bluuebunny/crossref_metadata_2025_split huggingface dataset:
WHAT IS THE MEANING OF FINDING A WANDERING ATRIAL RHYTHM?
Authors: Paterno Carlos Alberto 
Published: June 2022

Objective:
To know if the presence of a Wandering Atrial Rhythm (WAR), from childhood, is a pathophysiological condition that should be interpreted as an early sign of hypertension.

Design and method:
For this cross-sectional retrospective study, data were collected from 251 patients with episodes of WAR, registered during 24hs-Holter monitoring. Female-male (F-M) 126–125 mean age (SD) 56 (18.4) - 52 (18.3) from 6 to 89 years. Some patients were unaware of having hypertension, others with and without antihypertensive therapy. Was registered the anthropomorphic measures, systolic and diastolic blood pressure (S-DBP), heart rate, Central Haemodynamics Parameters, and difference of augmentation index (Diff-AIx) between observed values and normal levels, evaluated by applanation tonometry according to established protocols (SphygmoCor System-PVX AtCor-Medical Australia).

Results:
In the sample of males who were overweight from the 30 s, in females overweight/obese from the 40 s. In this study, the average of S-DBP before 20 years was registered in F-M 113.9/69–113.9/67.9 mmHg, and from 20 years to octogenarians in F-M was 140/82.5–136.8/84.2 mmHg. Among the groups of the F-M from 40–20 years, the average BP was higher than 120/80 mmHg. In all groups, the Central Haemodynamics Parameters (principally end-systolic pressure) and Diff-AIx (surrogate value of arterial stiffness) were higher than normal. A minimal mitral regurgitation was found in a female-male 38%-33.6% after 18–11 years, and brief phases of atrial fibrillation were found in 23%-19.2% from 35–48 years, respectively.

Conclusions:
Wandering Atrial Rhythm appearance is more early in life than minimal mitral regurgitation, it was observed during life even in octogenarians, which is correlated with an increase of S-DBP and Central Haemodynamics Parameters, and the frequent presence of atrial fibrillation. It could be interpreted as an early sign of hypertension from childhood.
MAJOR ADVERSE EVENTS WITH THE USE OF FINERENONE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A META-ANALYSIS OF CARDIOVASCULAR OUTCOME TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Sviggou Asimina , Kordalis Vasilios , Aidinis Asterios , Imprialos Konstantinos , Stavropoulos Konstantinos , Karagiannis Asterios , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Type 2 diabetes mellitus (T2DM) is recognized as the main cause of chronic kidney disease (CKD) and end-stage renal disease worldwide, carrying enormous human and financial costs. Mineralocorticoid receptor antagonists (MRAs) have been shown to decrease proteinuria and albuminuria, posing a favorable effect against the progression of CKD. Recently, we welcomed the publication of two large randomized controlled trials (RCTs), namely FIGARO-DKD and FIDELIO-DKD, addressing the cardio-renal efficacy of finerenone, a newer MRA, in patients with T2DM. Herein we sought to assess major adverse events with the use of finerenone in patients with T2DM.

Design and method:
We pooled data from the two relevant, published RCTs with finerenone in patients with T2DM, to provide pooled effect estimates for its cardio-renal efficacy and safety. We utilized data from published reports, also searching relevant supplementary appendices for any missing data. We assessed the following safety outcomes: acute kidney injury (AKI), hospitalization due to AKI, hyperkalemia, hospitalization due to hyperkalemia, all-cause death, hospitalization for any cause

Results:
We demonstrated that finerenone increased the risk for hyperkalemia by two times compared to placebo (RR = 2.03, 95% CI; 1.82–2.26, I2 = 0%, p < 0.00001), while it also significantly increased the risk for hospitalization due to hyperkalemia (RR = 5.86, 95% CI; 2.99 – 11.47, I2 = 0%, p < 0.00001). We have also documented that finerenone did not significantly affect the risk for development of AKI (p = 0.94) or hospitalization in the context of AKI (p = 0.92). In addition, finerenone resulted in a marginally non-significant reduction in the risk for all-cause death, equal to 10% (p = 0.05).

Conclusions:
Finerenone appears to provide significant cardiovascular and renal benefits for patients with T2DM. However, extra caution is required, since hyperkalemia appears to be the most important side effect with the use of finerenone, representing also the main cause of hospitalization due to a drug side effect. Large-scale use of potassium-binding drugs, such as patiromer or zirconium, as adjunct to finerenone might be a reasonable treatment combination in high-risk patients for hyperkalemia.
THE STATE OF ELASTIC PROPERTIES OF ARTERIES IN PATIENTS WITH CHRONIC PANCREATITIS IN COMBINATION WITH ARTERIAL HYPERTENSION
Authors: Kryvoshei Volodymyr , Filippova Aleksandra 
Published: June 2022

Objective:
Arterial stiffness is considered to be an independent predictor of cardiovascular events. Factors associated with increased arterial stiffness in patients with hypertension continue to be actively studied. The aim of this study was to determine whether the presence of chronic pancreatitis is associated with arterial stiffness in patients with hypertension.

Design and method:
110 patients aged 45–65 years with chronic pancreatitis were examined. The first group consisted of patients with a combined course of chronic pancreatitis with arterial hypertension; the second group - patients with chronic pancreatitis without concomitant hypertension. All patients were examined for blood lipids. Arterial stiffness was determined by the pulse wave velocity.

Results:
The level of brachial artery augmentation index was significantly lower by 43% in patients with chronic pancreatitis in combination with arterial hypertension, while the aortic augmentation index was significantly higher by 37.6% (p < 0.01). It was found that patients of the 1st group had a significantly higher pulse wave velocity in the carotid-femoral segment in comparison with 2nd group - 9.3 [8.5;9.7] and 8.6 [8.1;8.9] respectively (p < 0.01). Significant correlations have been established between the brachial artery augmentation index and age, total cholesterol, atherogenic ratio, high and low density lipoprotein cholesterol, triglycerides, cardiovascular risk level by the SCORE scale – r = 0.39; p < 0.01; r = 0.31; p < 0.01 r = 0.34; p < 0.01; r = 0.36; p < 0.01; r = 0.42; p < 0.01; r = 0.43; p < 0.01; r = 0.36; p < 0.01 respectively.

Conclusions:
The presence of chronic panreatitis is associated with increased arterial stiffness in patients with hypertension.
GENETIC DETERMINANTS OF ACTIVATED FACTOR VII-ANTITHROMBIN COMPLEX (FVIIA-AT) PLASMA LEVELS AND MORTALITY IN PATIENTS WITH ANGIOGRAPHICALLY DEMONSTRATED CORONARY ARTERY DISEASE
Authors: Pizzolo Francesca , Veneri Mariangela , Sartori Filippo , Osti Nicola , Donini Martino , Moruzzi Sara , Mazzi Filippo , Castagna Annalisa , Udali Silvia , Pattini Patrizia , Lunghi Barbara , Baroni Marcello , Bernardi Francesco , Olivieri Oliviero , Friso Simonetta , Martinelli Nicola 
Published: June 2022

Objective:
Plasma concentration of activated factor VII (FVIIa)-antithrombin (AT) complex is considered as a marker of interaction between tissue factor (TF) and FVIIa. Data on possible genetic determinants of FVIIa-AT plasma levels are scarce until now. In this observational study we assessed 7 gene polymorphisms within 4 potential candidate genes, i.e. TF, coagulation factor 7 (F7), endothelial protein C receptor (EPCR), and LDL-receptor related protein 1 (LRP1) genes, which may contribute to the modulation of TF/FVIIa pathway.

Design and method:
Within the frame of Verona Heart Study and we selected 610 subjects (478 CAD and
132 CAD-free) for whom DNA for genotype analysis and FVIIa - ATplasma levels were available. Genotyping of TF (-603 A>G and + 5466 A>G), F7 (-402 G>A, -323 A1/A2 and R353Q), EPCR (219 A>G), and LRP1 (25 C>G) polymorphisms was performed on all the subjects. Patients with acute coronary syndromes and those taking anticoagulant drugs at enrolment were excluded.

Results:
TF -603 G>A, EPCR 219 A>G, and F7 -323 A1/A2 polymorphisms were predictors of FVIIa-AT plasma levels in adjusted linear regression models. Subjects carrying TF -603 A allele or EPCR 219 G allele had higher FVIIa-AT levels, while F7 A2 allele was associated with lower levels. Among the evaluated genotypes F7 -323 A1/A2 polymorphism was the strongest genetic determinant of FVIIa-AT variability and its association with FVIIa-AT levels was consistent with the influence on FVIIa levels. None of the polymorphisms had a different distribution between CAD and CAD-free subjects. In the follow-up analysis TF -603 G>A polymorphism was associated with mortality in CAD patients, with carriers of A allele having an increased risk of both total (sex and age-adjusted HR 1.93 with 95%CI 1.09–3.42) and cardiovascular mortality (sex and age-adjusted HR 2.54 with 95%CI 1.15–5.63), consistent with the higher FVIIa-AT levels.

Conclusions:
Polymorphisms in TF, EPCR, and F7 genes may contribute to the modulation of FVIIa-AT plasma levels. Results on the different genotypes suggest that the mechanisms originating the increase of FVIIa-AT plasma concentration may have a key role in CAD prognosis, addressing the interest on TF pathway.
ARTERIAL STIFNESS AND SYMPATHETIC OVERDRIVE IN HYPERTENSIVE PATIENTS WITH ANGINA AND NON-OBSTRUCTIVE CORONARY ARTERY DISEASE
Authors: Sakalidis Athanasios , Dimitriadis Kyriakos , Dri Eirini , Soulaidopoulos Stergios , Manta Eleni , Leontsinis Ioannis , Mantzouranis Emmanouil , Fragoulis Christos , Konstantinidis Dimitrios , Tsioufis Konstantinos 
Published: June 2022

Objective:
Existing data support that hypertension is related to sympathetic overdrive and arterial stiffness. Non-obstructive coronary artery disease (CAD) is frequent among hypertensive patients with angina. Nowadays, there are scarce evidence on the role of sympathetic nervous system (SNS) in the above population. The aim of this preliminary analysis of our study was to assess whether hypertensive patients with angina and non-obstructive CAD, hypertensives without angina and normotensive controls are characterized by different level of SNS activation and arterial stifness.

Design and method:
We studied 13 hypertensive patients with angina and non-obstructive CAD in coronary angiography [9 females, mean age: 61.2 ± 9.9 years, office blood pressure (BP): 159/96 ± 14/10 mmHg], 16 treated hypertensive patients without angina (9 females, mean age: 59.5 ± 7.5 years, office BP:142/88 mmHg) and 11 normotensive controls (8 females, mean age: 51.8 ± 11 years, BP:125/87 mmHg). In all participants, sympathetic drive was assessed by muscle sympathetic nerve activity (MSNA) estimated by microneurography and arterial stiffness, measured with heart rate-corrected aortic augmentation index (Aix@75), calculated by analyzing the ambulatory blood pressure monitoring (ABPM) waveforms.

Results:
Hypertensives with angina and non-obstructive CAD (n = 13) compared to hypertensive patients without angina (n = 16) and normotensive individuals (n = 11) exhibited higher levels of MSNA (59.6 ± 6.6 vs 43 ± 8.4 vs 45 ± 9.5 bursts per minute, respectively; p < 0.01 for all) and 24-h BP (146/85 ± 18/11 vs 141/83 ± 7/10 vs 125/81 ± 7/6 mmHg, respectively; p < 0.001 for all). Hypertensives with and without angina did not differ regarding renal function based on eGFR (p = NS). Moreover, there were no differences in left ventricular mass index, total cholesterol and low-density lipoprotein between hypertensive patients with and without angina and no gender related effects on MSNA and Aix@75 (p = NS). Furthermore, patients with angina and non-obstructive CAD patients compared to hypertensives without angina were characterized by increased levels of Aix@75 (36.13 ± 7.4 vs 22.5 ± 11.7, p < 0.05).

Conclusions:
Patients with hypertension and non-obstructive CAD are characterized by higher MSNA and increased Aix levels compared to hypertensives without angina and normotensive controls. These preliminary results suggest that therapies targeting sympathetic overdrive and vascular stiffening could provide additional clinical benefit in this special category of hypertensive patients.
SMOKING PARADOX IN HYPERTENSIVE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION PATIENTS: 25-YEAR POPULATION-BASED STUDY
Authors: Ghrab Aiman , Chamtouri Ikram , Louati Molka , Abdallah Wajih , Jomaa Walid , Hamda Khaldoun Ben , Faouzi Maatouk 
Published: June 2022

Objective:
The main objective of our paper is to study the effect of smoking status on the outcomes of hypertensive patients presenting with ST-segment elevation myocardial infraction.

Design and method:
Patients with STEMI who were hospitalised in our coronary care unit during a 25-year period (since 1994) were included in a specific registry. Their in-hospital and follow-up data have been regularly updated.
We selected only patients with known or newly diagnosed hypertension in our study. Then, we divided the population into two groups according to their smoking status. The primary endpoints were death, rehospitalization, non-fatal myocardial infarction. The secondary endpoints were in-hospital mortality, left ventricular dysfunction, life-threatening arrythmias, prolonged hospital stay and bleeding complications.

Results:
A total of 1609 patients were included during the study period. Among 489 patients having hypertension, 45.5% were smokers with male sex predominance (sex ratio 11/1). Baseline characteristics are detailed in table 1. Among the primary endpoint: One-year mortality was significantly more important in the non-smokers group (p = 0.012): there was no significant difference in non-fatal MI (p = 0,142) and in all cause rehospitalization (p = 0.093). As for the secondary endpoints, there was no significant difference between the two groups except for the in-hospital death (p < 0.01). The results of the endpoints are detailed in table 1.

Conclusions:
Smoking seems to have a beneficial effect on the outcomes of STEMI of hypertensive patients.
COVID-19 AND CARDIOVASCULAR SYSTEM: NOT ONLY HEART BUT ALSO VASCULAR. THE EFFECTS OF THE INFECTION ON ARTERIAL STIFFNESS
Authors: Maloberti Alessandro , Gualini Elena , Scarpellini Sara , Algeri Michela , Biolcati Marco , Grasso Enzo , Tognola Chiara , Moreo Antonella , Fabbri Saverio , Giannattasio Cristina 
Published: June 2022

Objective:
SARS-CoV-2 determines a framework of multi-organ dysfunction that can involve the cardiovascular system creating damages of different nature. Among these, endothelial damage could play a key role in increasing arterial stiffness and thus the cardiovascular risk of infected patients. The aim of this study is to evaluate the Pulse Wave Velocity (PWV) of a population of patients after recovery from infection and to compare them with those of a group affected by arterial hypertension.

Design and method:
This prospective observational monocentric study involved 143 patients with previous diagnosis of Covid-19 who undergone PWV measurement during the follow-up at a median time of 3.8 months after the infection. These patients were compared to a population of 143 patients with hypertension matched by age, sex, Systolic Blood Pressure values and Body Mass Index.

Results:
PWV values were higher in Covid-19 group comparing to hypertension group (10.5 ± 3.0 m/s VS 8.9 ± 2.5 m/s). Furthermore, there is a correlation between higher PWV values and lower values of SpO2% at time of admission at the Emergency Department. (R = -0.302; p < 0.001).

Conclusions:
SARS-CoV-2 infection seems related to increased PWV values. Moreover, higher arterial stiffness seems correlated to a worse oxygen saturation in Emergency Department. More studies with longer follow-up time are necessary to establish whether the vascular damage is reversible and whether it correlates with an increase of long-term cardiovascular risk.
CONTINUOUS REMOTE PATIENT MONITORING SHOWS EARLY CARDIOVASCULAR CHANGES IN COVID-19 PATIENTS
Authors: Eisenkraft Arik 
Published: June 2022

Objective:
COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. This study aimed to analyze the trajectories of key vitals amongst hospitalized COVID-19 patients using a chest-patch wearable medical-grade monitor providing continuous remote patient monitoring of numerous vital signs.

Design and method:
This retrospective multicenter observational cohort study was conducted in five COVID-19 isolation units. 492 COVID-19 patients were included in the final analysis. Physiological parameters were measured every 15 minutes.

Results:
More than 3 million measurements were collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. Cardiovascular deterioration appeared early after admission and in parallel with changes in the respiratory parameters, showing a significant difference in trajectories within sub-populations at high risk.

Conclusions:
Early detection of cardiovascular deterioration of COVID-19 patients is achievable when using frequent remote patient monitoring.
AORTIC STIFFNESS AND INDEXES OF DISEASE SEVERITY IN SUBJECTS WITH PREVIOUS COVID-19 PNEUMONIA: A FOLLOW-UP STUDY
Authors: Baiano Valeria , Catena Cristiana , Bulfone Luca , Scandolin Laura , Vacca Antonio , Brosolo Gabriele , Da Porto Andrea , Cavarape Alessandro , Colussi Gianluca , Bertin Nicole , Vivarelli Cinzia , Sechi Leonardo 
Published: June 2022

Objective:
Up to date the possibility of a vascular damage due to COVID-19 pneumonia is a not clarified. We searched for relationships between the carotid-femoral pulse wave velocity (cfPWV) and clinical and biochemical markers of severity of the infectious disease, after hospital discharge, in a group of patients who had been admitted in care units.

Design and method:
In 69 subjects (age 58 ± 13 years, 36 males), previously admitted in hospital because of COVID-19 pneumonia, we evaluated at the time of hospital admission anthropometric parameters, blood pressure, history of arterial hypertension or other diseases, drugs, smoking and alcohol habit, physical activity level, and indexes of infectious disease severity, such as the SIMEU score, need for invasive oxygen delivery, PaO2, PaCo2, inflammatory markers such as white blood cells count, levels of proadrenomedulline (proADM), reactive C protein, procalcitonin, IL- 6, glomerular filtration rate (GFR), troponin, mioglobin, B natriuretic peptide. After an average 2 months follow-up the cfPWV was measured.

Results:
At univariate analysis the cfPWV was significantly and positively related to age (r = 0.454, P < 0.001), body mass index (r = 0.436, P = 0.016), waist circumference (r = 0.345, P = 0.004), levels of plasma glucose (r = 0.430, P = 0.001), proADM (r = 0.456, P = 0.006), IL-6 (r = 0.280, P = 0.037), mioglobin (r = 0.443, P = 0.001) and inversely related to GFR (r = -0.289, P = 0.023). The cfPWV was higher in diabetics subjects than in non-diabetics (P = 0.011), and in patients who had needed invasive oxygen support (P = 0.044). There was no difference in cfPWV in patients with or without history of arterial hypertension or with different blood pressure levels at admission. At multivariate analysis the cfPWV was independently associated with invasive oxygen support (B = 0.168, P = 0.012), body mass index (B = 0.180, P = 0.001), waist circumference (B = 0.162, P = 0.002), GFR (B = 0.078, P = 0.008), and proADM levels (B = 0.161, P = 0.003).

Conclusions:
In patients who recovered from COVID-19 pneumonia the aortic stiffness is associated with severity of disease and levels of proADM, but not with history of hypertension. Patients with more higher proADM levels in acute phase of the infectious disease could need a longer follow-up evaluation of the CFPWV after the recovering from disease to search for long time vascular damage.
RISK FACTORS FOR POST-COVID-19 SYNDROME DEVELOPMENT IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Makeeva Tatiana , Zbyshevskaya Elizaveta , Bitakova Fatima , Butaev Tamerlan , Saiganov Sergey , Talibov Faiz , Mayer Mark 
Published: June 2022

Objective:
To determine risk factors for post-COVID-19 syndrome development in patients with arterial hypertension (AH).

Design and method:
A total of 81 patients with AH were examined 3–6 months after COVID-19. 48 people (group 1: 27 women, 21 men) suffered from SARS-CoV-2 pneumonia with lungs lesion from 15% to 74%. The patients’ age was 18–87 years old (65 years old on average). In 38 patients chronic ischemic heart disease (IHD) was diagnosed; in 18 – myocardial infarction (MI); in 10 – permanent atrial fibrillation (AF); in 12 – AF paroxysms. 33 people (group 2: 18 women, 15 men) suffered from COVID-19 in the form of an acute respiratory illness without pneumonia. These patients were aged from 41 to 74 (56.9 years old on average). 25 patients had coronary artery disease; 2 – MI; 2 – permanent AF; 4 – AF paroxysms.

Results:
Comparing to group 2, in group 1 the patients had higher blood pressure; higher left atrial volume index (LAVI) (35.1 ± 3.3 ml/m2 vs. 29.6 ± 3.2 ml/m2; p < 0.05); higher left ventricular (LV) end-diastolic volume index (EDVI) (76.1 ± 8.8 ml/m2 vs. 62.6 ± 10.3 ml/m2; p < 0.05); lower LV ejection fraction (EF) (56.1 ± 8.1% vs. 63.2 ± 3.9%; p < 0.05). In 7 group 1 patients, an increase in the frequency of AF attacks was detected. In group 1 symptoms of inflammation persisted for a long time: higher levels of C-reactive protein (15 ± 4.9 mg/l vs. 5.5 ± 3.8 mg/l), of blood ferritin (275 ± 106.3 mcg/l vs. 155.6 ± 85.8 mcg/l; p < 0.05), of D-dimer (919.3 ± 77.1 ng/ml vs. 609 ± 87.4 ng/ml; p < 0.05) as well as of total cholesterol (5.8 ± 1.2 mmol/l vs. 4.9 ± 1.1 mmol/l; p < 0.05) and of LDL (4.1 ± 1.1 mmol/l vs. 3.2 ± 1.3 mmol/l; p < 0.05).

Conclusions:
The revealed risk factors were high blood pressure, an increase in LAVI and LV EDVI, a decrease in LVEF, an increase in LDL, previous MI, and an increase in the frequency of AF paroxysms.