bluuebunny/crossref_metadata_2025_split huggingface dataset:
RENAL SYMPATHETIC DENERVATION AS TREATMENT FOR REFRACTORY HYPERTENSION: CASE REPORT
Authors: Paffer Matheus Toscano , Paffer Pedro Toscano , Procópio Arthur , Ribeiro Fernando , Montenegro Gabriela , Montenegro Patrícia 
Published: June 2022

Objective:
Among hypertensive patients, a portion is considered refractory hypertension, where the pressure remains uncontrolled with the use of five or more antihypertensive drugs. For such patients with refractory hypertension, a new hemodynamic procedure has been gaining ground in recent years, being performed in selected cases, the renal sympathetic denervation. We present the case of Mr. GAS, 55 years old.

Design and method:
GAS, male, 55 years old, BMI of 33.95, hypertensive for a long, was refractory to drug treatment, using 7 antihypertensive drugs. At the admission, laboratory tests, he presented potassium of 4, sodium of 141, blood urea nitrogen of 31 and creatinine of 1.4. The admission BP was 130x80 mmHg. On September 25, 2021, the procedure was performed through percutaneous access in the right femoral artery, up to the renal arteries, with the Simplicity catheter. Thirty-one ablations were performed in the right kidney and 28 ablations in the left kidney. Soon after the procedure, the patient had a blood pressure of 116x69mmHg and at discharge it was 120x80mmHg. The patient was discharged with 3 antihypertensive drugs and maintains follow-up with maintenance of the discharge prescription so far.

Results:
Hypertension refractory to drug treatment showed the need for an alternative treatment leading to the development of radiofrequency renal denervation. The procedure consists of applying radiofrequency in the lumen of the renal arteries, leading to thermal rupture of the postganglionic sympathetic nerves that innervate the kidneys. Its goal is to reduce the renal efferent activity, with an increase in blood flow in the kidneys, decreasing the activation of the renin-angiotensin-aldosterone system and water retention.

Conclusions:
In the present report, the patient on admission was not out of control, but also had a high antihypertensive load, in order to maintain pressure control. Renal sympathetic denervation can provide a better quality of life to the patient, since in some cases, it can reduce the amount of medication and also the chance of future problems, such as target organ damage, heart attack and stroke. Proving to be a good option, in selected cases in patients with refractory hypertension.
ASSOCIATION BETWEEN THE REFLECTION MAGNITUDE AND BLOOD-PRESSURE IN A MULTI-ETHNIC COHORT: THE HELIUS STUDY
Authors: Bouwmeester Thomas , Van De Velde Lennart , Galenkamp Henrike , Postema Pieter G. , Westerhof Berend E. , van den Born Bert-Jan H. , Collard Didier 
Published: June 2022

Objective:
The reflection magnitude (RM), the ratio of the amplitudes of the backward and forward central arterial pressure waves, has been shown to be predictive for future cardiovascular events, but the association between blood pressure (BP) and RM remains unknown. We aimed to assess the association between RM, BP and hypertension in a large multi-ethnic population-based cohort study.

Design and method:
We assessed RM in 10 195 individuals of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged between 18–70 years (54.2% female) participating in the HEalthy Life in an Urban Setting (HELIUS) study. To determine RM, central arterial pressure and flow were reconstructed from non-invasive finger BP measurements using a generalized transfer function and Windkessel model, whereafter wave separation was performed (Fig 1, panel A & B). Hypertension was defined based on office-BP and use of BP lowering medication. Associations between RM and systolic- and diastolic BP, hypertension, and hypertension mediated end-organ damage were assessed using regression models with correction for age, height, ethnicity and an interaction term for sex.

Results:
Mean RM was 62.5% (SD 8.0) in men and 63.8% (SD 8.1) in women. For every 10 mmHg increase in systolic BP, RM increased linearly by 1.35 (95% CI 1.23–1.46) from 120 mmHg onwards, while for every 10 mmHg increase in diastolic BP above 80 mmHg RM increased by 1.99 (95% CI 1.61 – 2.38) (Fig 1, panel C & D). RM was 2.40 (95% CI 2.04–2.76) higher in hypertensive men and 3.82 (95% CI 3.46–4.19) higher in hypertensive women compared to normotensive men and women. RM was 1.64 (95% CI 1.09–2.20) and 0.94 (95% CI 0.37–1.52) higher in hypertensive men and women with ECG-based left ventricular hypertrophy or increased albuminuria compared to hypertensive men and women without hypertensive organ damage. Following correction for height ethnic and sex differences in RM were attenuated, however the relation with BP did not change.

Conclusions:
Hypertension is associated with a higher RM in men and women of different ethnic origins, and may, in part, explain disparities in hypertension associated cardiovascular risk.
VALIDATION AND FEASIBILITY OF AN AUTOMATED SYSTEM FOR THE ASSESSMENT OF VASCULAR STRUCTURE AND MECHANICAL PROPERTIES IN THE DIGITAL ARTERIES THROUGH ULTRA-HIGH FREQUENCY ULTRASOUND
Authors: Poli Federica , Fortier Catherine , Khettab Hakim , Faita Francesco , Vitali Saverio , Aringhieri Giacomo , Ghiadoni Lorenzo , Taddei Stefano , Amar Laurence , Lorthioir Aurelien , Boutouyrie Pierre , Bruno Rosa Maria 
Published: June 2022

Objective:
The validation of a semi-automatic software to quantify vascular structure and mechanical properties of digital arteries acquired using ultra high frequency ultrasound (UHFUS).

Design and method:
UHFUS 5-second longitudinal scans of digital arteries of 15 patients with vascular diseases and 15 healthy controls were obtained by VevoMD (70 MHz probe, FUJIFILM, VisualSonics, Toronto, Canada) and analyzed using Carotid Studio (Quipu Srl, Pisa, Italy), using as reference technique a manual measurement in a Matlab interface (MathWorks, R2019b). Agreement between the two techniques for diameter, distension and intima-media thickness (IMT) was evaluated using Bland-Altman analyses; inter- and intra-operator reproducibility was carried out using coefficients of variation (CV).

Results:
No trend or significant bias were observed between Carotid Studio and Matlab manual analysis for diameter, distension, and IMT. All limits of agreement were acceptable. Intra-observer CV of diastolic diameter and IMT were 4.1 %, and 4.2 % respectively. Inter-observer CV for diastolic diameter, and IMT were 7.3 % and 5.4% respectively. Intra- and inter- observer CV for distension were higher (25.7 % and 26.7 % respectively).

Conclusions:
Carotid Studio software is a valid and reproducible tool for the assessment of vascular structure and mechanical properties in UHFUS scans of digital arteries.
GLOBAL LOGITUDINAL STRAIN IN HYPERTENSIVE DISORDERS DURING PREGNANCY AS A PREDICTOR FOR EARLY DETECTION OF SUBCLINICAL LEFT VENTRICULAR DYSFUNCTION
Authors: Farhan Hasan Ali , Ybeer Hanaa Falah 
Published: June 2022

Objective:
To identify the role of left ventricular (LV) global longitudinal strain (GLS) in the early diagnosis of LV dysfunction among pregnant women with hypertensive disorders.

Design and method:
Cross-sectional study was conducted at one of the heart centers in Iraq from November 2020 – July 2021, included pregnant women with hypertensive disorder. Echocardiographic data was collected using GE (Vivid E9) diagnostic ultrasound equipment with (M5ScD) MHz transducer. Pregnant women were classified into three groups according to the hypertensive disorders: chronic hypertension (HTN), gestational HTN, and preeclampsia (PE).

Results:
A 60 pregnant women were enrolled in the study, mean age (32.7 ± 5.8) years, 25% with chronic HTN, 33% with gestational HTN, and 42% with PE. The mean of systolic and diastolic blood pressure were (130.1 ± 10.8) mmHg and (79 ± 7.9) mmHg; respectively, 90% were on medication, and 18% were diabetic. See Table 1.

Conclusions:
Echocardiography is a valuable tool in diagnosis of LV hypertrophy and diastolic dysfunction in all types of hypertensive disorders during pregnancy. Subclinical cardiac dysfunction in pregnancy related hypertension and preeclampsia can be early detected by impaired GLS.
ASTRAGALOSIDE IV INHIBITS H2O2-INDUCED APOPTOSIS IN H9C2 CELLS BY ATTENUATING OXIDATIVE STRESS AND MITOCHONDRIAL DAMAGE
Authors: Qi Miaomiao , Wang Qiongying , Sun Runmin , Tian Li , Yu Jing 
Published: June 2022

Objective:
To investigate the effects and mechanisms of As-IV on H2O2-induced apoptosis in H9c2 cells.

Design and method:
H9c2 cells were divided into three groups, including normal control group (cultured without intervention), H2O2 group (cultured with 200umol/L H2O2 for 2 hours), As-IV group (cultured with 100umol/L As-IV for 1 hour), As-IV with H2O2 group (pretreated with 100umol/L As-IV for 1 hour, then incubated with H2O2 for 2 hours). FITC/PI and DCFH-DA are stained to examine levels of apoptosis and ROS receptively. Levels of SOD and MDA were measured. Stained with JC-1 probe to observe the change of mitochondrial membrane potential (MMP). Western-blot was detected to analyze the expression of Drp-1.

Results:
1. The apoptosis rate of H2O2 group ((13.22 ± 3.17 vs 40.55 ± 13.74)%, P < 0.05) was significantly higher than that of control group, which was lower in As-IV with H2O2 group((23.43 ± 4.3 vs 40.55 ± 13.74) %, P < 0.05). 2. The ROS levels were higher in H2O2 group than control group((73.53 ± 5.33 vs 39.02 ± 7.90) %, P < 0.05), which were significant reduced in As-IV with H2O2 group((57.6 ± 4.63 vs 73.53 ± 5.33) %, P < 0.05) Meanwhile, the activity of MDA was increased and the activity of SOD was decreased in H2O2 group compared with that in control group((10.97 ± 0.56 vs 4.85 ± 0.55) nmol/mL, P < 0.05), ((1192.23 ± 341.59 vs 2710.95 ± 274.32)U/L, P < 0.05). Compared with H2O2 group, As-IV with H2O2 group significantly decrease the activity of MDA and increase the activity of SOD ((6.58 ± 0.79 vs 10.97 ± 0.56) nmol/mL, P < 0.05), ((1984.66 ± 188.81 vs 1192.23 ± 341.59) U/L, P < 0.05). 3.MMP was lower and the expression of Drp1 was higher in H2O2 group than that in control group ((0.31 ± 0.01 vs 1.52 ± 0.25) %, P < 0.05), ((0.86 ± 0.003 vs 0.45 ± 0.004) %, P < 0.05). Compared with H2O2 group, MMP was significantly increased and the expression of Drp1 was downregulated ((0.65 ± 0.38 vs 0.31 ± 0.01) %, P < 0.05), ((0.72 ± 0.005 vs 0.86 ± 0.003) %, P < 0.05).

Conclusions:
As-IV exerts protective effects on H2O2-induced apoptosis by attenuating oxidative stress and mitochondrial damage.
PATIENT PREFERENCE FOR RENAL DENERVATION THERAPY IN HYPERTENSION: A CROSS-SECTIONAL SURVEY IN CHENGDU, CHINA
Authors: Zhipeng Zhang , Xiaoping Chen 
Published: June 2022

Objective:
Recent new-generation randomized controlled trials have shown good efficiency and safety of catheter-based renal denervation (RDN) in patients on and off antihypertensive medications. We aimed to investigate patients’ preferences for RDN therapy in hypertension in Chengdu, China.

Design and method:
A questionnaire-based cross-sectional study was conducted from August 2020 to December 2020. Information on demographics, duration of hypertension, medication or not, medication regimen, duration on medication, maximal and minimal blood pressure levels, self-reported comorbidities, their willingness to choose RDN as blood pressure control strategy, determinants of the choice and their expectations for RDN were collected and analyzed.

Results:
A total of 485 patients were interviewed and 402 questionnaires were considered eligible for analysis. Mean age of the participants was 61 years, 53.9% of them were males. 32.6% patients indicated a willingness to choose RDN as blood pressure control strategy, the proportion was 34.7% in patients already on medication and 23.3% in patients not on medication. Patients willing to choose RDN treatment tended to be younger males, more obese, have higher levels of office blood pressure, take more antihypertensive pills and have larger proportions of cardiovascular comorbidities. Patients’ perspectives on RDN did not depend on their education levels. Physicians’ recommendations accounted for the reasons to choose RDN in vast majority of patients, followed by that patients could take less pills after RDN. 47.3% patients would choose RDN treatment if the procedure could decrease their blood pressure by over 20mmHg and no patient would choose the device treatment if their blood pressure decreased by less than 5 mmHg. 56.5% patients expected that they could take one less pill after RDN. Appropriately 70% patients expected RDN could persistently decrease blood pressure for at least 15 years.

Conclusions:
Among hypertensive patients in Chengdu, appropriately one-third were willing to choose RDN as blood pressure control strategy. These patients tended to be younger males, take more antihypertensive drugs and have concomitant metabolic disorders. Patients’ perspectives on RDN did not depend on their education levels and their expectations for RDN were high.
LEPTIN AS A PREDICTOR OF CARDIOPROTECTIVE EFFICIENCY OF RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION AND TYPE 2 DIABETES MELLITUS
Authors: Manukyan Musheg , Falkovskaya Alla , Mordovin Victor , Zyubanova Irina , Tsoy Ekaterina , Pekarskiy Stanislav , Ryabova Tamara , Khunkhinova Simzhit , Vtorushina Anastasia , Gusakova Anna , Suslova Tatiana 
Published: June 2022

Objective:
To evaluate serum leptin level before renal denervation (RDN) and to assess whether this baseline metabolic marker predicts cardioprotective efficacy in patients with resistant hypertension (RHTN) and type 2 diabetes mellitus (T2DM).

Design and method:
The study included 25 patients with RHTN and T2DM (mean age 60.9 ± 7.1 years, 16 women, mean 24-hour (24-h) blood pressure (BP) (systolic/diastolic) 158.8 ± 16.5/81.1 ± 13.1 mm Hg, mean HbA1c 7.4 ± 1.5%). All patients were enrolled in the prospective interventional study with RDN (NCT02667912 and NCT01499810 at ClinicalTrials.gov). Office BP and ABPM, tissue Doppler echocardiography with assessment of diastolic function, serum leptin level were performed at baseline and 6-months after RDN. Twenty patients completed a 6-month follow-up.

Results:
RDN led to a significant reduction in systolic and diastolic 24-h BP (-13.4/-7.6 mm Hg, p = 0.001/0.002).
The baseline leptin level correlated with the mean E/e ‘ratio at baseline (R = 0.52, p = 0.015) and its dynamics after 6 months (R = 0.71, p = 0.001). Depending on the degree of decrease in average E/e’ ratio, the patients were retrospectively divided into 2 groups: 1st (with improvement) (persons with a decrease in average E/e’ ratio by 1 unit or more, n = 10 (50%)) and 2nd (without improvement) (with a lesser degree of decrease in average E/e’ ratio). Initially, the pts of 1st group not differed from those of 2nd group by age, BP and HbA1c level. At the same time, pts of the 1st group had higher baseline leptin level (60.4 ± 24.05 and 35.8 ± 9.82 ng/ml, p = 0.008) than pts of the 2nd group. A ROC analysis showed that the best cut-off value of the leptin level is 47.4 ng/ml with 70% sensitivity and 85% specificity (AUC: 0.84; 95% CI:0.64–1.04; p = 0.001).

Conclusions:
Estimation of the leptin allows predicting the cardioprotective efficacy of renal denervation in patients with resistant hypertension and type 2 diabetes mellitus.
BRAIN OXYGENATION ASSESSED BY NEAR-INFRARED SPECTROSCOPY DURING A MENTAL TASK AND A MILD PHYSICAL STRESS IN HEMODIALYSIS AND PERITONEAL DIALYSIS
Authors: Faitatzidou Danai , Dipla Konstantina , Zafeiridis Andreas , Theodorakopoulou Marieta , Koutlas Aggelos , Polychronidou Georgia , Chalkidis Georgios , Dimitriadis Chrysostomos , Tsouchnikas Ioannis , Giamalis Panagiotis , Papagianni Aikaterini , Sarafidis Pantelis 
Published: June 2022

Objective:
Cognitive impairment is highly prevalent in end-stage kidney disease (ESKD) individuals. Brain oxygenation is a parameter that plays major role in cognitive function. This study aimed to examine for the first time changes in brain oxygenation during a mental and a mild physical task in hemodialysis (HD) and peritoneal dialysis (PD) patients.

Design and method:
63 ESKD patients (>18 years old) were enrolled in this cross-sectional study. Patients were allocated in two groups according to dialysis modality (n = 29 HD and n = 34 PD). All participants underwent a mental (countdown from 100 to 0 by 7, performed twice) and a mild physical task (a 3-min intermittent handgrip exercise at 35% of maximal handgrip strength). Changes in brain oxygenation [oxy- (O2Hb), deoxy- (HHb) and total- (tHb) hemoglobin] during the two tasks were continuously recorded via near-infrared spectroscopy (NIRS, Artinis).

Results:
Age, sex, and dialysis vintage did not differ between the two groups. The average response in brain oxygenation during the mental task (O2Hb change from rest: 1.51 ± 1.68 vs 1.60 ± 1.82 micromol/l, in HD and PD, respectively, p = 0.841), as well as the duration needed for task completion (191.53 ± 124.27 vs 200.19 ± 118.84 s, p = 0.781) were similar between groups. Furthermore, the average response in brain oxygenation during the handgrip exercise also did not differ between the groups (O2Hb change 1.20 ± 1.03 vs 1.49 ± 0.95 micromol/l, respectively, p = 0.262). In the total cohort, the average response in brain oxygenation during handgrip exercise was inversely correlated with dialysis vintage (p < 0.05).

Conclusions:
Dialysis modality does not appear to have an impact on brain oxygenation, as HD and PD patients presented similar responses during a mental and a mild physical task. Dialysis vintage may negatively affect brain oxygenation in ESKD individuals.
ASSOCIATION OF LEFT VENTRICULAR MASS INDEX WITH ALL-CAUSE MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Manousopoulos Konstantinos , Spiliopoulou Sotiria , Tsoutsoura Nefeli , Lykka Aikaterini , Dimitriou Athina , Manios Efstathios 
Published: June 2022

Objective:
Although the association of left ventricular mass (LVM) with outcome is well established in dialysis patients, the importance of this association in pre-dialysis chronic kidney disease (CKD) populations is not well documented. Aim of the study was to examine the association of LVM index with all-cause mortality in CKD patients.

Design and method:
Our study population consisted of 126 patients with CKD stages 3–4, referred for evaluation at the Hypertension Unit of our department. The patients underwent office blood pressure measurements and echocardiographic measurements. LVM was estimated using Devereux’s formula according to the Penn Convention Protocol. LVM index was defined as LVM divided by the body surface area. Cox regression analysis was used to evaluate the association between LVM index and all-cause mortality.

Results:
After a median follow-up of 3 years, 11 cardiovascular and 16 non-cardiovascular deaths occurred. The study population consisted of 95 men (75%). Mean age was 70 years, mean office BP was 143/76 mmHg. The multivariate Cox regression analyses revealed that LVM index was independently associated with all-cause mortality (HR: 1.011, 95%CI 1.000–1.023, p = 0.049) after adjustment for age, sex, history of diabetes mellitus and hyperlipidemia, smoking, antihypertensive treatment and mean office blood pressure values.

Conclusions:
Left ventricular mass index is an independent predictor of all-cause mortality in hypertensive patients with CKD.
HIGH FRUCTOSE DIET INCREASES RENAL CHREBP-BETA EXPRESSION AND LEADS TO INTRA-RENAL FAT ACCUMULATION IN A METABOLIC-LIKE SYNDROME RAT MODEL
Authors: Leibowitz Avshalom , Bier Ariel , Shpira Eli , Khashab Rawan , Sharabi Yehonatan , Grossman Ehud 
Published: June 2022

Objective:
A high fructose diet induces metabolic syndrome (MeS) which includes ectopic lipid accumulation, such as fatty liver. MeS is also associated with chronic kidney disease (CKD). A novel isoform of ChREBP, ChREBPb, was recently reported to regulate liver fructose metabolism that leads to fatty liver development.
The aim of this study was to evaluate fructose metabolism in the kidney and whether this metabolism leads to intra-renal fat accumulation.

Design and method:
In-vivo: Sprague Dawley rats were fed either normal chow (Ctrl) or a high fructose diet (HFrD) for eight weeks. Blood pressure, fasting blood glucose and triglycerides were measured. The kidneys were harvested for ChREBPb and de novo lipogenesis (DNL) gene expression, triglyceride content and histopathology staining.
In-vitro: HK2 (human kidney) cells were treated with fructose for 48 h and gene expression for ChREBPb and DNL were determined.

Results:
The HFrD rats exhibited higher blood pressure (152 vs. 138 mmHg), glucose (146 vs. 127 mg/dl) and triglyceride (280 vs. 143 mg/dl) levels. Kidneys weight normalized to body weight of the HFrD rats were significant higher than the Ctrl (7.32 vs. 5.87). The difference can be explained by the higher triglyceride content in the HFrD kidneys (16.4 vs. 12.4 mg). Oil red staining revealed higher lipid droplet formation in the HFrD kidneys, which was also supported by higher adipophilin mRNA expression. The expression level of ChREBPb and its downstream genes, scd and fasn, were elevated in the HFrD kidney.
Treating HK2 cells with 40 mM fructose increased ChREBPb expression levels. Its downstream genes, fasn and acc, also showed an increasing trend. In three out of five experiments, adipophilin was increased as well.

Conclusions:
In this study, we demonstrated that fructose consumption leads to intra-renal lipid accumulation and to the formation of a fatty kidney. This suggests a potential mechanism that can partially explain CKD development in fructose induced MeS.