bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in mitochondrial efficiency and heart function after different modes of exercise training in hypertension
Authors: Dorofeyeva N , Sagach V F 
Published: October 2022

Abstract

Physical exercise is often used for the cardioprotective purpose in hypertension. However, it's not clear whether the mitochondrial efficacy will depend on the intensity and mode of physical exercise. The aim of the work is to investigate the effect of different modes of exercise training on mitochondria function and cardyohemodynamic in hypertension. All experimental procedures were performed in accordance with the European Communities Council Directive of 24 November 1986 (86/609 /EEC). Six-month-old spontaneously hypertensive rats (SHR) and normotensive control–Wistar rats were randomly assigned to 2 different training modes: moderate (20 min) and enhanced (45 min). Swimming training was done five times per week for 5–6 weeks. The functional cardiohemodynamic indicators were registered via microcatheter and Millar Pressure-Volume System. Mitochondrial oxygen consumption registered by Oxygraph. Moderate exercise training mode in SHR had a positive effect on the respiratory chain of mitochondria, respiratory control increased by 25,3%, the mitochondrial membrane potential increased by 47,8%. Moderate exercise training mode protected mitochondrial permeability transition pore (MPTP) formation. The threshold of MPTP opening increased by 1.4 times and the sensitivity of MPTP to inductor Ca2+ decreased. It was shown that end-systolic and end-diastolic pressure of SHR was decreased by 23,8% and 32,7% respectively. Moderate exercise improves end-diastolic heart function in SHR by increasing dP/dtmin and reducing the end-diastolic myocardial stiffness in 8,3 times. Stroke volume increased in 3,3 times, stroke work decreased by 17.2%, which may indicate the heart work efficiency increased after moderate exercise training. The Frank-Starling mechanism efficiency after moderate exercise was increased by 3,7 times. After enhanced exercise mode we didn't observe a protected effect on heart mitochondria and heart function in SHR. The mitochondrial membrane potential didn't increase, mitochondrial respiration in states V2, V3, V4 were significantly decreased. In conclusion, we showed that a moderate mode of exercise in SHR rats increased mitochondrial efficiency and improved heart function. The enhanced mode of exercise was excessive for SHR which was confirmed by suppressing the mitochondrial respiration and end-diastolic function of the heart.

Funding Acknowledgement
Type of funding sources: None.
Association between vitamin D receptor gene polymorphism and essential hypertension: a systematic review and meta-analysis
Authors: Addai M F , Maulana R , Widyantoro B 
Published: October 2022

Abstract

Background and aim
Recent publications reported that the association between Vitamin D Receptor (VDR) gene polymorphism of Fokl (rs228570 or rs10735810) and essential hypertension (EH) remains controversial. Thus, we conducted this study to investigate the relationship between Fokl and EH.

Methods
Major medical databases (EMBASE, PUBMED, Science Direct, Cochrane, Springer, Scopus, ProQuest, and Lilacs) were systematically searched for observational studies evaluating the impact of Fokl polymorphism on EH, published until January 2022 with predefined protocol and without language restriction regarding PRISMA guideline. Analysis was performed in RevMan 5.3 (fixed and random-effects model through heterogeneity test) to provide pooled measures for odds ratio (OR) under Hardy-Weinberg Equilibrium based-on allele contrast, additive, dominant, and recessive genetic models.

Results
Eight observational studies enrolled comprising 3,762 cases and 4,445 controls. Under the allele model, Fokl polymorphism (f vs F) significantly increased the odds of having EH (OR=1.27; 95% confidence interval: 1.05–1.53), p=0.01. Fokl polymorphism was not significantly associated with EH under additive model (ff vs FF) with OR=0.94 (0.57–1.54), p=0.79, dominant model (Ff + ff vs FF) with OR=0.97 (0.8–1.16), p=0.76 and recessive model (FF + Ff vs ff) with OR=0.96 (0.59–1.56), p=0.97 However, subgroup analysis based on ethnicities, comprising Asian, European, American, and African, showed that only in African population, Fokl polymorphism was associated with reduced odds of EH under additive (OR=0.36; 0.17–0.74), p=0.005 and recessive model (OR=0.31; 0.14–0.7), p=0.005.

Conclusions
VDR gene polymorphism of Fokl was significantly associated with EH in a particular genetic model and could be affected by ethnicity. However, further studies are needed to make the robust evidence.

Funding Acknowledgement
Type of funding sources: None.
The diastolic blood pressure U-curve
Authors: Rocha Carvalho P , Moreira I , Carvalho C , Bernardo M , Monteiro J , Fontes P , Moreira J I 
Published: October 2022

Abstract

Introduction
It is known that low diastolic blood pressure (DBP) at admission is associated with short-term cardiovascular events after acute coronary syndrome (ACS). However, there is a lack of further investigation into the nonlinear relationship between admission diastolic blood pressure (DBP) and adverse outcomes of ACS patients.

Objective
To investigate the relationship between admission diastolic blood pressure and subsequent cardiovascular mortality in patients with acute coronary syndrome.

Methods
Retrospective study of patients with ACS periodically included in our center registry between October/2012 and September/2018. Patients with class killip 4 at admission or that needed ionotropic support during hospitalization were excluded. The association between admission DBP and cardiovascular mortality during the follow-up period among this population was analyzed using multivariate COX regression model. Results were presented according to DBP quartiles: Q1, less than 70 mm Hg; Q2, from 71 to 80 mm Hg; Q3, from 81 to 90 mm Hg; Q4, above 90 mmHg.

Results
A total of 548 patients were included in this cohort study. Mean patient age was 65.9±13.1 years and 75.2% were men. A nonlinear relation was observed between DBP at admission and cardiovascular mortality over the follow-up.
During a median follow-up of 42 months (IQR: 27–59), 47 patients (8.6%) died from cardiovascular causes. After adjusting for potential confounders (age and diabetes mellitus), patients in Q3 had the lowest risk for cardiovascular death by Cox proportional hazard model (HR 0.44; 95% CI: 0.16–1.00). Meanwhile, compared with Q1, Q3 patients had significantly lower risk for cardiovascular death (HR 0.35, 95% CI: 0.13–0.92).

Conclusion
Among patients admitted for ACS, there is a U curve relationship between admission DBP and risk for cardiovascular death. These results could be explained by a reduction in diastolic coronary blood flow which influences myocardial oxygen supply relative to the necessary demand in an ACS.

Funding Acknowledgement
Type of funding sources: None.
PR interval as arisk factor for atrial fibrillation in patients with arterial hypertension
Authors: Papakonstantinou P , Andrikou I , Konstantinidis D , Tsioufis C 
Published: October 2022

Abstract

Introduction
Hypertension (HTN) is one of the most important risk factors associated with atrial fibrillation (AF). Prolongation of the PR interval has been associated with an increased risk of incident AF, while PR interval is a component of the Framingham risk score for AF. However, the results regarding PR prolongation as a risk factor for AF are inconsistent.

Purpose
We aim to evaluate the predictive role of the PR interval for AF development in a large cohort of HTN patients.

Methods
Consecutive patients with essential hypertension without known AF at baseline were followed up for a mean period of 5.3±3.3 years. A 12-lead ECG and an echocardiography study were performed on each patient at baseline and annually, and 24h Holter rhythm monitoring was used in the event of arrhythmia symptoms. Routine clinical and paraclinical examinations as well as medications were implemented during the follow-up period according to the European Society of Cardiology/ European Society of Hypertension guidelines for HTN management. The PR interval and P wave duration were obtained from the baseline ECG.

Results
We included 1807 hypertensives (mean age 57±11 years; 49% males) with office systolic blood pressure (SBP)/ diastolic blood pressure (DBP) 144±17/89±11mmHg. During the follow-up period, 65 cases (3%) of new-onset AF were recorded. Patients with new-onset AF (n=67) compared to those without AF (n=1740) had greater baseline P wave duration (115 vs 110 ms) and PR internal (174 vs 157 ms). Multivariable Cox regression analysis showed that higher baseline PR internal is significantly associated with the development of AF (HR 1.01, 95% CI 1.01–1.02; p=0.01), while there was no significant predictive value for baseline P wave duration on the incidence of new-onset AF. Baseline increased DBP was associated with a higher incidence of AF (HR 1.05, 95% 1.003–1.091; p=0.037).

Conclusions
Baseline PR internal is a significant predictor of new-onset AF in hypertensive patients. The PR prolongation could be considered as a marker for cardiovascular degenerative aging caused by vascular inflammation and myocardial fibrosis.

Funding Acknowledgement
Type of funding sources: None.
Screening for familial hypercholesterolaemia; extending a role for blood programs in promoting public health
Authors: Eason S , Khera A , Gore O , Sayers M H 
Published: October 2022

Abstract

Background
Familial hypercholesterolaemia (FH) is a genetic disorder characterized by high levels of cholesterol with evidence of coronary arterial disease at an early age. The prevalence of FH has been recently reported as 1/200 to 1/250 in the general population and although early identification and treatment is recommended (2019 ESC/EAS Guidelines for the Management of Dyslipidaemias), the disorder is largely underdiagnosed in asymptomatic individuals.1
A number of blood programs has recognised the opportunity that blood donation provides to identify ostensibly healthy individuals who might be unaware of risks to their health. These programs have included, along with mandated serological testing, such assays as non-fasting total cholesterol (TC) and haemoglobin A1C. They have also taken steps to notify individuals whose results suggest risk for cardiovascular disease or diabetes.

Purpose
Since our blood donation program has a long history of providing donors information about their TC, we tested whether some donors with elevated TC met the criteria for FH.

Methods
We reviewed unlinked total non-fasting cholesterol results from volunteers donating between 2015 and June 2019. Cholesterols were measured on a chemistry analyzer system (Beckman Coulter AU680) on residual blood after routine testing for infectious disease markers. For volunteers donating more than once, we included only their highest TC recording. TC was classified by American Heart Association (AHA) 2020 Goal Metrics as high, if ≥240 mg/dL (6.2 mmol/L) in donors ≥20 years of age and ≥200 (5.1 mmol/L) in donors &lt;20 years of age. 2 We applied the United States Center for Disease Control Cooperative MEDPED diagnostic criteria for FH. Using these criteria, FH is diagnosed when TC exceeds 270 mg/dL (7.0 mmol/L) in individuals less than 20, 290 mg/dL (7.5 mmol/L) in individuals 20 to 29, 340 mg/dL (8.8 mmol/L) in individuals 30 to 39, and 360 mg/dL (9.3 mmol/L) in individuals 40 years of age and older. 3

Results
There were 432,389 unique donors during the study period. The overall prevalence of high cholesterol, 11.1% and the prevalence of FH 0.24% are similar to published data for the general population. As shown in the table, the prevalence of FH was highest in blood donors 20 to 29 years of age and was lower in those over 30 years, while the prevalence of high TC was higher in older age groups.

Conclusion
There is a subset of blood donors, at all ages who can be identified as satisfying familial hypercholesterolaemia criteria that could benefit from additional evaluation and family screening. A sizeable proportion of blood donors have high cholesterol despite not having FH.

Funding Acknowledgement
Type of funding sources: None.
Preterm birth, abnormal foetal growth and the risk of atrial fibrillation later in life: a cohort study in Denmark, Finland and Sweden
Authors: Yang F , Janszky I , Gissler M , Obel C , Cnattingius S , Roos N , Miao M H , Yuan W , Li J , Laszlo K D 
Published: October 2022

Abstract

Background
Increasing evidence suggests that adverse birth outcomes, including preterm birth, small for gestational age (SGA) and large for gestational age (LGA), are associated with increased risks of hypertension, ischemic heart disease, stroke and heart failure. However, knowledge regarding their associations with atrial fibrillation (AF) is limited and inconsistent.

Objective
To investigate whether preterm birth, SGA and LGA are associated with increased risks of AF later in life.

Methods
We conducted a population-based cohort study involving 8,012,433 live singleton births based on the nation-wide Danish (1978–2016), Swedish (1973–2014) and Finnish (1987–2014) Medical Birth Registers. Information on birth outcomes, atrial fibrillation and covariates was obtained from nationwide health and socioeconomic registers. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for AF according to preterm birth (&lt;37 weeks), SGA and LGA (&lt;10th and &gt;90th birth weight for gestational age percentiles, respectively) with multivariable Cox proportional hazard models and flexible parametric survival models. We conducted sibling analyses to control for unmeasured familial risk factors.

Results
Preterm birth and LGA were associated with increased AF risks in both the full population cohort and in the sibling analyses; the multivariate HRs (95% CI) from the cohort analyses were 1.53 (1.37–1.71) and 1.55 (1.44–1.65), respectively. The associations were stronger with AF in childhood than in adulthood. Children born SGA had an increased risk of AF in the first 18 years of life, but not later.

Conclusions
Individuals born preterm or LGA had an increased AF risk independently of familial confounding factors. Individuals born SGA had an increased AF risk only during childhood. Persons born prematurely or with abnormal foetal growth may benefit from early screening and prevention to reduce the risk of AF later in life.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swedish Council for Working Life and Social Research; China Scholarship Council
An observational analysis of trends in rheumatic heart disease incidence and mortality in EU15+ countries over 29 years
Authors: Ojha U , Marshall D , Salciccioli J , Al-Khayatt B , Goodall R , Borsky K , Crowley C , Shalhoub J , Hartley A 
Published: October 2022

Abstract

Background
Rheumatic heart disease (RHD) is a debilitating sequela of acute rheumatic fever (ARF), caused by Group A streptococcus (GAS) infection. Repeated episodes of ARF results in valvular damage over time. As a preventable disorder which was once common worldwide, RHD has largely been eradicated in affluent nations due to widespread availability of penicillin, improvement in socioeconomic standards and advancements in health and social infrastructures. However, it has been speculated that the global refugee crisis, especially in Europe, might contribute to a resurgence of RHD cases in these regions.

Purpose
This observational study aimed to analyse trends in RHD incidence and mortality rates in European Union 15+ (EU15+) over a 29-year period.

Methods
Data was obtained from the Global Burden of Disease database. Age-standardised mortality and incidence rates for RHD were extracted for the EU15+ countries for the years 1990–2019. Trends were subsequently analysed using Joinpoint regression analysis.

Results
Over the 29-year period, an overall declining trend in RHD incidence and mortality across EU 15+ nations was observed. The United Kingdom demonstrated the largest decrease in RHD incidence amongst females (−54.9%) and Finland amongst males (−55.3%). Both RHD incidence and mortality were higher among females compared to males across EU15+ countries over the observed period. The most recent incidence trends, starting predominantly after 2014, demonstrated a rise in RHD incidence in most countries. For both sexes, increases were seen in Australia, Belgium, Ireland, Italy, Netherlands, Norway, Sweden and USA. For males specifically, increase in RHD incidence was seen in Spain, and Finland, and for females only in Canada and Ireland. The recent increasing RHD incidence rates ranged from +0.4% to + 24.7% for males and +0.6% to +11.4% for females.

Conclusion
Whilst overall there are decreases in incidence and mortality from RHD, we observe more than half of EU15+ countries have increasing incidence trends in RHD in recent years. This increasing trend primarily started after 2014, overlapping with the start of the European migration crisis. Although speculative, disparities in access to healthcare for migrants, amongst other socioeconomic factors, may be potential causes; subsequently, further efforts by governments and public health officials are required to recognise and control the resurgence of RHD in high income nations.

Funding Acknowledgement
Type of funding sources: None.
Cardiometabolic multimorbidity and lifetime risk of atrial fibrillation among men and women
Authors: Lu Z , Ntlapto N , Tilly M , Ikram M A , De Groot N M S , Kavousi M 
Published: October 2022

Abstract

Background
Atrial fibrillation (AF) is the most common cardiac arrythmia worldwide, with an increased risk of comorbidity, and significant sex differences in pathophysiology and prognosis. Cardiometabolic disorders, including obesity, hypertension, diabetes mellitus, coronary heart disease, stroke, and heart failure commonly coexist with AF. However, the sex-specific patterns and (combined) impact of cardiometabolic disorders on the risk of new-onset AF remains largely unknown.

Purpose
To examine the association between patterns of cardiometabolic multimorbidity and new-onset AF and lifetime risk of AF incidence among men and women.

Methods
4,113 men and 5,432 women free of prevalent AF at baseline (from 1996 to 2008) from the Rotterdam Study were included. AF incidents were assessed by electrocardiograms and general practitioners' and hospital records, and followed up to January 1st, 2014. Sex-specific Cox proportional hazards regression models were used to assess the association between the amount of cardiometabolic disorders and risks of new-onset AF. Models were adjusted for traditional cardiovascular risk factors. Remaining lifetime risk for AF was estimated across the cardiometabolic multimorbidity groups at index ages of 55, 65, and ≥75 years up to age 108.

Results
Mean age at baseline was 65.5±9.4 years. Median follow-up time was 10.8 years. In the fully-adjusted model, a significant association was found between the amount of cardiometabolic disorders and incident AF among women but not men. Compared to women without cardiometabolic disorders, women with 3 (hazard ratios, 95% conference intervals: 2.17 (1.24–3.79)) and ≥4 comorbidities (4.58 (2.22–9.48)) had higher AF risks. The lifetime risk for AF was significantly increased with the number of cardiometabolic disorders among both men and women. At index age of 55 years, the lifetime risks (95% confidence interval) for AF were 25.2% (17.1–33.4), 24.2% (20.0–28.9), 27.1% (23.2–31.0), 30.0% (24.3–35.7) and 34.1% (22.4–45.7), for 0, 1, 2, 3, and ≥4 comorbid cardiometabolic disorders among men, respectively. Corresponding risks were 16.3% (6.68–25.9), 20.3% (16.3–24.3), 27.6% (24.1–31.2), 23.6% (17.8–29.4) and 33.3% (16.0–50.2) among women.

Conclusions
We observed a significant combined impact of cardiometabolic disorders on AF risk, most evidently among women. Participants with cardiometabolic multimorbidity had a significantly increased lifetime risk of AF, especially at a young index age.

Funding Acknowledgement
Type of funding sources: None.
COVID-19 pandemic and cardiovascular mortality and morbidity in the Czech Republic
Authors: Bruthans J , Rychtarikova J , Jarkovsky J 
Published: October 2022

Abstract

Background
During 2020–2021 the Czech Republic was hit by several waves of COVID-19 epidemic. 1,700,000 acquired the disease and in 39,000 this was the main cause of death, making the Czech Republic one of the most affected countries. But there was also a considerable increase in CV (cardiovascular) mortality. Due to repeated lockdowns and further restrictions the CV medical care was restricted.

Purpose
To learn about the impact of covid pandemics on CV health we performed further analyses.

Methods
We analysed the 2019–2021 data of CV mortality, CV hospital and outpatient treatments and data on risk profiles of CV patients. The analysis was based on the Czech Mortality and Hospitalization Register and Health Insurance Register (data about health care provided) from the Institute for Health Information and Statistics of the Czech Republic.

Results
The total CV mortality 2019–2021, after years of declining CV mortality, increased from 47,393 in 2019 to 51,299 in 2021 (8.24%), slightly less in women than in men. The mortality from acute coronary syndrome (ACS, I20–I24) decreased from 4287 to 4182 (2.45%), mortality for chronic CHD (I25) increased from 18,049 to 19,216 (6.47%), for pulmonary embolism (I26) from 824 to 867 (5.2%), for sudden cardiac death and heart arrest from 1143 to 1276 (increase 11.6%). Mortality for heart failure (I50) increased from 5477 to 6728 (22.8%), for stroke (I60-I64) did not change: from 5406 to 5426 (+0.4%), for arterial hypertension increased from 3923 to 4822 (22.9%). There was a shift from inhospital to outhospital CV mortality. Hospital admissions for ACS declined by 40% to recover to former numbers in the second half of 2021. In the outpatient CV care there was a decrease in clinical and laboratory investigations. Based on data from the Czech AH excellence centers of the ESH, with the first lockdown the number of patients attending centers decreased by 90% to recover nearly to previous numbers with lifted restrictions and to decrease less with further waves of epidemics. The patients continued drug treatment and home BP measurements. The laboratory controls of hyperlipidaemias and of diabetes were affected in similar way, the impact on blood pressure, lipid and diabetes control needs further analyses. There was increase in prevalence of obesity and substantial decrease in physical activities.

Conclusions
In changing CV mortality, not only morbidity and mortality caused by direct deleterious effect of covid infection on CV system (injury to heart muscle, thromboembolic complications, arrhytmias, etc), but also “colateral damage”, caused by compromised CV medical care and prevention should be considered. The most striking increase in mortality we found in heart failure and arterial hypertension, obviously conditions in need of close medical follow up. Only full restitution of complex CV treatment and prevention will restore positive trends in CV morbidity and mortality.

Funding Acknowledgement
Type of funding sources: None.