOD PRESSURE MANAGEMENT WITH THE ESH CARE APP – PRELIMINARY RESULTS
Authors: Siafi Eirini , Konstantinidis Dimitrios , Andrikou Ioannis , Polyzos Dimitrios , Drogkaris Sotiris , Manta Eleni , Tatakis Fotis , Zammanis Ioannis , Grigoriou Kalliopi , Dimitriadis Kyriakos , Leontsinis Ioannis , Tsioufis Konstantinos 
Published: June 2022

Objective:
Main issues in the treatment of hypertension are the low level of blood pressure (BP) control and the economic burden for health care systems. Mobile application with telemonitoring of BP could contribute to better control and lower costs by reducing office visits. This could be useful nowadays with difficult access to health system due to covid-19. The purpose of this study was to investigate if an innovative management strategy of hypertension, such as the use of ESH care application for smartphones combined with a dedicated platform, could improve hypertension control and replace frequent office visits.

Design and method:
30 uncontrolled hypertensive patients, treated or untreated [mean age 53 ± 9 years, mean office BP (OBP) 146.3 ± 6.2 / 92.5 ± 9 mmHg, 53% men, 33% smokers, 23% with hypercholesterolemia] were randomized to the application assisted strategy (AAS) (17 patients), where a mobile phone application was offered to communicate home BP measurements (HBPm), or to regular office visits (13 patients). Patients’ BP measurements (HBPm for AAS and OBP for standard care group) were evaluated in 1 and 3 months with treatment titration if uncontrolled. In all patients OBP and ambulatory BP measurement (ABPM) were evaluated in 6 months.

Results:
In both groups the reduction in OBP and ABPM was significant in 6 months. In the AAS group the reduction in systolic/diastolic OBP and 24 h systolic/diastolic BP in 6 months was -26.5 ± 5.6 / -19.4 ± 8.2 mmHg (p < 0,001) and -19.6 ± 7.7 / -13.8 ± 4.8 mmHg (p < 0.001), respectively. In the standard care group, the reduction in systolic/diastolic OBP and 24 h systolic/diastolic BP in 6 months was -22.6 ± 9.7 / -9.6 ± 11 mmHg (p < 0.005) and
-18.4 ± 6.0 / - 8.8 ± 4.4 mmHg (p < 0.001). In AAS group compared to standard care group there was a greater reduction in 24 h diastolic BP (-13.8 ± 4.8 mmHg vs -8.8 ± 4.4 mmHg, p = 0.016) and in diastolic OBP (-19.4 ± 8.2 mmHg vs -9.6 ± 11.0 mmHg, p = 0.04)

Conclusions:
The present results indicate that the monitoring of patients through a mobile health tool could be useful in hypertension management as it is correlated with better BP control compared to office visits. The trial is still enrolling patients.
THE INFLUENCE OF HEREDITY ON LIFESTYLE CHANGES AND PARTICIPATION IN SCHOOL OF CHRONIC PATIENTS IN PATIENTS WITH HYPERTENSION
Authors: Bekbergenova Zhanagul , Derbissalina Gulmira , Umbetzhanova Ayagyoz , Batarbekova Sholpan , Masharipova Alexandra , Mauletbayeva Gulsum , Akhmetova Dina , Kelimberdiyeva Elmira 
Published: June 2022

Objective:
Background / Introduction. Hypertension is one of the most common causes of myocardial infarction and stroke in the Republic of Kazakhstan. One of the unmodifiable risk factors is heredity.
Purpose: evaluating the impact of heredity on lifestyle changes, taking basic therapy, and participating in school for a chronic patient.

Design and method:
A survey of 354 patients with hypertension identified at screening was carried out.

Results:
The average age of patients is 54 years [Q1-Q3: 50–54], of which 36.2% are men, 63.8% are women. In 66.7% of patients, heredity is burdened.
According to the data obtained, when assessing heredity depending on lifestyle changes, significant differences were revealed (p = 0.004) (methods used: Fisher’s exact test).
The chances of changing the lifestyle in the group with a burden of heredity were 2.11 times lower than in the group of non-burdened heredity, the differences in the chances were statistically significant (OR = 0.48; 95% CI: 0.28 - 0.82).
According to the data obtained, when analyzing heredity, depending on the intake of basic therapy and the participation of chronic patients in school, we found statistically significant differences (p = 0.003) (methods used: Fisher’s exact test).
The chances of receiving basic therapy and participation in school of chronic patients in the group with burdened heredity were 1.97 times higher than in the group of non-burdened heredity, the differences in chances were statistically significant (95% CI: 1.22 - 3.19).

Conclusions:
According to the data obtained, persons with a burdened heredity change their lifestyle less often, but more often they take basic therapy and participate in the school of chronic patients.
CLOFIBRATE TREATMENT IMPROVED THE STRUCTURAL DAMAGE ELICITED BY MYOCARDIAL ISCHEMIA THROUGH MODULATION OF RENIN-ANGIOTENSIN SYSTEM
Authors: Aguilar Maria Sanchez , Lara Luz Ibarra , Mondragon Leonardo Del Valle , Castro Elizabeth Soria , Perez Luz Graciela Cervantes , Hernandez Gustavo Pastelin , Mendoza Alicia Sanchez 
Published: June 2022

Objective:
Myocardial ischemia is an acute condition that, if not treated in a timely manner, produces the loss of heart tissue which can lead to heart failure or death of the patients. Our group has studied fibrates, exogenous ligands of PPAR, as an alternative to reduce processes associated with inflammation and we interested to know the exogenous ligand effect over damage in the cardiac tissue by RAS system.
To study the effect of PPAR alpha ligand; clofibrate, on renin angiotensin system and on the structural morphology of the heart in myocardial infarcted subjects.

Design and method:
Male Wistar rats were separated in two groups: 1.- Sham, 2.- Myocardial infarct by coronary artery ligation. Seven days after, the rats were subdivided in vehicle (Vh)- or clofibrate treatment (Clof 100 mg/kg/day) administered for seven more days. At the end of the treatment (14 days in total), serum and left ventricle were analyzed.

Results:
Angiotensin converting enzyme (ACE), AT1 receptor and Ang II decreased in MI-Clof vs. MI-Vh, whereas non-classic RAS system components: ACE2, AT2 receptor, bradykinin, and Ang-(1–7) augmented in MI-Clof with respect to MI-Vh. VEGF also raised in clofibrate-treated animals. Clofibrate treatment preserved the structure of the sarcomere (fiber).

Conclusions:
Clofibrate treatment to MI rats exerts an antifibrotic effect and augmented the expression of non-classical axis of RAS system.
PERMISSIVE ROLE OF ANGIOTENSIN II IN MANTENANCE OF ENDOTHELIUM-DEPENDENT VASODILATION IN CEREBRAL MICROCIRCULATION
Authors: Mihaljevic Zrinka , Jukic Ivana , Matic Anita , Stupin Ana , Kolobaric Nikolina , Kozina Natasa , Susnjara Petar , Mihalj Martina , Drenjancevic Ines 
Published: June 2022

Objective:
A number of data suggest, rather controversial, permissive role of angiotensin II (ANGII) in maintaining vasodilator responses in microcirculation, via its interaction with AT1 receptors (AT1R). This study aimed to determine the role of ANGII and AT1R in the mechanisms of flow-induced dilation (FID) in middle cerebral arteries (MCA) and incidence of oxidative stress at the functional, cellular and molecular level in the cerebral vasculature and in the serum of Sprague-Dawley (SD) rats fed high salt diet (HS).

Design and method:
Eleven-week old, male SD rats were randomly assigned to control group (CTRL, 0.4% NaCl in rat chow); Losartan group (rats on a standard diet given the AT1R blocker losartan (1 mg/mL) in drinking water); HS group (7 days 4% NaCl in rat chow) or HS+ANGII group (7 days HS with 3 days ANGII administration via osmotic minipumps (100 ng/kg/min on days 4–7)). FID of MCA was determined in absence/presence of the NOS inhibitor L-NAME, the non-selective cyclooxygenases inhibitor indomethacin, and the superoxide dismutase mimetic TEMPOL. Gene and protein expression of antioxidative enzymes and enzymes involved in FID mechanisms were determined by RT-qPCR and western blot. Vascular NO and superoxide/ROS levels were assessed by direct fluorescence. Serum systemic oxidative stress parameters was measured by spectrophotometry. All experimental procedures conformed to the EU Directive 2010/63/EU.

Results:
HS or AT1R blockade impaired FID and increased oxidative stress. Supplementation of ANGII restored the mechanisms of FID in MCA of rats fed HS diet to the ones present in CTRL rats without affecting arterial blood pressure by decreasing systemic oxidative stress and decreasing superoxide/ROS levels and increased NO bioavailability in the vascular wall of HS treated rats. The AT1R blockade resulted in significantly attenuated endothelium-dependent dilation, changed mechanisms of FID, increased vascular and systemic oxidative stress and decreased expression/ activity of antioxidative enzymes.

Conclusions:
ANGII is crucial in the preservation of vascular oxidative stress-antioxidant system balance and via AT1R, in maintenance of physiological vasodilation mechanisms of MCA. Suppression of ANGII is a key link between HS intake and development of endothelial dysfunction, and impaired regulation of cerebral blood flow.
RENIN ANGIOTENSIN SYSTEM BLOCKADE AT BEDTIME VERSUS ON AWAKENING TO PREVENT ALDOSTERONE BREAKTHROUGH
Authors: Laurain Audrey , Lemoine Sandrine , Fauvel Jean-Pierre , Sampol Jerome , Fontas Eric , Zorzi Kevin , Esnault Vincent , Favre Guillaume 
Published: June 2022

Objective:
Aldosterone breakthrough (AB) is defined by an increase of serum aldosterone levels over baseline values before starting blockers of renine angiotensine system (RAS) treatment by angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB). AB may limit the efficacy of these drugs. We hypothesized that short-acting blockers taken on awakening may not inhibit the aldosterone peak occuring at the awakening. To address this hypothesis, we compared the incidence of AB in patients randomized to take their medications either on awakening or at bedtime.

Design and method:
participants had chronic kidney disease stage 3 or 4 and a urinary protein over creatinine ratio above than 0.5 g/g. Blood pressure, renal function, urinary sodium excretion, levels of aldosterone and renin were measured at baseline and after 1 year exposure to RAS blockers. Incidence of AB was tested with Chi-square test and the variables associated with AB were searched with Mann-Whitney-Wilcoxon tests.

Results:
among 105 participants, 97 were randomized and 77 completed the study. The incidence of AB was not significantly different between subjects having their treatment on awakening or at bedtime (43% versus 41%, p = 0.83). AB was associated with the decrease of systolic blood pressure (-1 ± 14 vs 5 ± 19 mm Hg, p = 0.05), the decrease of urinary sodium excretion (-31 ± 52 vs 1 ± 59 meq/d, p = 0.007), or the increase of serum creatinine levels (-0.2 ± 0.36 vs -0.10 ± 0.30 mg/dl, p = 0.018). As expected, AB was also associated with the increase of plasma levels of renin (42 ± 125 vs -1 ± 65 ng/L, p = 0.04) and the increase of urinary aldosterone excretion (4 ± 13 vs -1 ± 3, p = 0.0003). The independent factors associated with AB were systolic blood pressure (p = 0.03) and urinary aldosterone excretion (0.03).

Conclusions:
the intake of a short half-life RAS blockers at bedtime does not prevent AB in CKD patients with macroproteinuria. Mineralocorticoid receptor antagonists may be required to prevent the deleterious consequences of AB.
CHANGES OF THE ZONA GLOMERULOSA IN HUMAN ADRENALS FROM BIRTH TO 40 YEARS OF AGE
Authors: Baz Amir-Hossein Chaman , Van De Wiel Elle , Küsters Benno , Mukai Kuniaki , Bonzel Lidia Van , Erp Merijn Van , Langenhuijsen Johan , Deinum Jaap 
Published: June 2022

Objective:
Antibodies to CYP11B2 (aldosterone synthase) allow imaging of the zona glomerulosa (zG) by immunohistochemistry. Studies demonstrate that the area and continuity of the zG decreases with aging and accumulations of aldosterone-producing cell clusters occur. Research on age-related changes in the zG in younger patients and comparison of both adrenals is limited. Therefore, the objective of this study was to elucidate age-related changes of the zG by quantifying CYP11B2 expression in adrenals of patients below the age of 40 years.

Design and method:
We collected human adrenals from autopsy cases, that were anonymized except for age, sex and medical history. We excluded adrenal glands of patients with premature birth, hypertension, cardiovascular disease, adrenal tumors, use of steroids. In case of two available adrenals in one patient, one was randomly selected of the two. We validated software for automated quantification by comparing manually outlined CYP11B2 expressing area with automated outlined area. We then used this automated method to quantify CYP11B2 expressing area, CYP11B2 continuity and mean and maximum CYP11B2 depth. If the zG was discontinuous, mean length of ‘gaps’ between ZG tissue was calculated. We also determined the structural similarity between both adrenals of the same case. The study was approved by the local Medical Ethics Committee.

Results:
There was a negative correlation between age and CYP11B2 expressing area (rs = -.63); negative correlation between age and CYP11B2 continuity (rs = -.80); positive correlation with age and mean gap length (rs = 0.71); positive correlation between age and maximum CYP11B2 depth (rs = .30, P = <0.001) and no correlation between age and mean CYP11B2 depth (rs = .01, p = <0.001). The intraclass correlation coefficient between both adrenals of one subject for CYP11B2 expressing area was 0.78 (95%CI = 0.56–0.89), for CYP11B2 continuity 0.94 (95%CI = 0.88–0.97) and for mean gap length 0.76 (95%CI = 0.32–0.81).

Conclusions:
We demonstrate a decrease in CYP11B2 area and continuity, whilst the mean gap length and maximum CYP11B2 depth increases, which we consider as involution and clustering of the zG. This is seen in both adrenals and therefore suggests a common process. The relation with the development of aldosterone-producing adenoma remains to be determined.
STATE OF TARGET ORGANS DAMAGE AND PREVALENCE OF CLINICAL ASSOCIATED CONDITIONS IN PATIENTS WITH A HYPERTENSIVE CRISIS AND UNCONTROLLED HYPERTENSION. (PILOT STUDY)
Authors: Solntseva Tatyana , Denisova Anastasia , Sivakova Olga , Chazova Irina 
Published: June 2022

Objective:
To assess the state of target organs damage and prevalence of clinical associated conditions in patients with a hypertensive crisis and uncontrolled arterial hypertension.

Design and method:
The pilot study included 20 patients hospitalized at the National Medical Research Center of Cardiology over the period from September 2019 to September 2021. The all patients had uncontrolled hypertension (BP < 140/90 mmHg while taking antihypertensive drugs). Among them there are 11 men (55%), 9 women (45%) aged 34 to 80 years old (the average age is 60.9 years). The examination was carried out according to the standard examination protocols for patients with hypertension. After the patients had been followed up to 1 year, the damage of target organs (left ventricular hypertrophy, chronic kidney disease, carotid atherosclerosis), as well as the presence of associated clinical conditions (myocardial infarction, stroke, chronic heart failure, aortic aneurysm, retinal haemorrhages) were assessed.

Results:
10 patients formed a group with a hypertensive crisis (BP increased > 140/90 mmHg 1 per week), another 10 patients formed a comparison group (BP increased less than 1 per week without pronounced clinical symptoms). The level of LVMI in patients of the study group was 125.5 ± 52.4 g/m2, and in the comparison group was 93.8 ± 16.0 g/m2. Calculated GFR (using the CKD-EPI formula) in the study group was 69.1 ± 18.4 ml/min/1.73 m2, and in the comparison group was 75.9 ± 21.5 ml/min/1.73 m2, carotid atherosclerosis was 44.5 ± 22.8% and 37.5 ± 13.6% respectively. Associated clinical conditions occurred in 43% of patients with a hypertensive crisis, and in the group of patients with uncontrolled hypertension in only 29%. But future randomized control studies are necessary to proof our preliminary results.

Conclusions:
Patients with hypertensive crisis have more pronounced damage of target organs, as well as the most frequent prevalence of associated clinical conditions.
BLOOD PRESSURE REDUCTION AFTER CATHETER-BASED RENAL DENERVATION IN PATIENTS WITH CARDIOVASCULAR DISEASE IN THE GLOBAL SYMPLICITY REGISTRY
Authors: Mahfoud Felix , Schmieder Roland , Schlaich Markus , Narkiewicz Krzysztof , Ruilope Luis , Williams Bryan , Fahy Martin , Mancia Giuseppe , Bohm Michael 
Published: June 2022

Objective:
To evaluate the efficacy of catheter-based renal denervation (RDN) to lower blood pressure (BP) in patients with a history of myocardial infarction or stroke in the Global SYMPLICITY Registry (GSR).

Design and method:
GSR is a prospective, global, all-comers registry to evaluate the safety and efficacy of catheter-based RDN to lower BP. Patients are enrolled with the intention to receive RDN using either the Symplicity Flex or Symplicity Spyral catheter. Patients are followed at 3, 6, and 12 months, and then annually up to 3 years post-procedure. Office and ambulatory BP are measured at each follow-up and any adverse events are collected. The current post-hoc analysis compares systolic BP (SBP) reduction in patients with and without a history of myocardial infarction as well as with and without history of stroke. Differences in SBP reduction between groups were adjusted for baseline SBP using ANCOVA methods.

Results:
In March 2021 in GSR, there were 267 patients (10%) with a history of myocardial infarction and 2579 without, and 294 patients with a history of stroke (10%) and 2539 without. Patients with and without a history of myocardial infarction had similar baseline office and ambulatory SBP measurements, whereas patients with a history of stroke had similar office SBP measurements but significantly higher ambulatory SBP (159 ± 22 vs. 154 ± 18, p = 0.005) compared to patients without history of stroke. Office and ambulatory SBP reductions from 6 months to 3 years were similar for patients with and without a history of myocardial infarction after adjusting for differences in baseline SBP (Figure). SBP reductions were also similar for patients with and without a history of stroke except at 6 months for office and ambulatory SBP and at 12 months for ambulatory SBP, when patients with a history of stroke had less BP reduction.

Conclusions:
Patients with and without a history of stroke or myocardial infarction had similar office and ambulatory SBP reductions after catheter-based RDN, suggesting efficacy of RDN regardless of baseline cardiovascular history.