bluuebunny/crossref_metadata_2025_split huggingface dataset:
VASCULAR OR CARDIAC? DIFFERENT TARGET ORGAN DAMAGE IN HYPERTENSIVE PATIENTS WITH OR WITHOUT CHRONIC KIDNEY DISEASE
Authors: Meazza Roberto , Rossi Marilisa , Guareschi Alessandro , Iaci Gioella , Soraruff Nora , Villarini Anna , Carugo Stefano 
Published: June 2022

Objective:
The aim of our study was to evaluate different types of target organ damage (TOD) in hypertensive patients, with or without chronic kidney disease (CKD).

Design and method:
90 hypertensive patients were enrolled from our Hypertension Center: 48 with normal renal function and 42 with CKD. We performed a complete echocardiographic study in all subjects in order to evaluate cardiac damage; non-mydriatic digital fundus oculi examination and carotid-femoral PWV to assess, respectively, small vessels and large arteries alterations.
We considered Left Ventricular Mass index (LVMi) and h/r index to determine Left Ventricular Hypertrophy (LVH) or remodeling, Arteriolar-Venular Ratio (AVR) to evaluate retinal vessels and carotid-femoral PWV as a measure of arterial stiffness.

Results:
Both groups showed abnormal values of PWV, but significantly higher in CKD group (13.72 ± 1.3 vs 9.78 ± 0.491, p = 0.0166). Mean AVR values were abnormal only in CKD hypertensive, with a significant difference compared to simply hypertensive patients (0.75 ± 0.006 vs 0.84 ± 0.020, p = 0.0001). In the echocardiographic examination, no statistically significant alterations were found between the two groups (LVMi 118.04 ± 4.870 vs 113.42 ± 3.440, p = 0.123; h/r 0.42 ± 0.119 vs 0.44 ± 0.010, p = 0.454).

Conclusions:
Our results confirm that TOD is different in hypertensive patients with CKD. In these patients the target is essentially vascular, affecting either big and small vessels. Hypertensive patients without CKD showed a more typical cardiac TOD with an increase of left ventricular remodeling and hypertrophy.
The assessment of vascular damage pays an essential role in TOD detection, so the use of PWV and the evaluation of retinal vessels should be always performed.
EFFECTS OF CAFFEINE ON BLOOD PRESSURE AND HEART RATE VARIABILITY AT REST AND DURING COLD PRESSOR TEST
Authors: Ketelhut Sascha , Gassner Carole , Nigg Claudio 
Published: June 2022

Objective:
Caffeine is the most widely consumed pharmacologically active substance in the world and is found in a variety of foods, and beverages. Even though the acute and long-term effects on the cardiovascular system are widely studied, the accumulated effects of caffeine and physiological stress are not clear. This study aimed to characterize the acute effects of caffeine on blood pressure (BP), heart rate (HR), and heart rate variability (HRV) at rest and during a cold pressor test (CPT) in healthy individuals.

Design and method:
Nineteen normotensive male participants (25 ± 2 years, BMI 24 ± 3) were enrolled in this double-blinded, placebo-controlled trial. Participants randomly received both a placebo (PL) and a caffeinated (3 mg/kg) drink (CAF) on two separate days. Before and following a 45-minute wash-in period BP, HR, and HRV were measured at supine rest and during a CPT. During the CPT, participants immersed their right hand into cold water (5C) for two minutes.

Results:
There were no significant differences in resting systolic (130 ± 13 mmHg vs. 125 ± 12 mmHg, p = .187), and diastolic (76 ± 7 mmHg vs. 73 ± 8 mmHg, p = .236) BP, as well as in HR (61 ± 10 bpm vs. 60 ± 8 bpm, p = .531), RMSSD (74 ± 36 ms vs. 83 ± 40 ms, p = .217), and Mean RR (1014 ± 155 ms vs. 1034 ± 140 ms, p = .570) between CAF and PL. The same was true for systolic (152 ± 14 mmHg vs. 151 ± 14 mmHg, p = .785) and diastolic (95 ± 11 mmHg vs. 96 ± 13 mmHg, p = .236) BP during CPT. However, CAF supplementation resulted in a significantly lower HR (62 ± 8 bpm vs. 73 ± 18 bpm, p = .013), and a significantly higher RMSSD (83 ± 51 ms vs. 55 ± 28 ms, p = .004), and Mean RR (1005 ± 158 ms vs. 867 ± 152 ms, p < .001) during CPT compared to PL.

Conclusions:
The often reported acute increase in BP after caffeine supplementation could not be confirmed in this cohort of normotensive young adults. Caffeine supplementation neither increased nor blunted BP response during the CPT. However, HR was significantly lower, and parasympathetic HRV indices were significantly higher during the CPT after consuming CAF. Thus, caffeine seems to attenuate stress response with a shift in sympathovagal control toward enhanced parasympathetic activity.
NEPHROPROTECTIVE EFFECT OF RD ACCORDING TO 5-YEAR FOLLOW-UP
Authors: Ryumshina Nadezhda , Zyubanova Irina , Baev Andrew , Mochula Olga , Manukyan Musheg , Suhareva Anna , Tsoy Ekaterina , Shelkovnikova Tatyana , Gusakova Anna , Maksimova Aleksandra , Falkovskaya Alla , Ussov Wladimir , Pekarskiy Stanislav 
Published: June 2022

Objective:
To evaluate the nephroprotective effect of renal denervation (RD) in the form of anatomical and functional preservation of the kidneys in patients with resistant hypertension (RHT) over 5 years of follow-up.

Design and method:
The data of 23 patients with RHT (average age 57.6 ± 8.3 years) were analyzed. Initially and 6, 12, 24, 36 and 60 months after RD of observation, all patients were measured office and average 24-hour blood pressure (BP) monitoring, kidney function was assessed by serum creatinine and cystatin C levels and the calculation of glomerular filtration rate (eGFR). Non-contrast MRI of the kidneys (magnetic field strength 1.5 T) was performed at all observation points. RD was performed using a renal ablation electrode Symplicity Flex and an automated RF voltage generator Symplicity G2.

Results:
The average values of creatinine level corresponded to 80.2 ± 14.8 mmol/L, cystatin C – 684.8 ± 86.2 mg/l. According to MRI data, the volume of the right/left kidneys was 174 ± 41.6/ 194.9 ± 52.7 cm3, the cortical layer of the right/left kidneys was 62.7 ± 19.2/67.8 ± 26.1 cm3, respectively. 5 years after RD, there was a pronounced and significant decrease in the daily systolic BP/diastolic BP by -12.7/ -10.4 mmHg, respectively (p = 0.007), which confirms the effectiveness of RD. There was a statistically significant decrease in the volume of the cortex (right/left -24 cm3/21 cm3, p < 0.001), which was accompanied by a significant increase in creatinine ( 7 mmol/L, p = 0.0003) and cystatin C ( -298 mg/L, p = 0.0003), as well as a decrease in eGFR ( -14 ml/min/1.73 m2, p = 0.0005). Nevertheless, the average rate of decrease in eGFR was -2.8 ml/min/1.73 m2/year, which turned out to be significantly lower than those for the specified cohort according to literature sources (-6 ml/min/1.73 m2/year). In the dynamics of observation, eGFR was directly correlated with the volumes of the renal medulla (r = 0.78, p = ,005). Cystatin C correlated with the volume of the renal parenchyma (r = -0.88, p = ,000).

Conclusions:
RD is a successful way to reduce blood pressure in patients with RHT, allowing to slow down the rate of reduction in the amount of renal parenchyma and the progression of renal dysfunction during 5 years of follow-up.
THE IMPACT AND INTERACTION OF METABOLIC ELEMENTS ON LEFT ATRIAL STIFFNESS IN HYPERTENSION
Authors: Liu Yan , Sun Qiaobing , Fu Tingting , Pan Yu , Sun Yancui , Jiang Yinong 
Published: June 2022

Objective:
To evaluate left atrial (LA) stiffness using two-dimensional speckle-tracking echocardiography (2DSTE) and investigate the impact and interaction of metabolic elements on LA stiffness index (LASI).

Design and method:
340 subjects were enrolled and divided into three groups: Group I (n = 38), healthy controls; Group II (n = 138), hypertension without metabolic syndrome (MS); Group III (n = 164), hypertension with MS. All subjects were performed LA phasic strains using 2DSTE, and the following parameters were measured: LA reservoir strain and strain rate (LAS-S, LASR-S), LA conduit strain and strain rate (LAS-E and LASR-E), LA booster strain and strain rate (LAS-A and LASR-A). The LASI was defined as the ratio of early diastolic transmitral flow velocity/lateral mitral annulus myocardial velocity (E/e’) to LAS-S. Binary logistic regression models were performed, and the odds ratios (OR) at 95% confidence interval (CIs) were used to approximate the associated risk of the elements of MS (obesity, diabetes and dyslipidaemia) for LA stiffness, with the lowest binary serving as the reference category.

Results:
LASI was significantly higher in Group II (0.34 ± 0.21) than Group I (0.19 ± 0.04) (p < 0.001), and further increased in Group III (0.39 ± 0.22) (p < 0.001). LA reservoir and conduit functions gradually and significantly decreased from Group I to Group III (p < 0.001). However, there were no significant differences in LA booster pump function among three groups (p> 0.05). Regarding the elements of MS, body mass index (BMI), hemoglobin A1c (HbA1c) and triglyceride (TG) were positively associated with LASI. Furthermore, we performed the interaction analyses between two of the three elements of MS (BMI, HbA1c and TG). We simultaneously stratified both elements into equal-sized binaries of their individual distribution and then showed that compared with the lowest risk reference group, risk for LA stiffness significantly increased in other groups (Figure).

Conclusions:
LA phasic function was impaired and LA stiffness was increased in hypertensive patients with MS. Elements of MS (BMI, HbA1c and TG levels) had independent and interaction effect on LA stiffness in hypertension.
DIFFERENCES IN BOLD MRI SIGNAL INTENSITY BETWEEN HYPERTENSIVE PATIENTS AND HEALTHY VOLUNTEERS
Authors: Hendriks-Balk Mariëlle , Da Costa Sandra , Polychronopoulou Erietta , Damianaki Katerina , Theiler Kenji , Van De Ville Dimitri , Wuerzner Gregoire 
Published: June 2022

Objective:
An increased sympathetic tone is associated with the initiation and maintenance of most forms of arterial hypertension. Background activity of a core network of neurons in the brain and brainstem is supposed to be important for long-term blood pressure control. Imaging techniques such as blood oxygen level dependant magnetic resonance imaging (BOLD MRI) are now capable of detecting changes in oxygenation within the brain using blood oxygen levels. So far, the BOLD fMRI signal intensity changes provoked by a cold pressor test (CPT) have not been compared between hypertensive patients (HT) and normotensive subjects (NT). The primary objective was to compare the signal intensity changes in HT and NT participants.

Design and method:
This was a prospective case-controlled study. A 7 tesla MRI was used for fMRI acquisition. BOLD MRI signal intensity changes during a cold pressure test and during rest were analyzed using statistical parametric mapping (SPM) for whole brain analysis. The connectivity CONN toolbox was used to analyze functional networks.

Results:
30 NT subjects (age 34 ± 10 (mean ± SD), BMI 23 ± 2 kg/m2, systolic blood pressure (SBP) 117 ± 10 mm Hg and diastolic blood pressure (DBP) 71 ± 9 mm Hg) and 16 HT patients (age 46.5 ± 13, BMI 27 ± 3 kg/m2, SBP 148 ± 11 mm Hg and DBP 92 ± 6 mm Hg) were enrolled. The CPT increased the SBP by 21 ± 20 (median ± SD) and 25 ± 24 mm Hg in NT and HT, respectively, and the DBP by 20 ± 19 (NT) and 19 ± 17 (HT) mm Hg. BOLD fMRI signal intensity increased significantly in NT but not in HT. The pattern of resting state connectivity was different between NT and HT, with a decreased global connectivity in HT.

Conclusions:
BOLD fMRI signal intensity responses to CPT test were less pronounced in HTA patients compared to NT. The different response to stress may be secondary to different neuronal activity pattern during the resting state between the two groups as suggested by connectivity analysis.
THE EFFECT OF RENAL DENERVATION ON CEREBRAL BLOOD FLOW IN DIABETIC PATIENTS WITH RESISTANT HYPERTENSION
Authors: Falkovskaya Alla , Mordovin V. , Pekarskiy S. , Manukyan M. , Zyubanova I. , Lichikaki V. , Tsoy E. , Vtorushina A. , Khunkhinova S. , Guliaeva E. 
Published: June 2022

Objective:
Long-term and persistent increase in blood pressure (BP) leads to vascular remodeling, which deteriorates cerebral blood flow. The combination of hypertension (HTN) with diabetes mellitus (DM) accelerates the vascular damage and impairs the cerebral blood flow autoregulation, which may be accompanied by an uncompensated decrease in cerebral perfusion in response to a decrease in BP. Renal denervation (RDN) leads to a rapid and sustained decrease in BP, therefore the aim of this study was to assess of changes in cerebral blood flow in patients with resistant HTN (RHTN) and type 2 DM at 6 month after the intervention.

Design and method:
Evaluation of cerebral blood flow was performed in 21 patients with RHTN and type 2 DM, who were included in single-arm prospective interventional studies (protocol numbers NCT01499810 and NCT02667912 on ClinicalTrials.gov) (mean age 61.4 ± 7.6 years, mean office (systolic/diastolic) BP (SBP/DBP) 167.1 ± 19.4/85.6 ± 15.9 mmHg, HbA1c 7.1 ± 1.3%, 8 men (32%), 19 pts (91%) had atherosclerosis of internal carotid arteries (ICA) with mean values of stenosis 22.2 ± 9.7%). All patients were undergone to ambulatory 24-hour BP, Doppler high-resolution ultrasound of ICA and middle cerebral arteries (MCA) at baseline and 6 month follow-up. The patients were instructed not to change their medication regimen during the study.

Results:
There was a significant decrease in mean 24-hour BP (systolic/diastolic) (-12.6/-7.3 mmHg, p < 0.05). At the same time, there was no deterioration in blood flow of ICA and MCA at 6 months after RDN.

Conclusions:
Our data indicate that the significant decrease in BP after RDN does not lead to deterioration of cerebral blood flow and therefore indicates the safety of this procedure for the brain in patients with RHTN with type 2 DM.
SHORT TERM EVALUATION OF LEFT VENTRICULAR FUNCTION FOLLOWING DUAL CHAMBER PACEMAKER A SPECKLE TRACKING STUDY
Authors: Abdulrahman Fahad 
Published: June 2022

Objective:
Background:In 2012 the consensus issued by both the American College of Cardiology & Foundation Heart Rhythm
Society Recommend the use of Dual Chamber Pace maker instead of Single chamber pace maker for patients with
Sinus Node dysfunction. Restoration of atrioventricular synchrony in patient with sinus node dysfunction or
Atrioventricular block representing a new era in electrical therapy. the focus on normal physiology led to the nearly universal application of dual-chamber pacing to restore atrioventricular (AV) synchrony in patients with sinus rhythm.

Design and method:
Speckle tracking was used to evaluate the percent of ventricular deformation before and 3months follow upafter dual chamber implantation, this study included 28 patients with Sinus node dysfunction or Heart Failure-LBBB. This prospective observational study was carried out on patients of medical city, Baghdad Teaching Hospital, cardiology & Echocardiography Higher Education (Diploma) center from November 2016 to July 2017.

Results:
No statistical difference was noted between both gender groups in regard to main risk factors.Four methods were used to evaluate ventricular function synchrony (Ejection Fraction %, Global longitudinal stain, intraventricular synchrony using septal to posterior wall motion delay, interventricular Mechanical delay by Pulse wave), Global EF evaluated by Simpson biplane method remained the same in all patients after 3-month follow-up
(P = NS). Global longitudinal strain (GLS) significantly decreased in all patients. Inter-ventricular dyssynchrony evaluation revealed no significant change after 3 months.

Conclusions:
Global longitudinal strain and Left Ventricular dessynchrony assessment enables us to detect early signs of LV dysfunction in Subjects with dual chamber pacemaker.
IMPACT OF AQUAPORIN-3, AQUAPORIN-7 AND HEPARANASE GENETIC POLYMORPHISMS ON AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE PROGRESSION
Authors: Santos Ana Carolina , Rechitean Andreea , Silva Inês Vieira Da , Matos Andreia , Ferreira Joana , Soveral Graça , Bicho Manuel , Almeida Edgar 
Published: June 2022

Objective:
Autosomal Dominant Polycystic Kidney Disease(ADPKD) is a monogenic disease characterized by the growth of cysts in the kidneys, which can progress to end-stage renal disease(ESRD). However, this progression is heterogeneous.
Aquaporin-3(AQP3) and Aquaporin-7(AQP7) are water channels involved in the inflammatory response and proliferation, expressed in the kidney and may have a role in cyst epithelial proliferation. Heparanase(HPSE) is an enzyme that cleaves heparan sulfate side chains of proteoglycans and has an increased expression in the glomerulus in diseases associated with proteinuria.
This study aims to evaluate the impact of AQP3, AQP7 and HPSE genetic polymorphisms and some biomarkers related to cardiovascular risk in ESRD progression in patients with ADPKD.

Design and method:
95 ADPKD(52.6% females), mean age 44.78 ± 14.34 years were diagnosed and had follow-up> 60 months. Variation values of serum creatinine(SCr) were used to stratify patients into fast progressors(FP) and slow progressors. Biochemical parameters and genetic polymorphisms were determined by standardized methods and endpoint analysis, respectively. Statistical analysis was performed using SPSS software considering p-value < 0.05.

Results:
For HPSE, genotype AA was associated with increased risk for FP in CKD(p = 0.027), while allele G was associated with high values of SCr(p = 0.010). A trend was observed in genotype CC of AQP7 with higher SCr(p = 0.066). No associations were found between AQP3 polymorphism and progression in ADPKD.
The increased levels of: creatinine(SCr), albumin creatinine ratio(Alb/Cr), microalbumin(mAlb) and parathyroid hormone(PTH) were associated with the FP and stage 4 and 5 of chronic kidney disease(CKD). The opposite occurred in hemoglobin(Hb) levels and the product of calcium and phosphorus. No associations were found between AQP3 polymorphism and progression in ADPKD.
Higher values of SCr were found in genotype CC of AQP3(p = 0.016) and a trend in allele T of AQP7(p = 0.070) and genotype AA of HPSE(p = 0.056). PTH was higher in genotype CC of AQP3(p = 0.047).
AQP7 polymorphism was associated with elevated values of:Alb/Scr(p = 0.021) in allele T, calcium(p = 0.003) in genotype TT and Hb(p = 0.012) in allele C.

Conclusions:
The studied polymorphisms seem to directly impact and/or modulate levels of some biomarkers associated with progression and stage of CKD in ADPKD patients.
DECREASED URINARY LEVELS OF SIRT1 AS NON-INVASIVE BIOMARKER OF EARLY RENAL DAMAGE IN HYPERTENSION
Authors: Martinez-Arroyo Olga , Ortega Ana , Solaz Elena , Martinez Fernando , Martinez-Hervas Sergio , Redon Josep , Cortes Raquel 
Published: June 2022

Objective:
Hypertension and diabetes mellitus (DM) produce renal injury. Sirtuins have become important players in renal damage, but their value as biomarkers is poorly assessed. The aims of the study were to evaluate the sirtuin1 levels (SIRT1), and miRNAs miR-34a and miR-200, that regulate SIRT1 expression in urinary cell pellet from hypertensive patients with incipient renal damage with and without diabetes. In addition, to mimic disease conditions and deepen into the implications of SIRT1 in podocyte injury, employed cultured podocytes subjected to high glucose (HG) and angiotensin II (Ang II) concentrations.

Design and method:
We quantified urinary SIRT1 and claudin 1 (CLDN1) mRNA and miR-34a and miR-200a levels by quantitative real-time polymerase chain reaction (RT-qPCR) from urinary cell free pellet from patients and in cultured human immortalized podocytes treated with HG and ANG II. Protein levels and subcellular localization were analyzed by Western blot and fluorescence analyses by confocal microscopy.

Results:
We found decreased SIRT1 levels in patients with increased urinary albumin excretion (UAE), the lowest with diabetes presence, and a strong association with UAE, discriminating incipient renal damage. In vitro experiments also showed SIRT1 overall decreases in podocyte cultures under treatment conditions. In urine samples, miR-34a was reduced and miR-200a increased, both related to UAE levels. However, both miRNAs were generally increased in podocyte cultures under high glucose and angiotensin-II treatment.

Conclusions:
Results evidenced reduction of urinary SIRT1 from hypertensives with or without DM. The decrease of SIRT1 and increase of CLDN1 in patients and podocytes subjected to stress support the implication of both in renal injury and evidence a reflection in urinary levels. The alterations found in miR-34a and miR-200a both in patients’ urine and podocyte cultures reveal novel points to further address their implication in renal injury through SIRT1 regulation. Interestingly, SIRT1 mRNA levels and miR-200a are related to increases in UAE and discriminate the presence of UAE in patients. In summary, SIRT1 mRNA measurements is an easily accessible and non-invasive method to early characterize renal damage in patients.
ACUTE RENAL FAILURE PROGRESSING TO ESRD IN A PATIENT WITH UNTREATED HIGH GRADE HYPERTENSION – THE MALIGNANT NATURE OF “BENIGN’’ NEPHROSCLEROSIS
Authors: Leiba Adi , Rappoport Vladi , Hausmann Michael 
Published: June 2022

Objective:
A 43 year old male with history of hypertension, non-adherence to medications, heavy smoking (since age 8) and alcohol abuse was admitted with epigastric pain, heartburn and upper GI bleeding (hematochezia) for which he had been recently taking PPI. On arrival his BP was 182/100 mmHg, HR-89, decreased breath sounds + wheezes.

Design and method:
Hemoglobin was 7.4 mg/dL, Creatinine 11.2 mg/dl (recent baseline 1.1 mg/dl) Urea- 200 mg/dl.
He soon after needed HD which he continues a thrice weekly basis.
Four months prior to this admission he was hospitalized with hemoptysis, BP up to 261/136mmHg, proteinuria (1.5 gram/gram) and microhematuria, mild creatinine elevation to 1.3 mg/dL and hypokalemia of 2.6 mg/dL. Fundus examination revealed high grade retinopathy with cotton wool spots and flame hemorrhages but no papilledema. Supine Renin was 41.37microunits/ml, aldosterone was 30ng/dl.

Results:
Since his renal function has not improved, and in parallel with HD treatments he undergone a kidney biopsy which revealed advanced benign nephrosclerosis (figure 1) with some FSGS, a single crescent and marked interstitial inflammation with eosinophils (figure 2)

Conclusions:
Untreated high-grade hypertension and severe “benign’’ nephrosclerosis represent a microvascular ischemic nephropathy (similar to critical bilateral RAS) in which a relatively minor insult can deteriorate the patient into ESRD.
While being non-adherent to different anti hypertensive medications, patient did take omeprazole which triggered acute interstitial nephritis on the background of advanced ischemic nephropathy, leading to permanent loss of renal function.