Cause Of Cardiovascular Disease Research Articles

An MR Compatible Vascular Stenosis Method Based on Fiber Bragg Grating

Progressive stenosis of blood vessels is an important cause of cardiovascular diseases. Traditional intervention methods rely on fluoroscopy, which exposes both patients and operators to ionizing radiation. In this paper, we propose a real-time detection method for vascular stenosis intervention based on Fiber Bragg Grating (FBG) sensors that can be used under magnetic resonance imaging (MRI) guidance. An FBG sensor array with 5 sensors is developed and validated using a vascular flow phantom that simulates the morphological features of stenoses. We first verify the sensor for measuring vascular stenosis through flow rate and profile using the FBG sensor array, followed by a detailed assessment of the MRI compatibility of the sensor in terms of imaging artefact and changes in SNR, The error of FBG array is within the range of ±10με, the SNR variation is 3.608%, indicating that the FBG sensor array has excellent MR image compatibility. Experiment results show a good correlation between the degrees of stenoses with strain measurements, thus offering real-time information to aid MR guided vascular intervention.

Knowledge mapping of B cell and atherosclerosis over the past 20 years: A bibliometric analysis

ABSTRACT Atherosclerosis (AS) is the main underlying cause of cardiovascular disease, and B cells are considered a key immune cell type to regulate AS. So far, there is no bibliometric study on B cell and AS. This study aims to comprehensively analyze the scientific output about B cell and AS, summarize the literature characteristics, explore research hotspots, and point out emerging trends. We searched the literature from 2003 to 2022 from the Web of Science Core Collection (WoSCC) database. CiteSpace, VOSviewer, and the R package “Bibliometrix” were used for literature analysis and visualization. A total of 1,062 articles and reviews were identified. The number of annual publications generally showed an upward trend. The United States and China were the most productive countries. Medical University of Vienna was the most productive research institution, and Binder Christoph J. was the most productive author, who was also from Medical University of Vienna. “Arteriosclerosis Thrombosis and Vascular Biology” was the most published journal and the most frequently cited journal. The most cited reference was written by Caligiuri G (2002) in “Journal of Clinical Investigation.” The most frequent keywords were “inflammation,” “macrophages,” “cardiovascular disease,” “T cells,” “apoptosis,” “immunity,” “cytokines,” “lymphocytes,” etc. The trend topics were mainly focused on “immune infiltration,” “immunoglobulins,” and “biomarkers.” The complex role of B cell subtypes and a variety of B cell mediators is the main research direction at present. In-depth analysis of B cell-specific targets can provide new ideas and methods for the prevention and treatment of AS.

Diabetes and chronic kidney disease synergistically contribute to left ventricular diastolic dysfunction and coronary microvascular disease in swine

Abstract Background Chronic kidney disease (CKD) and diabetes (DM) are common causes of cardiovascular disease (CVD), and contribute to the development of left ventricular diastolic dysfunction (LVDD) and coronary microvascular dysfunction (CMD). Purpose To investigate if CKD and DM contribute synergistically to the development of CMD and LVDD by increasing myocardial interstitial fibrosis in a swine model. Methods CKD was induced by renal microembolization at 10-12 weeks of age in 8 wild type (WT) and 6 DM (INSC94Y) swine, while 6 WT and 5 DM swine served as control. LVDD was assessed using pressure volume loops and coronary flow reserve (CFR) was measured by intracoronary infusion of adenosine in the left anterior descending coronary artery. Afterwards, myocardium and kidney tissues were histologically examined for interstitial fibrosis. Results DM was confirmed by increased blood glucose values in the DM and DMCKD (figure 1-A). Renal embolization resulted in renal fibrosis in the WTCKD and DMCKD (figure 1-B), which was accompanied by a trend towards proteinuria, i.e., elevated protein/creatinine ratios (figure 1-C). LVDD was evidenced by an increase in the slope of the end-diastolic pressure volume relationship (EDPVR) in WTCKD, DM and DMCKD as compared to WT, with the largest increase in DMCKD (figure 1-D). WTCKD and DMCKD animals showed higher interstitial fibrosis levels in the LV (figure 1-E). CFR tended to be decreased in WTCKD, DM and DMCKD swine compared to WT (figure 1-F). Conclusions Renal embolization resulted in proteinuria and renal fibrosis, particularly in DM animals. DM and CKD also caused myocardial interstitial fibrosis, which impaired left ventricular diastolic function. The effects tended to be larger in DMCKD as compared to DM or WTCKD. Moreover, CFR tended to be decreased, suggestive of CMD, with the largest effect in DMCKD. In conclusion, DM and CKD contributed synergistically to LVDD and CMD.

Abstract 18626: Cardiac Malformations in a Pheochromocytoma and Paraganglioma Syndrome: Reconsidering the Origins of Structural Cardiovascular Disease

Introduction: Structural cardiovascular (CV) disease and heart failure in patients with pheochromocytoma/paraganglioma is thought to develop from catecholamines and hypertension. A syndrome of polycythemia, catecholamine-releasing paragangliomas, and resultant hypertension caused by pathogenic mosaic variants in hypoxia-inducible factor 2-alpha (HIF2A or EPAS1 ) was described. Hypothesis: We hypothesized this syndrome may have both developmental and secondary causes of structural CV disease. Methods: We evaluated CV structure and function in syndromic patients (n=10), hypertensive pheochromocytoma patients without a known syndrome (n=29), and polycythemic patients (n=29) using cardiac magnetic resonance imaging (MRI) and contrast-enhanced computed tomography (CT) and compared their findings to normal volunteers. We also evaluated the mouse model via vascular casting and subsequent micro-CT or ex vivo 14 tesla MRI at embryonic, post-natal, and adult stages. We tested affected tissue from the mouse model for the genetic variant. Results: Compared to normal volunteers, hypertensive pheochromocytoma, and polycythemic patients, syndromic patients had enlarged left and right atrial appendages relative to respective atria (LAA/LA ratio 0.18 ± 0.04 p<0.001; RAA/RA: 0.20 ±0.10 p=0.005) [ Table ]. We observed similar abnormalities in the mouse model and confirmed the genetic variant in the affected cardiac tissue ( Figure ). Conclusions: This study identifies a signature for distinguishing primary from secondary causes of CV disease in patients with pheochromocytoma and paraganglioma using an atrial appendage to atrial volume ratio.

Abstract 16881: Endothelial KLF11 is a Novel Endogenous Protectant Against Diabetic Atherosclerosis

Background: Atherosclerosis is the leading cause of cardiovascular diseases, which is also the primary cause of mortality among diabetic patients. Endothelial cell (EC) dysfunction is a critical early step in the development of atherosclerosis and aggravated in the presence of concurrent diabetes. Krüppel like factor 11 (KLF11), a transcription factor involved in diabetes, inhibits EC inflammation via regulation of NF-κB signaling. However, the potential function of KLF11 in pathogenesis of diabetic atherosclerosis remains undefined. Methods and results: Diet-induced type 2 diabetic atherosclerosis model is established in LDLR -/- mice by feeding a diabetogenic high-fat diet with cholesterol (DDC). KLF11 expression was increased in ECs from ascending aorta of LDLR -/- mice fed DDC diet. Moreover, EC specific KLF11 gain- (transgenic) and loss-of-function (knockout) mice in a LDLR -/- background were fed a DDC for 16 weeks. Endothelial KLF11 deficiency (Klf11 ECKO -LDLR -/- ) markedly increased atherogenesis, while EC-selective KLF11 overexpression significantly inhibited DDC-induced atherogenesis. Single cell RNA sequencing profiling the ECs isolated from DDC-fed Klf11 ECKO -LDLR -/- mice and littermate controls showed that KLF11 depletion increased endothelial-to-mesenchymal transition (EndMT) during atherogenesis. In vitro studies showed that KLF11 not only inhibited EC inflammation and oxidative stress, but also diminished EndMT in response to high glucose. Conversely, knockdown of KLF11 augmented the EC dysfunction and EndMT. Conclusions: Our study indicates that endothelial KLF11 protects against diabetic atherosclerosis through inhibition of EC inflammation, oxidative stress and EndMT.

Abstract 15365: The Effect of Mobile Phone Messaging in the Reduction of Ambulatory Blood Pressure in Adults: A Systematic Review

Introduction: Ample evidence supports a lower risk for cardiovascular disease (CVD) with controlled blood pressure (BP), yet hypertension (HTN) remains a leading cause of CVD. Mobile health such as text messaging is commonly included in BP management programs; however, the association of texting with BP interventions is less well known. We sought to examine the effectiveness of mobile messaging on BP in adults in the ambulatory setting. Methods: In this systematic review, we searched 4 databases from date of inception through February 2023 using search terms (texting, messaging, mobile phone, BP, HTN). After removing duplicate citations, two reviewers independently reviewed the references for eligibility (randomized control trial [RCT], participants > 18 years of age, participants either with elevated BP, and/or a diagnosis of HTN). Results: A total of 1,786 RCTs were identified of which 48 met eligibility criteria, for a combined total of 19,720 participants from 21 countries, including 13 US studies. Twenty-seven studies reported significant reductions in BP (systolic, diastolic or both). All three RCTs using texting and pharmacist counseling (n=3) demonstrated significant changes in BP, while 13 of 16 RCTs with texting and provider involvement observed significant improvement in BP. For the studies reporting between group changes in systolic BP from baseline, 7 studies noted significant improvements in BP (Figure 1). Conclusions: Despite heterogeneity in study components, we found text messaging when used with other intervention components was associated with BP reductions among adults with HTN. Larger studies using novel designs such as SMART (sequential multiple assignment randomized trials) are warranted to understand efficacy of texting with other intervention components.

Abstract 13186: Factors Associated With Dysglycemia and Type 2 Diabetes Mellitus Onset in Familial Hypercholesterolemia

Introduction: Familial hypercholesterolemia (FH) is an autosomal dominant monogenic disorder characterized by high blood LDL-C and cardiovascular disease (CVD). Type 2 diabetes mellitus (T2DM) is an independent cause of CVD and there is evidence that FH is associated with a lower frequency of its development. On the other hand, lipid lowering therapy (LLT) may increase T2DM risk. Goals: Evaluate the risk of dysglycemia and T2DM development in a cohort of molecularly proven FH individuals. Methods: This is a prospective analysis of a population enrolled on a genetic cascade screening program evaluated from March 2011 to January 2022. FH diagnosis was confirmed by molecular testing of variants in LDLR, APOB and PCSK9. Dysglycemia and T2DM diagnoses were done according to the ADA Criteria or use of any antidiabetic drugs. Results: 790 FH patients were included (age 45.5±15.0 years, 56.8% female, baseline LDL-C 198±74 mg/dL), 96.6% had LDLR variants. The prevalence of T2DM was 13.3% and 67.4% were taking LLT at baseline . There were 206 (26%) new cases of T2DM or dysglycemia after a median 51-month follow-up . In multivariate Cox regression analysis age (HR:1.026, CI95%: 1.014-1.038, p=0.000) , body mass index (HR: 1.062, CI95%: 1.035-1.090, p=0.000) and current smoking (HR: 2.005, HR: 1.337-3.008, p=0.001) were independently associated with T2DM and dysglycemia, while metformin use was associated with a lower risk (HR: 0.147, CI95%: 0.076-0.284, p=0.000). History of previous CVD, use of lipid lowering therapy at baseline, high intensity LLT , or type of molecular defect were not associated with higher T2DM/dysglycemia risk. Conclusions: In this cohort of molecularly proven FH subjects, T2DM affected more than 1 in 10 people at baseline. Previous CVD and classical risk factors but neither molecular defects nor lipid lowering therapy were associated with T2DM/dysglycemia onset.

The Effect of Sleep on Metabolism, Musculoskeletal Disease, and Mortality in the General US Population: Analysis of Results From the National Health and Nutrition Examination Survey.

Sleep is an important physiological behavior in humans that is associated with the occurrence and development of various diseases. However, the association of sleep duration with health-related outcomes, including obesity-related factors, musculoskeletal diseases, and mortality because of different causes, has not been systematically reported. This study aims to systematically investigate the effect of sleep duration on health-related outcomes. Overall, 54,664 participants with sleep information from 8 survey cycles of the National Health and Nutrition Examination Survey (2005-2020) were included in the analysis. Health-related outcomes comprised obesity-related outcomes (ie, BMI, obesity, waist circumference, and abdominal obesity), metabolism-related outcomes (ie, uric acid, hyperuricemia, and bone mineral density [BMD]), musculoskeletal diseases (ie, osteoarthritis [OA] and rheumatoid arthritis [RA]), and mortality because of different causes. The baseline information of participants including age, sex, race, educational level, marital status, total energy intake, physical activity, alcohol consumption, smoking, hypertension, and diabetes was also collected as covariates. Information about the metabolism index, disease status, and covariates was acquired from the laboratory, examination, and questionnaire data. Survival information, including survival status, duration, and cause of death, was obtained from the National Death Index records. Quantile regression models and Cox regression models were used for association analysis between sleep duration and health-related outcomes. In addition, the threshold effect analysis, along with smooth curve fitting method, was applied for the nonlinear association analysis. Participants were divided into 4 groups with different sleep durations. The 4 groups showed significant differences in terms of baseline data (P<.001). The quantile regression analysis indicated that participants with increased sleep duration showed decreased BMI (β=-.176, 95% CI -.220 to -.133; P<.001), obesity (odds ratio [OR] 0.964, 95% CI 0.950-0.977; P<.001), waist circumference (β=-.219, 95% CI -.320 to -.117; P<.001), abdominal obesity (OR 0.975, 95% CI 0.960-0.990; P<.001), OA (OR 0.965, 95% CI 0.942-0.990; P=.005), and RA (OR 0.940, 95% CI 0.912-0.968; P<.001). Participants with increased sleep duration also showed increased BMD (β=.002, 95% CI .001-.003; P=.005), as compared with participants who slept <5.5 hours. A significant saturation effect of sleep duration on obesity, abdominal obesity, and hyperuricemia was detected through smooth curve fitting and threshold effect analysis (sleep duration>inflection point). In addition, a significant threshold effect of sleep duration on BMD (P<.001); OA (P<.001); RA (P<.001); and all-cause (P<.001), cardiovascular disease-cause (P<.001), cancer-cause (P=.005), and diabetes-cause mortality (P<.001) was found. The inflection point was between 6.5 hours and 9 hours. The double-edged sword effect of sleep duration on obesity-related outcomes, embolism-related diseases, musculoskeletal diseases, and mortality because of different causes was detected in this study. These findings provided epidemiological evidence that proper sleep duration may be an important factor in the prevention of multisystem diseases.

Adapted Mindfulness Training for Interoception and Adherence to the DASH Diet

Hypertension is a major cause of cardiovascular disease, and although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP), adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption. To evaluate the effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness and DASH adherence. Parallel-group, phase 2, sequentially preregistered randomized clinical trials were conducted from June 1, 2017, to November 30, 2020. Follow-up was 6 months. Participants with elevated unattended office BP (≥120/80 mm Hg) were recruited from the population near Providence, Rhode Island. Of 348 participants assessed for eligibility, 67 did not meet inclusion criteria, 17 declined, and 63 did not enroll prior to study end date. In total, 201 participants were randomly assigned, 101 to the MB-BP program and 100 to the enhanced usual care control group, with 24 (11.9%) unavailable for follow-up. Outcome assessors and the data analyst were blinded to group allocation. Analyses were performed using intention-to-treat principles from June 1, 2022, to August 30, 2023. The 8-week MB-BP program was adapted for elevated BP, including personalized feedback, education, and mindfulness training directed to hypertension risk factors. Both MB-BP and control groups received home BP monitoring devices with instructions and options for referral to primary care physicians. The control group also received educational brochures on controlling high BP. The primary outcome was Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire scores (range 0-5, with higher scores indicating greater interoceptive awareness), and the secondary outcome was DASH adherence scores assessed via a 163-item Food Frequency Questionnaire (range 0-11, with higher scores indicating improved DASH adherence), all compared using regression analyses. Among 201 participants, 118 (58.7%) were female, 163 (81.1%) were non-Hispanic White, and the mean (SD) age was 60.0 (12.2) years. The MB-BP program increased the MAIA score by 0.54 points (95% CI, 0.35-0.74 points; P < .001; Cohen d = 0.45) at 6 months vs control. In participants with poor baseline DASH adherence, the MB-BP program also significantly increased the DASH score by 0.62 points (95% CI, 0.13-1.11 points; P = .01; Cohen d = 0.71) at 6 months vs controls. The intervention was also associated with a 0.34-point improvement in the DASH diet score in all MB-BP participants from baseline (95% CI, 0.09-0.59 points; P = .01; Cohen d = 0.27), while the control group showed a -0.04 point change in DASH diet score from baseline to 6 months (95% CI, -0.31 to 0.24 points; P = .78; Cohen d = -0.03). A mindfulness program adapted to improving health behaviors to lower BP improved interoceptive awareness and DASH adherence. The MB-BP program could support DASH dietary adherence in adults with elevated BP. ClinicalTrials.gov Identifiers: NCT03859076 and NCT03256890.

The Pattern of Blood Pressure Distribution and Analysis of Influencing Factors of Pre (Hypertension) Among Young Adults: A Cross-Sectional Survey in Western India

Background: Raised blood pressure is one of the significant preventable causes of cardiovascular diseases. The Global Burden of Diseases report 2019 has identified high systolic blood pressure as the leading risk factor for attributable deaths accounting for about 1.4 million deaths in India. The study aimed to determine the prevalence of prehypertension and hypertension, along with their associated risk factors, among young adults. Methods: A cross-sectional study was conducted in urban science colleges in Gujarat. A multicomponent questionnaire comprised of demographic, dietary and lifestyle characteristics was administered to the participants (18-23 years). Data on weight, height and blood pressure were collected by trained field personnel. The categorical variables were tested by a chi-square test, while the t-test was used to compare quantitative variables. Results: Overall, 415 participants (65% female) were included in the study, with a mean age of 19.5 years. The prevalence of prehypertension and hypertension was 23.4% and 4.8%, respectively. The multivariate analysis showed that the male gender, not being underweight, and overweight was found to be associated with elevated blood pressure. Conclusions: There is a pressing need to identify cardiovascular risk factors at younger ages through regular screening, with more focus should be put on the adaptation of healthy lifestyles.

Effectiveness of SMART heart package on knowledge and practice regarding prevention of coronary artery disease among high-risk adults in selected urban community at Bangalore

BACKGROUND: Coronary artery disease is the most common cause of cardiovascular disease. Smoking is one of the triggering factors for CAD, which increases mortality and morbidity rates. The aim of this study was to assess the impact of the SMART heart package on high-risk adults' knowledge and practice of coronary artery disease prevention. MATERIAL AND METHOD: A quasi-experimental research study was conducted in India from March 25 to April 23, 2022, through a house-to-house survey. This survey was conducted among 200 adults out of 159 high-risk adults who were identified by a screening tool, using a systematic random sampling technique to select 60 subjects for the study. A SMART heart package intervention was administered for selected high-risk adults. The pre-test and the post-test were conducted using self-administered structured questionnaires for knowledge and a non-observation checklist for practice. The data had been analyzed by the Statistical Package for Social Science (SPSS) version 20.0. RESULTS: The findings show that at the baseline level of knowledge and practice, the majority of the subjects had inadequate knowledge 43 (71.7%) and 51 (85.0%) had poor practice, whereas after administration of the SMART heart package, 29 (48.3%) of subjects had moderately adequate knowledge and 29 (48.3%) had average practice. At baseline, the mean score was 41.5%, which increased to 79.1% on knowledge and 37.2% to 72.5% on practice after the implementation of the intervention, which was statistically significant (P &lt; 0.001). CONCLUSION: Hence, the SMART heart package was effective in increasing the level of knowledge and practice of CAD prevention among high-risk adults.

LncRNA TPRG1-AS1 Screened the Onset of Acute Coronary Syndromes and Predicted Severity and the Occurrence of MACE During Patients' Hospitalization.

Acute coronary syndrome (ACS) is a common acute myocardial ischemia syndrome and is one of the death-related causes of cardiovascular diseases. Identifying biomarkers to indicate disease severity and predict the occurrence of major adverse cardiovascular events (MACE) would benefit the clinical prognosis of ACS. This study estimated the expression and significance of lncRNA TPRG1-AS1 in the onset and development of ACS, aiming to explore a novel biomarker for the diagnosis and prognosis of ACS. A total of 109 ACS patients and 66 patients who received coronary angiography and excluded ACS were enrolled in this study. TPRG1-AS1 in the serum of study subjects was analyzed by PCR. The significance of TPRG1-AS1 in screening ACS was evaluated by ROC analysis. The association of TPRG1-AS1 with the disease severity of ACS was assessed by Pearson correlation analysis with patients' clinicopathological features. The potential of TPRG1-AS1 in predicting the occurrence of MACE was assessed by logistic regression analysis. Significant upregulation of TPRG1-AS1 was observed in ACS patients, which served as a risk factor for ACS and distinguish between ACS patients and the normal group. TPRG1-AS1 was positively correlated with Gensini score, cys-C, cTnI, and NT-proBNP levels of ACS patients, which indicate severe development of ACS. Additionally, increasing serum TPRG1-AS1 was associated with the high incidence of MACE during patients' hospitalization and was identified as a risk factor for MACE in ACS patients. Upregulated TPRG1-AS1 in ACS served as a diagnostic biomarker and predicted the severe development of patients.

Beneficial effects of flavonoids on animal models of atherosclerosis: A systematic review and meta-analysis

Atherosclerosis is the main cause of cardiovascular diseases that seriously endanger human health. The existing treatment drugs are effective, but they have some side effects. Accumulating evidence suggests that flavonoids have attracted wide attention due to their multiple cardioprotective effects and fewer side effects. PubMed, Web of Science database, Embase, and Cochrane Library were searched for studies evaluating the effects of flavonoids against atherosclerosis. 119 studies published from August 1954 to April 2023 were included. Random-effects models were performed for synthesis. Compared with the control group, flavonoids significantly reduced longitudinal and cross-sectional plaque area. The findings indicated that flavonoids significantly reduced the concentrations of serum TC, TG, and LDL-C and increased serum HDL-C concentrations. Besides, flavonoids reduced the levels of circulating pro-inflammatory factors, including TNF-α, IL-1β, and IL-6, and increased the serum IL-10 level. This study provides evidence for the potential cardiovascular benefits of flavonoids.

Determination of cholesterol content in foods and functional foods by gas chromatography mass spectrometry GC-MS

Cholesterol is a soft, pale yellow steroid fat that exists in the body's cell membranes and is transported in the plasma of most animals. This compound plays an important role in the physiology of the human body. However, excess cholesterol in the diet is also one of the leading causes of cardiovascular diseases. Therefore, the quantification of cholesterol in foods and functional foods is essential so that consumers can choose a diet containing the right amount of cholesterol. This study used gas chromatography-mass spectrometry to quantify cholesterol, with ISQ 7000 GC-MS system, TraceGOLD TG-5MS chromatographic column, and electron impact (EI) ionization mode. The validity of the method was confirmed according to the guidelines of the Association of Official Analytical Collaborations (AOAC). The results showed that the method has good specificity, the linearity range from 5 to 100 &amp;mu;g/mL in working solution, the detection limit of 1.5 to 15 mg/kg, the quantification limit of 5.0 to 50 mg/kg, depending on the matrix; the method's recovery were from 92.6 to 108.4% and the precision has relative standard deviations of 1.18 - 2.84%, meeting the requirements of AOAC. The method was used to analyze samples of dairy foods and functional foods randomly purchased in the market.

Assessment of oxidative stress and protein modification in essential hypertensive subjects

&#x0D; &#x0D; Hypertension has been identified to be the leading cause of cardiovascular disease and premature death worldwide due to its numerous comorbidities and associated risk of damage to vital body organs like the brain, heart and kidneys. The aim of this study was to determine the level of protein modifications and oxidative stress of hypertensive patients. One hundred and fourteen (114) participants were recruited for this study comprising 81 subjects with essential hypertension and 33 control (non- hypertensive) subjects. Body Mass Index (BMI) was calculated, systolic and diastolic blood pressure(SBP and DBP) readings were taken using digital sphygmomanometer, glutathione peroxidase (GPx) and carbonyl (CO) group was estimated using ELISA, while protein sulfhydryl (SH) group was estimated using colorimetric assay. The results obtained showed that BMI of treated hypertensive patients was significantly decreased (p&lt;0.0001) compared with control. Systolic and diastolic blood pressure was significantly increased when treated patients were compared with control (p&lt;0.0001). GPx and SH groups of treated hypertensive patients was significantly increased (p&lt;0.0001) in treated hypertensive patients as compared to control. The study concludes that protein modification occurs as a result of oxidative stress resulting in reduced levels of glutathione peroxidase which could be a risk factor associated with the development of essential hypertension These findings could help in designing quality diagnostic strategies and effective treatment and management approach for better clinical outcomes.

Survivin regulates intracellular stiffness and extracellular matrix production in vascular smooth muscle cells.

Vascular dysfunction is a common cause of cardiovascular diseases characterized by the narrowing and stiffening of arteries, such as atherosclerosis, restenosis, and hypertension. Arterial narrowing results from the aberrant proliferation of vascular smooth muscle cells (VSMCs) and their increased synthesis and deposition of extracellular matrix (ECM) proteins. These, in turn, are modulated by arterial stiffness, but the mechanism for this is not fully understood. We found that survivin is an important regulator of stiffness-mediated ECM synthesis and intracellular stiffness in VSMCs. Whole-transcriptome analysis and cell culture experiments showed that survivin expression is upregulated in injured femoral arteries in mice and in human VSMCs cultured on stiff fibronectin-coated hydrogels. Suppressed expression of survivin in human VSMCs significantly decreased the stiffness-mediated expression of ECM components related to arterial stiffening, such as collagen-I, fibronectin, and lysyl oxidase. By contrast, expression of these ECM proteins was rescued by ectopic expression of survivin in human VSMCs cultured on soft hydrogels. Interestingly, atomic force microscopy analysis showed that suppressed or ectopic expression of survivin decreases or increases intracellular stiffness, respectively. Furthermore, we observed that inhibiting Rac and Rho reduces survivin expression, elucidating a mechanical pathway connecting intracellular tension, mediated by Rac and Rho, to survivin induction. Finally, we found that survivin inhibition decreases FAK phosphorylation, indicating that survivin-dependent intracellular tension feeds back to maintain signaling through FAK. These findings suggest a novel mechanism by which survivin potentially modulates arterial stiffness.

Update of Potential Biomarkers in Risk Prediction and Monitoring of Atherosclerosis in Systemic Lupus Erythematosus to Prevent Cardiovascular Disease.

Systemic lupus erythematosus is a chronic connective tissue disease associated with an increased risk of premature atherosclerosis. It is estimated that approximately 10% of SLE patients develop significant atherosclerosis each year, which is responsible for premature cardiovascular disease that is largely asymptomatic. This review summarizes the most recent reports from the past few years on biomarkers of atherosclerosis in SLE, mainly focusing on immune markers. Persistent chronic inflammation of the vascular wall is an important cause of cardiovascular disease (CVD) events related to endothelial dysfunction, cell proliferation, impaired production and function of nitric oxide and microangiopathic changes. Studies on pathogenic immune mediators involved in atherosclerosis will be crucial research avenues for preventing CVD.

Philadelphia chromosome-negative myeloproliferative chronic neoplasms: is clonal hematopoiesis the main determinant of autoimmune and cardio-vascular manifestations?

In this article, we reviewed the possible mechanisms linking the clonal hematopoiesis of indeterminate potential (CHIP) to chronic myeloproliferative neoplasms (MPNs), autoimmune diseases (ADs), and cardiovascular diseases (CADs). CHIP is characterized by the presence of clonal mutations with an allelic frequency >2% in the peripheral blood without dysplasia, overt hematological neoplasms, or abnormalities in blood cell count. The prevalence may reach 20% of elderly healthy individuals and is considered a risk factor for myelodysplastic neoplasms and acute leukemia. In MPNs, CHIP is often associated with mutations such as JAK2V617F or DNMT3A, TET2, or ASXL1, which exhibit a 12.1- and 1.7-2-fold increase in CADs. Specifically, JAK2-mutated cells produce excessive cytokines and reactive oxygen species, leading to proinflammatory modifications in the bone marrow microenvironment. Consequently, the likelihood of experiencing thrombosis is influenced by the variant allele frequency (VAF) of the JAK2V617F mutation, which also appears to be correlated with anti-endothelial cell antibodies that sustain thrombosis. However, DNMT3A mutations induce pro-inflammatory T-cell polarization and activate the inflammasome complex, while TET2 downregulation leads to endothelial cell autophagy and inflammatory factor upregulation. As a result, in patients with TET2 and DNMT3A-related CHIP, the inflammasome hyperactivation represents a potential cause of CADs. CHIP also occurs in patients with large and small vessel vasculitis, while ADs are more frequently associated with MPNs. In these diseases, monocytes and neutrophils play a key role in the formation of neutrophil extracellular trap (NET) as well as anti-endothelial cell antibodies, resulting in a final procoagulant effect. ADs, such as systemic lupus erythematosus, psoriasis, and arthritis, are also characterized by an overexpression of the Rho-associated coiled-coil containing protein kinase 2 (ROCK2), a serine/threonine kinase that can hyperactivate the JAK-STAT pathway. Interestingly, hyperactivation of ROCK2 has also been observed in myeloid malignancies, where it promotes the growth and survival of leukemic cells. In summary, the presence of CHIP, with or without neoplasia, can be associated with autoimmune manifestations and thrombosis. In the presence of these manifestations, it is necessary to consider a "disease-modifying therapy" that may either reduce the clonal burden or inhibit the clonally activated JAK pathway.

The Sympathetic Nervous System in Hypertensive Heart Failure with Preserved LVEF.

The neurohormonal model of heart failure (HF) pathogenesis states that a reduction in cardiac output caused by cardiac injury results in sympathetic nervous system (SNS) activation, that is adaptive in the short-term and maladaptive in the long-term. This model has proved extremely valid and has been applied in HF with a reduced left ventricular (LV) ejection fraction (LVEF). In contrast, it has been undermined in HF with preserved LVEF (HFpEF), which is due to hypertension (HTN) in the vast majority of the cases. Erroneously, HTN, which is the leading cause of cardiovascular disease and premature death worldwide and is present in more than 90% of HF patients, is tightly linked with SNS overactivity. In this paper we provide a contemporary overview of the contribution of SNS overactivity to the development and progression of hypertensive HF (HHF) as well as the clinical implications resulting from therapeutic interventions modifying SNS activity. Throughout the manuscript the terms HHF with preserved LVEF and HfpEF will be used interchangeably, considering that the findings in most HFpEF studies are driven by HTN.

Assessment of Risk Factors for Hypertension amongst the Staff of a Tertiary Institution in Nigeria

Background: Hypertension is a leading cause of cardiovascular disease, coronary heart disease, stroke, and kidney failure. The aim of this study was to assess the risk factors for hypertension amongst the staff of a tertiary institution in Nigeria. Materials and Methods: All consenting staff of College of basic and clinical medical sciences of the Enugu State University College of Medicine participated in the study. A structured questionnaire was used to collect data on the background characteristics and risk factors for hypertension. The weight and height measures were used to calculate the BMI of the participants. A systolic blood pressure of 140 mmHg and a diastolic blood pressure of 90 mmHg according to the guidelines from American Heart Association were classified as hypertension. Results: Majority of the staff (62.1%) were not aware of their blood pressure value. About 29.3% have a family history of hypertension, 17.9% are diabetic, 27.9% takes alcohol, 9.3% take tobacco, 20.0% exercises while 20.0% add salt to cooked food. Family history of hypertension, intake of alcohol and exercise were significant risk factors associated with hypertension. On logistic regression exercise [AOR = 0.119; CI = (0.030–0.481)] and family history of hypertension [AOR = 3.932; CI = (1.485–10.413)] positively predicted hypertension among the participants. Conclusion: The study revealed that both non modifiable (family history of hypertension) and modifiable risk factors (intake of alcohol and exercise) were significant risk factors for hypertension in the studied population. Hence, awareness should be directed to both areas.