scholarly journals Endothelial dysfunction and impaired arterial wall properties in patients with retinal vein occlusion

2020 ◽  
Vol 25 (4) ◽  
pp. 302-308
Author(s):  
Nikolaos Gouliopoulos ◽  
Gerasimos Siasos ◽  
Marilita M Moschos ◽  
Evangelos Oikonomou ◽  
Alexandros Rouvas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endothelial Dysfunction ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Retinal Vein Occlusion ◽  
Augmentation Index ◽  
Vascular Lesion ◽  
Reflected Waves ◽  
Vein Occlusion ◽  
Increased Risk

Retinal vein occlusion (RVO) is a common retinal vascular lesion, and a leading cause of visual impairment. Patients with RVO have an increased risk for cardiovascular disease and share multiple common risk factors. In this study, we investigated the endothelial function and arterial stiffness of patients with RVO compared to healthy-control (CL) subjects. We enrolled 40 consecutive patients with RVO and 40 CL subjects. RVO was diagnosed by an ophthalmologist, endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery, and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) of the radial artery were measured to evaluate arterial stiffness and reflected waves, respectively. No significant differences were detected between the studied groups in sex, age, presence of hypertension or dyslipidemia, body mass index, systolic and diastolic blood pressure levels, total cholesterol levels, and smoking habits ( p > 0.05 for all). However, patients with RVO had impaired FMD ( p = 0.002) and increased PWV ( p = 0.004), even after adjustment for several confounders. Both FMD and PWV were also significantly and independently associated with the development of RVO. Furthermore, a significant and positive correlation between PWV and systolic blood pressure existed only in the CL group. Therefore, we have shown that RVO is associated with significant endothelial dysfunction and increased arterial stiffness. Our results strengthen the vascular theory, according to which, systemic endothelial dysfunction and arteriosclerosis play a significant role in the pathogenesis of RVO.

scholarly journals Retinal Vein Occlusion: A Form of Local Venous Thrombosis or a Result of Systemic Endothelial Dysfunction

2021 ◽  
Author(s):  
Erdinç Bozkurt ◽  
Turkhun Cetin ◽  
Ibrahim Rencuzogulları
Keyword(s):  
Endothelial Dysfunction ◽  
Carotid Artery ◽  
Endothelial Function ◽  
Retinal Vein Occlusion ◽  
Carotid Artery Disease ◽  
Hematological Parameters ◽  
Intima Media Thickness ◽  
Control Group ◽  
Vein Occlusion ◽  
Significant Difference

Abstract Background: To determine the condition of systemic endothelial function and carotid intima media thickness (CIMT) in patients with retinal vein occlusion (RVO) and to identify the risk factors associated with the disease.Methods: Seventy-six patients who presented to the clinic with the diagnosis of RVO and 76 age- and gender-matched healthy individuals without a RVO history were included in the study. The patients' vision levels and central macular thickness were measures, and diabetes, hypertension, hyperlipidemia, carotid artery disease, body mass index and smoking histories were recorded. The endothelial function levels of the patients, pulse wave velocity (PWV), and CIMT were measured. Serum hematological parameters were evaluated.Results: The most important risk factor in patients with RVO was found to be hypertension (OR 1.455, 95% CI 1.981-9.272; p=0.001) compared to the control group, and diabetes (OR 0.460, 95% CI 1.981-9.272; p=0.001) and hyperlipidemia (OR 0.124, 95% CI 0.371-3.456; p=0.828) were significantly more common among the patients.There was a statistically significant difference between the RVO and control groups in terms of flow-mediated dilation (OR 0.050, 95% CI 0.020-0.080; p =0.001), PWV (OR 0.392, 95% CI 0.271-0.513; p<0.001), and the CIMT of both sides (OR 2.434, 95% CI 1.801-3.055 for the right CIMT and OR 2.284, 95% CI 1.646-2.922 for the left CIMT) (p<0.001 for all).Conclusion: Considering that RVO is associated with systemic endothelial dysfunction and may also be accompanied by carotid artery stenosis, we think that additional systemic diseases should be questioned in this patient group.

scholarly journals MON-LB52 Evaluation of Arterial Stiffness in Acromegaly Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
sevil alagüney ◽  
Goknur Yorulmaz ◽  
Toygar Ahmet Kalkan ◽  
Kadir Ugur Mert ◽  
Muhammet Dural ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Morbidity And Mortality ◽  
Increased Risk ◽  
Study Results ◽  
Blood Pressures

Abstract Acromegaly is associated with increased morbidity and mortality primarily attributed to cardiovascular and cerebrovascular diseases, thus demonstrating the negative arterial impact of chronic GH and IGF-1 excess. There are limited and conflicting data regarding coronary artery disease (CAD) in acromegaly that consists mainly of heterogeneous cohorts and pathological reviews of old case series. Increased arterial stiffness is associated with an increased risk of cardiovascular events such as myocardial infarction. Arterial stiffness may measured from pulse wave velocity(PWV). In this study we aimed to evaluate the association between pulse wave velocity and aortic augmentation index in acromegalic patients. Methods: Our study population consists of a consecutive subset of 32 acromegalic patients and 19 control. Acromegalic patients IGF 1 levels were noted. All patients BMI, age, blood pressure, gender also were noted. Also pulse pressure, central blood pressures were measured by non-invasive central blood pressure measurement device (SphygmoCor). Pulse wave velocity and aortic augmentation index were measured by the same device. Results: A total of 32 acromegalic patients and 19 control were enrolled in the study. Body mass index and gender were not significantly different between the groups. Aortic augmentation index (5 vs. 6, p =0,685) variables weren’t significantly different in the study. Systolic and diastolic blood pressures were significantly high in the acromegalic group. (130/82 vs. 120/70) PWV was significantly high in the acromegalic group. (13 vs 11,5 p=0,002)Conclusions: Our study results suggest that acromegaly patients have worse arterial stiffness due to increased pulse wave velocity. Acromegaly is associated with increased morbidity and mortality primarily attributed to cardiovascular problems. We thought that it may be a guiding method in disease management since it can be an early marker of cardiovascular risk.Keywords: acromegaly, pulse wave velocity, aortic augmentation index

scholarly journals Evaluation of Systemic Endothelial Dysfunction in Patients with Retinal Vein Occlusion

2021 ◽  
Author(s):  
Erdinc Bozkurt ◽  
Turkhun Cetin ◽  
Ibrahim Rencuzogulları
Keyword(s):  
Endothelial Dysfunction ◽  
Carotid Artery ◽  
Endothelial Function ◽  
Retinal Vein Occlusion ◽  
Carotid Artery Disease ◽  
Hematological Parameters ◽  
Intima Media Thickness ◽  
Control Group ◽  
Vein Occlusion ◽  
Significant Difference

Abstract Purpose: To determine the condition of systemic endothelial function and carotid intima media thickness (CIMT) in patients with retinal vein occlusion (RVO) and to identify the risk factors associated with the disease.Material-Method: Seventy-six patients who presented to the clinic with the diagnosis of RVO and 76 age- and gender-matched healthy individuals without a RVO history were included in the study. The patients' vision levels and central macular thickness were measures, and diabetes, hypertension, hyperlipidemia, carotid artery disease, body mass index and smoking histories were recorded. The endothelial function levels of the patients, pulse wave velocity (PWV), and CIMT were measured. Serum hematological parameters were evaluated.Results: The most important risk factor in patients with RVO was found to be hypertension (OR 1.455, 95% CI 1.981-9.272; p=0.001) compared to the control group, and diabetes (OR 0.460, 95% CI 1.981-9.272; p=0.001) and hyperlipidemia (OR 0.124, 95% CI 0.371-3.456; p=0.828) were significantly more common among the patients.There was a statistically significant difference between the RVO and control groups in terms of flow-mediated dilation (OR 0.050, 95% CI 0.020-0.080; p =0.001), PWV (OR 0.392, 95% CI 0.271-0.513; p<0.001), and the CIMT of both sides (OR 2.434, 95% CI 1.801-3.055 for the right CIMT and OR 2.284, 95% CI 1.646-2.922 for the left CIMT) (p<0.001 for all).Conclusion: Considering that RVO is associated with systemic endothelial dysfunction and may also be accompanied by carotid artery stenosis, we think that additional systemic diseases should be questioned in this patient group.

scholarly journals P0763A COMPARATIVE STUDY OF ARTERIAL STIFFNESS AND WAVE REFLECTIONS IN DIABETIC AND NON-DIABETIC PATIENTS WITH CKD

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Maria Schoina ◽  
Charalampos Loutradis ◽  
Evangelos Memmos ◽  
Rafael Papadopoulos ◽  
Eleni Intzevidou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Augmentation Index ◽  
Diabetic Patients ◽  
Additional Contribution ◽  
Wave Reflections ◽  
Increased Risk ◽  
Stage 4 ◽  
Ckd Stage ◽  
Significant Difference

Abstract Background and Aims Arterial stiffness is associated with increased risk for target-organ damage, cardiovascular events and overall mortality in the general population, patients with diabetes mellitus and patients with chronic kidney disease (CKD) of all stages. This is the first study to evaluate in comparison arterial stiffness and arterial wave reflections in diabetic and non-diabetic patients with CKD. Method This study included 48 diabetic and 48 non-diabetic adult patients (&gt;18 years) with CKD (eGFR: &lt;90 και ≥15mL/min/1.73m2), matched in a 1:1 ratio for age, sex and eGFR within each CKD stage (2, 3a, 3b and 4). All patients underwent carotid-femoral pulse wave velocity (PWV), central blood pressure (BP), and wave reflections measurement with applanation tonometry (Sphygmocor, Atcor Medical, Australia). Results Office systolic and diastolic blood pressure was similar between diabetic and non-diabetic subjects with CKD in total and across CKD stages. Office brachial pulse pressure (PP) was significantly lower in non-diabetics (49.00±8.0 vs 52.67±8.7 mmHg, p= 0.034). Office PWV was marginally higher in diabetics compared with non-diabetics (10.89±2.0 vs 10.06±2.2 m/sec, p=0.056). In CKD stages 2 and 4, no significant difference in PWV between the two groups was noted, but PWV was higher for diabetics in CKD stages 3a (11.28±1.4 vs 9.83±1.5 m/sec, p=0.023) and 3b (11.13±1.9 vs 9.46±1.2 m/sec, p=0.016). Heart-rate-adjusted augmentation index [AIx(HR75)] was higher in diabetic compared with non-diabetic subjects only in CKD stage 4 (32.08±4.2 vs 25.92±6.6%, p=0.013). Conclusion Diabetic CKD patients present higher arterial stiffness than non-diabetic counterparts. The additional contribution of diabetes towards increased arterial stiffness is more prominent in patients with moderately impaired renal function (CKD stage 3a and 3b), whereas at stage 4, PWV was increased independent of diabetes presence.

scholarly journals Augmentation Index Is Inversely Associated with Skeletal Muscle Mass, Muscle Strength, and Anaerobic Power in Young Male Adults: A Preliminary Study

2021 ◽  
Vol 11 (7) ◽  
pp. 3146
Author(s):  
Dongmin Lee ◽  
Kyengho Byun ◽  
Moon-Hyon Hwang ◽  
Sewon Lee
Keyword(s):  
Skeletal Muscle ◽  
Muscle Strength ◽  
Arterial Stiffness ◽  
Muscle Mass ◽  
Muscular Strength ◽  
Skeletal Muscle Mass ◽  
Augmentation Index ◽  
Anaerobic Power ◽  
Negatively Associated ◽  
Increased Risk

Arterial stiffness is associated with an increased risk of cardiovascular disease. Previous studies have shown that there is a negative correlation between arterial stiffness and variables such as skeletal muscle mass, muscular strength, and anaerobic power in older individuals. However, little research has been undertaken on relationships in healthy young adults. This study presents a preliminary research that investigates the association between arterial stiffness and muscular factors in healthy male college students. Twenty-three healthy young males (23.9 ± 0.5 years) participated in the study. The participants visited the laboratory, and variables including body composition, blood pressure, arterial stiffness, blood parameters, grip strength, and anaerobic power were measured. Measurements of augmentation index (AIx) and brachial-ankle pulse wave velocity (baPWV) were performed to determine arterial stiffness. There were significant positive correlations among skeletal muscle mass, muscle strength, and anaerobic power in healthy young adult males. AIx was negatively associated with a skeletal muscle mass (r = −0.785, p < 0.01), muscular strength (r = −0.500, p < 0.05), and anaerobic power (r = −0.469, p < 0.05), respectively. Likewise, AIx@75 corrected with a heart rate of 75 was negatively associated with skeletal muscle mass (r = −0.738, p < 0.01), muscular strength (r = −0.461, p < 0.05), and anaerobic power (r = −0.420, p < 0.05) respectively. However, the baPWV showed no correlation with all muscular factors. Our findings suggest that maintaining high levels of skeletal muscle mass, muscular strength, and anaerobic power from relatively young age may lower AIx.

Abstract 12770: The Significant Role of Endothelium and Arterial Wall Properties in Patients With Pseudoexfoliative Glaucoma

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Georgia Siasou ◽  
Gerasimos Siasos ◽  
Marilita M Moschos ◽  
Nikolaos Gouliopoulos ◽  
Evangelos Oikonomou ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Endothelial Function ◽  
Significant Role ◽  
Vascular Function ◽  
Arterial Wall ◽  
Augmentation Index ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Pseudoexfoliative Glaucoma

Introduction: Primary open-angle glaucoma (POAG) is one of the most prevalent causes of irreversible blindness and is associated with endothelial dysfunction and arterial stiffness. Pseudoexfoliative glaucoma (PEG) is another type of glaucoma observed in pseudoexfoliation syndrome. It is characterized by the deposition of pseudoexfoliative material not only to the anterior segment of the eye, but also to the vessels, heart and other organs. Hypothesis: Endothelial function and arterial stiffness are impaired in patients with POAG and PEG supporting the significant role of vascular function impairment in the progression of the disease. Methods: Forty four POAG patients, 22 PEG and 38 healthy subjects (Cl) were included in this study. All subjects were free of cardiovascular or inflammatory diseases. Endothelial function was evaluated by flow-mediated dilatation (FMD). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections Results: Between the three study groups CL, POAG, PEG there was no difference in age (67±10years vs. 70±9years vs. 66±12yeras, p=0.12) or prevalence of male sex (70% vs. 57% vs. 50%, p=0.21). Importantly, there was a linear impairment of FMD (7.35±2.77% vs. 6.58±3.18% vs. 4.88±3.29%, p=0.006), PWV (7.98±1.56m/sec vs. 9.20±1.84m/sec vs. 9.22±2.16m/sec, p=0.004) and AIx (21.29±8.77% vs. 25.14±5.71% vs. 28.20±8.75%, p=0.002) from CL to POAG and PEG. Interestingly post hoc test after Scheffe correction revealed also that PEG subjects had not only significantly impaired FMD, compared to control subjects, but also compared to POAG subjects (4.88±3.29% vs. 6.58±3.18%, p=0.02). Conclusions: Endothelial function and arterial stiffness are significantly impaired in patients with pseudoexfoliative glaucoma. These findings shed some light in the pathophysiology of pseudoexfoliative glaucoma and support the theory that pseudoexfoliative fibrils may also accumulate and damage the arterial wall.

MO570PULSE PRESSURE: A PREDICTOR OF CARDIOVASCULAR CALCIFICATION AND CARDIOVASCULAR MORTALITY IN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Merita Rroji (Molla) ◽  
Saimir Seferi ◽  
Majlinda Cafka ◽  
Erjola Likaj ◽  
Vilma Cadri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Abdominal Aorta ◽  
Cardiovascular Mortality ◽  
Pulse Pressure ◽  
Univariate Analysis ◽  
Hemodialysis Patients ◽  
Case Series Study ◽  
Increased Risk ◽  
Elevated Systolic Blood Pressure

Abstract Background and Aims The mortality rate is extremely high in chronic kidney disease (CKD), primarily due to the high prevalence of cardiovascular disease (CVD). Increased pulse pressure (PP), defined as the difference between inappropriately elevated systolic blood pressure (SBP) and reduced diastolic blood pressure (DBP) at any value of mean arterial pressure (MAP), is a surrogate measure of increased arterial stiffness of central elastic arteries (aorta and its major branches). CKD-MBD anomalies leading to calcification contribute to increased arterial stiffness and pulse pressure. This study aimed to evaluate the relationship of pulse pressure parameter with valve calcification and abdominal aortic calcification in hemodialysis patients and its impact on cardiovascular mortality. Method We performed a prospective case series study with 3 years follow- up. Plain X-ray images of the lateral lumbar spine from all subjects were studied to obtain images of the lower abdominal aorta using semiquantitative scores as described by Kauppila et al. Cardiac valve calcifications were evaluated by two-dimensional echocardiography with an HDI 5000 Sono CT echocardiographic machine with a 3.3-MHz multiphase array probe in subjects lying in the left decubitus position an according to the recommendations of the European Association of Echocardiography. The patient was evaluated as having vascular calcification if he had the presence of calcification in at least one of the site examined: a mitral valve, aortic valve or abdominal aorta. Results We studied 85 chronic stable hemodialysis patients. Mean age and meantime is therapy was 49.9±12.4 years and 51.5±28.7 months, respectively. Mean pulse pressure was 55.72±14.2 mmHg. Fifty-nine patients (69.4%) were identified with aortic abdominal calcification, and the mean Kauppila score was 4.91 ± 4.05. Sixty patients (70.5%) had at least one valve calcified, while thirty-three patients (38.8%) had both valves calcified. Univariate analysis revealed that every 1 mmHg increase in pulse pressure was associated with increased cardiovascular calcification risk p=0.020. In multivariate analysis, after adjustment for age, gender, diabetes mellitus, cholesterol, and triglyceride serum levels, the association also remained strong, where every increase of 1 mm Hg in pulse pressure was associated with increased risk for cardiovascular calcification (HR 1.02, 95% CI (1.00-1.03), p= 0.038). Besides, pulse pressure was an independent predictor for cardiovascular mortality (HR 1.03, 95% CI (1.02-1.05), p=0.002). Conclusion Pulse pressure may identify hemodialysis patients with subclinical cardiovascular calcification who need further evaluation. Wide pulse pressure is associated with increased cardiovascular mortality.

Effect of Salt Supplementation on Sympathetic Activity and Endothelial Function in Salt-Sensitive Type 2 Diabetes

2019 ◽  
Vol 105 (4) ◽  
pp. e1187-e1200 ◽  
Author(s):  
Sara Baqar ◽  
Yee Wen Kong ◽  
Angela X Chen ◽  
Christopher O’Callaghan ◽  
Richard J MacIsaac ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Endothelial Function ◽  
Augmentation Index ◽  
Sodium Intake ◽  
Blood Pressure Monitoring ◽  
Muscle Sympathetic Nerve Activity ◽  
Burst Frequency ◽  
Low Sodium

Abstract Context Lower sodium intake is paradoxically associated with higher mortality in type 2 diabetes (T2D). Objective To determine whether sympathetic nervous system (SNS) activation and endothelial dysfunction contribute to these observations, we examined the effect of salt supplementation on these systems in people with T2D with habitual low sodium. We hypothesized that salt supplementation would lower SNS activity and improve endothelial function compared to placebo. Design We conducted a randomized, double-blinded, placebo-controlled crossover trial. Setting The study took place in a tertiary referral diabetes outpatient clinic. Participants Twenty-two people with T2D with habitual low sodium intake (24-hour urine sodium &lt;150 mmol/24h) were included. Intervention Salt supplementation (100 mmol NaCl/24h) or placebo for 3 weeks was administered. Main outcome measures The primary outcome of SNS activity and endothelial function was assessed as follows: Microneurography assessed muscle sympathetic nerve activity (MSNA), pulse amplitude tonometry assessed endothelial function via reactive hyperemic index (RHI), and arterial stiffness was assessed via augmentation index (AI). Secondary outcomes included cardiac baroreflex, serum aldosterone, ambulatory blood pressure monitoring (ABPM), heart rate variability (HRV), and salt sensitivity. Results Compared to placebo, salt supplementation increased MSNA (burst frequency P = .047, burst incidence P = .016); however, RHI (P = .24), AI (P = .201), ABPM (systolic P = .09, diastolic P = .14), and HRV were unaffected. Salt supplementation improved baroreflex (slope P = .026) and lowered aldosterone (P = .004), and in salt-resistant individuals there was a trend toward improved RHI (P = .07). Conclusions In people with T2D and low habitual sodium intake, salt supplementation increased SNS activity without altering endothelial function or blood pressure but improved baroreflex function, a predictor of cardiac mortality. Salt-resistant individuals trended toward improved endothelial function with salt supplementation.

scholarly journals Time‐Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above‐Normal Blood Pressure

2021 ◽  
Author(s):  
Daniel H. Craighead ◽  
Thomas C. Heinbockel ◽  
Kaitlin A. Freeberg ◽  
Matthew J. Rossman ◽  
Rachel A. Jackman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Muscle Strength ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Systolic Blood Pressure ◽  
High Resistance ◽  
Maximal Inspiratory Pressure ◽  
No Bioavailability ◽  
Inspiratory Muscle Strength

Background High‐resistance inspiratory muscle strength training (IMST) is a novel, time‐efficient physical training modality. Methods and Results We performed a double‐blind, randomized, sham‐controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50–79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long‐lasting effects. Thirty‐six participants completed high‐resistance IMST (75% maximal inspiratory pressure, n=18) or low‐resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg ( P <0.01) with IMST, which was ≈75% sustained 6 weeks after IMST ( P <0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P =0.03); blood pressure was unaffected by sham training (all P >0.05). Twenty‐four hour systolic blood pressure was lower after IMST versus sham training ( P =0.01). Brachial artery flow‐mediated dilation improved ≈45% with IMST ( P <0.01) but was unchanged with sham training ( P =0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity ( P <0.05). IMST decreased C‐reactive protein ( P =0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness ( P >0.05). Conclusions High‐resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above‐normal initial systolic blood pressure. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03266510.

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