Search

Your search keyword '"Pengo, M"' showing total 346 results
Start Over Author "Pengo, M"
346 results on '"Pengo, M"'

2. Fine particulate matter and sleep-disordered breathing severity in a large Italian cohort

Author

Pengo, M, Iodice, S, Parati, G, Meriggi, P, Bollati, V, Lombardi, C, Pengo M. F., Iodice S., Parati G., Meriggi P., Bollati V., Lombardi C., Pengo, M, Iodice, S, Parati, G, Meriggi, P, Bollati, V, Lombardi, C, Pengo M. F., Iodice S., Parati G., Meriggi P., Bollati V., and Lombardi C.

Abstract

Background: Air pollution and obstructive sleep apnea (OSA) are both linked with cardiovascular co-morbidities and share similar pathophysiological mechanisms. A causal association between the two has been postulated. However, the results of the studies on this topic are conflicting mainly because of the lack of adjustment for important confounders such as seasonality and temperature. We aimed to evaluate if such an association exists in a highly polluted area like Lombardy region (Italy) when accounting for all confounders. Methods: Data of adult patients seen at the Sleep Disorder Centre in Milan from 2010 to 2020 were analysed and the main polygraphic data were retrieved. Air pollutant concentrations of the following pollutants NO2, O3, PM2.5, and PM10 were collected through monitoring stations. Results: A total of 3493 patients were included: males (2358, 67.5%) mean age 60.1 (SD = 14.3) years, BMI 29.2 (6.2) kg/m2, mean AHI 16.5 (18.1) events/h. After adjusting for all confounders, in the multivariable analysis, the only associations that remained significant were long-term exposure to O3 with indexes of OSA severity (AHI and ODI) but only in spring. Furthermore, a positive association was seen between long-term exposure to PM10 and ODI but in springtime only. Conclusion: The findings of the current study does not support an association between fine particulate matter and OSA severity.

Published
2024

3. DIAGNOSTIC ACCURACY OF ATTENDED AND UNATTENDED BLOOD PRESSURE MEASUREMENTS IN PATIENTS WITH ARTERIAL HYPERTENSION

Author

Mancusi, C, Maloberti, A, Fucile, I, Manzi, M, Pengo, M, Bertacchini, F, Monticone, S, Pucci, G, Mancusi, Costantino, Maloberti, Alessandro, Fucile, Ilaria, Manzi, Maria Virigina, Pengo, Martino, Bertacchini, Fabio, Monticone, Silvia, Pucci, Giacomo, Mancusi, C, Maloberti, A, Fucile, I, Manzi, M, Pengo, M, Bertacchini, F, Monticone, S, Pucci, G, Mancusi, Costantino, Maloberti, Alessandro, Fucile, Ilaria, Manzi, Maria Virigina, Pengo, Martino, Bertacchini, Fabio, Monticone, Silvia, and Pucci, Giacomo

Published
2024

6. Rationale and design of the CV-PREVITAL study: an Italian multiple cohort randomised controlled trial investigating innovative digital strategies in primary cardiovascular prevention

Author

Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., Protti G., Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., and Protti G.

Abstract

Introduction Prevention of cardiovascular disease (CVD) is of key importance in reducing morbidity, disability and mortality worldwide. Observational studies suggest that digital health interventions can be an effective strategy to reduce cardiovascular (CV) risk. However, evidence from large randomised clinical trials is lacking. Methods and analysis The CV-PREVITAL study is a multicentre, prospective, randomised, controlled, open-label interventional trial designed to compare the effectiveness of an educational and motivational mobile health (mHealth) intervention versus usual care in reducing CV risk. The intervention aims at improving diet, physical activity, sleep quality, psycho-behavioural aspects, as well as promoting smoking cessation and adherence to pharmacological treatment for CV risk factors. The trial aims to enrol approximately 80 000 subjects without overt CVDs referring to general practitioners' offices, community pharmacies or clinics of Scientific Institute for Research, Hospitalization and Health Care (Italian acronym IRCCS) affiliated with the Italian Cardiology Network. All participants are evaluated at baseline and after 12 months to assess the effectiveness of the intervention on short-term endpoints, namely improvement in CV risk score and reduction of major CV risk factors. Beyond the funded life of the study, a long-term (7 years) follow-up is also planned to assess the effectiveness of the intervention on the incidence of major adverse CV events. A series of ancillary studies designed to evaluate the effect of the mHealth intervention on additional risk biomarkers are also performed. Ethics and dissemination This study received ethics approval from the ethics committee of the coordinating centre (Monzino Cardiology Center; R1256/20-CCM 1319) and from all other relevant IRBs and ethics committees. Findings are disseminated through scientific meetings and peer-reviewed journals and via social media. Partners are informed about the study's

Published
2023

7. The effect of transcutaneous electrical stimulation of the submental area on the cardiorespiratory response in normal and awake subjects

Author

Alsharifi, A, Kaltsakas, G, Pengo, M, Parati, G, Serna-Pascual, M, Rafferty, G, Steier, J, Alsharifi A., Kaltsakas G., Pengo M., Parati G., Serna-Pascual M., Rafferty G., Steier J., Alsharifi, A, Kaltsakas, G, Pengo, M, Parati, G, Serna-Pascual, M, Rafferty, G, Steier, J, Alsharifi A., Kaltsakas G., Pengo M., Parati G., Serna-Pascual M., Rafferty G., and Steier J.

Abstract

Background: Electrical stimulation has recently been introduced to treat patients with Obstructive sleep apnoea There are, however, few data on the effects of transcutaneous submental electrical stimulation (TES) on the cardiovascular system. We studied the effect of TES on cardiorespiratory variables in healthy volunteers during head-down-tilt (HDT) induced baroreceptor loading. Method: Cardiorespiratory parameters (blood pressure, heart rate, respiratory rate, tidal volume, airflow/minute ventilation, oxygen saturation, and end-tidal CO2/O2 concentration) were recorded seated, supine, and during head-down-tilt (50) under normoxic, hypercapnic (FiCO2 5%) and poikilocapnic hypoxic (FiO2 12%) conditions. Blood pressure (BP) was measured non-invasively and continuously (Finapres). Gas conditions were applied in random order. All participants were studied twice on different days, once without and once with TES. Results: We studied 13 healthy subjects (age 29 (12) years, six female, body mass index (BMI) 23.23 (1.6) kg·m−2). A three-way ANOVA indicated that BP decreased significantly with TES (systolic: p = 4.93E-06, diastolic: p = 3.48E-09, mean: p = 3.88E-08). Change in gas condition (systolic: p = 0.0402, diastolic: p = 0.0033, mean: p = 0.0034) and different postures (systolic: 8.49E-08, diastolic: p = 6.91E-04, mean: p = 5.47E-05) similarly impacted on BP control. When tested for interaction, there were no significant associations between the three different factors electrical stimulation, gas condition, or posture, except for an effect on minute ventilation (gas condition/posture p = 0.0369). Conclusion: Transcutaneous electrical stimulation has a substantial impact on the blood pressure. Similarly, postural changes and variations in inspired gas impact on blood pressure control. Finally, there was an interaction between posture and inspired gases that affects minute ventilation. These observations have implications on our understanding of integrated cardiorespira

Published
2023

8. Effect of Continuous Positive Airway Pressure on Glucose and Lipid Profiles in Patients With Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author

Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, Fava, C, Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., Fava C., Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, Fava, C, Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., and Fava C.

Abstract

Background and aim: Continuous Positive Airway Pressure (CPAP) is the most effective therapy for symptomatic obstructive sleep apnoea (OSA). However, uncertainty remains about the effectiveness of CPAP in improving OSA-related metabolic dysregulation. This meta-analysis of randomized controlled trials (RCTs) aimed to investigate whether CPAP, compared to other control treatments, could improve glucose or lipid metabolism in OSA patients. Methods: Relevant articles were searched in three different databases (MEDLINE, EMBASE and Web of Science) from inception to 6th Feb 2022 through specific search terms and selection criteria. Results: From a total of 5553 articles, 31 RCTs were included. CPAP modestly improved insulin sensitivity as determined by mean fasting plasma insulin and Homeostasis Model Assessment of Insulin Resistance reduction of 1.33 mU/L and 0.287, respectively. In subgroup analyses pre-diabetic/type 2 diabetic patients as well as those with sleepy OSA showed a greater response to CPAP. Regarding lipid metabolism, CPAP was associated with a mean total cholesterol reduction of 0.064 mmol/L. In subgroup analyses, the benefit was higher in patients that showed more severe OSA and oxygen desaturations at the baseline sleep study as well as in younger and obese subjects. Neither glycated haemoglobin nor triglycerides, HDL- and LDL-cholesterol were reduced by CPAP. Conclusion: CPAP treatment may improve insulin sensitivity and total cholesterol levels in OSA patients but with low effect size. Our results suggest that CPAP does not substantially improve metabolic derangements in an unselected OSA population, but the effect may be higher in specific subgroups of OSA patients.

Published
2023

9. Effects of Acute Hypoxia on Heart Rate Variability in Patients with Pulmonary Vascular Disease

Author

Meszaros, M, Schneider, S, Mayer, L, Lichtblau, M, Pengo, M, Berlier, C, Saxer, S, Furian, M, Bloch, K, Ulrich, S, Schwarz, E, Meszaros M., Schneider S. R., Mayer L. C., Lichtblau M., Pengo M., Berlier C., Saxer S., Furian M., Bloch K. E., Ulrich S., Schwarz E. I., Meszaros, M, Schneider, S, Mayer, L, Lichtblau, M, Pengo, M, Berlier, C, Saxer, S, Furian, M, Bloch, K, Ulrich, S, Schwarz, E, Meszaros M., Schneider S. R., Mayer L. C., Lichtblau M., Pengo M., Berlier C., Saxer S., Furian M., Bloch K. E., Ulrich S., and Schwarz E. I.

Abstract

Pulmonary vascular diseases (PVDs), defined as arterial or chronic thromboembolic pulmonary hypertension, are associated with autonomic cardiovascular dysregulation. Resting heart rate variability (HRV) is commonly used to assess autonomic function. Hypoxia is associated with sympathetic overactivation and patients with PVD might be particularly vulnerable to hypoxia-induced autonomic dysregulation. In a randomised crossover trial, 17 stable patients with PVD (resting PaO2 ≥ 7.3 kPa) were exposed to ambient air (FiO2 = 21%) and normobaric hypoxia (FiO2 = 15%) in random order. Indices of resting HRV were derived from two nonoverlapping 5–10-min three-lead electrocardiography segments. We found a significant increase in all time- and frequency-domain HRV measures in response to normobaric hypoxia. There was a significant increase in root mean squared sum difference of RR intervals (RMSSD; 33.49 (27.14) vs. 20.76 (25.19) ms; p < 0.01) and RR50 count divided by the total number of all RR intervals (pRR50; 2.75 (7.81) vs. 2.24 (3.39) ms; p = 0.03) values in normobaric hypoxia compared to ambient air. Both high-frequency (HF; 431.40 (661.56) vs. 183.70 (251.25) ms2; p < 0.01) and low-frequency (LF; 558.60 (746.10) vs. 203.90 (425.63) ms2; p = 0.02) values were significantly higher in normobaric hypoxia compared to normoxia. These results suggest a parasympathetic dominance during acute exposure to normobaric hypoxia in PVD.

Published
2023

10. Blood pressure variability: methodological aspects, clinical relevance and practical indications for management - a European Society of Hypertension position paper ∗

Author

Parati, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Castiglioni, P, Stergiou, G, Mancia, G, Asayama, K, Asmar, R, Avolio, A, Caiani, E, De La Sierra, A, Dolan, E, Grillo, A, Guzik, P, Hoshide, S, Head, G, Imai, Y, Juhanoja, E, Kahan, T, Kario, K, Kotsis, V, Kreutz, R, Kyriakoulis, K, Li, Y, Manios, E, Mihailidou, A, Modesti, P, Omboni, S, Palatini, P, Persu, A, Protogerou, A, Saladini, F, Salvi, P, Sarafidis, P, Torlasco, C, Veglio, F, Vlachopoulos, C, Zhang, Y, Parati G., Bilo G., Kollias A., Pengo M., Ochoa J. E., Castiglioni P., Stergiou G. S., Mancia G., Asayama K., Asmar R., Avolio A., Caiani E. G., De La Sierra A., Dolan E., Grillo A., Guzik P., Hoshide S., Head G. A., Imai Y., Juhanoja E., Kahan T., Kario K., Kotsis V., Kreutz R., Kyriakoulis K. G., Li Y., Manios E., Mihailidou A. S., Modesti P. A., Omboni S., Palatini P., Persu A., Protogerou A. D., Saladini F., Salvi P., Sarafidis P., Torlasco C., Veglio F., Vlachopoulos C., Zhang Y., Parati, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Castiglioni, P, Stergiou, G, Mancia, G, Asayama, K, Asmar, R, Avolio, A, Caiani, E, De La Sierra, A, Dolan, E, Grillo, A, Guzik, P, Hoshide, S, Head, G, Imai, Y, Juhanoja, E, Kahan, T, Kario, K, Kotsis, V, Kreutz, R, Kyriakoulis, K, Li, Y, Manios, E, Mihailidou, A, Modesti, P, Omboni, S, Palatini, P, Persu, A, Protogerou, A, Saladini, F, Salvi, P, Sarafidis, P, Torlasco, C, Veglio, F, Vlachopoulos, C, Zhang, Y, Parati G., Bilo G., Kollias A., Pengo M., Ochoa J. E., Castiglioni P., Stergiou G. S., Mancia G., Asayama K., Asmar R., Avolio A., Caiani E. G., De La Sierra A., Dolan E., Grillo A., Guzik P., Hoshide S., Head G. A., Imai Y., Juhanoja E., Kahan T., Kario K., Kotsis V., Kreutz R., Kyriakoulis K. G., Li Y., Manios E., Mihailidou A. S., Modesti P. A., Omboni S., Palatini P., Persu A., Protogerou A. D., Saladini F., Salvi P., Sarafidis P., Torlasco C., Veglio F., Vlachopoulos C., and Zhang Y.

Abstract

Blood pressure is not a static parameter, but rather undergoes continuous fluctuations over time, as a result of the interaction between environmental and behavioural factors on one side and intrinsic cardiovascular regulatory mechanisms on the other side. Increased blood pressure variability (BPV) may indicate an impaired cardiovascular regulation and may represent a cardiovascular risk factor itself, having been associated with increased all-cause and cardiovascular mortality, stroke, coronary artery disease, heart failure, end-stage renal disease, and dementia incidence. Nonetheless, BPV was considered only a research issue in previous hypertension management guidelines, because the available evidence on its clinical relevance presents several gaps and is based on heterogeneous studies with limited standardization of methods for BPV assessment.The aim of this position paper, with contributions from members of the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability and from a number of international experts, is to summarize the available evidence in the field of BPV assessment methodology and clinical applications and to provide practical indications on how to measure and interpret BPV in research and clinical settings based on currently available data. Pending issues and clinical and methodological recommendations supported by available evidence are also reported. The information provided by this paper should contribute to a better standardization of future studies on BPV, but should also provide clinicians with some indications on how BPV can be managed based on currently available data.

Published
2023

11. D-dimer trends elaborate the heterogeneity of risk in hospitalized patients with COVID-19: A multi-national case series from different waves

Author

Ronderos Botero, D, Omar, A, Pengo, M, Haider, S, Latif, H, Parati, G, Pengo, V, Canas Arboleda, A, Diaz, M, Villaquiran-Torres, C, Contreras, J, Chilimuri, S, Ronderos Botero D. M., Omar A. M. S., Pengo M., Haider S. W., Latif H., Parati G., Pengo V., Canas Arboleda A., Diaz M., Villaquiran-Torres C., Contreras J., Chilimuri S., Ronderos Botero, D, Omar, A, Pengo, M, Haider, S, Latif, H, Parati, G, Pengo, V, Canas Arboleda, A, Diaz, M, Villaquiran-Torres, C, Contreras, J, Chilimuri, S, Ronderos Botero D. M., Omar A. M. S., Pengo M., Haider S. W., Latif H., Parati G., Pengo V., Canas Arboleda A., Diaz M., Villaquiran-Torres C., Contreras J., and Chilimuri S.

Abstract

Introduction: Variable D-dimer trends during hospitalization reportedly result in distinct in-hospital mortality. In this multinational case series from the first and second waves, we show the universality of such D-dimer trends. Methods: We reviewed 405 patients with COVID-19 during the first wave admitted to three institutions in the United States, Italy, and Colombia, and 111 patients admitted to the U.S. site during the second wave and 55 patients during the third wave. D-dimer was serially followed during hospitalization. Results: During the first wave, 66 (15%) patients had a persistently-low pattern, 33 (8%) had early-peaking, 70 (16%) had mid-peaking, 94 (22%) had fluctuating, 30 (7%) had late-peaking, and 112 (26%) had a persistently-high pattern. During the second and third waves, similar patterns were observed. D-dimer patterns were significantly different in terms of in-hospital mortality similarly in all waves. Patterns were then classified into low-risk patterns (persistently-low and early-peaking), where no deaths were observed in both waves, high-risk patterns (mid-peaking and fluctuating), and malignant patterns (late-peaking and persistently-high). Overall, D-dimer trends were associated with an increased risk for in-hospital mortality in the first wave (overall: HR: 1.73) and stayed the same during the second (HR: 1.67, p < 0.001) and the third (HR: 4.4, p = 0.001) waves. Conclusion: D-dimer behavior during COVID-19 hospitalization yielded universal categories with distinct mortality risks that persisted throughout all studied waves of infection. Monitoring D-dimer behavior may be useful in the management of these patients.

Published
2023

13. Head-to-Head Comparison of Tissue Factor-Dependent Procoagulant Potential of Small and Large Extracellular Vesicles in Healthy Subjects and in Patients with SARS-CoV-2 Infection

Author

Brambilla, M, Frigerio, R, Becchetti, A, Gori, A, Cretich, M, Conti, M, Mazza, A, Pengo, M, Camera, M, Brambilla M., Frigerio R., Becchetti A., Gori A., Cretich M., Conti M., Mazza A., Pengo M., Camera M., Brambilla, M, Frigerio, R, Becchetti, A, Gori, A, Cretich, M, Conti, M, Mazza, A, Pengo, M, Camera, M, Brambilla M., Frigerio R., Becchetti A., Gori A., Cretich M., Conti M., Mazza A., Pengo M., and Camera M.

Abstract

The relative contribution of small (sEVs) and large extracellular vesicles (lEVs) to the total plasma procoagulant potential is not yet well defined. Thus, we compared total and TFpos-sEVs and -lEVs isolated from healthy subjects and COVID-19 patients during the acute phase of the infection and after symptom remission in terms of (1) vesicle enumeration using nanoparticle tracking assay, imaging flow cytometry, and TF immunofluorescence localization in a single-vesicle analysis using microarrays; (2) cellular origin; and (3) TF-dependent Xa generation capacity, as well as assessing the contribution of the TF inhibitor, TFPI. In healthy subjects, the plasma concentration of CD9/CD63/CD81pos sEVs was 30 times greater than that of calceinpos lEVs, and both were mainly released by platelets. Compared to lEVs, the levels of TFpos-sEVs were 2-fold higher. The TF-dependent Xa generation capacity of lEVs was three times greater than that of sEVs, with the latter being hindered by TFPI. Compared to HSs, the amounts of total and TFpos-sEVs and -lEVs were significantly greater in acute COVID-19 patients, which reverted to the physiological values at the 6-month follow-up. Interestingly, the FXa generation of lEVs only significantly increased during acute infection, with that of sEV being similar to that of HSs. Thus, in both healthy subjects and COVID-19 patients, the TF-dependent procoagulant potential is mostly sustained by large vesicles.

Published
2023

14. Corrigendum: D-dimer trends elaborate the heterogeneity of risk in hospitalized patients with COVID-19: a multi-national case series from different waves (Frontiers in Medicine, (2023), 10, (1103842), 10.3389/fmed.2023.1103842)

Author

Ronderos Botero D. M., Ronderos Botero, D, Omar, A, Pengo, M, Haider, S, Latif, H, Parati, G, Pengo, V, Cañas Arboleda, A, Díaz, M, Villaquirán-Torres, C, Contreras, J, Chilimuri, S, Ronderos Botero D. M., Omar A. M. S., Pengo M. F., Haider S. W., Latif H., Parati G., Pengo V., Cañas Arboleda A., Díaz M., Villaquirán-Torres C., Contreras J., Chilimuri S., Ronderos Botero D. M., Ronderos Botero, D, Omar, A, Pengo, M, Haider, S, Latif, H, Parati, G, Pengo, V, Cañas Arboleda, A, Díaz, M, Villaquirán-Torres, C, Contreras, J, Chilimuri, S, Ronderos Botero D. M., Omar A. M. S., Pengo M. F., Haider S. W., Latif H., Parati G., Pengo V., Cañas Arboleda A., Díaz M., Villaquirán-Torres C., Contreras J., and Chilimuri S.

Published
2023

15. A Chatbot-based Recommendation Framework for Hypertensive Patients

Author

Montagna, S, Mariani, S, Pengo, M, Montagna S., Mariani S., Pengo M. F., Montagna, S, Mariani, S, Pengo, M, Montagna S., Mariani S., and Pengo M. F.

Abstract

Chatbot-based systems are recognised in literature as an effective tool to support chronic diseases self-management. However, the core of most of this work is on the description of the application domain and on the motivations behind the adoption of recommendation systems that exploit chatbot to mediate the interaction with users, but they fail in providing sufficient details on the system architecture and on the technology adopted. Moreover, they are usually designed with a strong focus on the specific pathology, and a reference architectural solution that can be adopted in different contexts is missing, thus making the work useful only in the domain it is devised for. In this paper we provide a framework for developing recommendation systems based on chatbots that is meant to be applied in different scenarios. The framework is composed by a back-end recommendation engine that autonomously computes the user's adherence profile to prescription, and proactively provides motivational feedback to the user through the application front-end based on a chatbot. The chatbot is also meant to collect and aggregate data for profiling the individual health and habits. To demonstrate the feasibility of our framework, we present a recommendation system, based on a Telegram chatbot, that has been developed and trained for managing hypertensive patients.

Published
2023

16. Data Decentralisation of LLM-Based Chatbot Systems in Chronic Disease Self-Management

Author

Montagna, S, Ferretti, S, Klopfenstein, L, Florio, A, Pengo, M, Montagna S., Ferretti S., Klopfenstein L. C., Florio A., Pengo M. F., Montagna, S, Ferretti, S, Klopfenstein, L, Florio, A, Pengo, M, Montagna S., Ferretti S., Klopfenstein L. C., Florio A., and Pengo M. F.

Abstract

Chronic patient self-management is crucial for maintaining physical and psychological health, reducing pressure on healthcare systems, and promoting patient empowerment. Digital technologies, particularly chatbots, have emerged as powerful tools for supporting patients in managing their chronic conditions. Large language models (LLMs), such as GPT-4, have shown potential in improving chatbot-based systems in healthcare. However, their adoption in clinical practice faces challenges, including reliability, the need for clinical trials, and privacy concerns. This paper proposes a general architecture for developing an LLM-based chatbot system that supports chronic patients while addressing privacy and security concerns. The architecture is designed to be independent of specific technologies and health conditions, focusing on data protection legislation compliance. A prototype of the system has been developed for hypertension management, demonstrating its potential for motivating patients to monitor their blood pressure and adhere to prescriptions.

Published
2023

17. PB0064 Involvement of Platelet Activation in Long COVID-19 Syndrome

Author

Brambilla, M., primary, Conti, M., additional, Becchetti, A., additional, Canzano, P., additional, Agostoni, P., additional, Pengo, M., additional, Tortorici, E., additional, Mancini, M., additional, Andreini, D., additional, Bonomi, A., additional, Parati, G., additional, and Camera, M., additional

Published
2023
Full Text
View/download PDF

19. The effect of transcutaneous electrical stimulation of the submental area on the cardiorespiratory response in normal and awake subjects

Author

Alsharifi A., Kaltsakas G., Pengo M., Parati G., Serna-Pascual M., Rafferty G., Steier J., Alsharifi, A, Kaltsakas, G, Pengo, M, Parati, G, Serna-Pascual, M, Rafferty, G, and Steier, J

Subjects
hypoxia, Physiology, Physiology (medical), sleep-disordered breathing, blood pressure, upper airway physiology, sleep apnoea
Abstract

Background: Electrical stimulation has recently been introduced to treat patients with Obstructive sleep apnoea There are, however, few data on the effects of transcutaneous submental electrical stimulation (TES) on the cardiovascular system. We studied the effect of TES on cardiorespiratory variables in healthy volunteers during head-down-tilt (HDT) induced baroreceptor loading.Method: Cardiorespiratory parameters (blood pressure, heart rate, respiratory rate, tidal volume, airflow/minute ventilation, oxygen saturation, and end-tidal CO2/O2 concentration) were recorded seated, supine, and during head-down-tilt (50) under normoxic, hypercapnic (FiCO2 5%) and poikilocapnic hypoxic (FiO2 12%) conditions. Blood pressure (BP) was measured non-invasively and continuously (Finapres). Gas conditions were applied in random order. All participants were studied twice on different days, once without and once with TES.Results: We studied 13 healthy subjects (age 29 (12) years, six female, body mass index (BMI) 23.23 (1.6) kg·m−2). A three-way ANOVA indicated that BP decreased significantly with TES (systolic: p = 4.93E-06, diastolic: p = 3.48E-09, mean: p = 3.88E-08). Change in gas condition (systolic: p = 0.0402, diastolic: p = 0.0033, mean: p = 0.0034) and different postures (systolic: 8.49E-08, diastolic: p = 6.91E-04, mean: p = 5.47E-05) similarly impacted on BP control. When tested for interaction, there were no significant associations between the three different factors electrical stimulation, gas condition, or posture, except for an effect on minute ventilation (gas condition/posture p = 0.0369).Conclusion: Transcutaneous electrical stimulation has a substantial impact on the blood pressure. Similarly, postural changes and variations in inspired gas impact on blood pressure control. Finally, there was an interaction between posture and inspired gases that affects minute ventilation. These observations have implications on our understanding of integrated cardiorespiratory control, and may prove beneficial for patients with SDB who are assessed for treatment with electrical stimulation.

Published
2023
Full Text
View/download PDF

20. Effect of Continuous Positive Airway Pressure on Glucose and Lipid Profiles in Patients With Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author

Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., Fava C., Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, and Fava, C

Subjects
OSA, Pulmonary and Respiratory Medicine, Glucose level, CPAP, Insulin resistance, Meta-analysi, Lipids level
Abstract

Background and aim: Continuous Positive Airway Pressure (CPAP) is the most effective therapy for symptomatic obstructive sleep apnoea (OSA). However, uncertainty remains about the effectiveness of CPAP in improving OSA-related metabolic dysregulation. This meta-analysis of randomized controlled trials (RCTs) aimed to investigate whether CPAP, compared to other control treatments, could improve glucose or lipid metabolism in OSA patients. Methods: Relevant articles were searched in three different databases (MEDLINE, EMBASE and Web of Science) from inception to 6th Feb 2022 through specific search terms and selection criteria. Results: From a total of 5553 articles, 31 RCTs were included. CPAP modestly improved insulin sensitivity as determined by mean fasting plasma insulin and Homeostasis Model Assessment of Insulin Resistance reduction of 1.33 mU/L and 0.287, respectively. In subgroup analyses pre-diabetic/type 2 diabetic patients as well as those with sleepy OSA showed a greater response to CPAP. Regarding lipid metabolism, CPAP was associated with a mean total cholesterol reduction of 0.064 mmol/L. In subgroup analyses, the benefit was higher in patients that showed more severe OSA and oxygen desaturations at the baseline sleep study as well as in younger and obese subjects. Neither glycated haemoglobin nor triglycerides, HDL- and LDL-cholesterol were reduced by CPAP. Conclusion: CPAP treatment may improve insulin sensitivity and total cholesterol levels in OSA patients but with low effect size. Our results suggest that CPAP does not substantially improve metabolic derangements in an unselected OSA population, but the effect may be higher in specific subgroups of OSA patients.

Published
2023
Full Text
View/download PDF

21. Machine Learning in Hypertension Detection: A Study on World Hypertension Day Data

Author

Montagna, S, Pengo, M, Ferretti, S, Borghi, C, Ferri, C, Grassi, G, Muiesan, ML, Parati, G, Montagna S, Pengo MF, Ferretti S, Borghi C, Ferri C, Grassi G, Muiesan ML, Parati G., Montagna, S, Pengo, M, Ferretti, S, Borghi, C, Ferri, C, Grassi, G, Muiesan, M, and Parati, G

Subjects
Hypertension Data analysis Prevention, Health Information Management, Prevention, Hypertension, Medicine (miscellaneous), Health Informatics, Data analysi, Information Systems
Abstract

Background: Many modifiable and non-modifiable risk factors have been associated with hypertension. However, current screening programs are still failing in identifying individuals at higher risk of hypertension. Given the major impact of high blood pressure on cardiovascular events and mortality, there is an urgent need to find new strategies to improve hypertension detection. Aim: We aimed to explore whether a machine learning (ML) algorithm can help identifying individuals predictors of hypertension. Methods: We analysed the data set generated by the questionnaires administered during the World Hypertension Day from 2015 to 2019. A total of 20206 individuals have been included for analysis. We tested five ML algorithms, exploiting different balancing techniques. Moreover, we computed the performance of the medical protocol currently adopted in the screening programs. Results: Results show that a gain of sensitivity reflects in a loss of specificity, bringing to a scenario where there is not an algorithm and a configuration which properly outperforms against the others. However, Random Forest provides interesting performances (0.818 sensitivity - 0.629 specificity) compared with medical protocols (0.906 sensitivity - 0.230 specificity). Conclusion: Detection of hypertension at a population level still remains challenging and a machine learning approach could help in making screening programs more precise and cost effective, when based on accurate data collection. More studies are needed to identify new features to be acquired and to further improve the performances of ML models.

Published
2023

24. Differences in Diagnosis and Management of Hypertensive Urgencies and Emergencies According to Italian Doctors from Different Departments Who Deal With Acute Increase in Blood Pressure—Data from Gear (Gestione Dell’emergenza e Urgenza in ARea Critica) Study

Author

Saladini, F, Mancusi, C, Bertacchini, F, Spannella, F, Maloberti, A, Giavarini, A, Rosticci, M, Bruno, R, Pucci, G, Grassi, D, Pengo, M, Muiesan, M, Saladini F., Mancusi C., Bertacchini F., Spannella F., Maloberti A., Giavarini A., Rosticci M., Bruno R. M., Pucci G., Grassi D., Pengo M., Muiesan M. L., Saladini, F, Mancusi, C, Bertacchini, F, Spannella, F, Maloberti, A, Giavarini, A, Rosticci, M, Bruno, R, Pucci, G, Grassi, D, Pengo, M, Muiesan, M, Saladini F., Mancusi C., Bertacchini F., Spannella F., Maloberti A., Giavarini A., Rosticci M., Bruno R. M., Pucci G., Grassi D., Pengo M., and Muiesan M. L.

Abstract

Background: Diagnosis and treatment of hypertension emergency (HE) and urgency (HU) may vary according to the physicians involved and the setting of the treatment. The aim of this study was to investigate differences in management of HE and HU according to the work setting of the physicians. Methods: The young investigators of the Italian Society of Hypertension developed a 23-item questionnaire spread by email invitation to the members of Italian Scientific societies involved in the field of emergency medicine and hypertension. Results: Six-hundred and sixty-five questionnaires were collected. No differences emerged for the correct definitions of HE and HU or for the investigation of possible drugs that may be responsible for an acute increase in BP. The techniques used to assess BP values (p < 0.004) and the sizes of cuffs available were different according to the setting. Cardiologists more frequently defined epistaxis (55.2% p = 0.012) and conjunctival hemorrhages (70.7%, p < 0.0001) as possible presentation of HE, and rarely considered dyspnea (67.2% p = 0.014) or chest pain (72.4%, p = 0.001). Intensive care (IC) unit doctors were more familiar with lung ultrasound (50% p = 0.004). With regard to therapy, cardiologists reported the lowest prescription of i.v. labetalol (39.6%, p = 0.003) and the highest of s.l. nifedipine (43.1% p < 0.001). After discharge, almost all categories of physicians required home BP assessment or referral to a general practitioner, whereas hypertensive center evaluation or ambulatory BP monitoring were less frequently suggested. Conclusion: Management and treatment of HE and HU may be different according to the doctor’s specialty. Educational initiatives should be done to standardize treatment protocols and to improve medical knowledge.

Published
2022

25. Performance of non-invasive respiratory function indices in predicting clinical outcomes in patients hospitalized for COVID-19 pneumonia in medical and sub-intensive wards: a retrospective cohort study

Author

Cattazzo, F, Inglese, F, Dalbeni, A, Piano, S, Pengo, M, Montagnana, M, Dell'Atti, D, Soliani, F, Cascella, A, Vicini, S, Gambino, C, Minuz, P, Vettor, R, Parati, G, Angeli, P, Fava, C, Cattazzo F., Inglese F., Dalbeni A., Piano S., Pengo M., Montagnana M., Dell'Atti D., Soliani F., Cascella A., Vicini S., Gambino C., Minuz P., Vettor R., Parati G., Angeli P., Fava C., Cattazzo, F, Inglese, F, Dalbeni, A, Piano, S, Pengo, M, Montagnana, M, Dell'Atti, D, Soliani, F, Cascella, A, Vicini, S, Gambino, C, Minuz, P, Vettor, R, Parati, G, Angeli, P, Fava, C, Cattazzo F., Inglese F., Dalbeni A., Piano S., Pengo M., Montagnana M., Dell'Atti D., Soliani F., Cascella A., Vicini S., Gambino C., Minuz P., Vettor R., Parati G., Angeli P., and Fava C.

Abstract

Coronavirus disease 2019 (COVID-19) is a newly recognized infectious disease which can lead to acute respiratory distress syndrome requiring ventilatory support and intensive care unit admission. The aim of our study is to evaluate the performance of two non-invasive respiratory function indices (the ROX index and the SatO2/FiO2 ratio), as compared to the traditional PaO2/FiO2 ratio, in predicting a clinically relevant composite outcome (death or intubation) in hospitalized patients for COVID-19 pneumonia. Four hospital centers in Northern Italy conducted an observational retrospective cohort study during the first wave of COVID-19 pandemic. Four hundred and fifty-six patients with COVID-19 pneumonia admitted to medical or sub-intensive wards were enrolled. Clinical, laboratory, and respiratory parameters, for the calculation of different indices, were measured at hospital admission. In medical wards (Verona and Padua) the PaO2/FiO2 ratio, ROX index and SatO2/FiO2 ratio were able to predict intubation or death with good accuracy (AUROC for the PaO2/FiO2 ratio, ROX index and SatO2/FiO2 ratio of 75%, 75% and 74%, respectively). Regarding sub-intensive wards (Milan and Mantua), none of the three respiratory function indices was significantly associated with the composite outcome. In patients admitted to medical wards for COVID-19 pneumonia, the ROX index and the SatO2/FiO2 ratio demonstrated not only good performance in predicting intubation or death, but their accuracy was comparable to that of the PaO2/FiO2 ratio. In this setting, where repeated arterial blood gas tests are not always feasible, they could be considered a reliable alternative to the invasive PaO2/FiO2 ratio.

Published
2022

26. Should we treat with continuous positive airway pressure severe non-sleepy obstructive sleep apnea individuals without underlying cardiovascular disease?

Author

Pengo, M, Gozal, D, Martinez-Garcia, M, Pengo M., Gozal D., Martinez-Garcia M. A., Pengo, M, Gozal, D, Martinez-Garcia, M, Pengo M., Gozal D., and Martinez-Garcia M. A.

Abstract

The majority of the current international obstructive sleep apnea (OSA) guidelines base the recommendation to treat OSA with continuous positive airway pressure (CPAP) on the presence of symptoms (principally, albeit not exclusively on daytime hypersomnolence). In nonsleepy patients, even with severe OSA, controversies remain, as clear evidence supporting CPAP treatment of this subgroup of OSA patients is lacking. However, given the nonnegligible proportion of non-sleepy OSA patients, clinicians often face a serious dilemma since CPAP treatment in these patients may prove to be not cost-effective. Here, we propose a simple three-step-based algorithm that attempts to better phenotype non-sleepy OSA patients prior to reaching a CPAP treatment decision while also considering a series of clinically relevant elements in the process that may improve with CPAP therapy. Such algorithm focuses on the presence of several OSA symptoms that are susceptible to benefit from treatment and also relies on OSA phenotypes that need to be considered in an effort to achieve optimal cardiovascular prevention. Here, we attempt to establish a framework for clinicians who are evaluating severe nonsleepy OSA patients in their practices. However, the algorithm proposal needs to be extensively validated before being systematically implemented in clinical settings.

Published
2022

27. Association between hypotension during 24 h ambulatory blood pressure monitoring and reflex syncope: the SynABPM 1 study

Author

Rivasi, G, Groppelli, A, Brignole, M, Soranna, D, Zambon, A, Bilo, G, Pengo, M, Sharad, B, Hamrefors, V, Rafanelli, M, Testa, G, Rice, C, Kenny, R, Sutton, R, Ungar, A, Fedorowski, A, Parati, G, Rivasi G., Groppelli A., Brignole M., Soranna D., Zambon A., Bilo G., Pengo M., Sharad B., Hamrefors V., Rafanelli M., Testa G. D., Rice C., Kenny R. A., Sutton R., Ungar A., Fedorowski A., Parati G., Rivasi, G, Groppelli, A, Brignole, M, Soranna, D, Zambon, A, Bilo, G, Pengo, M, Sharad, B, Hamrefors, V, Rafanelli, M, Testa, G, Rice, C, Kenny, R, Sutton, R, Ungar, A, Fedorowski, A, Parati, G, Rivasi G., Groppelli A., Brignole M., Soranna D., Zambon A., Bilo G., Pengo M., Sharad B., Hamrefors V., Rafanelli M., Testa G. D., Rice C., Kenny R. A., Sutton R., Ungar A., Fedorowski A., and Parati G.

Abstract

Aims: Diagnostic criteria for ambulatory blood pressure monitoring (ABPM) in patients with suspected reflex syncope are lacking. The study hypothesis was that patients with reflex syncope have a higher prevalence of systolic blood pressure (SBP) drops on ABPM. Methods and results: ABPM data from reflex syncope patients and controls, matched by average 24h SBP, age, sex, and hypertension were compared. Patients with constitutional hypotension, orthostatic hypotension, and predominant cardioinhibition during carotid sinus massage or prolonged electrocardiogram monitoring or competing causes of syncope were excluded. Daytime and nighttime SBP drops (<110, 100, 90, 80mmHg) were assessed. Findings were validated in an independent sample. In the derivation sample, daytime SBP drops were significantly more common in 158 syncope patients than 329 controls. One or more daytime drops <90mmHg achieved 91% specificity and 32% sensitivity [odds ratio (OR) 4.6, P < 0.001]. Two or more daytime drops <100mmHg achieved 84% specificity and 40% sensitivity (OR 3.5, P = 0.001). Results were confirmed in the validation sample of 164 syncope patients and 164 controls: one or more daytime SBP drops <90mmHg achieved 94% specificity and 29% sensitivity (OR 6.2, P < 0.001), while two or more daytime SBP drops <100mmHg achieved 83% specificity and 35% sensitivity (OR 2.6, P < 0.001) Conclusion: SBP drops during ABPM are more common in reflex syncope patients than in controls. Cut-off values that may be applied in clinical practice are defined. This study expands the current indications for ABPM to patients with reflex syncope.

Published
2022

29. Psychometric Properties of a Brief Version of the Perception of Risk of Heart Disease Scale in an Italian Sample

Author

Rosa, D, Pengo, M, Adorni, R, Bilo, G, Parati, G, Steca, P, Pengo, MF, Rosa, D, Pengo, M, Adorni, R, Bilo, G, Parati, G, Steca, P, and Pengo, MF

Abstract

Introduction: The number of Italian citizens unaware of their risk of cardiovascular disease it is still very high. Aim: This study aimed to translate and preliminarily validate a brief Italian version of the Perception of Risk of Heart Disease Scale (PRHDS). Methods: PRHDS was culturally adapted to the Italian context. Then, the scale was administered to 772 healthy adults. By randomly dividing the sample into two subsamples, we tested the scale dimensionality through Exploratory Factor Analysis (EFA) followed by Confirmatory Factor Analysis (CFA). Finally, we evaluated internal consistency. Results: Psychometric properties of the scale were appropriate. EFA and CFA evidenced a unidimensional structure of a brief version of the scale, composed of six items. Internal consistency was adequate. Conclusions: Italian version of the brief PRHDS is a promising self-report questionnaire to measure cardiovascular risk perception among Italian adults.

Published
2023

30. Telemedicine and Digital Medicine in the Clinical Management of Hypertension and Hypertension-Related Cardiovascular Diseases: A Position Paper of the Italian Society of Arterial Hypertension (SIIA)

Author

Minuz, P, Albini, F, Imbalzano, E, Izzo, R, Masi, S, Pengo, M, Pucci, G, Scalise, F, Salvetti, M, Tocci, G, Cicero, A, Iaccarino, G, Savoia, C, Sechi, L, Parati, G, Borghi, C, Volpe, M, Ferri, C, Grassi, G, Muiesan, M, Minuz, Pietro, Albini, Fabio Lucio, Imbalzano, Egidio, Izzo, Raffaele, Masi, Stefano, Pengo, Martino F, Pucci, Giacomo, Scalise, Filippo, Salvetti, Massimo, Tocci, Giuliano, Cicero, Arrigo, Iaccarino, Guido, Savoia, Carmine, Sechi, Leonardo, Parati, Gianfranco, Borghi, Claudio, Volpe, Massimo, Ferri, Claudio, Grassi, Guido, Muiesan, Maria Lorenza, Minuz, P, Albini, F, Imbalzano, E, Izzo, R, Masi, S, Pengo, M, Pucci, G, Scalise, F, Salvetti, M, Tocci, G, Cicero, A, Iaccarino, G, Savoia, C, Sechi, L, Parati, G, Borghi, C, Volpe, M, Ferri, C, Grassi, G, Muiesan, M, Minuz, Pietro, Albini, Fabio Lucio, Imbalzano, Egidio, Izzo, Raffaele, Masi, Stefano, Pengo, Martino F, Pucci, Giacomo, Scalise, Filippo, Salvetti, Massimo, Tocci, Giuliano, Cicero, Arrigo, Iaccarino, Guido, Savoia, Carmine, Sechi, Leonardo, Parati, Gianfranco, Borghi, Claudio, Volpe, Massimo, Ferri, Claudio, Grassi, Guido, and Muiesan, Maria Lorenza

Abstract

High blood pressure is the leading cause of death and disability globally and an important treatable risk factor for cardiovascular, cerebrovascular and chronic kidney diseases. Digital technology, including mobile health solutions and digital therapy, is expanding rapidly in clinical medicine and has the potential to improve the quality of care and effectiveness of drug treatment by making medical interventions timely, tailored to hypertensive patients' needs and by improving treatment adherence. Thus, the systematic application of digital technologies could support diagnosis and awareness of hypertension and its complications, ultimately leading to improved BP control at the population level. The progressive implementation of digital medicine in the national health systems must be accompanied by the supervision and guidance of health authorities and scientific societies to ensure the correct use of these new technologies with consequent maximization of the potential benefits. The role of scientific societies in relation to the rapid adoption of digital technologies, therefore, should encompass the entire spectrum of activities pertaining to their institutional role: information, training, promotion of research, scientific collaboration and advice, evaluation and validation of technological tools, and collaboration with regulatory and health authorities.

Published
2023

37. Effect of CPAP therapy on blood pressure in patients with OSA: a worldwide individual patient data meta-analysis

Author

Pengo, M, primary, Schwarz, E I, additional, Barbe, F, additional, Drager, L, additional, Fava, C, additional, Ip, M S M, additional, Martinez Garcia, M A, additional, McEvoy, D, additional, Peker, Y, additional, Phillips, C L, additional, Soranna, D, additional, Steier, J, additional, Stradling, J, additional, Zambon, A, additional, and Parati, G, additional

Published
2022
Full Text
View/download PDF

38. Current challenges for hypertension management: From better hypertension diagnosis to improved patients' adherence and blood pressure control

Author

Parati, G, Lombardi, C, Pengo, M, Bilo, G, Ochoa, J, Parati G., Lombardi C., Pengo M., Bilo G., Ochoa J. E., Parati, G, Lombardi, C, Pengo, M, Bilo, G, Ochoa, J, Parati G., Lombardi C., Pengo M., Bilo G., and Ochoa J. E.

Abstract

Hypertension control still remains a largely unmet challenge for public health systems. Despite the progress in blood pressure (BP) measurement techniques, and the availability of effective and safe antihypertensive drugs, a large number of hypertensive patients are not properly identified, and a significant proportion of those who receive antihypertensive treatment fail to achieve satisfactory control of their BP levels. It is thus not surprising that hypertension is still a major contributor to disease burden and disability worlwide, even in developed countries. This paper will address current challenges in hypertension management and potential strategies for an improvement in this field. In its first part relevant issues related to hypertension diagnosis will be addressed, in particular how to improve identification of sustained BP elevation and specific BP phenotypes such as white coat and masked hypertension trough the combined use of office and out-of-office BP monitoring techniques. In its second part focus will be on how to improve achievement of hypertension control in treated patients by optimization and simplification of medication regimens, including more efficient selection and titration of antihypertensive drugs and their combinations, aimed at achieving a more consistent 24hBP control; and by favoring a more active patients' and physicians' involvement in hypertension management also through BP telemonitoring and mobile health technologies.

Published
2021

39. Does treatment for obstructive sleep apnoea improve arterial stiffness? evidence from randomized clinical trials on carotid-femoral pulse wave velocity

Author

Marcon, D, Faconti, L, Farukh, B, Mcnally, R, Fava, C, Pengo, M, Chowienczyk, P, Cruickshank, J, Marcon D., Faconti L., Farukh B., McNally R., Fava C., Pengo M., Chowienczyk P., Cruickshank J. K., Marcon, D, Faconti, L, Farukh, B, Mcnally, R, Fava, C, Pengo, M, Chowienczyk, P, Cruickshank, J, Marcon D., Faconti L., Farukh B., McNally R., Fava C., Pengo M., Chowienczyk P., and Cruickshank J. K.

Abstract

Obstructive Sleep Apnoea (OSA) is a breathing disorder characterized by narrowing of the upper airway that impairs normal ventilation during sleep. OSA is a highly prevalent condition which is associated with several Cardiovascular (CV) risk factors and CV diseases. Despite this clear association, Randomized Controlled Trials (RCTs) have provided equivocal data that treatment of sleep apnoea can improve CV outcomes regardless of its ability to reduce blood pressure. Here, we critically review the evidence that supports role of OSA as a risk factor for increased arterial stiffness which represents an early manifestation of vascular damage often preceding major CV events. Additionally, we examined evidence from interventional RCTs to assess if treatment of OSA by continuous positive airway pressure can affect arterial stiffness measured as carotid-femoral pulse wave velocity. Overall, a large body of evidence supports the role of OSA as a risk factor for increased arterial stiffness and several pathophysiological mechanisms, including activation of the autonomic nervous system, may help to explain the link between breathing disorders and vascular alterations (here mainly examined as functional properties). Whether the causal relationship between OSA and vascular damage exists or is mostly explained by confounders and whether OSA treatment can improve vascular stiffening is still debated.

Published
2021

40. Acute cardiovascular events in patients with community acquired pneumonia: results from the observational prospective FADOI-ICECAP study

Author

Pieralli, F, Vannucchi, V, Nozzoli, C, Augello, G, Dentali, F, De Marzi, G, Uomo, G, Risaliti, F, Morbidoni, L, Mazzone, A, Santini, C, Tirotta, D, Corradi, F, Gerloni, R, Gnerre, P, Gussoni, G, Valerio, A, Campanini, M, Manfellotto, D, Fontanella, A, Attardo, T, Tavecchia, L, Gessi, V, Torrigiani, A, Corbo, L, Gallucci, F, Mastrobuoni, C, Giani, A, Teodora, C, Ricchiuti, E, Rosato, A, Giampaolo, L, Di Gregorio, S, Parodi, L, Pallini, F, Landini, G, Giuri, P, Prampolini, G, Arioli, D, Leone, M, Canale, C, Condemi, F, Lupica, R, Manzola, F, Masciana, R, Agnelli, G, Becattini, C, D'Agostini, E, Mosconi, M, Bogliari, G, Rossi, A, Iannantuoni, G, Bartolino, L, Montagnani, A, Verdiani, V, Gambacorta, M, Lenti, S, Francioni, S, Pierfranceschi, M, Cattabiani, C, Orlandini, F, Scuotri, L, La Regina, M, Corsini, F, Anastasio, L, Mumoli, N, Mazzi, V, Camaiti, A, Balbi, G, Ragazzo, F, Pengo, M, Pieralli F., Vannucchi V., Nozzoli C., Augello G., Dentali F., De Marzi G., Uomo G., Risaliti F., Morbidoni L., Mazzone A., Santini C., Tirotta D., Corradi F., Gerloni R., Gnerre P., Gussoni G., Valerio A., Campanini M., Manfellotto D., Fontanella A., Attardo T., Tavecchia L., Gessi V., Torrigiani A., Corbo L., Gallucci F., Mastrobuoni C., Giani A., Teodora C., Ricchiuti E., Rosato A., Giampaolo L., Di Gregorio S., Parodi L., Pallini F., Landini G., Giuri P., Prampolini G., Arioli D., Leone M. C., Canale C., Condemi F., Lupica R., Manzola F., Masciana R., Agnelli G., Becattini C., D'Agostini E., Mosconi M. G., Bogliari G., Rossi A., Iannantuoni G., Bartolino L., Montagnani A., Verdiani V., Gambacorta M., Lenti S., Francioni S., Pierfranceschi M. G., Cattabiani C., Orlandini F., Scuotri L., La Regina M., Corsini F., Anastasio L., Mumoli N., Mazzi V., Camaiti A., Balbi G., Ragazzo F., Pengo M., Pieralli, F, Vannucchi, V, Nozzoli, C, Augello, G, Dentali, F, De Marzi, G, Uomo, G, Risaliti, F, Morbidoni, L, Mazzone, A, Santini, C, Tirotta, D, Corradi, F, Gerloni, R, Gnerre, P, Gussoni, G, Valerio, A, Campanini, M, Manfellotto, D, Fontanella, A, Attardo, T, Tavecchia, L, Gessi, V, Torrigiani, A, Corbo, L, Gallucci, F, Mastrobuoni, C, Giani, A, Teodora, C, Ricchiuti, E, Rosato, A, Giampaolo, L, Di Gregorio, S, Parodi, L, Pallini, F, Landini, G, Giuri, P, Prampolini, G, Arioli, D, Leone, M, Canale, C, Condemi, F, Lupica, R, Manzola, F, Masciana, R, Agnelli, G, Becattini, C, D'Agostini, E, Mosconi, M, Bogliari, G, Rossi, A, Iannantuoni, G, Bartolino, L, Montagnani, A, Verdiani, V, Gambacorta, M, Lenti, S, Francioni, S, Pierfranceschi, M, Cattabiani, C, Orlandini, F, Scuotri, L, La Regina, M, Corsini, F, Anastasio, L, Mumoli, N, Mazzi, V, Camaiti, A, Balbi, G, Ragazzo, F, Pengo, M, Pieralli F., Vannucchi V., Nozzoli C., Augello G., Dentali F., De Marzi G., Uomo G., Risaliti F., Morbidoni L., Mazzone A., Santini C., Tirotta D., Corradi F., Gerloni R., Gnerre P., Gussoni G., Valerio A., Campanini M., Manfellotto D., Fontanella A., Attardo T., Tavecchia L., Gessi V., Torrigiani A., Corbo L., Gallucci F., Mastrobuoni C., Giani A., Teodora C., Ricchiuti E., Rosato A., Giampaolo L., Di Gregorio S., Parodi L., Pallini F., Landini G., Giuri P., Prampolini G., Arioli D., Leone M. C., Canale C., Condemi F., Lupica R., Manzola F., Masciana R., Agnelli G., Becattini C., D'Agostini E., Mosconi M. G., Bogliari G., Rossi A., Iannantuoni G., Bartolino L., Montagnani A., Verdiani V., Gambacorta M., Lenti S., Francioni S., Pierfranceschi M. G., Cattabiani C., Orlandini F., Scuotri L., La Regina M., Corsini F., Anastasio L., Mumoli N., Mazzi V., Camaiti A., Balbi G., Ragazzo F., and Pengo M.

Abstract

Background: The burden of cardiovascular (CV) complications in patients hospitalised for community-acquired pneumonia (CAP) is still uncertain. Available studies used different designs and different criteria to define CV complications. We assessed the cumulative incidence of acute of CV complications during hospitalisation for CAP in Internal Medicine Units (IMUs). Methods: This was a prospective study carried out in 26 IMUs, enrolling patients consecutively hospitalised for CAP. Defined CV complications were: newly diagnosed heart failure, acute coronary syndrome, new onset of supraventricular or ventricular arrhythmias, new onset hemorrhagic or ischemic stroke or transient ischemic attack. Outcome measures were: in-hospital and 30-day mortality, length of hospital stay and rate of 30-day re-hospitalisation. Results: A total of 1266 patients were enrolled, of these 23.8% experienced at least a CV event, the majority (15.5%) represented by newly diagnosed decompensated heart failure, and 75% occurring within 3 days. Female gender, a history of CV disease, and more severe pneumonia were predictors of CV events. In-hospital (12.2% vs 4.7%, p < 0.0001) and 30-day (16.3% vs 8.9%, p = 0.0001) mortality was higher in patients with CV events, as well as the re-hospitalisation rate (13.3% vs 9.3%, p = 0.002), and mean hospital stay was 11.4 ± 6.9 vs 9.5 ± 5.6 days (p < 0.0001). The occurrence of CV events during hospitalisation significantly increased the risk of 30-day mortality (HR 1.69, 95% CI 1.14–2.51; p = 0.009). Conclusion: Cardiovascular events are frequent in CAP, and their occurrence adversely affects outcome. A strict monitoring might be useful to intercept in-hospital CV complications for those patients with higher risk profile. Trial registration: NCT03798457 Registered 10 January 2019 - Retrospectively registered

Published
2021

41. Digitally enabled health service for the integrated management of hypertension: A participatory user-centred design process

Author

De Luca, V, Lazic, V, Birov, S, Piesche, K, Beyhan, O, Pengo, M, Melgara, M, Sherman, M, Lilja, M, Balenovic, A, Parati, G, Triassi, M, Izzo, R, Iaccarino, G, Illario, M, De Luca V., Lazic V., Birov S., Piesche K., Beyhan O., Pengo M., Melgara M., Sherman M. H., Lilja M., Balenovic A., Parati G., Triassi M., Izzo R., Iaccarino G., Illario M., De Luca, V, Lazic, V, Birov, S, Piesche, K, Beyhan, O, Pengo, M, Melgara, M, Sherman, M, Lilja, M, Balenovic, A, Parati, G, Triassi, M, Izzo, R, Iaccarino, G, Illario, M, De Luca V., Lazic V., Birov S., Piesche K., Beyhan O., Pengo M., Melgara M., Sherman M. H., Lilja M., Balenovic A., Parati G., Triassi M., Izzo R., Iaccarino G., and Illario M.

Abstract

This article describes a user-centred approach taken by a group of five procurers to set specifications for the procurement of value-based research and development services for IT-sup-ported integrated hypertension management. The approach considered the unmet needs of patients and health systems of the involved regions. The procurers established a framework for requirements and a solution design consisting of nine building blocks, divided into three domains: service delivery, devices and integration, and health care organisation. The approach included the development of questionnaires, capturing patients’ and professionals’ views on possible system functionalities, and a template collecting information about the organisation of healthcare, professionals involved and existing IT systems at the procurers’ premises. A total of 28 patients diagnosed with hypertension and 26 professionals were interviewed. The interviewees identified 98 functional requirements, grouped in the nine building blocks. A total of nine use cases and their corresponding process models were defined by the procurers’ working group. As result, a digitally enabled integrated approach to hypertension has been designed to allow citizens to learn how to prevent the development of hypertension and lead a healthy lifestyle, and to receive comprehensive, individualised treatment in close collaboration with healthcare professionals.

Published
2021

42. May Measurement Month 2019: An analysis of blood pressure screening results from Italy

Author

Torlasco, C, Faini, A, Pengo, M, Borghi, C, Grassi, G, Ferri, C, Muiesan, M, Salvetti, M, Sechi, L, Minuz, P, Mulatero, P, Pucci, G, Volpe, M, Carugo, S, Sarzani, R, Mule, G, Beaney, T, Poulter, N, Xia, X, Parati, G, Torlasco C., Faini A., Pengo M., Borghi C., Grassi G., Ferri C., Muiesan M. L., Salvetti M., Sechi L., Minuz P., Mulatero P., Pucci G., Volpe M., Carugo S., Sarzani R., Mule G., Beaney T., Poulter N. R., Xia X., Parati G., Torlasco, C, Faini, A, Pengo, M, Borghi, C, Grassi, G, Ferri, C, Muiesan, M, Salvetti, M, Sechi, L, Minuz, P, Mulatero, P, Pucci, G, Volpe, M, Carugo, S, Sarzani, R, Mule, G, Beaney, T, Poulter, N, Xia, X, Parati, G, Torlasco C., Faini A., Pengo M., Borghi C., Grassi G., Ferri C., Muiesan M. L., Salvetti M., Sechi L., Minuz P., Mulatero P., Pucci G., Volpe M., Carugo S., Sarzani R., Mule G., Beaney T., Poulter N. R., Xia X., and Parati G.

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.

Published
2021

43. Impact of sleep apnea on cardioembolic risk in patients with atrial fibrillation data from the ESADA cohort

Author

Pengo, M, Faini, A, Grote, L, Ludka, O, Joppa, P, Pataka, A, Dogas, Z, Mihaicuta, S, Hein, H, Anttalainen, U, Ryan, S, Lombardi, C, Parati, G, Pengo M., Faini A., Grote L., Ludka O., Joppa P., Pataka A., Dogas Z., Mihaicuta S., Hein H., Anttalainen U., Ryan S., Lombardi C., Parati G., Pengo, M, Faini, A, Grote, L, Ludka, O, Joppa, P, Pataka, A, Dogas, Z, Mihaicuta, S, Hein, H, Anttalainen, U, Ryan, S, Lombardi, C, Parati, G, Pengo M., Faini A., Grote L., Ludka O., Joppa P., Pataka A., Dogas Z., Mihaicuta S., Hein H., Anttalainen U., Ryan S., Lombardi C., and Parati G.

Abstract

BACKGROUND AND PURPOSE: An accurate determination of the cardioembolic risk in patients with atrial fibrillation (AF) is crucial to prevent consequences like stroke. Obstructive sleep apnea (OSA) is a known risk factor for both AF and stroke. We aim to explore a possible association between OSA and an increased cardioembolic risk in patients with AF. METHODS: We assessed data from the ESADA (European Sleep Apnea Database) cohort where patients with known AF and OSA were included. Parameters of OSA severity and related hypoxia like lowest Spo2 and 4% oxygen desaturation index were analyzed. Patients were stratified according to their cardioembolic risk estimated with the CHA2DS2-VASc score. RESULTS: From the initial cohort of 14 646 patients, a final set of 363 patients were included in the analysis. Indices of hypoxia during sleep were associated with increased CHA2DS2-VASc score (4% oxygen desaturation index 17.9 versus 29.6 versus 30.5 events/hour and the lowest Spo2 81.2 versus 77.8 versus 77.5% for low, moderate, and high cardioembolic risk, respectively, P<0.05). CONCLUSIONS: These results support the potential role of OSA-related hypoxia in the risk for cardioembolic complications such as stroke in patients with AF.

Published
2021

44. Platelet and Endothelial Activation as Potential Mechanisms Behind the Thrombotic Complications of COVID-19 Patients

Author

Canzano, P, Brambilla, M, Porro, B, Cosentino, N, Tortorici, E, Vicini, S, Poggio, P, Cascella, A, Pengo, M, Veglia, F, Fiorelli, S, Bonomi, A, Cavalca, V, Trabattoni, D, Andreini, D, Omodeo Sale, E, Parati, G, Tremoli, E, Camera, M, Canzano P., Brambilla M., Porro B., Cosentino N., Tortorici E., Vicini S., Poggio P., Cascella A., Pengo M., Veglia F., Fiorelli S., Bonomi A., Cavalca V., Trabattoni D., Andreini D., Omodeo Sale E., Parati G., Tremoli E., Camera M., Canzano, P, Brambilla, M, Porro, B, Cosentino, N, Tortorici, E, Vicini, S, Poggio, P, Cascella, A, Pengo, M, Veglia, F, Fiorelli, S, Bonomi, A, Cavalca, V, Trabattoni, D, Andreini, D, Omodeo Sale, E, Parati, G, Tremoli, E, Camera, M, Canzano P., Brambilla M., Porro B., Cosentino N., Tortorici E., Vicini S., Poggio P., Cascella A., Pengo M., Veglia F., Fiorelli S., Bonomi A., Cavalca V., Trabattoni D., Andreini D., Omodeo Sale E., Parati G., Tremoli E., and Camera M.

Abstract

The authors hypothesized that the cytokine storm described in COVID-19 patients may lead to consistent cell-based tissue factor (TF)-mediated activation of coagulation, procoagulant microvesicles (MVs) release, and massive platelet activation. COVID-19 patients have higher levels of TF+ platelets, TF+ granulocytes, and TF+ MVs than healthy subjects and coronary artery disease patients. Plasma MV-associated thrombin generation is present in prophylactic anticoagulated patients. A sustained platelet activation in terms of P-selectin expression and platelet–leukocyte aggregate formation, and altered nitric oxide/prostacyclin synthesis are also observed. COVID-19 plasma, added to the blood of healthy subjects, induces platelet activation similar to that observed in vivo. This effect was blunted by pre-incubation with tocilizumab, aspirin, or a P2Y12 inhibitor.

Published
2021

46. Sequelae in adults at 12 months after mild-to-moderate coronavirus disease 2019 (COVID-19)

Author

Boscolo-Rizzo, P, Guida, F, Polesel, J, Marcuzzo, A, Capriotti, V, D'Alessandro, A, Zanelli, E, Marzolino, R, Lazzarin, C, Antonucci, P, Sacchet, E, Tofanelli, M, Borsetto, D, Gardenal, N, Pengo, M, Tirelli, G, Boscolo-Rizzo P., Guida F., Polesel J., Marcuzzo A. V., Capriotti V., D'Alessandro A., Zanelli E., Marzolino R., Lazzarin C., Antonucci P., Sacchet E., Tofanelli M., Borsetto D., Gardenal N., Pengo M., Tirelli G., Boscolo-Rizzo, P, Guida, F, Polesel, J, Marcuzzo, A, Capriotti, V, D'Alessandro, A, Zanelli, E, Marzolino, R, Lazzarin, C, Antonucci, P, Sacchet, E, Tofanelli, M, Borsetto, D, Gardenal, N, Pengo, M, Tirelli, G, Boscolo-Rizzo P., Guida F., Polesel J., Marcuzzo A. V., Capriotti V., D'Alessandro A., Zanelli E., Marzolino R., Lazzarin C., Antonucci P., Sacchet E., Tofanelli M., Borsetto D., Gardenal N., Pengo M., and Tirelli G.

Published
2021

47. The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure [El proyecto ANDANTE: un metanálisis a nivel mundial de datos individuales sobre el efecto del tratamiento de la apnea del sueño en la presión arterial]

Author

Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, Zambra, G, Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., Zambra G., Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, Zambra, G, Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., and Zambra G.

Published
2021

49. The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure [El proyecto ANDANTE: un metanálisis a nivel mundial de datos individuales sobre el efecto del tratamiento de la apnea del sueño en la presión arterial]

Author

Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., Zambra G., Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, and Zambra, G

Subjects
hypertension, blood pressure, sleep apnea
Published
2021

Catalog

Books, media, physical & digital resources
See catalog results