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Mangini V, Rosini E, Caliandro R, Mangiatordi GF, Delre P, Sciancalepore AG, Pollegioni L, Haidukowski M, Mazzorana M, Sumarah MW, Renaud JB, Flaig R, Mulè G, Belviso BD, Loi M. DypB peroxidase for aflatoxin removal: New insights into the toxin degradation process. Chemosphere 2024; 349:140826. [PMID: 38040262 DOI: 10.1016/j.chemosphere.2023.140826] [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] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 12/03/2023]
Abstract
Aflatoxin B1 (AFB1) is one of the most potent carcinogens and a widespread food and feed contaminant. As for other toxins, many efforts are devoted to find efficient and environmentally-friendly methods to degrade AFB1, such as enzymatic treatments, thus improving the safety of food and feed products. In this regard, the dye decolorizing peroxidase of type B (DypB) can efficiently degrade AFB1. The molecular mechanism, which is required to drive protein optimization in view of the usage of DypB as a mycotoxin reduction agent in large scale application, is unknown. Here, we focused on the role of four DypB residues in the degradation of AFB1 by alanine-scanning (residues 156, 215, 239 and 246), which were identified from biochemical assays to be kinetically relevant for the degradation. As a result of DypB degradation, AFB1 is converted into four products. Interestingly, the relative abundancy of these products depends on the replaced residues. Molecular dynamics simulations were used to investigate the role of these residues in the binding step between protein and manganese, a metal ion which is expected to be involved in the degradation process. We found that the size of the haem pocket as well as conformational changes in the protein structure could play a role in determining the kinetics of AFB1 removal and, consequently, guide the process towards specific degradation products.
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Affiliation(s)
- V Mangini
- Istituto di Cristallografia, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy
| | - E Rosini
- Department of Biotechnology and Life Sciences, University of Insubria, Via J. H. Dunant 3, Varese, 21100, Italy
| | - R Caliandro
- Istituto di Cristallografia, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy
| | - G F Mangiatordi
- Istituto di Cristallografia, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy
| | - P Delre
- Istituto di Cristallografia, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy
| | - A G Sciancalepore
- Istituto di Cristallografia, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy
| | - L Pollegioni
- Department of Biotechnology and Life Sciences, University of Insubria, Via J. H. Dunant 3, Varese, 21100, Italy
| | - M Haidukowski
- Istituto di Scienze delle Produzioni Alimentari, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy
| | - M Mazzorana
- Diamond Light Source Ltd., Diamond House, Harwell Science & Innovation Campus, Didcot, OX11 0DE, UK; Research Complex at Harwell, Harwell Science and Innovation Campus, Didcot, OX11 0FA, UK
| | - M W Sumarah
- London Research and Development Centre, Agriculture and Agri-Food Canada, 1391 Sandford Street London, Ontario, Canada, N5V4T3
| | - J B Renaud
- London Research and Development Centre, Agriculture and Agri-Food Canada, 1391 Sandford Street London, Ontario, Canada, N5V4T3
| | - R Flaig
- Diamond Light Source Ltd., Diamond House, Harwell Science & Innovation Campus, Didcot, OX11 0DE, UK; Research Complex at Harwell, Harwell Science and Innovation Campus, Didcot, OX11 0FA, UK
| | - G Mulè
- Istituto di Scienze delle Produzioni Alimentari, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy.
| | - B D Belviso
- Istituto di Cristallografia, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy.
| | - M Loi
- Istituto di Scienze delle Produzioni Alimentari, Consiglio Nazionale delle Ricerche, Via Amendola 122/o, Bari, 70126, Italy
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2
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Nobili A, Butti AC, Mulè G, Clivio A, Re D. Evaluation of the prevalence of dental agenesis through the use of orthopantomography in a sample of subjects residing in Lombardy and Piedmont regions. Eur J Paediatr Dent 2023; 24:287 - 291. [PMID: 37934061 DOI: 10.23804/ejpd.2023.1925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
AIM Dental agenesis is one of the most frequent dental anomalies, with a prevalence varying from 1.6% to 36.5%, depending on the populations studied. The patient's age at diagnosis, sex, and ethnic differences are considered possible influenting factors that can explain such a wide range of prevalence. The objective of the study was to define the frequency of dental agenesis in a sample of subjects living in Piedmont and Lombardy regions of Italy. MATERIALS X-rays, already taken for other diagnostic purposes, were collected. Orthopantomographies belonging to subjects born after 1995 and aged between 7.9 and 16.9 years were selected. It was assessed the presence of each tooth, except for third molars since they are frequently absent due to their variability. If a tooth was missing and the patient had additional radiographs, the other radiographs were evaluated to confirm the diagnosis or to rule out a delayed calcification or the presence of a malposition tooth. Results Orthopantomographies were collected from 1,020 subjects and 98 of them presented agenesis, with a prevalence of 5% for females and 4.61% for males. The most affected teeth were 35 and 45, followed by 12 and 22. The lower arch was more frequently involved by agenesis: there were 107 teeth absent in the mandibular arch and 83 in the maxillary arch.
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Affiliation(s)
- A Nobili
- University of Milan, Department of Biomedical, Surgical and Dental Sciences, Aesthetic Dentistry, Istituto Stomatologico Italiano, Milan, Italy
| | - A C Butti
- University of Milan, Department of Biomedical, Surgical and Dental Sciences, Aesthetic Dentistry, Istituto Stomatologico Italiano, Milan, Italy
| | - G Mulè
- University of Insubria, post graduate School in Orthodontics, Varese, Italy
| | - A Clivio
- Orthodontics department, Istituto Stomatologico Italiano, Milan, Italy
| | - D Re
- University of Milan, Department of Biomedical, Surgical and Dental Sciences, Aesthetic Dentistry, Istituto Stomatologico Italiano, Milan, Italy
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3
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Patti A, Giustino V, Hirose N, Messina G, Cataldi S, Grigoli G, Marchese A, Mulè G, Drid P, Palma A, Bianco A. Effects of an experimental short-time high-intensity warm-up on explosive muscle strength performance in soccer players: A pilot study. Front Physiol 2022; 13:984305. [PMID: 36091405 PMCID: PMC9452805 DOI: 10.3389/fphys.2022.984305] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/20/2022] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aimed to evaluate the effects of an experimental short-time warm-up consisting of a small number of intermittent high-intensity sprints on explosive muscle strength performance in soccer players and to identify recovery times after performing the sprints. Furthermore, we evaluated the reliability of a smartphone app in jumping performance. Methods: Twenty male soccer players were given the following tests: 1) the counter-movement jump (CMJ) test with the Microgate system, 2) the counter-movement jump (CMJ) test with the MyJump smartphone app, and 3) the handgrip strength test. The experimental short-time high-intensity warm-up was carried out 1 week after test administration. The warm-up consisted of three maximum sprints over 60 m with 120 s of recovery between sprints. Then, the tests were administered again: the vertical jump height (VJH) performances (five trials) were measured 90 s after the last sprint; the handgrip strength performances (three trials) were measured 120 s after the last vertical jump test. Results: The maximum VJH was found in the third trial of the CMJ test, 330 s after the last sprint (p < 0.01), the result closest to the baseline. The lowest VJH was found in the first trial of the CMJ test, 90 s after the last sprint (p < 0.05). Pearson’s analysis between the CMJ test with the Microgate system and the CMJ test with MyJump showed a strong correlation (R = 0.96). Lin’s concordance correlation coefficient showed a substantial concordance (ρc = 0.959) between measures. Conclusion: This experimental short-time warm-up of high-intensity intermittent sprints appears to be a simple, quick, and efficient activity to accelerate soccer players’ optimal performance.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Norikazu Hirose
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Giuseppe Messina
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
- *Correspondence: Giuseppe Messina,
| | - Stefania Cataldi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, Bari, Italy
| | - Giuseppe Grigoli
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Alida Marchese
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Giuseppe Mulè
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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4
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Giammanco A, Mattina A, Geraci G, Zammuto M, Maida C, Nardi E, Tuzzolino F, Averna M, Cottone S, Mulè G. Newly imaging biomarker of hypertension-related vascular and kidney damage: The ophthalmic artery index. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.984] [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: 11/25/2022]
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5
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Del Pinto R, Grassi G, Muiesan ML, Borghi C, Carugo S, Cicero AFG, Di Meo L, Iaccarino G, Minuz P, Mulatero P, Mulè G, Parati G, Pucci G, Salvetti M, Sarzani R, Savoia C, Sechi L, Tocci G, Volpe M, Vulpis V, Ferri C. World Hypertension Day 2021 in Italy: Results of a Nationwide Survey. High Blood Press Cardiovasc Prev 2022; 29:353-359. [PMID: 35416590 PMCID: PMC9006201 DOI: 10.1007/s40292-022-00519-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/25/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Hypertension is the biggest contributor to the global burden of cardiovascular diseases and related death, but the rates of hypertension awareness, treatment, and control remain largely perfectible. Methods During the XVII World Hypertension Day (May 17th, 2021), a nationwide cross-sectional opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of high blood pressure (BP). A questionnaire on major demographic/clinical features (sex, age, employment, education, BP status awareness, hypertension family/personal history, antihypertensive medications use) and BP measurement habits (≥1 BP measurement in the previous month/week) was administered. Due to the ongoing SARS-CoV-2 pandemic, BP was measured with standard procedures in a subset of participants (24.4%). Results A total of 1354 participants (mean age 56.3 ± 15.3 years; 57.3% women; mean BP: 131.2 ± 17.5/81.6 ± 10.5 mmHg; 42.3% self-declared hypertensive; 41.4% on antihypertensive medications) were enrolled; 73.6% declared being aware of their BP status. Among treated individuals with measured BP, 26.9% showed BP levels within the predefined therapeutic goals. Interestingly, BP status awareness rates were the highest among individuals with uncontrolled hypertension (85.1%) and the lowest among those with normal measured BP (54.4%). Conclusions This survey provides an updated insight into hypertension awareness and control in a setting of daily clinical practice, emphasizing the centricity of patients in the therapeutic alliance for a successful reduction of cardiovascular risk. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-022-00519-4.
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Affiliation(s)
- Rita Del Pinto
- Internal Medicine and Nephrology Unit, ESH Excellence Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, Department of Clinical Medicine, Public Health, Life and Environmental Sciences, G. Petrini str., 67100, L'Aquila, Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.,Monza General Hospital, Via Amati, 111, 20900, Monza, Italy
| | - Maria Lorenza Muiesan
- Internal Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy.,IRCCS S. Orsola-Malpighi Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Carugo
- Division of Cardiology, San Paolo University Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy.,Department of Health Sciences, University of Milan, via Festa del Perdono, 7, 20122, Milan, Italy
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy.,IRCCS S. Orsola-Malpighi Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luciano Di Meo
- Hypertension and Cardiovascular Prevention Center-ASL CE, District 14, Via Leonardo 10, Cellole, Italy
| | - Guido Iaccarino
- Interdepartmental Research Center for Hypertension and Related Conditions, University of Naples Federico II, Naples, Italy
| | - Pietro Minuz
- Unit of General Medicine for the Study and Treatment of Hypertensive Disease, Department of Medicine, Policlinico GB Rossi, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Via Giuseppe Verdi, 8, 10124, Turin, Italy
| | - Giuseppe Mulè
- Unit of Nephrology and Hypertension, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, European Society of Hypertension Excellence Center, University of Palermo, Piazza Marina, 61, 90133, Palermo, Italy
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.,Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, 20149, Milan, Italy
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Massimo Salvetti
- Internal Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS INRCA, Via Festa del Perdono, 7, 20122, Ancona, Italy.,Department of Clinical and Molecular Sciences, University 'Politecnica delle Marche', via Tronto, 10/a, 60126, Ancona, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine Department, Cardiology Unit Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 00189, Rome, Italy
| | - Leonardo Sechi
- Division of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine, Udine, Italy
| | - Giuliano Tocci
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189, Rome, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189, Rome, Italy
| | - Vito Vulpis
- Department of Medicine "Pende-Ferrannini", Bari University Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Claudio Ferri
- Internal Medicine and Nephrology Unit, ESH Excellence Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, Department of Clinical Medicine, Public Health, Life and Environmental Sciences, G. Petrini str., 67100, L'Aquila, Italy.
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6
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Mattina A, Geraci G, Zammuto M, Maida C, Giammanco A, Nardi E, Tuzzolino F, Averna M, Cottone S, Mulè G. Resistive index of ophthalmic artery as an imaging biomarker of hypertension-related vascular and kidney damage. Biomark Med 2021; 15:1155-1166. [PMID: 34397266 DOI: 10.2217/bmm-2020-0829] [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: 11/21/2022] Open
Abstract
Aim: Resistive index of ophthalmic artery (RI-OA) is associated with atherosclerotic diseases. The aim of this study was to evaluate the association of RI-OA and hypertension-related vascular and kidney damage. Materials and methods: Two-hundred and eighty hypertensive patients underwent evaluation of RI-OA, carotid atherosclerosis and level of 24 h albuminuria. Results: Albuminuria and carotid atherosclerosis were positively associated with RI-OA independently of other cardiovascular risk factors. Receiver-operating characteristic curve analysis allowed us to calculate a cut-off value of RI-OA >0.625, which would be suspicious about the existence of atherosclerotic disease. Conclusion: The ophthalmic vascular circulation allows to study connections between macro- and microcirculation in vivo. RI-OA could be a useful marker for a better stratification of the risk of developing kidney and cardiovascular disease.
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Affiliation(s)
- Alessandro Mattina
- Diabetes and Islet Transplantation Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), UPMC, Palermo, 90127, Italy.,Unit of Internal Medicine, Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
| | - Giulio Geraci
- Unit of Nephrology & Hypertension, European Society of Hypertension Excellence Center, Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
| | - Marta Zammuto
- Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
| | - Carlo Maida
- Unit of Internal Medicine, 'G. Longo' hospital, Mussomeli (CL), 93014, Italy
| | - Antonina Giammanco
- Unit of Internal Medicine, Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
| | - Emilio Nardi
- Unit of Internal Medicine, Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
| | - Fabio Tuzzolino
- Office of Research, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), UPMC, Palermo, 90127, Italy
| | - Maurizio Averna
- Unit of Internal Medicine, Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
| | - Santina Cottone
- Unit of Nephrology & Hypertension, European Society of Hypertension Excellence Center, Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
| | - Giuseppe Mulè
- Unit of Nephrology & Hypertension, European Society of Hypertension Excellence Center, Department of Health Promotion Sciences, Maternal & Infant Care, Internal Medicine & Medical Specialties (PROMISE), University of Palermo, Policlinico Universitario Paolo Giaccone, Palermo, 90127, Italy
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7
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Torlasco C, Faini A, Pengo MF, Borghi C, Grassi G, Ferri C, Muiesan ML, Salvetti M, Sechi L, Minuz P, Mulatero P, Pucci G, Volpe M, Carugo S, Sarzani R, Mulè G, Beaney T, Poulter NR, Xia X, Parati G. May Measurement Month 2019: an analysis of blood pressure screening results from Italy. Eur Heart J Suppl 2021; 23:B77-B81. [PMID: 34248433 PMCID: PMC8263076 DOI: 10.1093/eurheartj/suab054] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiovascular (CV) diseases are burdened by high mortality and morbidity, being responsible for half of the deaths in Europe. Although hypertension is recognized as the most important CV risk factor, hypertension awareness, and blood pressure (BP) control are still unsatisfactory. In 2017 and 2018, respectively >10 000 and >5000 individuals took part in the May Measurement Month (MMM) campaign in Italy, of whom 30.6% and 26.3% were found to have high BP, respectively. To raise public awareness on the importance of hypertension and to collect BP data on a nation-wide scale in Italy. In the frame of the MMM campaign, an opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2019. BP measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. Screening was conducted in multiple sites by health personnel. Among the 10 182 people screened (females: 52.3%, mean age 58 ± 16years) mean BP was 127/78 mmHg, and 3171 (31.1%) participants had arterial hypertension, of whom 62.1% were aware of being hypertensive. Diabetes, body mass index >25 kg/m2 were associated with higher BP and previous myocardial infarction with lower BP. For the third consecutive year we collected a nation-wide snapshot of BP control in a large sample of individuals. The high participation, with some yearly fluctuations likely due to the limitations of the sampling technique, confirms the power of this kind of health campaign in reaching a significant number of people to raise awareness on health topics.
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Affiliation(s)
- Camilla Torlasco
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy
| | - Martino F Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy
| | - Claudio Borghi
- Department of Internal Medicine, Ospedale S. Orsola-Malpighi, University of Bologna, Via Giuseppe Massarenti, 9, 40138 Bologna (BO), Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy
| | - Claudio Ferri
- Internal Medicine and Nephrology Unit, University of L'Aquila, Via Camponeschi, 19, 67100 L'Aquila (AQ), Italy
| | - Maria Lorenza Muiesan
- General Medicine, Department of Clinical and Experimental Science, University of Brescia, Piazza del Mercato, 15 - 25121 Brescia (BS), Italy
| | - Massimo Salvetti
- General Medicine, Department of Clinical and Experimental Science, University of Brescia, Piazza del Mercato, 15 - 25121 Brescia (BS), Italy
| | - Leonardo Sechi
- Department of Internal Medicine, University of Udine, Via delle Scienze, 206, 33100 Udine (UD), Italy
| | - Pietro Minuz
- Department of Medicine, University of Verona, Via S. Francesco, 22, 37129 Verona (VR), Italy
| | - Paolo Mulatero
- Department of Medical Sciences, University of Turin, Via Verdi, 8, 10124 Torino (TO), Italy
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Piazza dell'Università, 1, 06123 Perugia (PG), Italy
| | - Massimo Volpe
- Department of Medicine and Psychology, Sapienza University, Piazzale Aldo Moro 5, 00185 Roma (RO), Italy
| | - Stefano Carugo
- Department of Health Sciences, University of Milano, Via Carlo Pascal, 36, 20100, Milano (MI), Italy
| | - Riccardo Sarzani
- Clinica di Medicina Interna e Geriatria, Università Politecnica delle Marche, Via S.Margherita, 5 - 60124 Ancona (AN), Italy
| | - Giuseppe Mulè
- Nephrology and Hypertension Unit, University of Palermo, Via Giovanni Pascoli, 6, 90133 Palermo (PA), Italy
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy
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8
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Mulè G, Vadalà M, Sinatra N, Mancia E, Sorce A, Geraci G, Carollo C, Montalbano K, Castellucci M, Guarrasi G, Cillino S, Cottone S. Relationship of choroidal thickness with pulsatile hemodynamics in essential hypertensive patients. J Clin Hypertens (Greenwich) 2021; 23:1030-1038. [PMID: 33492773 PMCID: PMC8678803 DOI: 10.1111/jch.14196] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022]
Abstract
Controversy exists about the association of choroidal thickness (CTh) with blood pressure (BP) values. There is some evidence suggesting that central hemodynamics changes are associated with microvascular disease. Our study was aimed to assess the relationships between CTh and clinic and 24‐h BP and between CTh and estimated 24‐h aortic pulse pressure (aPP), 24‐h aortic systolic BP (aSBP), and 24‐h aortic augmentation index (aAIx) in a group of hypertensive patients. We enrolled 158 hypertensive subjects (mean age 48 ± 13 years) all of which underwent evaluation of the choroidal district by Swept‐Source optical coherence tomography (SS‐OCT) and 24‐h BP monitoring, in order to measure peripheral BP and to estimate central hemodynamic parameters. Inverse significant correlations of clinic PP, 24‐h aPP, 24‐h aSBP, and 24‐h aAIx with thicknesses of central ring, inner ring, and outer ring of the choroid and its overall average were found. The strongest of these correlations was that relating 24‐h aPP with overall average choroidal thickness (r = −.531; P < .001). When we divided the study population in subjects with 24‐h aPP above and below the median value (35 mm Hg), CTh were thinner in subjects with higher values of 24‐aPP as compared to those with lower ones, even after adjustment for age, and other potential confounders. The relationships of CTh with 24‐h aPP remained significant also taking into account the effects of various covariates in linear multiple regression analyses. Our findings support the concept of a cross‐talk between macro‐ and microcirculation.
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Affiliation(s)
- Giuseppe Mulè
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
| | - Maria Vadalà
- Dipartimento di Biomedicina sperimentale e Neuroscienze cliniche, Università degli studi di Palermo, Palermo, Italy
| | - Nicola Sinatra
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
| | - Ettore Mancia
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
| | - Alessandra Sorce
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
| | - Giulio Geraci
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
| | - Caterina Carollo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
| | - Katia Montalbano
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
| | - Massimo Castellucci
- Dipartimento di Biomedicina sperimentale e Neuroscienze cliniche, Università degli studi di Palermo, Palermo, Italy
| | - Giulia Guarrasi
- Dipartimento di Biomedicina sperimentale e Neuroscienze cliniche, Università degli studi di Palermo, Palermo, Italy
| | - Salvatore Cillino
- Dipartimento di Biomedicina sperimentale e Neuroscienze cliniche, Università degli studi di Palermo, Palermo, Italy
| | - Santina Cottone
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy.,Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università degli studi di Palermo, Palermo, Italy
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Nardi E, Mulè G, Giammanco A, Mattina A, Geraci G, Nardi C, Averna M. Left ventricular hypertrophy in chronic kidney disease: A diagnostic criteria comparison. Nutr Metab Cardiovasc Dis 2021; 31:137-144. [PMID: 33092976 DOI: 10.1016/j.numecd.2020.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/16/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS CKD patients have a high prevalence of LVH and this leads to an increase of cardiovascular risk. The aim of this study was to assess the prevalence of left ventricular hypertrophy (LVH) and left ventricular geometry in a group of 293 hypertensive patients with stage 2-5 chronic kidney disease (CKD), compared with 289 essential hypertensive patients with normal renal function. METHODS AND RESULTS All patients underwent echocardiographic examination. Patients on stage 1 CKD, dialysis treatment, or with cardiovascular diseases were excluded. LVH was observed in 62.8% of patients with CKD and in 51.9% of essential hypertensive patients (P < 0.0001). We found increasingly higher left ventricular diameters, thicknesses, and mass from stage 2-5 CKD. Distribution of concentric and eccentric LVH was not very different between the two groups. However, after introducing mixed hypertrophy, the difference between the two groups group was disclosed (P = 0.027). Multiple regression analysis confirmed that the association between renal function and left ventricular mass (β -0.287; P < 0.0001) was independent by potential confounders. Diastolic function was significantly worse in patients with CKD, especially in more advanced stages. CONCLUSION Our study confirms that LVH is highly prevalent in patients with CKD, especially by using the most recent cut off; in this population, LVH is often characterized by the simultaneous increase of wall thicknesses and diameters with negative effects on diastolic function.
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Affiliation(s)
- Emilio Nardi
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy.
| | - Giuseppe Mulè
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
| | - Antonina Giammanco
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
| | - Alessandro Mattina
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy; Diabetes and Islet Transplantation Unit, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), UPMC, Palermo, Italy
| | - Giulio Geraci
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy; University of Palermo - Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, Palermo, Italy
| | - Chiara Nardi
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
| | - Maurizio Averna
- Dipartimento di Promozione Della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università Degli Studi di Palermo, Italy
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Mulè G, Geraci G, Carollo C, Cottone S. Haemodynamics of primary aldosteronism associated with adrenocortical adenoma: insights from bioimpedance cardiography measurements. J Intern Med 2021; 289:134-136. [PMID: 32533871 DOI: 10.1111/joim.13127] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/05/2020] [Indexed: 11/29/2022]
Affiliation(s)
- G Mulè
- From the, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), Università degli studi di Palermo, Palermo, Italy
| | - G Geraci
- From the, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), Università degli studi di Palermo, Palermo, Italy
| | - C Carollo
- From the, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), Università degli studi di Palermo, Palermo, Italy
| | - S Cottone
- From the, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE), Università degli studi di Palermo, Palermo, Italy
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11
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Torlasco C, Faini A, Ferri C, Grassi G, Salvetti M, Destro M, Cicero AFG, Galletti F, Ghiadoni L, Carugo S, Sarzani R, Minuz P, Morganti A, Mulatero P, Mulè G, Savoia C, Volpe M, Borghi C, Beaney T, Ster AC, Poulter NR, Xia X, Parati G. May Measurement Month 2018: an analysis of blood pressure screening results from Italy. Eur Heart J Suppl 2020; 22:H70-H73. [PMID: 32884475 PMCID: PMC7455302 DOI: 10.1093/eurheartj/suaa032] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cardiovascular (CV) diseases are burdened by high mortality and morbidity, being responsible for half of the deaths in Europe. Although hypertension is recognized as the most important CV risk factor, hypertension awareness and blood pressure (BP) control are still unsatisfactory. In 2017, 30.6% of a >10 000 individual sample who took part in the May Measurement Month (MMM) campaign in Italy was found to have high BP. To raise awareness on the hypertension issue and to report BP data on a nation-wide scale in Italy. In the frame of the MMM campaign, an opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Screenings were conducted in multiple sites by health care personnel. Among the 5554 people screened (females: 48.3%, mean age 58 ± 17 years) mean BP was 127/77 mmHg, and after imputations, 1462 (26.3%) participants were found to have high BP levels. Body mass index >25 was associated with higher systolic BP and diastolic BP (DBP), while diabetes was associated with high DBP only. Our data provide a nation-wide snapshot of BP control in a sample of individuals participating in a national health care campaign, and confirm the power of this kind of healthcare-related activities in reaching a significant number of people to raise awareness on health topics. The apparent positive trend in BP control compared to available data from other similar campaigns carried out during the past years needs to be confirmed with more methodologically robust studies.
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Affiliation(s)
- Camilla Torlasco
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, piazza Santa Margherita 2, 67100, L'Aquila, Italy
| | - Guido Grassi
- Policlinico di Monza, Via Amati, 111 - 20900, Monza, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
| | - Massimo Salvetti
- Department of Clinical & Experimental Sciences and Postgraduate School of Emergency & Urgency Medicine, University of Brescia, Via Amati, 111 - 20900, Brescia, Italy.,2a Medicina-ASST Spedali Civili Brescia, Piazzale Spedali Civili, 1 25123, Brescia, Italy
| | - Maurizio Destro
- Medical Science, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, Italy
| | - Arrigo F G Cicero
- Medical and Surgical Sciences Department, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, Naples, Via Pansini, 5 - 80131, Italy.,"Federico II" University of Naples Medical School, Corso Umberto I 40, Naples, 80138, Italy
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Lungarno Antonio Pacinotti, 43, 56121, Italy
| | - Stefano Carugo
- Division of Cardiology, San Paolo University Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy.,Department of Health Sciences, University of Milan, ia Festa del Perdono, 7, 20122, Milan, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS INRCA, Via Festa del Perdono, 7, 20122, Ancona, Italy.,Department of Clinical and Molecular Sciences, University 'Politecnica delle Marche', ia Tronto, 10/a, 60126, Ancona, Italy
| | - Pietro Minuz
- Department of Medicine, Unit of General Medicine for the Study and Treatment of Hypertensive Disease, Policlinico GB Rossi, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy
| | - Alberto Morganti
- Centro Fisiologia Clinica e Ipertensione, Ospedale Policlinico, Università Milano, Via Francesco Sforza, 35, 20122, Milan, Italy
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Via Giuseppe Verdi, 8, 10124, Torino, Italy
| | - Giuseppe Mulè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Piazza Marina, 61, 90133, Palermo, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine Department, Cardiology Unit Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035/1039, 00189, Via di Grottarossa, 1035/1039, 00189, Rome, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa, 1035/1039, 00189, Rome, Italy
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy
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12
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Oliva M, Calia C, Ferrara M, D'Addabbo P, Scrascia M, Mulè G, Monno R, Pazzani C. Antimicrobial resistance gene shuffling and a three-element mobilisation system in the monophasic Salmonella typhimurium strain ST1030. Plasmid 2020; 111:102532. [PMID: 32853586 DOI: 10.1016/j.plasmid.2020.102532] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/30/2022]
Abstract
In this study we describe the genetic elements and the antimicrobial resistance units (RUs) harboured by the Salmonella Typhimurium monophasic variant 1,4,[5],12:i:- strain ST1030. Of the three identified RUs two were chromosomal, RU1 (IS26-blaTEM-1-IS26-strAB-sul2- IS26) and RU2 (IS26-tetR(B)-tetA(B)-ΔIS26), and one, RU3 (a sul3-associated class 1 integron with cassette array dfrA12-orfF-aadA2-cmlA1-aadA1), was embedded in a Tn21-derived element harboured by the conjugative I1 plasmid pST1030-1A. IS26 elements mediated the antimicrobial resistance gene (ARG) shuffling and this gave rise to pST1030-1A derivatives with different sets of ARGs. ST1030 also harboured two ColE1-like plasmids of which one, pST1030-2A, was mobilisable and the target of an intracellular translocation of the Tn21-derived element; the second (pST1030-3) was an orphan mob-associated oriT plasmid co-transferred with pST1030-1A and pST1030-2A. pST1030-2A and pST1030-3 also carried a parA gene and a type III restriction modification system, respectively. Overall analysis of our data reinforces the role played by IS26, Tn21-derived elements and non-conjugative plasmids in the spread of ARGs and supplies the first evidence, at least in Salmonella, for the identification of a natural isolate harbouring a three-element mobilisation system in the same cell.
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Affiliation(s)
- M Oliva
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - C Calia
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - M Ferrara
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), Via G. Amendola 122/O, 70126 Bari, Italy
| | - P D'Addabbo
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - M Scrascia
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy
| | - G Mulè
- Institute of Sciences of Food Production, National Research Council of Italy (ISPA-CNR), Via G. Amendola 122/O, 70126 Bari, Italy
| | - R Monno
- Department of Basic Medical Sciences Neurosciences and Sense Organs Medical Faculty, University of Bari Piazza G. Cesare Policlinico, 70124 Bari, Italy
| | - C Pazzani
- Department of Biology, University of Bari, via Orabona, 4, 70125 Bari, Italy.
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13
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Geraci G, Zammuto MM, Cottone S, Mulè G. Renal resistive index: Beyond the hemodynamics. J Clin Hypertens (Greenwich) 2020; 22:1288-1289. [DOI: 10.1111/jch.13920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Giulio Geraci
- Department of Health Promotion, Mother and Child Care Internal Medicine and Medical Specialties University of Palermo Palermo Italy
| | - Marta Maria Zammuto
- Department of Health Promotion, Mother and Child Care Internal Medicine and Medical Specialties University of Palermo Palermo Italy
| | - Santina Cottone
- Department of Health Promotion, Mother and Child Care Internal Medicine and Medical Specialties University of Palermo Palermo Italy
| | - Giuseppe Mulè
- Department of Health Promotion, Mother and Child Care Internal Medicine and Medical Specialties University of Palermo Palermo Italy
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14
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Iaccarino G, Borghi C, Cicero AFG, Ferri C, Minuz P, Muiesan ML, Mulatero P, Mulè G, Pucci G, Salvetti M, Savoia C, Sechi LA, Volpe M, Grassi G. Renin-Angiotensin System Inhibition in Cardiovascular Patients at the Time of COVID19: Much Ado for Nothing? A Statement of Activity from the Directors of the Board and the Scientific Directors of the Italian Society of Hypertension. High Blood Press Cardiovasc Prev 2020; 27:105-108. [PMID: 32266708 PMCID: PMC7138256 DOI: 10.1007/s40292-020-00380-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/02/2020] [Indexed: 12/23/2022] Open
Abstract
Cardiovascular diseases, in particular hypertension, as well as the cardiovascular treatment with Renin–Angiotensin System inhibitors such as Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs), are claimed once again as mechanisms of Severe Acute Respiratory Syndrome (SARS) during the COVID-19 outbreak due to Cov-2 epidemics. In vitro studies are available to support the eventual role of ACE inhibitors and ARBs in both the promotion and antagonism of the disease. The available literature, indeed, presents contrasting results, all concentrated in experimental models. Evidence in humans is lacking that those mechanisms are actually occurring in the present COVID-19 outbreak. Here we present the reasoned statement of the Italian Society of Hypertension to maintain ongoing antihypertensive treatments. Furthermore, the Italian Society of Hypertension presents its own initiative to investigate the issue using an online questionnaire to collect relevant data in human disease.
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Affiliation(s)
- Guido Iaccarino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Claudio Borghi
- Department of Medicine and Surgery Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudio Ferri
- Department of Clinical Medicine, Public Health, Life and Environment Sciences, University of Aquila, L'Aquila, Italy
| | - Pietro Minuz
- Department of Medicine, University of Verona, Verona, Italy
| | - Maria Lorenza Muiesan
- Dept of Clinical & Experimental Sciences, University of Brescia-Medicina 2, ASST Spedali Civili Brescia, Brescia, Italy
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Turin, Italy
| | - Giuseppe Mulè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, University of Palermo, Palermo, Italy
| | - Giacomo Pucci
- Section of Internal Medicine Terni, Department of Medicine, University of Perugia, Terni, Italy
| | - Massimo Salvetti
- Dept of Clinical & Experimental Sciences, University of Brescia-Medicina 2, ASST Spedali Civili Brescia, Brescia, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine Department, Sapienza University of Rome, Rome, Italy
| | | | - Massimo Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.,IRCCS Neuromed, Pozzilli, IS, Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
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15
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Omboni S, Posokhov I, Parati G, Arystan A, Tan I, Barkan V, Bulanova N, Derevyanchenko M, Grigoricheva E, Minyukhina I, Mulè G, Orlova I, Paini A, Peixoto Maldonado JM, Pereira T, Ramos-Becerra CG, Tilea I, Waisman G. Variable association of 24-h peripheral and central hemodynamics and stiffness with hypertension-mediated organ damage: the VASOTENS Registry. J Hypertens 2020; 38:701-715. [DOI: 10.1097/hjh.0000000000002312] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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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16
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Geraci G, Sorce A, Mulè G. The "Renocentric Theory" of Renal Resistive Index: Is It Time for a Copernican Revolution? J Rheumatol 2020; 47:486-489. [PMID: 32238542 DOI: 10.3899/jrheum.190930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Giulio Geraci
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy.
| | - Alessandra Sorce
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Giuseppe Mulè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
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Affiliation(s)
- Giuseppe Mulè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
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Geraci G, Maria Zammuto M, Vadalà M, Mattina A, Castellucci M, Guarrasi G, Nardi E, Maida C, Zanoli L, Cillino S, Cottone S, Mulè G. Choroidal thickness is associated with renal hemodynamics in essential hypertension. J Clin Hypertens (Greenwich) 2020; 22:245-253. [PMID: 31945274 PMCID: PMC8030072 DOI: 10.1111/jch.13777] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 10/26/2019] [Accepted: 11/17/2019] [Indexed: 01/02/2023]
Abstract
The choroid is the most vascularized structure of the eye and plays a central role in the development of the retinal vascular changes that occur in arterial hypertension. Changes of choroidal thickness (ChT) assessed by optical coherence tomography (OCT) technology could reflect the vascular complications of hypertension. Also, intrarenal hemodynamic damage, associated with endothelial dysfunction, demonstrated to be a good indicator of systemic morphofunctional arterial impairment. The aim of this study is to assess the relationship between ChT and renal hemodynamics in subjects with essential hypertension. Routine laboratory tests, clinical history, and physical examination, including blood pressure assessment, were performed in 90 subjects with essential hypertension. All patients underwent Doppler ultrasonographic evaluation of intra-renal hemodynamics and OCT imaging to assess ChT. When subjects were divided in two groups based on renal resistive index (RRI), group I (RRI ≥ 75% percentile) showed significantly lower values of ChT than group II (RRI < 75% percentile) (P < .001). When divided in two groups based on the ChT median values, patients with lower ChT had significantly higher RRI values than those with ChT above the median values (P < .05). In multivariate model including age, eGFR, and other variables as confounding factors, RRI ≥ 75% was independently associated with ChT. ChT was significantly correlated with renal resistive index in subjects with essential hypertension, confirmed in multivariate analyses. This result could be referred to changes in vascular elastic properties that occur in retinal and intrarenal vascular system probably due to oxidative stress and endothelial dysfunction commonly found in early complications of hypertension.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Marta Maria Zammuto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Maria Vadalà
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Alessandro Mattina
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Internal MedicineUniversity of PalermoPalermoItaly
- IRCCS Centro Neurolesi "Bonibo‐Pulejo"MessinaItaly
| | - Massimo Castellucci
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Giulia Guarrasi
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Internal MedicineUniversity of PalermoPalermoItaly
| | - Carlo Maida
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Luca Zanoli
- Clinical and Experimental MedicineSection of NephrologyUniversity of CataniaCataniaItaly
| | - Salvatore Cillino
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheSection of OphthalmologyUniversity of PalermoPalermoItaly
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS)Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CenterUniversity of PalermoPalermoItaly
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Mulè G, Mulè G, Tranchida V, Colletti P, Mazzola G, Trizzino M, Colomba C, Cascio A. Aortic Stiffness in HIV Infection with and without Antiretroviral Therapy. A Meta-analysis of Observational Studies. Artery Res 2020. [DOI: 10.2991/artres.k.200314.002] [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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Mulè G, Sorce A, Nardi E, Geraci G, Cottone S. The nephroprotective effect of sacubitril/valsartan in heart failure: insights from the real-life clinical setting. Intern Emerg Med 2019; 14:1205-1208. [PMID: 31309521 DOI: 10.1007/s11739-019-02149-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Giuseppe Mulè
- Unit of Nephrology and Hypertension, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, European Society of Hypertension Excellence Centre, University of Palermo, Via Monte San Calogero, 29, 90146, Palermo, Italy.
| | - Alessandra Sorce
- Unit of Nephrology and Hypertension, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, European Society of Hypertension Excellence Centre, University of Palermo, Via Monte San Calogero, 29, 90146, Palermo, Italy
| | - Emilio Nardi
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Internal Medicine, University of Palermo, Palermo, Italy
| | - Giulio Geraci
- Unit of Nephrology and Hypertension, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, European Society of Hypertension Excellence Centre, University of Palermo, Via Monte San Calogero, 29, 90146, Palermo, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, European Society of Hypertension Excellence Centre, University of Palermo, Via Monte San Calogero, 29, 90146, Palermo, Italy
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Nardi E, Mulè G, Nardi C, Geraci G, Giammanco A, Bentivegna R, Averna M. Is echocardiography mandatory for patients with chronic kidney disease? Intern Emerg Med 2019; 14:923-929. [PMID: 30912000 DOI: 10.1007/s11739-019-02028-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/05/2018] [Accepted: 01/08/2019] [Indexed: 12/21/2022]
Abstract
This study aims at evaluating the prevalence of left ventricular diastolic dysfunction in a group of 319 hypertensive patients with stage 3b-4-5 chronic kidney disease (according to Kidney Disease Improving Global Outcomes classification), compared with 216 patients with essential hypertension and normal renal function. All patients underwent echocardiographic examination. Patients on stage 1-2-3a chronic kidney disease, dialysis treatment, or with previous manifestations of heart failure or other cardiovascular diseases were excluded. Patients with renal disease had significantly worse diastolic function (both considering trans-mitral flow and tissue Doppler imaging parameters). Diastolic dysfunction is found in 70.5% of the CKD group and in 41.6% of hypertensive patients (p < 0.0001). Multiple regression analysis shows an association between renal function and diastolic function (β 0.223; p < 0.0001), independent of potential confounders. Our study shows that diastolic dysfunction is highly prevalent in patients with advanced chronic kidney disease; we posit that in this population, the risk of diastolic heart failure is very high. We think that patients with a marked decrease of glomerular filtration rate (GFR) must be considered at high risk for diastolic heart failure and should have an echocardiographic examination performed, even if asymptomatic and in the absence of evident cardiovascular disease.
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Affiliation(s)
- Emilio Nardi
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy.
| | - Giuseppe Mulè
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy
| | - Chiara Nardi
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy
| | - Giulio Geraci
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy
| | - Antonina Giammanco
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy
| | - Riccardo Bentivegna
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy
| | - Maurizio Averna
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy
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Mulè G, Sorce A, Carollo C, Geraci G, Cottone S. Self-blood pressure monitoring as a tool to increase hypertension awareness, adherence to antihypertensive therapy, and blood pressure control. J Clin Hypertens (Greenwich) 2019; 21:1305-1307. [PMID: 31393070 DOI: 10.1111/jch.13638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Giuseppe Mulè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Alessandra Sorce
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Caterina Carollo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Giulio Geraci
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Santina Cottone
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
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Geraci G, Zammuto M, Gaetani R, Mattina A, D'Ignoto F, Geraci C, Noto D, Averna M, Cottone S, Mulè G. Relationship of a Body Shape Index and Body Roundness Index with carotid atherosclerosis in arterial hypertension. Nutr Metab Cardiovasc Dis 2019; 29:822-829. [PMID: 31204196 DOI: 10.1016/j.numecd.2019.04.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 06/21/2018] [Revised: 02/16/2019] [Accepted: 04/29/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS A Body Shape Index (ABSI) and Body Roundness Index (BRI) are two new anthropometric adiposity indices that have shown to be associated better than BMI with adipose abdominal tissue, with the onset of diabetes and the risk of premature death. Little is known about the influence of ABSI and BRI on subclinical vascular damage. The study was aimed to assess the relationship between ABSI and BRI with carotid atherosclerosis damage in subjects with arterial hypertension. METHODS AND RESULTS A total of 468 patients with arterial hypertension (30-80 years old) were enrolled; adiposity indices were calculated (BMI, WC, ABSI, BRI) and carotid ultrasonographic examination was performed to detect atherosclerotic damage (IMT or atherosclerotic plaque). BRI, but not ABSI, was higher in subjects with IMT> 0.90 mm in comparison to those with a lower IMT (p < 0.001), whereas patients with carotid plaques showed higher values of ABSI (p = 0.001), as well as of BRI (p = 0.003). Linear regression analysis disclosed significant correlation of IMT with ABSI, BRI and BMI (all p < 0.001). In the multivariate analysis, BRI was independently correlated with cIMT (p = 0.015). On the contrary, ABSI did not show any independent association with cIMT. However, ABSI was strongly associated with carotid plaques in multiple logistic regression analysis after adjustment for potential confounding factors. When BRI or BMI replaced ABSI into the multivariate models, they did not show any independent correlation with carotid plaques. CONCLUSIONS ABSI may be proposed as a better correlate of carotid atherosclerosis than the traditional measures of adiposity.
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Affiliation(s)
- Giulio Geraci
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy.
| | - Marta Zammuto
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - Rossella Gaetani
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - Alessandro Mattina
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Internal Medicine, University of Palermo, Italy
| | - Francesco D'Ignoto
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - Calogero Geraci
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - Davide Noto
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Internal Medicine, University of Palermo, Italy
| | - Maurizio Averna
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Internal Medicine, University of Palermo, Italy
| | - Santina Cottone
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - Giuseppe Mulè
- Dipartimento di Scienze della Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica d'Eccellenza "G. D'Alessandro" (PROMISE), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
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Omboni S, Posokhov I, Parati G, Rogoza A, Kotovskaya Y, Arystan A, Avolio A, Barkan V, Bulanova N, Cardona Muñoz E, Grigoricheva E, Konradi A, Minyukhina I, Muiesan ML, Mulè G, Orlova I, Pereira T, Peixoto Maldonado JM, Statsenko ME, Tilea I, Waisman G, Rogoza A, Forcada P, Zelveian P, Butlin M, Barin E, Tan I, Ghiadoni L, Bruno RM, Sarzani R, Espinosa E, Volpe M, Savoia C, Tocci G, Borghi C, Schillaci G, Pucci G, Paini A, Rizzoni D, Ramos C, Alanis A, Varga A, Volkov D, Kurlykina N, Rotar O, Orlov A, Gorbunov V, Boytsov S, Fedorova E, Korneva V, Kuznetsova T, Kulikova N, Evdokimov VV, Kuznetsova A, Zheleznyak E, Kobalava Z, Borisova I, Svetozarsky T, Gubanova M, Lazareva V, Derevyanchenko MV, Kopylov P, Sirenko Y, Recovets O. Ambulatory blood pressure and arterial stiffness web‐based telemonitoring in patients at cardiovascular risk. First results of the VASOTENS (Vascular health ASsessment Of The hypertENSive patients) Registry. J Clin Hypertens (Greenwich) 2019; 21:1155-1168. [DOI: 10.1111/jch.13623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit Italian Institute of Telemedicine Varese Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Igor Posokhov
- Hemodynamic Laboratory Ltd Nizhniy Novgorod Russian Federation
| | - Gianfranco Parati
- Department of Cardiology Istituto Auxologico Italiano Milan Italy
- Department of Medicine and Surgery University of Milano‐Bicocca Milan Italy
| | - Anatoly Rogoza
- Department of New Diagnostic Methods Russian Cardiology Research and Production Complex Moscow Russian Federation
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology Pirogov Russian National Research Medical Moscow Russian Federation
| | - Ayana Arystan
- Department of Functional Diagnostics Medical Center Hospital of President’s Affairs Administration of The Republic of Kazakhstan Astana Kazakhstan
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia
| | - Vitaliy Barkan
- Diagnostics Department The Hospital within the Russian Railroad Network Chita Russian Federation
| | - Natalia Bulanova
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | | | | | - Alexandra Konradi
- Department of Epidemiology North‐West Federal Medical Research Center St. Petersburg Russian Federation
| | - Irina Minyukhina
- Lomonosov Moscow State University Clinic Moscow Russian Federation
| | - Maria Lorenza Muiesan
- Dipartimento di Scienze Mediche e Chirurgiche Università di Brescia, Medicina 2 Brescia Italy
| | - Giuseppe Mulè
- Unità Operativa di Nefrologia ed Ipertensione, Centro di Riferimento Regionale per l'Ipertensione Arteriosa Policlinico Paolo Giaccone Palermo Italy
| | - Iana Orlova
- Volga District Medical Center Nizhniy Novgorod Russian Federation
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra Instituto Politécnico de Coimbra Coimbra Portugal
| | | | | | - Ioan Tilea
- Cardiac Rehabilitation Clinic Tirgu Mures Emergency Clinical County Hospital Tirgu Mures Romania
| | - Gabriel Waisman
- Servicio de Clínica Médica y Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires Argentina
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Vadalà M, Castellucci M, Guarrasi G, Terrasi M, La Blasca T, Mulè G. Retinal and choroidal vasculature changes associated with chronic kidney disease. Graefes Arch Clin Exp Ophthalmol 2019; 257:1687-1698. [PMID: 31147842 DOI: 10.1007/s00417-019-04358-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [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: 11/17/2018] [Revised: 05/04/2019] [Accepted: 05/14/2019] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Retinal and choroidal microvascular changes can be related to renal impairment in hypertension and chronic kidney disease (CKD). The study examines the association between retinochoroidal parameters and renal impairment in hypertensive, non-diabetic patients. METHODS This is a cross-sectional study on Caucasian patients with systemic arterial hypertension with different levels of renal function. All subjects were studied by blood chemistry, urine examination, microalbuminuria and blood pressure. Complete eye examination was completed with swept source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCTA) scans of macular region. Patients were divided in groups: LowGFR and HighGFR and CKD- and CKD+, according to the value of glomerular filtrate (GFR) and albuminuria. LowGFR and CKD+ groups included patients with clinical kidney impairment. RESULTS One hundred and twenty eyes of 120 hypertensive patients were evaluated. The mean retinal thickness was thinner in CKD+ versus CKD- group (p < 0.009). LowGFR and CKD+ groups showed thinner choroidal values than HighGFR (p < 0.02) and CKD- (p < 0.001) groups. OCTA showed lower density in LowGFR than in HighGFR group (p < 0.001) and in CKD+ versus CKD- group (p < 0.001). Albuminuria was inversely related to choroidal and retinal thickness measures (p < 0.001) and to the indices of superficial parafoveal (p < 0.05) and foveal (p < 0.05) vascular densities. CONCLUSIONS CKD is associated with retinal thinning, eGFR and decreasing renal function with progressive reduction of choroidal and retinal vascular density. SS-OCT and OCTA documented close association between CKD and reduction of both choroidal thickness and paracentral retinal vascular density in hypertensive patients.
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Affiliation(s)
- Maria Vadalà
- Dipartimento di Biomedicina Sperimentale e Neuroscienze cliniche, Sezione di Oftalmologia, University of Palermo, Via Liborio Giuffrè 13, 90127, Palermo, Italy.
| | - Massimo Castellucci
- Dipartimento di Biomedicina Sperimentale e Neuroscienze cliniche, Sezione di Oftalmologia, University of Palermo, Via Liborio Giuffrè 13, 90127, Palermo, Italy
| | - Giulia Guarrasi
- Dipartimento di Biomedicina Sperimentale e Neuroscienze cliniche, Sezione di Oftalmologia, University of Palermo, Via Liborio Giuffrè 13, 90127, Palermo, Italy
| | - Micol Terrasi
- Dipartimento di Biomedicina Sperimentale e Neuroscienze cliniche, Sezione di Oftalmologia, University of Palermo, Via Liborio Giuffrè 13, 90127, Palermo, Italy
| | - Tiziana La Blasca
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy
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Mulè G, Vadalà M, La Blasca T, Gaetani R, Virone G, Guarneri M, Castellucci M, Guarrasi G, Terrasi M, Cottone S. Association between early-stage chronic kidney disease and reduced choroidal thickness in essential hypertensive patients. Hypertens Res 2019; 42:990-1000. [DOI: 10.1038/s41440-018-0195-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 01/01/2023]
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Affiliation(s)
- Giuseppe Mulè
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Marco Guarneri
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Clarissa Pugliares
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Giulio Geraci
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
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Geraci G, Zammuto MM, Mattina A, Zanoli L, Geraci C, Granata A, Nardi E, Fatuzzo PM, Cottone S, Mulè G. Para-perirenal distribution of body fat is associated with reduced glomerular filtration rate regardless of other indices of adiposity in hypertensive patients. J Clin Hypertens (Greenwich) 2018; 20:1438-1446. [PMID: 30218482 DOI: 10.1111/jch.13366] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 03/22/2018] [Revised: 07/07/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022]
Abstract
Obesity is a well-known risk factor for the development and progression of chronic kidney disease. Recently, para-perirenal ultrasonographic fat thickness (PUFT) has shown to correlate with both total and visceral fat better than body mass index (BMI), waist circumference (WC), and other indices of obesity. Moreover, a local paracrine and mechanical action of the PUFT on kidney has been described in recent studies. Aim of our study was to assess the relationship between glomerular filtration rate (GFR) and PUFT in comparison with other anthropometric and ultrasonographic indices of adiposity. Two hundred and ninety-six hypertensive patients were enrolled. PUFT, cutis-rectis thickness and rectis-aorta thickness were obtained by ultrasonography. Anthropometric measures of adiposity were also measured. Estimated GFR was calculated using the CKD-EPI equation. Higher PUFT values were observed in patients with impaired renal function (P < 0.001), whereas no differences in BMI and WC were shown between groups divided by GFR. PUFT significantly correlated with GFR in all patients (r = -0.284; P < 0.001), with no differences in groups divided by sex, diabetes, or BMI. This association held in multivariate analyses also after correction for confounding factors, including other adiposity indices (P < 0.001). When receiver operating characteristic curves were built to detect a eGFR < 60 mL/minutes per 1.73 m2 , a PUFT value ≤3.725 cm showed a negative predictive value of 94.0%, with the largest area under the curve (AUC: 0.700) among the variables considered. In conclusion, the relationship between PUFT and GFR seems to be more accurate and less influenced by the bias affecting traditional indices of adiposity.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Marta Maria Zammuto
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Alessandro Mattina
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Internal Medicine, University of Palermo, Palermo, Italy.,IRCCS Centro Neurolesi "Bonibo-Pulejo", via Provinciale Palermo, Messina, Italy
| | - Luca Zanoli
- Clinical and Experimental Medicine, Section of Nephrology, University of Catania, Italy
| | - Calogero Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Antonio Granata
- Unit of Nephrology and Dialysis, San Giovanni di Dio" Hospital, Agrigento, Italy
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Internal Medicine, University of Palermo, Palermo, Italy.,IRCCS Centro Neurolesi "Bonibo-Pulejo", via Provinciale Palermo, Messina, Italy
| | | | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
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Abstract
Takayasu arteritis (TA) is a chronic vasculitis disease of unknown etiology. Clinically significant renal disease is relatively common, and renovascular hypertension is the major renal problem. The assessment of TA activity is usually challenging because vascular inflammation may progress to fixed vascular injury without findings of active disease. Until now, the best therapeutic options have not been identified. This review highlights the current perspectives of renal involvement in TA.
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Affiliation(s)
- Gioacchino Li Cavoli
- Nephrology, Dialysis and Renal Transplant Department, Civico and Di Cristina Hospital, Palermo, Italy,
| | - Giuseppe Mulè
- Internal Medicine, Cardiovascular and Renal Diseases Department, University of Palermo, Palermo, Italy
| | | | - Flavia Caputo
- Nephrology, Dialysis and Renal Transplant Department, Civico and Di Cristina Hospital, Palermo, Italy,
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Nardi E, Mulè G, Nardi C, Geraci G, Averna M. Diabetes and aortic root dimension: A controversial subject. Int J Cardiol 2018; 264:190. [DOI: 10.1016/j.ijcard.2018.03.071] [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] [Received: 03/09/2018] [Accepted: 03/14/2018] [Indexed: 11/26/2022]
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Mulè G, Nardi E, Lattuca L, Cottone S. Hyperuricemia and high blood pressure at rest and during exercise: Guilty or innocent? The jury is still out. J Clin Hypertens (Greenwich) 2018; 20:557-559. [PMID: 29457338 DOI: 10.1111/jch.13227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Giuseppe Mulè
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Emilio Nardi
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Luigi Lattuca
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
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Geraci G, Mulè G, Paladino G, Zammuto MM, Castiglia A, Scaduto E, Zotta F, Geraci C, Granata A, Mansueto P, Cottone S. Relationship between kidney findings and systemic vascular damage in elderly hypertensive patients without overt cardiovascular disease. J Clin Hypertens (Greenwich) 2017; 19:1339-1347. [DOI: 10.1111/jch.13127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/03/2017] [Accepted: 08/14/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
| | - Gabriella Paladino
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Geriatrics; University of Palermo; Palermo Italy
| | - Marta Maria Zammuto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
| | - Antonella Castiglia
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
| | - Emilia Scaduto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
| | - Federica Zotta
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
| | - Calogero Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
| | - Antonio Granata
- “San Giovanni di Dio” Hospital; Unit of Nephrology and Dialysis; Agrigento Italy
| | - Pasquale Mansueto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Geriatrics; University of Palermo; Palermo Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Center; University of Palermo; Palermo Italy
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Mulè G, Vadalà M, Geraci G, Cottone S. Retinal vascular imaging in cardiovascular medicine: New tools for an old examination. Atherosclerosis 2017; 268:188-190. [PMID: 29145994 DOI: 10.1016/j.atherosclerosis.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/01/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
| | - Maria Vadalà
- Dipartimento di Biomedicina Sperimentale e di Neuroscienze Cliniche (BIONEC), Ophthalmology Section, Università di Palermo, Palermo, Italy
| | - Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
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Nardi E, Mulè G, Nardi C, Averna M. Differences in Cardiac Structure and Function Between Black and White Patients: Another Step in the Evaluation of Cardiovascular Risk in Chronic Kidney Disease. Am J Hypertens 2017. [PMID: 28645164 DOI: 10.1093/ajh/hpx093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Italy
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Italy
| | - Chiara Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Italy
| | - Maurizio Averna
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Italy
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Mulè G, Nardi E, Geraci G, Schillaci MK, Cottone S. The relationships between lipid ratios and arterial stiffness. J Clin Hypertens (Greenwich) 2017; 19:777-779. [DOI: 10.1111/jch.13030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Giuseppe Mulè
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Emilio Nardi
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Giulio Geraci
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Margherita Ketty Schillaci
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Santina Cottone
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
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Mulè G, Castiglia A, Morreale M, Geraci G, Cusumano C, Guarino L, Altieri D, Panzica M, Vaccaro F, Cottone S. Serum uric acid is not independently associated with plasma renin activity and plasma aldosterone in hypertensive adults. Nutr Metab Cardiovasc Dis 2017; 27:350-359. [PMID: 28274727 DOI: 10.1016/j.numecd.2016.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 09/23/2016] [Revised: 12/17/2016] [Accepted: 12/20/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS In experimental investigations conducted in rats, raising serum uric acid (SUA) levels resulted in the stimulation of intrarenal renin expression. Studies in humans exploring the association of SUA with plasma renin activity (PRA) yielded conflicting results. Moreover, little is known about the relationship of SUA with plasma aldosterone concentration (PAC). The study aimed to assess the relationship between SUA levels, PRA, and PAC and the influence of age, gender, body mass index (BMI), and hyperuricemia on these relationships in subjects with essential hypertension (EH). METHODS AND RESULTS We enrolled 372 hypertensive patients (mean age 45 ± 12 years, men 67%) with uncomplicated EH that was not pharmacologically treated. The study population was divided in tertiles according to SUA levels. While PRA did not differ significantly across the three tertiles, PAC was higher in subjects belonging to the uppermost tertile of SUA than those in the lower ones (p = 0.0429); however, this difference lost statistical significance after adjustment for age, sex, BMI, and serum creatinine. Univariate correlation analyses showed significant associations of SUA with PRA (r = 0.137; p = 0.008) and PAC (r = 0.179; p < 0.001). However, these relationships were not significant after correcting for confounding factors in multiple linear regression analyses. We did not observe statistically significant effect modification by gender, age, BMI, and hyperuricemia. CONCLUSION SUA levels are weakly associated with PRA and PAC in adults with untreated EH. These relationships were lost after adjustment for age, sex, BMI, and serum creatinine.
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Affiliation(s)
- G Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy.
| | - A Castiglia
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - M Morreale
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - G Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - C Cusumano
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - L Guarino
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - D Altieri
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - M Panzica
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - F Vaccaro
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
| | - S Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Italy
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Omboni S, Posokhov IN, Parati G, Barkan VS, Cardona Muñoz E, Grigoricheva EA, Minyukhina IE, Muiesan ML, Mulè G, Orlova IA, Pereira T. P42 24-HOUR CENTRAL BLOOD PRESSURE IS MORE STRONGLY ASSOCIATED TO TARGET ORGAN DAMAGE THAN BRACHIAL BLOOD PRESSURE: FIRST RESULTS OF THE VASOTENS REGISTRY. Artery Res 2017. [DOI: 10.1016/j.artres.2017.10.072] [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: 12/01/2022] Open
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Nardi E, Mulè G, Nardi C, Geraci G, Averna M. Inverse association between type 2 diabetes and aortic root dimension in hypertensive patients. Int J Cardiol 2016; 228:233-237. [PMID: 27865191 DOI: 10.1016/j.ijcard.2016.11.163] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 11/06/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Some data support the concept that aortic root diameter (ARD) in hypertension may be regarded as a marker of subclinical organ damage. The impact of type 2 diabetes mellitus (DM) on cardiac structure and function is known, although the relationship between DM and ARD is not clear. The aim of our study was to evaluate the influence of DM on ARD in hypertensive patients. METHODS We enrolled 1693 hypertensive patients (aged 63.7±9.6years). The population was divided into two groups: the first one with DM (n=747) and the second one without DM (n=946). ARD was measured by echocardiography at level of Valsalva's sinuses using echocardiography M-mode tracings. It was considered as absolute measure and normalized to height (ARD/H) and body surface area (ARD/BSA). Left ventricular mass index (LVMI) and some parameters of systolic and diastolic function have been valued by means of echocardiography and tissue Doppler imaging. RESULTS The DM group was characterized by more elevated values of LVMI and a worst systolic and diastolic function. ARD value was significantly lower in DM group in comparison to patients without DM only when indexed for BSA (ARD/BSA=18.7±2.3mm/m2 vs 18.3±2.0mm/m2, p=0.01). This difference remained statistically significant, even after correction by age, sex and BMI (p=0.01). A multivariate linear regression analysis demonstrated an inverse relationship between DM and ARD/BSA after correction for potential confounders (β=0.10, p<0.001). CONCLUSIONS Our results confirm the hypothesis of a protective role of DM on aortic root dilatation.
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Affiliation(s)
- Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy
| | - Chiara Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy
| | - Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy
| | - Maurizio Averna
- Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy
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Omboni S, Posokhov IN, Parati G, Avolio A, Rogoza AN, Kotovskaya YV, Mulè G, Muiesan ML, Orlova IA, Grigoricheva EA, Cardona Muñoz E, Zelveian PH, Pereira T, Peixoto Maldonado JM. Vascular Health Assessment of The Hypertensive Patients (VASOTENS) Registry: Study Protocol of an International, Web-Based Telemonitoring Registry for Ambulatory Blood Pressure and Arterial Stiffness. JMIR Res Protoc 2016; 5:e137. [PMID: 27358088 PMCID: PMC4945820 DOI: 10.2196/resprot.5619] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/01/2016] [Accepted: 05/04/2016] [Indexed: 01/20/2023] Open
Abstract
Background Hypertension guidelines recommend ambulatory blood pressure (ABP), central aortic pressure (CAP), and pulse wave velocity (PWV) as parameters for estimating blood pressure (BP) control and vascular impairment. Recent advances in technology have enabled devices to combine non-invasive estimation of these parameters over the 24-hour ABP monitoring. However, currently there is limited evidence on the usefulness of such an approach for routine hypertension management. Objective We recently launched an investigator-initiated, international, multicenter, observational, prospective study, the Vascular health Assessment Of The Hypertensive patients (VASOTENS) Registry, aimed at (1) evaluating non-invasive 24-hour ABP and arterial stiffness estimates (through 24-hour pulse wave analysis, PWA) in hypertensive subjects undergoing ambulatory blood pressure monitoring (ABPM) for clinical reasons; (2) assessing the changes in estimates following treatment; (3) weighing the impact of 24-hour PWA on target organ damage and cardiovascular prognosis; (4) assessing the relationship between arterial stiffness, BP absolute mean level and variability, and prognosis; and (5) validating the use of a 24-hour PWA electronic health (e-health) solution for hypertension screening. Methods Approximately 2000 subjects, referred to 20 hypertension clinics for routine diagnostic evaluation and follow-up of hypertension of any severity or stage, will be recruited. Data collection will include ABPM, performed with a device allowing simultaneous non-invasive assessment of 24-hour CAP and arterial stiffness (BPLab), and clinical data (including cardiovascular outcomes). As recommended by current guidelines, each patient will be followed-up with visits occurring at regular intervals (ideally every 6 months, and not less than once a year depending on disease severity). A Web-based telemedicine platform (THOLOMEUS) will be used for data collection. The use of the telemedicine system will allow standardized and centralized data collection, data validation by experts and counseling to remote centers, setup and maintenance of the Registry, and prompt data analysis. Results First follow-up results are expected to be available in the next 2 years. Conclusions The results of the VASOTENS Registry will help define the normalcy thresholds for current and future indices derived from 24-hour PWA, according to outcome data, and will also provide supporting evidence for the inclusion of this type of evaluation in hypertension management. Trial registration Clinicaltrials.gov NCT02577835; https://clinicaltrials.gov/ct2/show/NCT02577835 (Archived by WebCite at http://www.Webcitation.org/6hzZBKY2Q)
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Affiliation(s)
- Stefano Omboni
- Italian Institute of Telemedicine, Clinical Research Unit, Solbiate Arno, Italy.
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Morreale M, Mulè G, Ferrante A, D'ignoto F, Cottone S. Association of Renal Resistive Index with Markers of Extrarenal Vascular Changes in Patients with Systemic Lupus Erythematosus. Ultrasound Med Biol 2016; 42:1103-10. [PMID: 26924695 DOI: 10.1016/j.ultrasmedbio.2015.12.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/03/2015] [Accepted: 12/22/2015] [Indexed: 05/23/2023]
Abstract
Recent data suggest that renal hemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RRI), may be associated with systemic vascular changes. We evaluated the relationships between RRI and arterial stiffness, assessed by aortic pulse wave velocity, and between RRI and subclinical atherosclerosis, assessed by measuring carotid intima-media thickness in patients with systemic lupus erythematosus. We enrolled 39 patients with systemic lupus erythematosus (mean age 39 y) compared with 19 healthy controls, matched for age and sex. Each participant underwent 24 h of ambulatory blood pressure, aortic pulse wave velocity, carotid intima-media thickness and RRI measurements. RRI correlated significantly with aortic pulse wave velocity (r = 0.44, p = 0.006), and with carotid intima-media thickness (r = 0.46, p = 0.003). Both correlations held (p = 0.01), even after correction for age, mean arterial pressure and glomerular filtration rate. Our results suggest that the RRI may be considered a marker of systemic vascular changes and probably a predictor of cardiovascular risk in patients with systemic lupus erythematosus.
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Affiliation(s)
- Massimiliano Morreale
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, Society of Hypertension Excellence, Centre Università di Palermo, Italy.
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, Society of Hypertension Excellence, Centre Università di Palermo, Italy
| | | | - Francesco D'ignoto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, Society of Hypertension Excellence, Centre Università di Palermo, Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, Society of Hypertension Excellence, Centre Università di Palermo, Italy
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Geraci G, Mulè G, Costanza G, Mogavero M, Geraci C, Cottone S. Relationship Between Carotid Atherosclerosis and Pulse Pressure with Renal Hemodynamics in Hypertensive Patients. Am J Hypertens 2016; 29:519-27. [PMID: 26232780 PMCID: PMC4886487 DOI: 10.1093/ajh/hpv130] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 06/02/2015] [Revised: 06/16/2015] [Accepted: 07/13/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Structural atherosclerotic damage, arterial stiffness, pulse pressure (PP), and renal hemodynamics may interact and influence each other. Renal resistance index (RRI) appears as a good indicator of systemic vascular changes. The aim of our study was to assess the independent relationships of carotid intima-media thickness (cIMT), aortic pulse wave velocity (aPWV), and peripheral PP with RRI in hypertensives with various degrees of renal function. METHODS We enrolled 463 hypertensive patients (30-70 years) with normal renal function (group 0; n = 280) and with chronic kidney disease (groups I-V; n = 183). All subjects underwent ultrasonographic examination of intrarenal and carotid vasculature, as well as a 24-h ambulatory blood pressure monitoring. RESULTS A statistically significant difference in RRI, cIMT, aPWV, and clinic PP was observed in the different 6 groups (all P < 0.001), even after adjustment for age. RRI correlated with cIMT (r = 0.460, P < 0.001), aPWV (r = 0.386, P < 0.001), clinic PP (r = 0.279, P < 0.001), and 24-h PP (r = 0.229, P < 0.001) in the entire study population. These correlations were similar in subjects with and without renal dysfunction. In the overall study population, the association between RRI, cIMT, and clinic PP remained statistically significant even after adjustment for various confounding factors, whereas the relationship between RRI and aPWV was lost in multivariate analysis. CONCLUSIONS cIMT and clinic PP rather than directly aPWV are associated with intrarenal hemodynamics. Our results confirm that in hypertensives RRI not only detects derangement of intrarenal circulation but may also be considered as a sensor of systemic vascular changes, independently of level of renal function.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy.
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Giuseppa Costanza
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Manuela Mogavero
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Calogero Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
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Geraci G, Mulè G, Mogavero M, Geraci C, Nardi E, Cottone S. Association Between Uric Acid and Renal Hemodynamics: Pathophysiological Implications for Renal Damage in Hypertensive Patients. J Clin Hypertens (Greenwich) 2016; 18:1007-1014. [PMID: 27012304 DOI: 10.1111/jch.12812] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 01/30/2016] [Accepted: 02/01/2016] [Indexed: 12/01/2022]
Abstract
The role of vascular renal changes in mediating the association between serum uric acid (SUA) and renal damage is unclear. The purposes of this study were to investigate the relationship between SUA and renal resistive index (RRI), assessed by duplex Doppler ultrasonography, and to assess whether hemodynamic renal changes may explain the association between SUA and renal damage in hypertensive patients. A total of 530 hypertensive patients with and without chronic kidney disease were enrolled and divided into SUA tertiles based on sex-specific cutoff values. RRI and albuminuria were greater and glomerular filtration rate (GFR) was lower in the uppermost SUA tertile patients when compared with those in the lowest tertiles (all P<.001). Moreover, SUA strongly correlated with RRI (P<.001) in all patients. However, RRI did not seem to explain the relationship between SUA and renal damage, and GFR significantly related with SUA in the overall population (P<.001) even after adjustment for RRI.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy.
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Manuela Mogavero
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Calogero Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
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Abstract
Mycotoxins are secondary metabolites produced by toxigenic fungi contaminating foods and feeds in pre-, post-harvest and processing, and represent a great concern worldwide, both for the economic implications and for the health of the consumers. Many environmental conditions are involved in the regulation of mycotoxin biosynthesis. Among these, light represents one of the most important signals for fungi, influencing several physiological responses such as pigmentation, sexual development and asexual conidiation, primary and secondary metabolism, including mycotoxin biosynthesis. In this review we summarise some recent findings on the effect of specific light wavelength and intensity on mycotoxin biosynthesis in the main toxigenic fungal genera. We describe the molecular mechanism underlying light perception and its involvement in the regulation of secondary metabolism, focusing on VeA, global regulator in Aspergillus nidulans, and the White-Collar proteins, key components of light response in Neurospora crassa. Light of specific wavelength and intensity exerts different effects both on growth and on toxin production depending on the fungal genus. In Penicillium spp. red (627 nm) and blue wavelengths (455-470 nm) reduce ochratoxin A (OTA) biosynthesis by modulating the level of expression of the ochratoxin polyketide synthase. Furthermore a mutual regulation between citrinin and OTA production is reported in Penicillium toxigenic species. In Aspergillus spp. the effect of light treatment is strongly dependent on the species and culture conditions. Royal blue wavelength (455 nm) of high intensity (1,700 Lux) is capable of completely inhibit fungal growth and OTA production in Aspergillus stenyii and Penicillum verrucosum. In Fusarium spp. the effect of light exposure is less effective; mycotoxin-producing species, such as Fusarium verticillioides and Fusarium proliferatum, grow better under light conditions, and fumonisin production increased. This review provides a comprehensive picture on light regulation of mycotoxin biosynthesis and discusses possible new applications of this resource in food safety.
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Affiliation(s)
- F. Fanelli
- Institute of Sciences of Food Production, CNR, via Amendola 122/0, 70126 Bari, Italy
| | - R. Geisen
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Haid-und-Neu-Str. 9, 76131 Karlsruhe, Germany
| | - M. Schmidt-Heydt
- Department of Safety and Quality of Fruit and Vegetables, Max Rubner-Institut, Haid-und-Neu-Str. 9, 76131 Karlsruhe, Germany
| | - A.F. Logrieco
- Institute of Sciences of Food Production, CNR, via Amendola 122/0, 70126 Bari, Italy
| | - G. Mulè
- Institute of Sciences of Food Production, CNR, via Amendola 122/0, 70126 Bari, Italy
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Mulè G, Nardi E, Morreale M, Castiglia A, Geraci G, Altieri D, Cacciatore V, Schillaci M, Vaccaro F, Cottone S. The Relationship Between Aortic Root Size and Hypertension: An Unsolved Conundrum. Adv Exp Med Biol 2016; 956:427-445. [PMID: 27873227 DOI: 10.1007/5584_2016_86] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Thoracic aortic aneurysms rupture and dissection are among the most devastating vascular diseases, being characterized by elevated mortality, despite improvements in diagnostic imaging and surgical techniques.An increased aortic root diameter (ARD) represents the main risk factor for thoracic aortic dissection and rupture and for aortic valve regurgitation.Even though arterial hypertension is commonly regarded as a predisposing condition for the development of thoracic aorta aneurysms, the role of blood pressure (BP) as determinant of aortic root enlargement is still controversial. The use of different methods for indexation of ARD may have in part contributed to the heterogeneous findings obtained in the investigations exploring the relationships between ARD and BP. Indeed, the best methods for ARD indexation, as well as the normal values of aortic root size, are still a matter of debate.Several non-hemodynamic factors influence ARD, including age, gender, and anthropometric variables, such as height, weight and their derivatives body surface area (BSA) and body mass index. Of these factors, anthropometric variables have the greatest impact.Several studies documented an association between ARD enlargement, assessed by echocardiography, and some indices of hypertensive target organ damage such as left ventricular hypertrophy, diastolic dysfunction, and carotid intima-media thickening. Recently, we found that ARD, expressed either as absolute values or normalized for BSA (ARD/BSA) or height (ARD/H), was significantly greater in hypertensive subjects with chronic kidney disease (CKD) when compared to their counterparts with normal renal function. Moreover, at univariate analyses estimated glomerular filtration rate (eGFR) showed significant inverse correlations with ARD not indexed and with ARD/BSA and ARD/H. Taking into account the effect of age, sex, duration of hypertension and other potentially confounding factors, in multiple regression analyses, only the association of GFR with ARD/H and that between GFR and ARD/BSA remained statistically significant. The receiver-operating characteristic curve analysis revealed that an estimated GFR of about 50 ml/min/1.73 m2 represents the better threshold to distinguish hypertensive patients with dilated aortic root from those with a normal one.Some population-based studies showed that an enlarged ARD might predict an adverse prognosis, even in absence of aneurysmatic alterations.In the Cardiovascular Health Study, a dilated aortic root was independently associated with an increased risk for stroke, cardiovascular and total mortality in both sexes and with incident congestive heart failure only in men. The relationship between ARD and heart failure has been observed also in the Framingham Heart Study. More recently, the PAMELA (Pressioni Arteriose Monitorate E Loro Associazioni) study demonstrated an independent relationship of ARD/H with incident cardiovascular morbidity and mortality.Although the relationship between BP and aortic root size is still a matter of debate, increasing evidence seems to support the notion that aortic root dilatation, even in absence of aneurysmatic alterations, may be regarded as an hypertensive organ damage paralleling other preclinical markers whose unfavourable prognostic significance is firmly established. Future studies are needed to assess whether or not antihypertensive therapy is able to reduce aortic root dimension and the increased risk associated with its enlargement.
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Affiliation(s)
- Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Massimiliano Morreale
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Antonella Castiglia
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Giulio Geraci
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Dario Altieri
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Valentina Cacciatore
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Margherita Schillaci
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Francesco Vaccaro
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
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Affiliation(s)
- Giuseppe Mulè
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy.
| | - Giulio Geraci
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Calogero Geraci
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Massimiliano Morreale
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, University of Palermo, Palermo, Italy
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Morreale M, Mulè G, Ferrante A, D'ignoto F, Cottone S. Early Vascular Aging in Normotensive Patients With Systemic Lupus Erythematosus: Comparison With Young Patients Having Hypertension. Angiology 2015; 67:676-82. [PMID: 26535012 DOI: 10.1177/0003319715613917] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 12/14/2022]
Abstract
Connective tissue diseases, like systemic lupus erythematosus (SLE), are associated with early and accelerated atherosclerosis. Recently, the concept of "early vascular aging" (EVA) has been more widely accepted. Aortic stiffness is one of the important markers of EVA. We evaluated EVA and subclinical atherosclerosis, by measuring aortic pulse wave velocity (aPWV) and carotid intima-media thickness (cIMT), in 50 normotensive patients with SLE (mean age: 39 ± 12 years). We compared these participants with 50 age- and sex-matched patients with essential hypertension (EH) and 20 healthy controls. Each participant underwent 24-hour ambulatory blood pressure monitoring (ABPM), aPWV, and cIMT measurements. Clinic and 24-hour ABPM values were significantly lower in patients with SLE and controls when compared with the participants having EH (all P < .0001), but aPWV and cIMT were significantly lower in the control group when compared with patients having SLE and EH (all P < .001). Overall, patients with SLE and EH had similar cIMT and aPWV values (P = .31 and P = .47, respectively). Our results suggest that SLE has a similar deleterious impact on EVA as EH.
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Affiliation(s)
- Massimiliano Morreale
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Renal Disease and Dialysis, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Renal Disease and Dialysis, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Angelo Ferrante
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Rheumatology, Università di Palermo, Palermo, Italy
| | - Francesco D'ignoto
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Renal Disease and Dialysis, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Renal Disease and Dialysis, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
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Mulè G, Calcaterra I, Costanzo M, Morreale M, D'Ignoto F, Castiglia A, Geraci G, Rabbiolo G, Vaccaro F, Cottone S. Average real variability of 24-h systolic blood pressure is associated with microalbuminuria in patients with primary hypertension. J Hum Hypertens 2015; 30:164-70. [DOI: 10.1038/jhh.2015.66] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 05/04/2015] [Accepted: 05/19/2015] [Indexed: 11/09/2022]
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Mulè G, Calcaterra I, Foraci A, Castiglia A, Costanzo M, Vario M, Cerasola G, Cottone S. PP.17.24. J Hypertens 2015. [DOI: 10.1097/01.hjh.0000468247.70400.34] [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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Mulè G, Calcaterra I, Costanzo M, Geraci G, Guarino L, Foraci AC, Vario MG, Cerasola G, Cottone S. Relationship Between Short-Term Blood Pressure Variability and Subclinical Renal Damage in Essential Hypertensive Patients. J Clin Hypertens (Greenwich) 2015; 17:473-80. [PMID: 25808042 DOI: 10.1111/jch.12534] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 02/02/2015] [Accepted: 02/04/2015] [Indexed: 12/14/2022]
Abstract
The authors aimed to analyze the relationship between subclinical renal damage, defined as the presence of microalbuminuria or an estimated glomerular filtration rate (eGFR) between 30 mL/min/1.73 m(2) and 60 mL/min/1.73 m(2) and short-term blood pressure (BP) variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24-hour BP, and SD of daytime and nighttime BP. A total of 328 hypertensive patients underwent 24-hour ambulatory BP monitoring, 24-hour albumin excretion rate determination, and eGFR calculation using the Chronic Kidney Disease Epidemiology Collaboration equation. ARV of 24-hour systolic BP (SBP) was significantly higher in patients with subclinical renal damage (P=.001). This association held (P=.04) after adjustment for potential confounders. In patients with microalbuminuria, ARV of 24-hour SBP, weighted SD of 24-hour SBP, and SD of daytime SBP were also independently and inversely related to eGFR. These results seem to suggest that in essential hypertension, short-term BP variability is independently associated with early renal abnormalities.
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Affiliation(s)
- Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Ilenia Calcaterra
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Miriam Costanzo
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Laura Guarino
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Anna C Foraci
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Maria G Vario
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Giovanni Cerasola
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
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Geraci G, Mulè G, Mogavero M, Geraci C, D'Ignoti D, Guglielmo C, Cottone S. Renal haemodynamics and severity of carotid atherosclerosis in hypertensive patients with and without impaired renal function. Nutr Metab Cardiovasc Dis 2015; 25:160-166. [PMID: 25455723 DOI: 10.1016/j.numecd.2014.10.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 08/08/2014] [Revised: 09/29/2014] [Accepted: 10/14/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIM Renal resistance index (RRI), assessed by Duplex-Doppler sonography, has been classically considered as a mere expression of intrarenal vascular resistance. Recent studies, however, have showed that RRI is also influenced by upstream factors, especially arterial compliance, confirming its possible role as a marker of systemic vascular alterations. Several studies have shown that carotid intima-media thickness (cIMT) and carotid plaques (cP), assessed by ultrasonography, are documented markers of subclinical organ damage as well as expression of progressive atherosclerotic disease, and that they get worse with the progressive deterioration of renal function. The study was aimed to evaluate the relationship between RRI and severity of carotid atherosclerosis in hypertensive subjects with and without impaired renal function. METHODS AND RESULTS The study population, including 263 hypertensive patients (30-70 years), was split into 3 groups based on cIMT and presence of cP (cIMT ≤ 0.9 mm and no cP; cIMT > 0.9 mm and no cP; cP). All patients were also divided into 2 subgroups (normal renal function; CKD stage I-IV). A stepwise increase in RRI corresponding to the groups of progressive severity of carotid atherosclerosis was observed (respectively 0.61 ± 0.07, 0.65 ± 0.06, 0.68 ± 0.06; p < 0.001). A strong positive correlation was observed between RRI and cIMT in the whole population (r = 0.43; p < 0.001) and in the subgroups with (r = 0.42; p < 0.001) and without (r = 0.39; p < 0.001) CKD. These associations remained statistically significant even after adjustment for various confounding factors. CONCLUSION Showing a close association between RRI and severity of carotid atherosclerosis, our results strengthen the concept that RRI is a marker of systemic vascular changes.
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Affiliation(s)
- G Geraci
- Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy
| | - G Mulè
- Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy.
| | - M Mogavero
- Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy
| | - C Geraci
- Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy
| | - D D'Ignoti
- Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy
| | - C Guglielmo
- Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy
| | - S Cottone
- Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy; Cattedra di Nefrologia - European Society of Hypertension Excellence Centre, Università di Palermo, Italy
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