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Buso G, Paini A, Agabiti-Rosei C, De Ciuceis C, Bertacchini F, Stassaldi D, Salvetti M, Ritelli M, Venturini M, Colombi M, Muiesan ML. Despite celiprolol therapy, patients with vascular Ehlers-Danlos syndrome remain at risk of vascular events: A 12-year experience in an Italian referral center. Vasc Med 2023:1358863X231215330. [PMID: 38102934 DOI: 10.1177/1358863x231215330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
BACKGROUND Vascular Ehlers-Danlos syndrome (vEDS) is an inherited connective tissue disorder characterized by arterial fragility. Celiprolol has been suggested to significantly reduce rates of vascular events in this setting, though real-world evidence is limited. The aim of this study was to report our experience with celiprolol therapy in vEDS management. METHODS Patients with a genetically confirmed diagnosis of vEDS who were referred for outpatient consultation at the Brescia University Hospital between January 2011 and July 2023 were included. At each visit, patients' medical history, results of vascular imaging, and office blood pressure measurements were recorded. Celiprolol therapy was progressively titrated to the maximum tolerated dose of up to 400 mg daily, according to the patients' tolerance. RESULTS Overall, 26 patients were included. Female sex was prevalent (62%). Mean (SD) age was 37 (16) years. Follow-up duration was 72 (41) months. At the last follow-up visit, all patients were on celiprolol therapy, 80% of whom were taking the maximum recommended dose. The yearly risk of symptomatic vascular events was 8.8%, the majority of which occurred after reaching the maximum recommended dose of celiprolol. No significant predictor of symptomatic vascular events was identified among patients' clinical characteristics. CONCLUSION In our cohort, rates of celiprolol use were high and the drug was well tolerated overall. Nonetheless, the risk of symptomatic vascular events remained nonnegligible. Future studies should identify reliable predictors of major adverse events and explore additional therapeutic strategies that could further lower the risk of life-threatening events in this population.
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Affiliation(s)
- Giacomo Buso
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
- University of Lausanne, Lausanne, Switzerland
| | - Anna Paini
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
| | - Claudia Agabiti-Rosei
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
| | - Carolina De Ciuceis
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
| | - Fabio Bertacchini
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
| | - Deborah Stassaldi
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
| | - Massimo Salvetti
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
| | - Marco Ritelli
- Department of Molecular and Translational Medicine, Division of Biology and Genetics, University of Brescia, Brescia, Lombardy, Italy
| | - Marina Venturini
- Department of Clinical and Experimental Sciences, Division of Dermatology, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
| | - Marina Colombi
- Department of Molecular and Translational Medicine, Division of Biology and Genetics, University of Brescia, Brescia, Lombardy, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Brescia, Lombardy, Italy
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Crisafulli E, Sartori G, Vianello A, Maroccia A, Lepori E, Quici M, Cogliati C, Salvetti M, Paini A, Aggiusti C, Bertacchini F, Busti F, Marchi G, Muiesan ML, Girelli D. Use of non-invasive respiratory supports in high-intensity internal medicine setting during the first two waves of the COVID-19 pandemic emergency in Italy: a multicenter, real-life experience. Intern Emerg Med 2023; 18:1777-1787. [PMID: 37470891 PMCID: PMC10504094 DOI: 10.1007/s11739-023-03371-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
During the first two waves of the COVID-19 emergency in Italy, internal medicine high-dependency wards (HDW) have been organized to manage patients with acute respiratory failure (ARF). There is heterogeneous evidence about the feasibility and outcomes of non-invasive respiratory supports (NIRS) in settings outside the intensive care unit (ICU), including in patients deemed not eligible for intubation (i.e., with do-not-intubate, DNI status). Few data are available about the different NIRS modalities applied to ARF patients in the newly assembled internal medicine HDW. The main aim of our study was to describe a real-life experience in this setting of cure, focusing on feasibility and outcomes. We retrospectively collected data from COVID-19 patients with ARF needing NIRS and admitted to internal medicine HDW. Patients were treated with different modalities, that is high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), or non-invasive mechanical ventilation (NIMV). Switching among different NIRS during the hospitalization and the success rate (weaning with the same NIRS) or failure (endotracheal intubation-ETI or in-hospital death) were recorded. Three hundred thirty four ARF patients (median age 74 years), of which 158 (54%) had a DNI status, were included. CPAP, NIMV, and HFNC's success rates were 54, 33, and 13%, respectively. Although DNI status was strongly associated with death (Gehan-Breslow-Wilcoxon test p < 0.001), an acceptable success rate was observed in these patients using CPAP (47%). Multivariate regression models showed older age (odds ratio-OR 4.74), chronic ischemic heart disease (OR 2.76), high respiratory rate after 24 h (OR 7.13), and suspected acute respiratory distress syndrome-ARDS (OR 21.1) as predictors of mortality risk or ETI. Our real-life experience shows that NIRS was feasible in internal medicine HDW with an acceptable success rate. Although DNI patients had a worse prognosis, the use of NIRS represented a reasonable chance of treatment.
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Affiliation(s)
- Ernesto Crisafulli
- Department of Medicine, Respiratory Medicine Unit and Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Largo L. A. Scuro, 10, 37124, Verona, Italy.
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
| | - Giulia Sartori
- Department of Medicine, Respiratory Medicine Unit and Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Largo L. A. Scuro, 10, 37124, Verona, Italy
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alice Vianello
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alessio Maroccia
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Elisa Lepori
- Internal Medicine, L.Sacco Hospital, ASST-FBF-Sacco, Milan, Italy
| | | | - Chiara Cogliati
- Internal Medicine, L.Sacco Hospital, ASST-FBF-Sacco, Milan, Italy
- Department of Biochemical and Clinical Sciences, University of Milan, Milan, Italy
| | - Massimo Salvetti
- Dipartimento Di Scienze Cliniche E Sperimentali, Università Di Brescia, Brescia, Italy
- SSVD Medicina Di Urgenza ASST Spedali Civili Brescia, Brescia, Italy
| | - Anna Paini
- SSVD Medicina Di Urgenza ASST Spedali Civili Brescia, Brescia, Italy
| | - Carlo Aggiusti
- SSVD Medicina Di Urgenza ASST Spedali Civili Brescia, Brescia, Italy
| | - Fabio Bertacchini
- SSVD Medicina Di Urgenza ASST Spedali Civili Brescia, Brescia, Italy
| | - Fabiana Busti
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giacomo Marchi
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Maria Lorenza Muiesan
- Dipartimento Di Scienze Cliniche E Sperimentali, Università Di Brescia, Brescia, Italy
- UOC 2° Medicina Generale ASST Spedali Civili Brescia, Brescia, Italy
| | - Domenico Girelli
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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Airale L, Borrelli F, Arrivi A, Baracchi A, Bertacchini F, Cartella I, Curcio R, Izzo R, Lembo M, Mancusi C, Manzi MV, Milani M, Moreo A, Paini A, Pucci G, Ruscelli F, Salvetti M, Soldati M, Milan A. Ascending aorta dilatation is associated to hard cardiovascular events, follow-up from multicentric ARGO-Perspective project. Hypertens Res 2023; 46:2016-2023. [PMID: 37328694 DOI: 10.1038/s41440-023-01340-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/30/2023] [Accepted: 05/18/2023] [Indexed: 06/18/2023]
Abstract
Aortic root dilatation has been proposed as hypertension-mediated organ damage (HMOD). Nevertheless, the role of the aortic root dilatation as a possible additional HMOD is still unclear since studies conducted so far are quite heterogeneous regarding the type of population analyzed, the aortic tract considered, and the type of outcomes accounted for. The aim of the present study is to assess whether the presence of aortic dilatation is associated with strong cardiovascular (CV) events (MACE: heart failure, CV death, stroke, acute coronary syndrome, myocardial revascularization) in a population of patients affected by essential hypertension. Four hundred forty-five hypertensive patients from six Italian hospitals were recruited as part of ARGO-SIIA study1. For all centers, follow-up was obtained by re-contacting all patients by telephone and through the hospital's computer system. Aortic dilatation (AAD) was defined through absolute sex-specific thresholds as in previous studies (41 mm for males, 36 mm for females). Median follow-up was 60 months. AAD was found to be associated with the occurrence of MACE (HR = 4.07 [1.81-9.17], p < 0.001). This result was confirmed after correction for main demographic characteristics such as age, sex and BSA (HR = 2.91 [1.18-7.17], p = 0.020). At penalized Cox regression, age, left atrial dilatation, left ventricular hypertrophy and AAD were identified as best predictor of MACEs and AAD resulted a significant predictor of MACEs even after correction for these confounders (HR = 2.43 [1.02-5.78], p = 0.045). The presence of AAD was found to be associated with an increased risk of MACE independently of for major confounders, including established HMODs. AAD ascending aorta dilatation, LAe left atrial enlargement, LVH left ventricular hypertrophy, MACEs major adverse cardiovascular events, SIIA Società Italiana dell'Ipertensione Arteriosa (Italian Society for Arterial Hypertension).
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Affiliation(s)
- Lorenzo Airale
- Department of Medical Sciences, Hypertension Center-University of Torino-AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Francesco Borrelli
- Department of Medical Sciences, Hypertension Center-University of Torino-AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessio Arrivi
- SC Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Alessandro Baracchi
- Cardiothoracic and Vascular Department, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Fabio Bertacchini
- Department of Internal Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Iside Cartella
- Echo Lab, Cardiologia IV, De Gasperis Department, ASST Niguarda Ca Granda e Dip Medicina e Chirurgia, Università Milano Bicocca, Milano, Italy
| | - Rosa Curcio
- SC Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Raffaele Izzo
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Maria Lembo
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Costantino Mancusi
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Maria Virgina Manzi
- Hypertension Research Center, Federico II University Hospital, Napoli, Italy
| | - Martina Milani
- Echo Lab, Cardiologia IV, De Gasperis Department, ASST Niguarda Ca Granda e Dip Medicina e Chirurgia, Università Milano Bicocca, Milano, Italy
| | - Antonella Moreo
- Echo Lab, Cardiologia IV, De Gasperis Department, ASST Niguarda Ca Granda e Dip Medicina e Chirurgia, Università Milano Bicocca, Milano, Italy
| | - Anna Paini
- Department of Internal Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Giacomo Pucci
- SC Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Federico Ruscelli
- Cardiothoracic and Vascular Department, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Massimo Salvetti
- Department of Internal Medicine, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mario Soldati
- Cardiothoracic and Vascular Department, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Alberto Milan
- Department of Medical Sciences, Hypertension Center-University of Torino-AOU Città della Salute e della Scienza di Torino, Torino, Italy.
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Mancusi C, Bisogni V, Maloberti A, Manzi MV, Visco V, Biolcati M, Giani V, Spannella F, Monticone S, Saladini F, Rivasi G, Turrin G, Pucci G, Pengo M, Bertacchini F, Ferri C, Grassi G, Muiesan ML, Fucile I, Sorvillo G, Grieco F, Jacobitti G, Di Costanzo A, Vittoria Govetosa M, D’Avino G, D’Agosto D, Schiavi P, Biondini S, Ristori L. Accuracy of home blood pressure measurement: the ACCURAPRESS study – a proposal of Young Investigator Group of the Italian Hypertension Society (Società Italiana dell’Ipertensione Arteriosa). Blood Press 2022; 31:297-304. [DOI: 10.1080/08037051.2022.2137461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Costantino Mancusi
- Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Valeria Bisogni
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Alessandro Maloberti
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
- ASST GOM Niguarda Hospital, Milan, Italy
| | - Maria Virginia Manzi
- Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Fisciano, Italy
| | - Marco Biolcati
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - Valentina Giani
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | - Silvia Monticone
- Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
| | | | - Giulia Rivasi
- Hypertension Clinic, Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Giada Turrin
- Hypertension Clinic, Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Unit of Internal Medicine, Terni University Hospital, Terni, Italy
| | - Martino Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Fabio Bertacchini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy and 2a Medicina ASST Spedali Civili di Brescia, Brescia, Italy
| | - Claudio Ferri
- MeSVA Department and San Salvatore Hospital, UOC Internal Medicine and Nephrology, University of L’Aquila, L’Aquila, Italy
| | - Guido Grassi
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy and 2a Medicina ASST Spedali Civili di Brescia, Brescia, Italy
| | - Ilaria Fucile
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Gianmarco Sorvillo
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Fabrizia Grieco
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Giulia Jacobitti
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Anita Di Costanzo
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Maria Vittoria Govetosa
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Giuseppina D’Avino
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
| | - Domenico D’Agosto
- Hypertension Research center and Department of Advanced Biomedical Science, Federico II University of Naples, Napoli, Italy
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Bertacchini F, Agabiti Rosei C, Buso G, Cappellini S, Stassaldi D, Aggiusti C, Salvetti M, Paini A, De Ciuceis C, Muiesan ML. Subclinical HMOD in Hypertension: Left Ventricular Diastolic Dysfunction. High Blood Press Cardiovasc Prev 2022; 29:585-593. [PMID: 36352335 PMCID: PMC9708770 DOI: 10.1007/s40292-022-00548-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023] Open
Abstract
Arterial hypertension represents an important risk factor for the development of cardiac, vascular and renal events, predisposing to heart failure, acute coronary syndromes, peripheral artery disease, stroke, and chronic renal disease. Arterial hypertension leads to the development of subclinical hypertension mediated organ damage (HMOD) which has prognostic relevance and may influence the choice of treatment options. Alterations of cardiac structure and function represent the more widely assessed form of HMOD. This manuscript will focus on the diagnostic opportunities, prognostic significance and treatment of diastolic dysfunction alterations.
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Affiliation(s)
- Fabio Bertacchini
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Claudia Agabiti Rosei
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Giacomo Buso
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Sara Cappellini
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Deborah Stassaldi
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Carlo Aggiusti
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Massimo Salvetti
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Anna Paini
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Carolina De Ciuceis
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, 2a Medicina-ASST Spedali Civili Brescia, University of Brescia, 25100, Brescia, Italy.
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Bertacchini F, Pantano P, Bilotta E. Shaping the aesthetical landscape by using image statistics measures. Acta Psychol (Amst) 2022; 224:103530. [PMID: 35168145 DOI: 10.1016/j.actpsy.2022.103530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/27/2022] Open
Abstract
Aesthetics and evaluation of objects is becoming increasingly important in contemporary society. Although there have been many studies on processes related to computational aesthetic, a clear formalisation and visualization of the aesthetic field is still lacking. In this paper, we present a set of Machine Learning techniques and mathematical methods to extract the most important features related to aesthetical evaluation, thus making this process automatic, without the human intervention. The techniques are then applied to a sample of 83 images of triangles, produced by artists. The results of the empirical method provide a series of measurements that allow the extrapolation of mathematical aesthetic characteristics of the images and their location in the aesthetic space.
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Paini A, Tarozzi L, Bertacchini F, Aggiusti C, Rosei CA, De Ciuceis C, Malerba P, Broggi A, Perani C, Salvetti M, Muiesan ML. Cardiovascular prognosis in patients admitted to an emergency department with hypertensive emergencies and urgencies. J Hypertens 2021; 39:2514-2520. [PMID: 34420015 PMCID: PMC9698186 DOI: 10.1097/hjh.0000000000002961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 06/26/2021] [Accepted: 06/27/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND At present, few data are available on the prognosis of hypertensive emergencies and urgencies admitted to emergency departments. AIM The aim of our study was to evaluate the incidence of total and cardiovascular events during follow-up in hypertensive patients admitted to the emergency departments of Brescia Hospital (Northern Italy) with hypertensive emergencies or urgencies from 1 January to 31 December 2015. METHODS Medical records of patients aged more than 18 years, admitted to the emergency department with SBP values at least 180 mmHg (SBP) and/or DBP values at least 120 mmHg (DBP) were collected and analysed (18% of patients were classified as 'hypertensive emergency' and 82% as 'hypertensive urgency'). Data in 895 patients (385 men and 510 women, mean age 70. 5 ± 15 years) were analysed; the mean duration of follow-up after admission to the emergency department was 12 ± 5 months. RESULTS During the follow-up, 96 cardiovascular events (28 fatal) occurred (20 cardiac events, 30 cerebrovascular events, 26 hospital admission for heart failure, 20 cases of new onset kidney disease). In 40 patients (4.5%), a new episode of acute blood pressure rise with referral to the emergency department was recorded. Cardiovascular mortality and morbidity were greater in patients with a previous hypertensive emergency (14.5 vs. 4.5% in patients with hypertensive emergency and urgency, respectively, chi-square, P < 0.0001). Similar results were obtained when the occurrence of cerebrovascular or renal events were considered separately. CONCLUSION Admission to the emergency department for hypertensive emergencies and urgencies identifies hypertensive patients at increased risk for fatal and nonfatal cardiovascular events. Our findings add some new finding suggesting that further research in this field should be improved aiming to define, prevent, treat and follow hypertensive urgencies and emergencies.
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Agabiti Rosei E, Muiesan ML, Salvetti M, Paini A, Agabiti Rosei C, Aggiusti C, Bertacchini F, Castellano M, Giacchè M. The Vobarno study. Panminerva Med 2021; 63:458-463. [PMID: 33988330 DOI: 10.23736/s0031-0808.21.04433-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The Vobarno study represents the first observational study aimed to assess in a general population sample the relationship between parameters of cardiac and vascular structure (and function) and blood pressure values, measured in the clinic and during the 24 hours. EVIDENCE ACQUISITION AND SYNTHESIS In the frame of the Vobarno study blood samples for hematochemistry and DNA extraction, clinic and 24-hour blood pressure measurements, cardiac and carotid ultrasound, and aortic stiffness were measured in all subjects, living in a small town (Vobarno) between Brescia and the Garda lake, and randomly selected from electoral roles. In this sample of a general population an extensive evaluation of organ damage, including left ventricular (LV) mass and hypertrophy, LV systolic function, left atrial dimensions and aortic root diameters, carotid intima media thickness (IMT) and carotid plaques, carotid and aortic stiffness were performed. In this study subjects were included in a long follow-up, lasting 25 years, and cardiovascular morbility and mortality were assessed up to 2019. This will allow to update the information related to cardiovascular morbidity and mortality in the study cohort. CONCLUSIONS The present paper will report the results of some analyses performed, exploring epidemiological and clinical aspects of target organ damage.
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Affiliation(s)
- Enrico Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy - .,Medicina Generale 2, ASST Spedali Civili, Brescia, Italy -
| | - Maria L Muiesan
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Medicina Generale 2, ASST Spedali Civili, Brescia, Italy
| | - Massimo Salvetti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Anna Paini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Medicina Generale 2, ASST Spedali Civili, Brescia, Italy
| | - Claudia Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carlo Aggiusti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Medicina Generale 2, ASST Spedali Civili, Brescia, Italy
| | - Fabio Bertacchini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Medicina Generale 2, ASST Spedali Civili, Brescia, Italy
| | - Maurizio Castellano
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Mara Giacchè
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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9
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Saladini F, Mancusi C, Maloberti A, Giavarini A, Bertacchini F, Spannella F, Rosticci M, Bruno RM, Pucci G, Pengo M, Grassi D, Muiesan ML. DIFFERENT APPROACH FOR Management OF HYPERTENSION EMERGENCY AND URGENCY AMONG EMERGENCY PHYSICIANS AND OTHER SPECIALISTS IN THE ITALIAN REAL WORLD. J Hypertens 2021. [DOI: 10.1097/01.hjh.0000747092.17997.c4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Salvetti M, Paini A, Colonetti E, Mutti C, Bonetti S, Broggi A, Bertacchini F, Muiesan ML. Intravenous access placement and fluid administration appropriateness in the emergency department. Emerg Care J 2021. [DOI: 10.4081/ecj.2021.9150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to assess practice and effectiveness of Peripheral Venous Catheter (PVC) insertion and intravenous fluid administration in the Emergency Department (ED). A prospective study was conducted at a single primary ED in Brescia, Italy. 455 participants were included in the analysis. PVC were placed in 88 % of patients, 18 gauge catheters were the most frequently used (63%). In 360 patients PVC placement required one attempt. In 99 % of patients PVCs were used at least once. Fluid administration was considered appropriate in 23 patients. Out of 402 PVC placements, 244 were not necessary (in 225 patients PVCs were used only for blood samples withdrawal, and in 16 patients they were used for blood samples withdrawal, and inappropriate fluid administration). We concluded that a large number of PVC placements in the ED was potentially avoidable, and, when PVCs were used for IV fluid administration, the indication was often inappropriate. Physicians should carefully assess the real need of PVC placement in patients admitted to the ED and critically assess some issues of everyday practice, like PVC placement or IV fluids prescription, with evaluation of cost savings.
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11
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Salvetti M, Paini A, Bertacchini F, Aggiusti C, Stassaldi D, Capellini S, Arnoldi C, Rizzoni D, Agabiti Rosei C, De Ciuceis C, Muiesan ML. Myocardial mechano-energetic efficiency in primary aldosteronism. J Hypertens 2021; 39:318-324. [PMID: 32868642 DOI: 10.1097/hjh.0000000000002637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Available data indicate that patients with primary aldosteronism have an increased risk of cardiovascular events and cardiovascular risk seems to be, at least in part, independent of blood pressure (BP) values. Patients with primary aldosteronism have a greater prevalence of left ventricular (LV) hypertrophy and subtle alterations of ventricular function, which might contribute to the increase in cardiovascular risk. Recently, a noninvasive approach for the estimation of LV mechanical efficiency, obtained by echocardiography has been proposed. AIM OF THE STUDY To evaluate the determinants of myocardial mechanoenergetic efficiency index (MEEi), in a large group of patients with primary aldosteronism (n = 99) and in a control group of essential hypertensive patients (n = 99) matched for age, sex and BP values. RESULTS No differences between groups for age, sex, BMI, BP values, glucose, lipid profile and renal function were observed. LV mass index was greater in primary aldosteronism vs. essential hypertensive patients (46.0 ± 16.7 vs. 36.9 ± 8.6 g/m2, P < 0.001); also relative wall thickness was greater in primary aldosteronism (0.36 ± 0.1 vs. 0.32 ± 0.4, P < 0.001). Left atrial dimensions were significantly greater in primary aldosteronism. Ejection fraction was not different between groups, while endocardial and midwall fractional shortening were lower in primary aldosteronism vs. essential hypertensive patients (40 ± 7 vs. 43 ± 6, and 18 ± 3 vs. 21 ± 2, both P < 0.01). MEEi was lower in primary aldosteronism vs. essential hypertensive patients (0.44 ± 0.14 vs. 0.52 ± 0.10 ml/s per g, P < 0.01). A negative correlation was observed between MEEi and aldosterone levels (r = -0.203, P < 0.05) and aldosterone : renin ratio (P = -0.172, P < 0.05); the correlation remained significant after adjustment for possible confounders. CONCLUSION In patients with primary aldosteronism myocardial MEEi is lower as compared with essential hypertensive patients. A reduced MEEi may reflect an impairment of production and utilization of energy in the myocardium, which could lead to the occurrence of cardiovascular complications and therefore these findings may contribute to explain the increased risk of cardiovascular events in patients with primary aldosteronism.
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Affiliation(s)
- Massimo Salvetti
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Anna Paini
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Fabio Bertacchini
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carlo Aggiusti
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Deborah Stassaldi
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Sara Capellini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Chiara Arnoldi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Damiano Rizzoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Claudia Agabiti Rosei
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carolina De Ciuceis
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Lorenza Muiesan
- 2a Medicina ASST Spedali Civili di Brescia
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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12
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Muiesan M, Salvetti M, Fragoulis C, Paini A, Bertacchini F, Stassaldi D, Dimitriadis K, Konstantinidis D, Kasiakogias A, Andrikou I, Siafi E, Leontsinis I, Iliakis P, Tousoulis K, Tsoufis K. Cardiovascular risk and outcome in patients with hypertensive emergencies and urgencies in an emergency department. an italian greek collaboration. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
At present, few data are available on the prognosis of hypertensive emergencies and urgencies admitted to Emergency Departments (ED). The aim of our study was to evaluate the incidence of total and cardiovascular events during follow-up in hypertensive patients admitted in 2 ED in Italy and Greece with hypertensive emergencies or urgencies.
Methods
Medical records of patients aged >18 yrs, admitted to the ED with blood pressure values ≥180 mmHg (SBP) and/or ≥120 mmHg (DBP) were collected and analysed (24% of patients were classified as “hypertensive emergency” and 76% as “hypertensive urgency”). Data in 1218 patients (556 men and 662 women, mean age 70±13 years) were analysed; the mean duration of follow-up after admission to the ED was 19.5±7 months years.
Results
During the follow-up cardiovascular events occurred in 148 patients (69 cardiac events, 43 cerebrovascular events). In 272 pts (22%) a new episode of acute BP rise was recorded. A total of 87 deaths was recorded during follow-up (in 28 patients for cardiovascular causes). All cause and CV mortality were greater in patients with a previous hypertensive emergency (14.7 vs 4.7%, chi-square p=0.0001 and 5.8 vs 1.2% chisquare p<0.0001 for all-cause and for CV mortality, respectively). The incidence of non fatal cardiovascular events was 10,11 and 2,11 per 100 patient-years in patients with hypertensive emergency and urgency, respectively and similar results were obtained when we considered separately the occurrence of cerebrovascular events.
Conclusions
Admission to the ED for hypertensive emergencies identifies hypertensive patients at increased risk for fatal and non fatal cardiovascular events. Our results underline the need for an accurate follow-up in patients with hypertensive emergencies and urgencies.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M.L Muiesan
- Civil Hospital - university of Brescia, Brescia, Italy
| | - M Salvetti
- Civil Hospital - university of Brescia, Brescia, Italy
| | - C Fragoulis
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Paini
- Civil Hospital - university of Brescia, Brescia, Italy
| | - F Bertacchini
- Civil Hospital - university of Brescia, Brescia, Italy
| | - D Stassaldi
- Civil Hospital - university of Brescia, Brescia, Italy
| | - K Dimitriadis
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - D Konstantinidis
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Kasiakogias
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - I Andrikou
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - E Siafi
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - I Leontsinis
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - P Iliakis
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - K Tousoulis
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - K Tsoufis
- National & Kapodistrian University of Athens Medical School, Athens, Greece
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13
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Salvetti M, Bertacchini F, Saccà G, Muiesan ML. Hypertension Urgencies and Emergencies: The GEAR Project. High Blood Press Cardiovasc Prev 2020; 27:129-132. [PMID: 32200502 DOI: 10.1007/s40292-020-00372-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/16/2020] [Indexed: 01/08/2023] Open
Abstract
Acute elevations in blood pressure (BP), usually defined as ≥ 180/110 mmHg, may present with highly heterogeneous profiles ranging from absence of symptoms to life-threatening target organ damage. In most recent years the diagnostic approach and the treatment of hypertension have gained interest by patients and physicians. The GEAR project (Gestione delle Emergenze e urgenze in ARea critica, management of hypertensive emergencies and hypertensive urgencies in the emergency setting) was proposed by the group of Young Investigators of the Italian Society of Hypertension as a survey aimed to evaluate the awareness, diagnosis and treatment of hypertensive emergencies and urgencies in Italy.
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Affiliation(s)
- Massimo Salvetti
- Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia &Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy
| | - Fabio Bertacchini
- Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia &Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy
| | - Giovanni Saccà
- Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia &Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy
| | - Maria Lorenza Muiesan
- Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia &Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Brescia, Italy.
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14
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Salvetti M, Paini A, Andreoli L, Stassaldi D, Aggiusti C, Bertacchini F, Rosei CA, Piantoni S, Franceschini F, Tincani A, Muiesan ML. Cardiovascular target organ damage in premenopausal systemic lupus erythematosus patients and in controls: Are there any differences? Eur J Intern Med 2020; 73:76-82. [PMID: 31831254 DOI: 10.1016/j.ejim.2019.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/22/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE to analyze the presence of cardiac and vascular preclinical damage in premenopausal women with systemic lupus erythematosus (SLE) and controls, matched for demographic characteristics and for other cardiovascular risk factors. METHODS 33 women (mean age 32 ± 7 years) with SLE clinically stable (SLEDAI Score 2.5 ± +1.5) and 33 controls, matched (MC) for sex, age, body mass index (BMI), clinic blood pressure (BP) and antihypertensive treatment (if present) underwent: 24-h BP monitoring, echocardiography with tissue Doppler analysis for left ventricular (LV) structure, systolic and diastolic function, echo-tracking carotid ultrasound for intima-media thickness (IMT) and carotid distensibility measurement, and pulse wave velocity measurement for aortic stiffness (PWV). RESULTS by definition no difference was observed for age, sex, BMI and clinic BP values; Framingham risk score was low in SLE and MC (1.3 ± 2.7 vs 1.5 ± 2.3%, p = ns). 24-h BP was similar in SLE and in MC. Systolic function parameters, including LV longitudinal systolic function, an early index of LV systolic dysfunction, were reduced in SLE as compared to MC. Carotid IMT and carotid and aortic stiffness parameters were not different in SLE and MC. At multivariate regression analysis, PWV was independently associated with LV mass in controls and with the steroid weekly dose in SLE patients. CONCLUSIONS in young patients with SLE and low activity index of the disease, we did not observe significant vascular alterations as compared to controls with similar CV risk. The early LV systolic impairment observed in SLE patients needs confirmation.
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Affiliation(s)
- Massimo Salvetti
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; UOC 2° Medicina, ASST Spedali Civili Brescia, Italy
| | - Anna Paini
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; UOC 2° Medicina, ASST Spedali Civili Brescia, Italy
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Unit of Rheumatology and Clinical immunology ASST Spedali Civili Brescia, Italy
| | - Deborah Stassaldi
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; UOC 2° Medicina, ASST Spedali Civili Brescia, Italy
| | - Carlo Aggiusti
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; UOC 2° Medicina, ASST Spedali Civili Brescia, Italy
| | - Fabio Bertacchini
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; UOC 2° Medicina, ASST Spedali Civili Brescia, Italy
| | - Claudia Agabiti Rosei
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; UOC 2° Medicina, ASST Spedali Civili Brescia, Italy
| | - Silvia Piantoni
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Unit of Rheumatology and Clinical immunology ASST Spedali Civili Brescia, Italy
| | - Franco Franceschini
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Unit of Rheumatology and Clinical immunology ASST Spedali Civili Brescia, Italy
| | - Angela Tincani
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Unit of Rheumatology and Clinical immunology ASST Spedali Civili Brescia, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; UOC 2° Medicina, ASST Spedali Civili Brescia, Italy.
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15
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Saladini F, Mancusi C, Bertacchini F, Spannella F, Maloberti A, Giavarini A, Rosticci M, Bruno RM, Pucci G, Grassi D, Pengo M, Muiesan ML. Diagnosis and treatment of hypertensive emergencies and urgencies among Italian emergency and intensive care departments. Results from an Italian survey: Progetto GEAR (Gestione dell'Emergenza e urgenza in ARea critica). Eur J Intern Med 2020; 71:50-56. [PMID: 31690479 DOI: 10.1016/j.ejim.2019.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/26/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Abstract
Hypertensive emergencies (HE) and urgencies (HU) are frequent causes of patients referral to Emergency Department (ED) and the approach may be different according to local clinical practice. Our aim was to explore awareness, management, treatment and counselling after discharge of HE and HU in Italy, by mean of an on-line survey. The young investigator research group of the Italian Society of Hypertension developed a 23-item questionnaire spread by e-mail invitation to the members of Italian Scientific societies in the field of Hypertension. 665 questionnaires were collected from EDs, Emergency and Urgency Medicine, Cardiology or Coronary Units, Internal Medicines, Intensive care, Stroke units. Symptoms considered suspicious of acute organ damage were: chest pain (89.0%), visual disturbances (89.8%), dyspnoea (82.7%), headache (82.1%), dizziness (52.0%), conjunctival haemorrhages (41.5%), tinnitus (38.2%) and epistaxis (34.4%). Exams more frequent prescribed were: electrocardiogram (97.2%), serum creatinine (91.4%), markers of cardiomyocyte necrosis (66.2%), echocardiography (65.1%). The use of intravenous or oral medications to treat HEs was 94.7% and 3.5%, while for HUs 24.4% and 70.8% respectively. Of note, a surprisingly high percentage of physicians (22 % overall, 24.5% in North Italy) used to prescribe sublingual nifedipine. After discharge, home blood pressure monitoring and general practitioner re-evaluation were more frequently suggested, while ambulatory blood pressure monitoring and hypertension specialist examination were less prescribed. The differences observed across the different macro-areas, regarded prescription of diagnostic test and drug administration. This survey depicts a complex situation of shades and lights in the real-life management of HE and HU in Italy.
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Affiliation(s)
- F Saladini
- Department of Medicine, University of Padova, Italy; Cardiology Unit, Cittadella Town Hospital, Padova, Italy.
| | - C Mancusi
- Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University of Naples, Italy
| | - F Bertacchini
- Internal Medicine, University of Brescia-ASST Spedali Civili di Brescia, Italy
| | - F Spannella
- Internal Medicine and Geriatrics, IRCCS-INRCA, Ancona, Italy; Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy
| | - A Maloberti
- Cardiology 4, ASST Niguarda Hospital, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - A Giavarini
- Cardiology Unit, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milano, Italy
| | - M Rosticci
- Medicine and Surgery Sciences Department, Alma Mater Studiorum University of Bologna, Italy
| | - R M Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - G Pucci
- Internal Medicine, Department of Medicine, University of Perugia, Terni University Hospital, Italy
| | - D Grassi
- Department of Internal medicine and Public Health, University of Aquila, Italy
| | - M Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - M L Muiesan
- Internal Medicine, University of Brescia-ASST Spedali Civili di Brescia, Italy
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16
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Paini A, Aggiusti C, Bertacchini F, Stassaldi D, Capellini S, Rosei EA, Muiesan ML, Salvetti M. P111 Arterial Stiffness and Unattended and Attended BP Values. Artery Res 2020. [DOI: 10.2991/artres.k.191224.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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17
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Muiesan ML, Salvetti M, Paini A, Aggiusti C, Bertacchini F, Stassaldi D, Capellini S, Casella E, Arnoldi C, Agabiti Rosei E. P5460Prevalence of left atrial enlargement in patients undergoing an echocardiogram for cardiovascular risk stratification at an esh excellence centre in italy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left atrial (LA) enlargement (LAE) is associated to an increased risk of cardiovascular complications, and in particular of atrial fibrillation. The 2018 ESH/ESC Hypertension guidelines suggested the use of LA volume instead of linear dimensions, and for the first time proposed the indexation to height2 (h2)
The aim of our study was to assess the prevalence of left atrial dilatation in a large sample of patients undergoing an echocardiogram for cardiovascular risk stratification at an ESH excellence centre in Italy.
Design and methods 3872 subjects undergoing a diagnostic work-up for arterial hypertension (known or suspect) were analysed. The mean age was 56±15 years, BMI 26±5 kg/m, 44% normal weight, 39% overweight, 17% obese, 53% males. Left atrial volume was measured by the area-length method using the apical 4-chamber and 2-chamber views.
Results
The prevalence of left ventricular hypertrophy (LVH) was 11% when indexing for BSA and 12% when indexing for height2.7. LAE was observed in 30% of subjects when indexing for h2 and in 9% when indexing for BSA. In obese or overweight subjects the prevalence of LAE was 38% of subjects when indexing for h2 and in 11% when indexing for BSA. The different prevalence of LAE was particularly evident in extremely obese patients.
LAE was very common in patients with LVH: 62% and 26% when indexing for h2 and for BSA, respectively. Interestingly, it was frequent also in patients without LVH, in particular when the indexation for h2 was used (25% as compared to 7% when indexing for BSA).
Conclusions
In a large sample of subjects undergoing a diagnostic work-up for arterial hypertension LAE was frequently observed, particularly when the new indexation proposed by the 2018 ESH/ESC hypertension guidelines was used. Even in the absence of clear-cut LVH, LAE was observed in one quarter of subjects. The indexation to BSA leads to an under-recognition of LAE, in particular in patients with overweight and/or obesity
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Affiliation(s)
- M L Muiesan
- University of Brescia, Department of Clinical & Experimental Sciences, Brescia, Italy
| | - M Salvetti
- University of Brescia, Department of Clinical & Experimental Sciences, Brescia, Italy
| | - A Paini
- Civil Hospital of Brescia, Brescia, Italy
| | - C Aggiusti
- Civil Hospital of Brescia, Brescia, Italy
| | | | | | - S Capellini
- University of Brescia, Department of Clinical & Experimental Sciences, Brescia, Italy
| | - E Casella
- University of Brescia, Department of Clinical & Experimental Sciences, Brescia, Italy
| | - C Arnoldi
- University of Brescia, Department of Clinical & Experimental Sciences, Brescia, Italy
| | - E Agabiti Rosei
- University of Brescia, Department of Clinical & Experimental Sciences, Brescia, Italy
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18
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Salvetti M, Paini A, Aggiusti C, Bertacchini F, Stassaldi D, Capellini S, de Ciuceis C, Rizzoni D, Gatta R, Agabiti Rosei E, Muiesan ML. Response to Letter to the Editor Regarding Article "Unattended Versus Attended Blood Pressure Measurement: Relationship With Preclinical Organ Damage". Hypertension 2019; 73:e86. [PMID: 31030608 DOI: 10.1161/hypertensionaha.119.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Massimo Salvetti
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Anna Paini
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Carlo Aggiusti
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Fabio Bertacchini
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Deborah Stassaldi
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Sara Capellini
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Carolina de Ciuceis
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Damiano Rizzoni
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Roberto Gatta
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Enrico Agabiti Rosei
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
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19
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Salvetti M, Paini A, Aggiusti C, Bertacchini F, Stassaldi D, Capellini S, De Ciuceis C, Rizzoni D, Gatta R, Agabiti Rosei E, Muiesan ML. Unattended Versus Attended Blood Pressure Measurement. Hypertension 2019; 73:736-742. [DOI: 10.1161/hypertensionaha.118.12187] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Massimo Salvetti
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Anna Paini
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Carlo Aggiusti
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Fabio Bertacchini
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Deborah Stassaldi
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Sara Capellini
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Carolina De Ciuceis
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Damiano Rizzoni
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Roberto Gatta
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Enrico Agabiti Rosei
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
| | - Maria Lorenza Muiesan
- From the Department of Clinical and Experimental Sciences, University of Brescia, 2a Medicina ASST Spedali Civili di Brescia, Italy
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Muiesan ML, Paini A, Aggiusti C, Bertacchini F, Rosei CA, Salvetti M. Hypertension and Organ Damage in Women. High Blood Press Cardiovasc Prev 2018; 25:245-252. [DOI: 10.1007/s40292-018-0265-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/19/2018] [Indexed: 12/22/2022] Open
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Paini A, Bertacchini F, Stassaldi D, Aggiusti C, Maruelli G, Arnoldi C, De Ciuceis C, Agabiti Rosei C, Rizzoni D, Gatta R, Agabiti Rosei E, Muiesan ML, Salvetti M. Unattended versus attended blood pressure measurement: Mean values and determinants of the difference. Int J Cardiol 2018; 274:305-310. [PMID: 29945805 DOI: 10.1016/j.ijcard.2018.06.056] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/07/2018] [Accepted: 06/13/2018] [Indexed: 01/23/2023]
Affiliation(s)
- Anna Paini
- ASST Spedali Civili di Brescia, Clinica Medica-2 Medicina, Italy
| | | | | | - Carlo Aggiusti
- ASST Spedali Civili di Brescia, Clinica Medica-2 Medicina, Italy
| | - Giulia Maruelli
- ASST Spedali Civili di Brescia, Clinica Medica-2 Medicina, Italy
| | - Chiara Arnoldi
- ASST Spedali Civili di Brescia, Clinica Medica-2 Medicina, Italy
| | | | | | - Damiano Rizzoni
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Società Italiana dell'Ipertensione, Italy; Istituto Clinico Città di Brescia, Divisione of Medicine, Brescia, Italy
| | - Roberto Gatta
- ASST Spedali Civili di Brescia, Clinica Medica-2 Medicina, Italy
| | - Enrico Agabiti Rosei
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Società Italiana dell'Ipertensione, Italy
| | - Maria Lorenza Muiesan
- ASST Spedali Civili di Brescia, Clinica Medica-2 Medicina, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Italy; Società Italiana dell'Ipertensione, Italy
| | - Massimo Salvetti
- ASST Spedali Civili di Brescia, Clinica Medica-2 Medicina, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Italy; Società Italiana dell'Ipertensione, Italy.
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Salvetti M, Paini A, Bertacchini F, Aggiusti C, Stassaldi D, Verzeri L, Saccà G, Muiesan ML. Therapeutic Approach to Hypertensive Emergencies: Hemorrhagic Stroke. High Blood Press Cardiovasc Prev 2018; 25:191-195. [DOI: 10.1007/s40292-018-0262-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/23/2018] [Indexed: 12/29/2022] Open
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Paini A, Salvetti M, Bertacchini F, Aggiusti C, Cappellini S, Agabiti Rosei E, Muiesan ML. P123 UNATTENDED AND ATTENDED BP VALUES AND VASCULARE AND CARDIAC ORGAN DAMAGE. Artery Res 2018. [DOI: 10.1016/j.artres.2018.10.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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De Ciuceis C, Salvetti M, Paini A, Rossini C, Muiesan ML, Duse S, Caletti S, Coschignano MA, Semeraro F, Trapletti V, Bertacchini F, Brami V, Petelca A, Agabiti Rosei E, Rizzoni D, Agabiti Rosei C. Comparison of lercanidipine plus hydrochlorothiazide vs. lercanidipine plus enalapril on micro and macrocirculation in patients with mild essential hypertension. Intern Emerg Med 2017. [PMID: 28647890 DOI: 10.1007/s11739-017-1696-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Dihydropyridine calcium channel blockers may possess antioxidant properties, and might improve micro and macrovascular structure and function. Combination treatment with an ACE inhibitor may have additional advantages, compared with a thiazide diuretic. The aim of the present study is to investigate the effects of a short-term treatment with lercanidipine, and to compare two combination treatments: lercanidipine + enalapril vs. lercanidipine + hydrochlorothiazide on structural alterations in retinal arterioles, on skin capillary density and on large artery distensibility. Thirty essential hypertension patients are included in the study, and treated for 4 weeks with lercanidipine 20 mg per day orally. Then, they were treated for 6 months with lercanidipine + enalapril (n = 15) or lercanidipine + hydrochlorothiazide (n = 15) combinations. Investigations were performed on basal condition, after appropriate wash out of previous treatments, after 4 weeks of lercanidipine monotherapy treatment, and at the end of the combination treatment. Non-invasive measurements of wall-to-lumen ratio (WLR) and other morphological parameters of retinal arterioles were performed using either scanning laser Doppler flowmetry or adaptive optics. Capillary density was evaluated by capillaroscopy, while pulse wave velocity was measured, and central blood pressures were assessed by pressure waveform analysis. A significant improvement of WLR and other indices of retinal artery structure is observed with both technical approaches after treatment with lercanidipine alone, with a further improvement after treatment with lercanidipine + enalapril, while after treatment with lercanidipine + hydrochlorothiazide, the improvement is partially blunted. Central systolic and diastolic blood pressures are similarly reduced by both therapeutic strategies. Capillary density is increased only after treatment with lercanidipine + enalapril. In conclusion, lercanidipine both in monotherapy and in combination with enalapril but not with hydrochlorothiazide is able to improve microvascular structure; on the other hand, a decrease in central blood pressure is observed with both therapeutic combinations.
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Affiliation(s)
- Carolina De Ciuceis
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Massimo Salvetti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Anna Paini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Claudia Rossini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Maria Lorenza Muiesan
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Sarah Duse
- Chair of Ophthalmology, University of Brescia, Brescia, Italy
| | - Stefano Caletti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Maria Antonietta Coschignano
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | | | - Valentina Trapletti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Fabio Bertacchini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Valeria Brami
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Alina Petelca
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Enrico Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
| | - Damiano Rizzoni
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy.
- Division of Medicine, Istituto Clinico Città di Brescia, Brescia, Italy.
| | - Claudia Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy
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Salvetti M, Paini A, Bertacchini F, Stassaldi D, Agabiti Rosei C, Aggiusti C, Maruelli G, Rubagotti G, Verzeri L, Sacca' G, Agabiti-Rosei E, Muiesan M. P464Clinic and 24 hours blood pressure values are strictly related to dimensions of the ascending aorta in a general population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Salvetti M, Paini A, Stassaldi D, Bertacchini F, Maruelli G, Rubagotti G, Verzeri L, Sacca' G, Agabiti-Rosei E, Muiesan M. P4560Myocardial mechanoenergetic efficiency is correlated with arterial stiffness in a general population in northern Italy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Paini A, Salvetti M, Bertacchini F, Buglione M, Tevisan F, Baushi L, Magrini S, Muiesan M. P434Assessment of vascular damage in hodgkin lymphoma survivors: effect of radiotherapy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Muiesan ML, Paini A, Agabiti Rosei C, Bertacchini F, Stassaldi D, Salvetti M. Current Pharmacological Therapies in Heart Failure Patients. High Blood Press Cardiovasc Prev 2017; 24:107-114. [PMID: 28349441 DOI: 10.1007/s40292-017-0194-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/20/2017] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) is a major problem of public health. More than 23 million patients worldwide are affected by heart failure. Despite incidence and prevalence of heart failure may vary according to real world or randomized trials database, advancing age is a major determinant of heart failure. Heart failure is also characterized by an elevated rate of morbidity and mortality and represents one of the leading causes of hospitalization. A major consequence of heart failure is the frequent hospital admissions and related costs. Guidelines have clearly indicated evidence-based treatments in patients with heart failure, and the adherence to these indications has translated in an improvement of patient's prognosis. Nevertheless, the use of recommended treatments at the recommended dosages is still lower than expected. In the last year in Europe new guidelines on the diagnosis and treatment of heart failure and in USA an update on pharmacological treatment of heart failure were published, pointing the attention on the use of new available pharmacological and non-pharmacological treatments. HF syndrome reflects the interaction between hemodynamic dysregulation (alterations in myocardial preload, afterload, and contractility and a neurohormonal disarray those results in the development of symptoms and in the progression of the disease. Current treatment approaches target both hemodynamic alterations and the neurohumoral elements to slow disease progression as well as to improve symptoms and outcomes.
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Affiliation(s)
- Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy. .,Department of Medicine, ASST-Spedali Civili of Brescia, Brescia, Italy.
| | - Anna Paini
- Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy.,Department of Medicine, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Claudia Agabiti Rosei
- Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy.,Department of Medicine, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Fabio Bertacchini
- Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy.,Department of Medicine, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Deborah Stassaldi
- Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy.,Department of Medicine, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Massimo Salvetti
- Department of Clinical and Experimental Sciences, University of Brescia, c/o 2ª Medicina, Spedali Civili, 25100, Brescia, Italy.,Department of Medicine, ASST-Spedali Civili of Brescia, Brescia, Italy
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Paini* A, Salvetti M, Rosei CA, Bertacchini F, Maruelli G, Rubagotti G, Colonetti E, Donini C, Casella E, Rosei EA, Muiesan ML. P6.12 AORTIC AND LOCAL CAROTID STIFFNESS: RELATIONSHIP WITH CARDIAC AND VASCULAR ORGAN DAMAGE IN A GENERAL POPULATION SAMPLE IN NORTHERN ITALY. Artery Res 2015. [DOI: 10.1016/j.artres.2015.10.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Muiesan ML, Salvetti M, Paini A, Agabiti-Rosei C, Bertacchini F, Maruelli G, Colonetti E. Central blood pressure assessment using 24-hour brachial pulse wave analysis. ACTA ACUST UNITED AC 2014. [DOI: 10.2147/jvd.s47389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Bernocchi P, Scalvini S, Bertacchini F, Rivadossi F, Muiesan ML. Home based telemedicine intervention for patients with uncontrolled hypertension--a real life non-randomized study. BMC Med Inform Decis Mak 2014; 14:52. [PMID: 24920046 PMCID: PMC4066708 DOI: 10.1186/1472-6947-14-52] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 05/28/2014] [Indexed: 12/22/2022] Open
Abstract
Background Control of blood pressure is frequently inadequate in spite of availability of several classes of well tolerated and effective antihypertensive drugs. Several factors, including the use of suboptimal doses of drugs, inadequate or ineffective treatments and poor drug compliance may be the reason for this phenomenon. The aim of the current non- randomized study was to evaluate the effectiveness of a Home-Based Telemedicine service in patients with uncontrolled hypertension. Methods 74 patients were enrolled in a Home Based Telemedicine group and 94 patients in the Usual Care group. At baseline and at the end of the study, patients in both groups were seen in a cardiology office. Patients in Home Based Telemedicine group additionally were followed by a physician-nurse, through scheduled and unscheduled telephone appointments. These patients also received a blood pressure measuring device that could transmit the readings to a central data monitor via secure data connection. Results During the study period (80 ± 25 days), a total of 17401 blood pressure measurements were taken in the Home Based Telemedicine group corresponding to 236 ± 136 readings per patient and a mean daily measurement of 3 ± 1.7. The scheduled telephone contacts (initiated by the nurse) equaled to 5.2 ± 4.3/patient (370 in total) and the unscheduled telephone contacts (initiated by the patients) were 0.4 ± 0.9/patient (30 in total). The mean systolic blood pressure values decreased from 153 ± 19 mmHg to 130 ± 15 mmHg (p < 0.0001) at the end of the study and diastolic blood pressure values decreased from 89 ± 10 mmHg to 76 ± 11 mmHg (p < 0.0001). In the Usual Care group, the mean systolic blood pressure values decreased from 156 ± 16 mmHg to 149 ± 17 mmHg (p < 0.05) at the end of the study and diastolic blood pressure values decreased from 90 ± 8 mmHg to 86 ± 9 mmHg (p < 0.05). The changes in drug therapy initiated following telephone contacts were 1.81 ± 1.73 per patient. Conclusions The addition of a structured physician-nurse approach supported by remote telemonitoring of blood pressure is likely to improve outcome in patients with uncontrolled hypertension.
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Affiliation(s)
- Palmira Bernocchi
- Fondazione Salvatore Maugeri, IRCCS, Telemedicine Service - Institute of Lumezzane, Brescia, Italy.
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Paini A, Salvetti M, Agabiti Rosei C, Aggiusti C, Stassaldi D, Bertacchini F, Rubagotti G, Maruelli G, Agabiti Rosei E, Muiesan ML. Determinants of change in arterial stiffness in a general population in Northern Italy. The Vobarno study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Salvetti M, Paini A, Agabiti Rosei C, Aggiusti C, Stassaldi D, Bertacchini F, Rubagotti G, Maruelli G, Agabiti Rosei E, Muiesan ML. Relationship between left atrial volume, arterial stiffness and clinic and 24 hours blood pressure in a general population in northern Italy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p2741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Salvetti M, Zotti D, Bazza A, Paini A, Bertacchini F, Chiari E, Coletti G, Rosei EA, Muiesan ML. Platypnea and orthodeoxia in a patient with pulmonary embolism. Am J Emerg Med 2013; 31:760.e1-2. [DOI: 10.1016/j.ajem.2012.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 12/02/2012] [Indexed: 11/16/2022] Open
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Paini A, Salvetti M, Aggiusti C, Bertacchini F, Agabiti Rosei C, Stassaldi D, Rubagotti G, Maruelli G, Agabiti Rosei E, Muiesan M. P3.06 ASSESSMENT OF ARTERIAL STIFFNESS DURING A FIVE-YEARS FOLLOW UP IN A GENERAL POPULATION IN NORTHERN ITALY. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Iliuta L, Uno K, Ebihara A, Hayashi N, Chigira M, Yoshikawa T, Kimura K, Yamagata H, Yatomi Y, Takenaka K, Neves A, Mathias L, Leshko J, Linask K, Henriques-Coelho T, Areias J, Huhta J, Barbier P, Castiglioni L, Colazzo F, Fontana L, Nobili E, Franzosi M, Li Causi T, Sironi L, Tremoli E, Guerrini U, Stankovic I, Claus P, Jasaityte R, Putnikovic B, Neskovic A, Voigt J, Kutty S, Attebery J, Yeager E, Truemper E, Li L, Hammel J, Danford D, Tumasyan L, Adamyan K, Chilingaryan A, Mjolstad O, Andersen G, Dalen H, Graven T, Kleinau J, Skjetne K, Haugen B, Sucu M, Uku O, Sari I, Ercan S, Davutoglu V, Ozer O, Kim S, Na JO, Im S, Choi C, Lim H, Kim J, Han S, Seo H, Park C, Oh D, Hammoudi N, Duprey M, Regnier P, Vignalou J, Boubrit L, Pousset F, Jobard O, Isnard R, Shin SH, Woo S, Kim D, Park K, Kwan J, Andersen G, Mjolstad O, Graven T, Kleinau J, Skjetne K, Haugen B, Dalen H, Grigoryan S, Tunyan L, Hazarapetyan L, Shkolnik E, Vasyuk Y, Nesvetov V, Ruddox V, Edvardsen T, Otterstad J, Patrianakos A, Zacharaki A, Kalogerakis A, Nyktari E, Psathakis E, Parthenakis F, Vardas P, Yodwut C, Weinert L, Lang R, Mor-Avi V, Bandera F, Arena R, Labate V, Castelvecchio S, Menicanti L, Guazzi M, Nedeljkovic I, Ostojic M, Stepanovic J, Giga V, Beleslin B, Popovic D, Djordjevic-Dikic A, Petrovic M, Nedeljkovic M, Seferovic P, Popovic D, Ostojic M, Popovic B, Petrovic M, Vujisic-Tesic B, Nedeljkovic I, Arandjelovic A, Banovic M, Seferovic P, Damjanovic S, Horovitz A, Iriart X, De Guillebon D, Reant P, Lafitte S, Thambo J, Venkatesh A, Shahgaldi K, Johnson J, Brodin L, Winter R, Sahlen A, Manouras A, Szulik M, Streb W, Kalarus Z, Kukulski T, Lesniak-Sobelga AM, Kostkiewicz M, Tomkiewicz-Pajak L, Olszowska M, Hlawaty M, Rubis P, Podolec P, Spinelli L, Di Panzillo EA, Morisco C, Crispo S, Trimarco B, Lutay Y, Parkhomenko A, Stepura A, Zamfir D, Tautu O, Nestoruc A, Onut R, Comanescu I, Scafa Udriste A, Dorobantu M, Guseva O, Zhuravskaya N, Bartosh-Zelenaya S, Zagatina A, Kekovic P, Isailovic-Kekovic M, Squeri A, Macri' G, Anglano F, Censi S, Conti R, Pizzarelli M, Trecroci U, Bosi S, Le Tourneau T, Probst V, Kyndt F, Duval D, Trochu J, Bernstein J, Hagege A, Levine R, Le Marec H, Schott J, Enache R, Muraru D, Popescu B, Mateescu A, Purcarea F, Calin A, Beladan C, Rosca M, Ginghina C, Urdaniz MM, Rodriguez Palomares JF, Rius JB, Acosta Velez JG, Garcia-Moreno LG, Tura GT, Alujas MTG, Mas PT, Masip AE, Dorado DG, Zito C, Cusma-Piccione M, Miceli M, Di Bella G, Mohammed M, Oreto L, Di Matteo I, Crea P, Alongi G, Carerj S, Mizariene V, Zaliaduonyte-Peksiene D, Vaskelyte J, Jonkaitiene R, Jurkevicius R, D'auria F, Stinziani V, Grego S, Polisca P, Chiariello L, Cardoso M, Almeida A, David C, Marques J, Jorge C, Silva D, Magalhaes A, Goncalves S, Diogo A, Shiran A, Adawi S, Sachner R, Asmer I, Ganaeem M, Rubinshtein R, Gaspar T, Necas J, Kovalova S, Bombardini T, Sicari R, Ciampi Q, Gherardi S, Costantino M, Picano E, Casartelli M, Bombardini T, Simion D, Gaspari M, Procaccio F, Tsatsopoulou A, Prappa E, Kalantzi M, Patrianakos A, Anastasakis A, Protonotarios N, Monteforte N, Bloise R, Napolitano C, Priori S, Davos C, Varela A, Tsilafakis C, Kostavassili I, Mavroidis M, Di Molfetta A, Musca F, Fresiello L, Santini L, Forleo G, Lunati M, Ferrari G, Romeo F, Moreo A, Lourenco M, Azevedo O, Machado I, Nogueira I, Fernandes M, Pereira V, Quelhas I, Lourenco A, Estensen M, Langesaeter E, Gullestad L, Aakhus S, Skulstad H, Gronlund C, Gustavsson S, Morner S, Suhr O, Lindqvist P, Sunbul M, Kepez A, Durmus E, Ozben B, Mutlu B, Esposito R, Santoro A, Ippolito R, Schiano Lomoriello V, De Palma D, Santoro C, Muscariello R, Ierano P, Galderisi M, Mohammed M, Zito C, Cusma-Piccione M, Di Bella G, Antonini-Canterin F, Taha N, Di Bello V, Vriz O, Pugliatti P, Carerj S, Beladan C, Popescu B, Calin A, Rosca M, Matei F, Enache E, Gurzun M, Ginghina C, Stanescu C, Manoliu V, Branidou K, Daha I, Baicus C, Adam C, Ene I, Dan G, Von Bibra H, Wulf G, Schuster T, Pfuetzner A, Heilmeyer P, Dobson G, Smith B, Grapsa J, Nihoyannopoulos P, Montoro Lopez M, Alonso Ladreda A, Florez Gomez R, Itziar Soto C, Rios Blanco J, Gemma D, Iniesta Manjavacas A, Moreno Yanguela M, Lopez Sendon J, Guzman Martinez G, O'driscoll J, Marciniak A, Perez-Lopez M, Sharma R, Bombardini T, Cini D, Gherardi S, Del Bene R, Serra W, Moreo A, Sicari R, Picano E, Fernandez Cimadevilla O, De La Hera Galarza J, Pasanisi E, Alvarez Pichel I, Diaz Molina B, Martin Fernandez M, Corros C, Lambert Rodriguez J, Sicari R, Jedrzychowska-Baraniak J, Jarosz K, Jozwa R, Kasprzak J, Mohty D, Petitalot V, El Hamel C, Damy T, Lavergne D, Echahidi N, Virot P, Cogne M, Jaccard A, Weng KP, Hsieh KS, Yang YY, Wutthachusin T, Kaier T, Grapsa J, Morgan D, Hakky S, Purkayastha S, Connolly S, Fox K, Ahmed A, Cousins J, Nihoyannopoulos P, Sveric K, Richter U, Wunderlich C, Strasser R, Spethmann S, Dreger H, Baldenhofer G, Mueller E, Stuuer K, Stangl V, Laule M, Baumann G, Stangl K, Knebel F, Ruiz Ortiz M, Mesa D, Delgado M, Romo E, Castillo F, Morenate M, Baeza F, Toledano F, Leon C, De Lezo JS, Ishizu T, Seo Y, Kameda Y, Enomoto M, Atsumi A, Yamamoto M, Nogami Y, Aonuma K, Theodosis-Georgilas A, Tountas H, Fousteris E, Tsaoussis G, Margetis P, Deligiorgis A, Katidis Z, Melidonis A, Beldekos D, Foussas S, Butz T, Faber L, Piper C, Reckefuss N, Wirdeier S, Van Bracht M, Prull M, Plehn G, Horstkotte D, Trappe HJ, Winter S, Martinek M, Ebner C, Nesser H, Kilickiran Avci B, Yurdakul S, Sahin S, Tanrikulu A, Ermis E, Aytekin S, Cefalu C, Barbier P, Santoro A, Ippolito R, Esposito R, Schiano Lomoriello V, De Palma D, Muscariello R, Galderisi M, Karamanou A, Hamodraka E, Vrakas S, Paraskevaides I, Lekakis I, Kremastinos D, Enache R, Piazza R, Muraru D, Mateescu A, Popescu B, Calin A, Beladan C, Rosca M, Nicolosi G, Ginghina C, Erdogan E, Bacaksiz A, Akkaya M, Tasal A, Vatankulu M, Turfan M, Sonmez O, Ertas G, Uyarel H, Goktekin O, Singelton J, Petraco R, Shaikh R, Cole G, Francis D, Manisty C, Almeida A, Cortez-Dias N, Sousa J, Carpinteiro L, Marques J, Silva D, Jorge C, Carrilho-Ferreira P, Pinto F, Diogo A, Kleczynski P, Legutko J, Rakowski T, Dziewierz A, Siudak Z, Zdzienicka J, Brzozowska-Czarnek A, Dubiel J, Dudek D, Carvalho MS, De Araujo Goncalves P, Dores H, Sousa P, Marques H, Pereira Machado F, Gaspar A, Aleixo A, Mota Carmo M, Roquette J, Obase K, Sakakura T, Matsushita S, Takeuchi M, Tamai S, Komeda M, Yoshida K, Jimenez Rubio C, Isasti Aizpurua G, Miralles Ibarra J, Gianstefani S, Catibog N, Whittaker A, Wathen P, Kogoj P, Reiken J, Monaghan M, Salvetti M, Muiesan M, Paini A, Agabiti Rosei C, Aggiusti C, Bertacchini F, Stassaldi D, Rubagotti G, Comaglio A, Agabiti Rosei E, Soldati E, Corciu A, Zucchelli G, Di Cori A, Segreti L, De Lucia R, Paperini L, Viani S, Vannozzi A, Bongiorni M, Kablak-Ziembicka A, Przewlocki T, Stepien E, Wrotniak L, Karch I, Podolec P, Kleczynski P, Rakowski T, Dziewierz A, Jakala J, Legutko J, Dubiel J, Dudek D. Poster session Friday 7 December - PM: Effect of systemic illnesses on the heart. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Muiesan ML, Salvetti M, Rizzoni D, Paini A, Agabiti-Rosei C, Aggiusti C, Bertacchini F, Stassaldi D, Gavazzi A, Porteri E, De Ciuceis C, Agabiti-Rosei E. Pulsatile hemodynamics and microcirculation: evidence for a close relationship in hypertensive patients. Hypertension 2012; 61:130-6. [PMID: 23150518 DOI: 10.1161/hypertensionaha.111.00006] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The possible relationships between indicators of small resistance artery structure and of arterial stiffness and central hemodynamics have not yet been evaluated. Aim of this study was to assess the relationship between indicators of large arteries stiffness, including carotido-femoral pulse wave velocity and of vascular alterations in small resistance arteries (media/lumen ratio, M/L) in patients with primary and secondary hypertension. In 73 patients (mean age, 53±14 years, 34 females, 25 with type 2 diabetes mellitus, 18 never treated) with essential (n=37) and secondary (n=36) hypertension, carotido-femoral pulse wave velocity was measured. In all patients, small resistance arteries were dissected from subcutaneous fat biopsies and mounted on an isometric myograph, for the measurement of the M/L. Pulse wave analysis was performed in 67 patients. M/L ratio was significantly related to brachial systolic blood pressure and pulse pressure (r=0.36 and 0.31, P<0.001, respectively) and to central systolic and pulse pressure (r=0.44 and 0.42, P<0.001, respectively). A positive correlation was observed between M/L ratio and carotido-femoral pulse wave velocity (r=0.45; P<0.001); this correlation remained statistically significant after adjustment for age and mean blood pressure. M/L ratio was also associated to aortic augmentation index (r=0.33; P=0.008), and this correlations remained statistically significant after adjustment for potential confounders. In hypertensive patients, the presence of structural alterations of small resistance arteries may be associated with the increase in large arteries stiffness and possibly contribute to an increase in central pressure by increasing the magnitude of wave reflections.
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Affiliation(s)
- Maria Lorenza Muiesan
- Clinica Medica, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.
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Paini A, Salvetti M, Bertacchini F, Agabiti Rosei C, Aggiusti C, Stassaldi D, Rubagotti G, Comaglio A, Mattavelli F, Germano R, Agabiti Rosei E, Muiesan M. P4.51 NONINVASIVE EVALUATION OF STRUCTURAL AND FUNCTIONAL CHANGES IN THE HEART AND LARGE ARTERIES IN PATIENTS WITH PRIMARY ALDOSTERONISM. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Salvetti M, Paini A, De Ciuceis C, Porteri E, Rosei CA, Aggiusti C, Bertacchini F, Stassaldi D, Rizzoni D, Muiesan M, Rosei EA. P2.07 ENDOTHELIUM DEPENDENT AND INDEPENDENT DILATATION IN DIFFERENT VASCULAR BEDS. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Salvetti M, Muiesan M, Paini A, Rosei CA, Aggiusti C, Bertacchini F, Stassaldi D, Beschi F, Rubagotti G, Monteduro C, Castellano M, Rosei EA. P1.10 PREVALENCE OF RESISTANT HYPERTENSION IN A GENERAL POPULATION IN NORTHERN ITALY: ASSOCIATED CARDIOVASCULAR RISK FACTORS AND TARGET ORGAN DAMAGE. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Paini A, Muiesan M, Salvetti M, Rosei CA, Aggiusti C, Stassaldi D, Bertacchini F, Beschi F, Castellano M, Rosei EA. 8.1 BLOOD PRESSURE INCREASE AND DEVELOPMENT OF TARGET ORGAN DAMAGE IN SUBJECTS WITH HIGH NORMAL BLOOD PRESSURE IN A GENERAL POPULATION SAMPLE. A 9 YEARS FOLLOW-UP. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Paini A, Salvetti M, Aggiusti C, Belotti E, Galbassini G, Corbellini C, Agabiti-Rosei C, Micheletti L, Bertacchini F, Marino F, Muiesan M, Agabiti-Rosei E. 12.18 Correlation between Ambulatory Arterial Stiffness Index (AASI) and Pulse Wave Velocity in a General Population: the Vobarno Study. High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Paini A, Muiesan ML, Salvetti M, Belotti E, Galbassini G, Agabiti-Rosei C, Aggiusti C, Micheletti L, Marino F, Bertacchini F, Agabiti-Rosei E. 2.8 In Patients with Isolated Ambulatory Hypertension Central Blood Pressure and Augmentation Index are Increased: the VOBARNO Study. High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Salvetti S, Paini A, Belotti E, Aggiusti C, Agabiti-Rosei C, Marino F, Bertacchini F, Muiesan M, Agabiti-Rosei E. 12.17 Flow Dependent Vasodilation of Brachial Artery: Effect of Treatment with a Calcium Antagonist or Thiazide Diuretic in the Essential Hypertensive Patient. High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Paini A, Muiesan M, Salvetti M, Belotti E, Agabiti Rosei C, Aggiusti C, Micheletti L, Marino F, Bertacchini F, Agabiti Rosei E. P2.45 EVALUATION OF CENTRAL BLOOD PRESSURE AND AUGMENTATION INDEX IN PATIENTS WITH ISOLATED AMBULATORY AND ISOLATED OFFICE HYPERTENSION: THE VOBARNO STUDY. Artery Res 2008. [DOI: 10.1016/j.artres.2008.08.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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