Search

Your search keyword '"Repaci, S"' showing total 27 results
Start Over Author "Repaci, S"
27 results on '"Repaci, S"'

2. Left ventricular dysfunction and outcome at two-year follow-up in patients with type 2 diabetes: The DYDA study

Author

Cioffi G, Faggiano P, Lucci D, Maggioni AP, Manicardi V, Travaglini A, Girfoglio D, Masson S, Giorda CB, Velussi M, Di Lenarda A, Verdecchia P, Comaschi M. DYDA Investigators Collaborators Comaschi M, Giorda C, Tarantini L, de Simone G, Mureddu G, Comaschi M, Latini R, Vago T, Angeli F, Mazzotta G, Repaci S, Botta I, Casalnuovo G, Chinali M, Boemi M, Mocchegiani R, Corsi A, Ponzani P, Camerini A, Pinamonti B, Grosu A, Sforza A, Rambaldi R, Zarra E, Murtas MG, Montaldo C, Motta RM, Leonardi G, Marchese T, Brero ML, Magro G, Tanga M, Rotella CM, Lenuzza M, Baggiore CM, Leopardi A, Minneci C, Sulla A, De Micheli A, Papagna D, Maggi D, Spallarossa P, Aglialoro A, Magaja O, Sabbatini G, Cesareo F, Corda A, Pitzalis L, Masselli L, Midi P, Pontiroli AE, Mauri C, Carletti F, Piatti P, Agricola E, Donà G, Frigato N, Finardi L, Catellani E, Piazza A, Cozzolino D, Madau G, Scanu M, Reboldi G, Biagioli P, Arcangeli A, Marsocci A, Badia T, Dabizzi L, Trojani C, Amati S, Genovese S, Bragato RM, Vespasiani G, Galetta M, Floris F, Mastroianno S, Russo A, De Cosmo S, Sturaro R, Ubaldi S, Miselli V, Gambarati GP, Curci V, Mattioli R, Mezzetti P, Bovelli D, Limone P, Mabritto B, Fonda M, Manca E, Pinamonti B., GENTILE, Sandro, Cioffi, G, Faggiano, P, Lucci, D, Maggioni, Ap, Manicardi, V, Travaglini, A, Girfoglio, D, Masson, S, Giorda, Cb, Velussi, M, Di Lenarda, A, Verdecchia, P, Comaschi M., DYDA Investigators Collaborators Comaschi M, Giorda, C, Tarantini, L, de Simone, G, Mureddu, G, Comaschi, M, Latini, R, Vago, T, Angeli, F, Mazzotta, G, Repaci, S, Botta, I, Casalnuovo, G, Chinali, M, Boemi, M, Mocchegiani, R, Corsi, A, Ponzani, P, Camerini, A, Pinamonti, B, Grosu, A, Sforza, A, Rambaldi, R, Zarra, E, Murtas, Mg, Montaldo, C, Motta, Rm, Leonardi, G, Marchese, T, Brero, Ml, Magro, G, Tanga, M, Rotella, Cm, Lenuzza, M, Baggiore, Cm, Leopardi, A, Minneci, C, Sulla, A, De Micheli, A, Papagna, D, Maggi, D, Spallarossa, P, Aglialoro, A, Magaja, O, Sabbatini, G, Cesareo, F, Corda, A, Pitzalis, L, Masselli, L, Midi, P, Pontiroli, Ae, Mauri, C, Carletti, F, Piatti, P, Agricola, E, Donà, G, Frigato, N, Finardi, L, Catellani, E, Piazza, A, Gentile, Sandro, Cozzolino, D, Madau, G, Scanu, M, Reboldi, G, Biagioli, P, Arcangeli, A, Marsocci, A, Badia, T, Dabizzi, L, Trojani, C, Amati, S, Genovese, S, Bragato, Rm, Vespasiani, G, Galetta, M, Floris, F, Mastroianno, S, Russo, A, De Cosmo, S, Sturaro, R, Ubaldi, S, Miselli, V, Gambarati, Gp, Curci, V, Mattioli, R, Mezzetti, P, Bovelli, D, Limone, P, Mabritto, B, Fonda, M, Manca, E, and Pinamonti, B.

Abstract

Left ventricular dysfunction (LVD) in type 2 diabetes mellitus (DM) (DYDA) study is a prospective investigation enrolling 960 with DM without overt cardiac disease. At baseline, a high prevalence of LVD was detected by analysing midwall shortening. We report here the incidence of clinical events in DYDA patients after 2-year follow-up and the frequency of LVD detected at baseline and 2-year evaluation. METHODS: Systolic LVD was defined as midwall shortening ≤15%, diastolic LVD as any condition different from "normal diastolic function" identified as E/A ratio on Doppler mitral flow between 0.75 and 1.5 and deceleration time of E wave >140 ms. Major outcome was a composite of major events, including all-causes death and hospital admissions. RESULTS: During the study period, any systolic/diastolic LVD was found in 616 of 699 patients (88.1%) in whom LVD function could be measured at baseline or at 2 years. Older age and high HbA1c predicted the occurrence of LVD. During the follow-up 15 patients died (1.6%), 3 for cardiovascular causes, 139 were hospitalized (14.5%, 43 of them for cardiovascular causes, 20 for a new cancer). CONCLUSIONS: During a 2-year follow-up any LVD is detectable in a large majority of patients with DM without overt cardiac disease. Older age and higher HbA1c predict LVD. All-cause death or hospitalization occurred in 15% of patients, cardiovascular cause was uncommon. Independent predictors of events were older age, pathologic lipid profile, high HbA1c, claudicatio and repaglinide therapy. Echo-assessed LVD at baseline was not prognosticator of events. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Published
2013

3. Analysis of midwall shortening reveals high prevalence of left ventricular myocardial dysfunction in patients with diabetes mellitus: the DYDA study

Author

Cioffi G, Giorda CB, Chinali M, Di Lenarda A, Faggiano P, Lucci D, Maggioni AP, Masson S, Mureddu GF, Tarantini L, Velussi M, Comaschi M, DYDA I.n.v.e.s.t.i.g.a.t.o.r.s. Collaborators Comaschi M, Giorda C, de Simone G, Mureddu G, Verdecchia P, Latini R, Vago T, Angeli F, Mazzotta G, Repaci S, Botta I, Casalnuovo G, Girfoglio D, Boemi M, Mocchegiani R, Corsi A, Ponzani P, Camerini A, Pinamonti B, Grosu A, Sforza A, Rambaldi R, Zarra E, Murtas MG, Montaldo C, Motta RM, Leonardi G, Marchese T, Brero ML, Magro G, Tanga M, Rotella CM, Lenuzza M, Baggiore CM, Leopardi A, Minneci C, Sulla A, De Micheli A, Papagna D, Maggi D, Spallarossa P, Aglialoro A, Magaja O, Sabbatini G, Cesareo F, Corda A, Pitzalis L, Masselli L, Midi P, Pontiroli AE, Mauri C, Carletti F, Piatti P, Agricola E, Donà G, Frigato N, Manicardi V, Finardi L, Catellani E, Piazza A, Cozzolino D, Madau G, Scanu M, Reboldi G, Biagioli P, Arcangeli A, Marsocci A, Badia T, Dabizzi L, Trojani C, Amati S, Genovese S, Bragato RM, Vespasiani G, Galetta M, Floris F, Mastroianno S, Russo A, De Cosmo S, Sturaro R, Ubaldi S, Miselli V, Gambarati GP, Curci V, Mattioli R, Travaglini A, Mezzetti P, Bovelli D, Limone P, Mabritto B, Fonda M, Manca E, Pinamonti B., GENTILE, Sandro, Cioffi, G, Giorda, Cb, Chinali, M, Di Lenarda, A, Faggiano, P, Lucci, D, Maggioni, Ap, Masson, S, Mureddu, Gf, Tarantini, L, Velussi, M, Comaschi, M, Collaborators Comaschi M, DYDA I. n. v. e. s. t. i. g. a. t. o. r. s., Giorda, C, de Simone, G, Mureddu, G, Verdecchia, P, Latini, R, Vago, T, Angeli, F, Mazzotta, G, Repaci, S, Botta, I, Casalnuovo, G, Girfoglio, D, Boemi, M, Mocchegiani, R, Corsi, A, Ponzani, P, Camerini, A, Pinamonti, B, Grosu, A, Sforza, A, Rambaldi, R, Zarra, E, Murtas, Mg, Montaldo, C, Motta, Rm, Leonardi, G, Marchese, T, Brero, Ml, Magro, G, Tanga, M, Rotella, Cm, Lenuzza, M, Baggiore, Cm, Leopardi, A, Minneci, C, Sulla, A, De Micheli, A, Papagna, D, Maggi, D, Spallarossa, P, Aglialoro, A, Magaja, O, Sabbatini, G, Cesareo, F, Corda, A, Pitzalis, L, Masselli, L, Midi, P, Pontiroli, Ae, Mauri, C, Carletti, F, Piatti, P, Agricola, E, Donà, G, Frigato, N, Manicardi, V, Finardi, L, Catellani, E, Piazza, A, Gentile, Sandro, Cozzolino, D, Madau, G, Scanu, M, Reboldi, G, Biagioli, P, Arcangeli, A, Marsocci, A, Badia, T, Dabizzi, L, Trojani, C, Amati, S, Genovese, S, Bragato, Rm, Vespasiani, G, Galetta, M, Floris, F, Mastroianno, S, Russo, A, De Cosmo, S, Sturaro, R, Ubaldi, S, Miselli, V, Gambarati, Gp, Curci, V, Mattioli, R, Travaglini, A, Mezzetti, P, Bovelli, D, Limone, P, Mabritto, B, Fonda, M, Manca, E, and Pinamonti, B.

Abstract

Individuals with diabetes mellitus (DM) have a higher risk to develop heart failure. Clinical guidelines emphasize the importance of early diagnosis of left ventricular dysfunction (LVD) and preventive interventions in these patients. In this study we assessed the prevalence of LVD, systolic or diastolic, in DM patients without known cardiac disease recruited in the 'left ventricular DYsfunction in DiAbetes (DYDA)' study. DESIGN AND METHODS: We performed clinical, ECG, laboratory, and echocardiographic exams in 960 patients (61 ± 8 years, 59% hypertensive) recruited in the DYDA study from 37 Italian diabetes referral centres. ECG and echo exams were read in central facilities. Systolic LVD was defined as ejection fraction ≤ 50% or midwall shortening (MFS) ≤ 15%. Diastolic LVD was identified when transmitral E/A was out of the range of 0.75-1.5 or deceleration time of mitral E wave ≤ 140 msec. RESULTS: Echocardiographic data were obtained in 751 patients (78.2%). Isolated systolic LVD was detected in 22.0% of patients, isolated diastolic LVD in 21.5%, and combined systolic and diastolic LVD in 12.7%. All patients with systolic LVD had MFS ≤ 15%, while only 9% had an ejection fraction ≤ 50%. Higher LV mass, relative wall thickness, prevalence of concentric geometry, and LV hypertrophy characterized the patients with LVD. CONCLUSIONS: LVD is present in more than half of DM patients without clinically detectable cardiac disease and is associated with LV hypertrophy and concentric LV geometry. One-third of patients exhibits systolic LVD detectable at the midwall level.

Published
2012

4. Predictors of early-stage left ventricular dysfunction in type 2 diabetes: results of DYDA study

Author

Giorda CB, Cioffi G, de Simone G, Di Lenarda A, Faggiano P, Latini R, Lucci D, Maggioni AP, Tarantini L, Velussi M, Verdecchia P, Comaschi M, DYDA I.n.v.e.s.t.i.g.a.t.o.r.s. Collaborators Comaschi M, Giorda C, Mureddu G, Masson S, Vago T, Angeli F, Mazzotta G, Repaci S, Botta I, Casalnuovo G, Chinali M, Girfoglio D, Boemi M, Mocchegiani R, Corsi A, Ponzani P, Camerini A, Pinamonti B, Grosu A, Sforza A, Rambaldi R, Zarra E, Murtas MG, Montaldo C, Motta RM, Leonardi G, Marchese T, Brero LM, Magro G, Tanga M, Bardini G, Lenuzza M, Baggiore CM, Leopardi A, Minneci C, Sulla A, De Micheli A, Papagna D, Maggi D, Spallarossa P, Aglialoro A, Magaja O, Sabbatini G, Cesareo F, Corda A, Pitzalis L, Masselli L, Midi P, Pontiroli AE, Mauri C, Carletti F, Piatti P, Agricola E, Dona G, Zanocco A, Manicardi V, Michelini M, Pattoneri P, Catellani E, Cozzolino D, Madau G, Scanu M, Reboldi G, Biagioli P, Arcangeli A, Marsocci A, Badia T, Dabizzi L, Trojani C, Amati S, Genovese S, Genovese L, Vespasiani G, Galetta M, Floris F, Mastroianno S, Russo A, Sturaro R, Ubaldi S, Miselli V, Gambarati GP, Curci V, Mattioli R, Travaglini A, Mezzetti P, Bovelli D, Limone P, Pizzuti A, Fonda M, Manca E, Pinamonti B., GENTILE, Sandro, Giorda, Cb, Cioffi, G, de Simone, G, Di Lenarda, A, Faggiano, P, Latini, R, Lucci, D, Maggioni, Ap, Tarantini, L, Velussi, M, Verdecchia, P, Comaschi, M, Collaborators Comaschi M, DYDA I. n. v. e. s. t. i. g. a. t. o. r. s., Giorda, C, Mureddu, G, Masson, S, Vago, T, Angeli, F, Mazzotta, G, Repaci, S, Botta, I, Casalnuovo, G, Chinali, M, Girfoglio, D, Boemi, M, Mocchegiani, R, Corsi, A, Ponzani, P, Camerini, A, Pinamonti, B, Grosu, A, Sforza, A, Rambaldi, R, Zarra, E, Murtas, Mg, Montaldo, C, Motta, Rm, Leonardi, G, Marchese, T, Brero, Lm, Magro, G, Tanga, M, Bardini, G, Lenuzza, M, Baggiore, Cm, Leopardi, A, Minneci, C, Sulla, A, De Micheli, A, Papagna, D, Maggi, D, Spallarossa, P, Aglialoro, A, Magaja, O, Sabbatini, G, Cesareo, F, Corda, A, Pitzalis, L, Masselli, L, Midi, P, Pontiroli, Ae, Mauri, C, Carletti, F, Piatti, P, Agricola, E, Dona, G, Zanocco, A, Manicardi, V, Michelini, M, Pattoneri, P, Catellani, E, Gentile, Sandro, Cozzolino, D, Madau, G, Scanu, M, Reboldi, G, Biagioli, P, Arcangeli, A, Marsocci, A, Badia, T, Dabizzi, L, Trojani, C, Amati, S, Genovese, S, Genovese, L, Vespasiani, G, Galetta, M, Floris, F, Mastroianno, S, Russo, A, Sturaro, R, Ubaldi, S, Miselli, V, Gambarati, Gp, Curci, V, Mattioli, R, Travaglini, A, Mezzetti, P, Bovelli, D, Limone, P, Pizzuti, A, Fonda, M, Manca, E, and Pinamonti, B.

Abstract

Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease. METHOD: Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61 ± 7 years, 59% hypertensive) recruited by 37 Italian diabetes clinics were analysed. Clinical history, life habits, laboratory data (NT-proBNP, HsCRP, HbA1c, serum glucose, lipids and creatinine, liver enzymes, microalbuminuria, glomerular filtrate) and data on microvascular complications and drug therapy were collected. RESULTS: LVD was present in 59.9% of patients. Age (OR 1.05, 95% CI [1.02-1.07]), HbA1c (OR 1.27, 95% CI [1.09-1.49]), triglycerides (OR 1.003, 95% CI [1.001-1.006]), treatment with metformin (OR 1.62, 95% CI [1.09-2.40]) and doxazosine (OR 2.48, 95% CI [1.10-5.55]) were independent predictors of LVD. Glitazones were associated with reduced risk of diastolic dysfunction (OR 0.44, 95% CI [0.22-0.87]) whereas waist circumference and metformin were adversely associated with systolic dysfunction (OR 1.02, 95% CI [1.01-1.04] and 1.57, 95% CI [1.01-2.43], respectively). CONCLUSION: In asymptomatic and fairly controlled diabetic patients, age, worse HbA1c, traits of insulin resistance, such as visceral adiposity and triglycerides or treatment with metformin, and use of doxazosin indicate greater risk of LVD. Glitazones, at this stage, seem to be associated with better diastolic performance.

Published
2011

5. Inappropriately high left ventricular mass in patients with type 2 diabetes mellitus and no overt cardiac disease. The DYDA study

Author

Cioffi G, Faggiano P, Lucci D, Di Lenarda A, Mureddu GF, Tarantini L, Verdecchia P, Comaschi M, Giorda CB, Velussi M, Chinali M, Latini R, Masson S, De Simone G, DYDAInvestigators Collaborators Comaschi M, Giorda C, de Simone G, Mureddu G, Maggioni AP, Vago T, Angeli F, Mazzotta G, Repaci S, Botta I, Casalnuovo G, Girfoglio D, Boemi M, Mocchegiani R, Corsi A, Ponzani P, Camerini A, Pinamonti B, Grosu A, Sforza A, Rambaldi R, Zarra E, Murtas MG, Montaldo C, Motta RM, Leonardi G, Marchese T, Brero ML, Magro G, Tanga M, Rotella CM, Lenuzza M, Baggiore CM, Leopardi A, Minneci C, Sulla A, De Micheli A, Papagna D, Maggi D, Spallarossa P, Aglialoro A, Magaja O, Sabbatini G, Cesareo F, Corda A, Pitzalis L, Masselli L, Midi P, PontiroliAE, Mauri C, Carletti F, Piatti P, Agricola E, Donà G, Frigato N, Manicardi V, Finardi L, Catellani E, Piazza A, Cozzolino D, Madau G, Scanu M, Reboldi G, Biagioli P, Arcangeli A, Marsocci A, Badia T, Dabizzi L, Trojani C, Amati S, Genovese S, Bragato RM, Vespasiani G, Galetta M, Floris F, Mastroianno S, Russo A, De Cosmo S, Sturaro R, Ubaldi S, Miselli V, Gambarati GP, Curci V, Mattioli R, Travaglini A, Mezzetti P, Bovelli D, Limone P, Mabritto B, Fonda M, Manca E, Pinamonti B., GENTILE, Sandro, Cioffi, G, Faggiano, P, Lucci, D, Di Lenarda, A, Mureddu, Gf, Tarantini, L, Verdecchia, P, Comaschi, M, Giorda, Cb, Velussi, M, Chinali, M, Latini, R, Masson, S, De Simone, G, DYDAInvestigators Collaborators Comaschi, M, Giorda, C, de Simone, G, Mureddu, G, Maggioni, Ap, Vago, T, Angeli, F, Mazzotta, G, Repaci, S, Botta, I, Casalnuovo, G, Girfoglio, D, Boemi, M, Mocchegiani, R, Corsi, A, Ponzani, P, Camerini, A, Pinamonti, B, Grosu, A, Sforza, A, Rambaldi, R, Zarra, E, Murtas, Mg, Montaldo, C, Motta, Rm, Leonardi, G, Marchese, T, Brero, Ml, Magro, G, Tanga, M, Rotella, Cm, Lenuzza, M, Baggiore, Cm, Leopardi, A, Minneci, C, Sulla, A, De Micheli, A, Papagna, D, Maggi, D, Spallarossa, P, Aglialoro, A, Magaja, O, Sabbatini, G, Cesareo, F, Corda, A, Pitzalis, L, Masselli, L, Midi, P, Pontiroliae, Mauri, C, Carletti, F, Piatti, P, Agricola, E, Donà, G, Frigato, N, Manicardi, V, Finardi, L, Catellani, E, Piazza, A, Gentile, Sandro, Cozzolino, D, Madau, G, Scanu, M, Reboldi, G, Biagioli, P, Arcangeli, A, Marsocci, A, Badia, T, Dabizzi, L, Trojani, C, Amati, S, Genovese, S, Bragato, Rm, Vespasiani, G, Galetta, M, Floris, F, Mastroianno, S, Russo, A, De Cosmo, S, Sturaro, R, Ubaldi, S, Miselli, V, Gambarati, Gp, Curci, V, Mattioli, R, Travaglini, A, Mezzetti, P, Bovelli, D, Limone, P, Mabritto, B, Fonda, M, Manca, E, and Pinamonti, B.

Abstract

An inappropriately high left ventricular mass (iLVM) may be detected in patients with diabetes mellitus. Several hemodynamic and nonhemodynamic factors stimulating LVM growth may actively operate in these patients. In this study, we assessed prevalence and factors associated with iLVM in patients with diabetes mellitus. METHODS: We analyzed baseline data from 708 patients (61 ± 7 years, 57% treated for hypertension) with type 2 diabetes mellitus without evidence of cardiac disease enrolled in the left ventricular dysfunction in diabetes study. iLVM was diagnosed by Doppler echocardiography as LVM more than 28% of the expected LVM predicted from height, sex and stroke work. RESULTS: iLVM was detected in 166 patients (23%), irrespective of concomitant hypertension. Patients with iLVM were more frequently women, had higher BMI and prevalence of metabolic syndrome, higher serum triglyceride levels and were treated more frequently with metformin and diuretics. In a multivariate model, female sex [odds ratio (OR) 1.502 (95% confidence interval (CI) 1.010-2.231), P = 0.04], higher serum triglyceride levels [OR 1.007 (95% CI 1.003-1.012), P

Published
2011

6. Randomized study of traditional versus aggressive systolic blood pressure control (Cardio-Sis): rationale, design and characteristics of the study population. Cardio-Sis Study Group

Author

Verdecchia P, Staessen JA, Achilli A, DE SIMONE, GIOVANNI, Ganau A, Mureddu G, Pede S, Porcellati C, Fornari G, Repaci S, Castellani C, Achilli P, Jaspers C, Cucchiara G, Panzano C, Angeli F, Aillon C, Sclavo MG, Scherillo M, Raucci D, Di Donato M, Cas LD, Faggiano P, Porcu M, Calamida R, Pistia L, Vancheri F, Alletto M, Curcio M, Pettinati G, Ieva M, Muscella A, Guerrieri M, Denbek C, Gulizia M, Francese GM, Perticone F, Iemma G, Fariello R, Sala N, Mezzetti A, Pierdomenico SD, Bucci M, Benemio G, Gattobigio R, Sacchi N, Cocchieri M, Prosciutti L, Battocchi P, Garognoli O, Arcelli G, Pirelli S, Emanuelli C, Braschi GB, Abrignani M, De Ferrari G, Ponremoli R, Igidbashian D, Marini R, Scarpino L, Mandorla S, Buccolieri M, Picchi L, Casolo G, Pardini M, Marracci G, STRAZZULLO, PASQUALE, GALLETTI, FERRUCCIO, BARBATO, ANTONIO, Cavallini C, Borgioni C, Seghieri G, Cipollini F, Arcangeli E, Boddi W, Palermo C, Savelli F, Lembo G, Vecchione C, Malatino L, Belluardo P, Zoccali C, Leonardis D, Mallamaci F, Lacchè A, Gentile C, Boccanelli A, Mureddu GF, Santini M, Colivicchi F, Ficili S, Uguccioni M, Nardozi C, Tedeschi A, Martin G, Zanata G, Mos L, Dialti V, Martina S, Renna A, Farina G, Tripodi E, Miserrafiti B, Scali R, Stornello M, Valvo E, Bernardinangeli M, Proietti G, Poddighe G, Biscottini B, Panciarola R, Boccali A, Veglio F, Rabbia F, Caserta M, Chiatto M, Stefenelli C, Cioffi G, Bonazza G, Scabbia EV, Bottoni D., Verdecchia, P, Staessen, Ja, Achilli, A, DE SIMONE, Giovanni, Ganau, A, Mureddu, G, Pede, S, Porcellati, C, Fornari, G, Repaci, S, Castellani, C, Achilli, P, Jaspers, C, Cucchiara, G, Panzano, C, Angeli, F, Aillon, C, Sclavo, Mg, Scherillo, M, Raucci, D, Di Donato, M, Cas, Ld, Faggiano, P, Porcu, M, Calamida, R, Pistia, L, Vancheri, F, Alletto, M, Curcio, M, Pettinati, G, Ieva, M, Muscella, A, Guerrieri, M, Denbek, C, Gulizia, M, Francese, Gm, Perticone, F, Iemma, G, Fariello, R, Sala, N, Mezzetti, A, Pierdomenico, Sd, Bucci, M, Benemio, G, Gattobigio, R, Sacchi, N, Cocchieri, M, Prosciutti, L, Battocchi, P, Garognoli, O, Arcelli, G, Pirelli, S, Emanuelli, C, Braschi, Gb, Abrignani, M, De Ferrari, G, Ponremoli, R, Igidbashian, D, Marini, R, Scarpino, L, Mandorla, S, Buccolieri, M, Picchi, L, Casolo, G, Pardini, M, Marracci, G, Strazzullo, Pasquale, Galletti, Ferruccio, Barbato, Antonio, Cavallini, C, Borgioni, C, Seghieri, G, Cipollini, F, Arcangeli, E, Boddi, W, Palermo, C, Savelli, F, Lembo, G, Vecchione, C, Malatino, L, Belluardo, P, Zoccali, C, Leonardis, D, Mallamaci, F, Lacchè, A, Gentile, C, Boccanelli, A, Mureddu, Gf, Santini, M, Colivicchi, F, Ficili, S, Uguccioni, M, Nardozi, C, Tedeschi, A, Martin, G, Zanata, G, Mos, L, Dialti, V, Martina, S, Renna, A, Farina, G, Tripodi, E, Miserrafiti, B, Scali, R, Stornello, M, Valvo, E, Bernardinangeli, M, Proietti, G, Poddighe, G, Biscottini, B, Panciarola, R, Boccali, A, Veglio, F, Rabbia, F, Caserta, M, Chiatto, M, Stefenelli, C, Cioffi, G, Bonazza, G, Scabbia, Ev, and Bottoni, D.

Abstract

The hypothesis that a therapeutic strategy aimed at lowering systolic blood pressure (SBP) below 130 mm Hg is superior to a conventional strategy targeted at below 140 mm Hg in hypertensive subjects has never been tested in randomized intervention studies. The Studio Italiano Sugli Effetti Cardiovascolari del Controllo della Pressione Arteriosa Sistolica (Cardio-Sis) is a multi-centre study in non-diabetic, treated hypertensive subjects aged >55 years with uncontrolled SBP (>or=150 mm Hg) and at least one additional cardiovascular risk factor (ClinicalTrials.gov identifier: NCT00421863). Subjects are randomized to an SBP goal

Published
2008

9. Usual versus tight control of systolic blood pressure in non-diabetic patients with hypertension (Cardio-Sis): an open-label randomised trial

Author

Verdecchia, P, Staessen, Ja, Angeli, F, de Simone, G, Achilli, A, Ganau, A, Mureddu, G, Pede, S, Maggioni, Ap, Lucci, D, Reboldi, G, Porcellati, C, Fornari, G, Ceseri, M, Lorimer, A, Repaci, S, Castellani, C, Mazzotta, G, Berioli, S, Jaspers, C, Cucchiara, G, Panzano, C, Sclavo, Mg, Scherillo, M, Raucci, D, Faggiano, P, Porcu, M, Pistis, L, Vancheri, F, Curcio, M, Ieva, M, Muscella, A, Guerrieri, M, Dembech, C, Gulizia, Mm, Francese, Gm, Perticone, F, Iemma, G, Zanolini, G, Pierdomenico, Sd, Mezzetti, A, Benemio, G, Gattobigio, R, Sacchi, N, Cocchieri, M, Prosciutti, L, Garognoli, O, Pirelli, S, Emanuelli, C, Galeazzi, G, Abrignani, Mg, Lombardo, R, Braschi, Gb, Leoncini, G, Igidbashian, D, Marini, R, Mandorla, S, Buccolieri, M, Picchi, L, Casolo, G, Pardini, M, Galletti, F, Barbato, A, Cavallini, C, Borgioni, C, Sardone, Mg, Cipollini, F, Seghieri, G, Arcangeli, E, Boddi, W, Palermo, C, Lembo, G, Malatino, L, Leonardis, D, Gentile, C, Boccanelli, A, Colivicchi, F, Uguccioni, M, Zanata, G, Martin, G, Mos, L, Martina, S, Dialti, V, Pede, Sa, Farina, G, Tripodi, E, Miserrafiti, B, Stornello, M, Valvo, Ev, Proietti, G, Bernardinangeli, M, Poddighe, G, Marras, Ma, Biscottini, B, Panciarola, R, Veglio, Franco, Mulatero, Paolo, Caserta, Ma, Chiatto, M, Cioffi, G, Bonazza, G, and Achilli, P.

Subjects
Male, systolic blood pressure, Hemodynamics, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Left ventricular hypertrophy, ipertensione, trial clinico, ipertrofia cardiaca, law.invention, Electrocardiography, 0302 clinical medicine, Randomized controlled trial, law, Cause of Death, Prevalence, Clinical endpoint, Medicine, 030212 general & internal medicine, Incidence, General Medicine, Aged, Antihypertensive Agents, Cardiovascular Diseases, Drug Therapy, Hypertension, Treatment Outcome, Left Ventricular Hypertrophy, Randomised Controlled Trial, 3. Good health, Italy, anti-hypertensive therapy, Cardiology, Drug Therapy, Combination, Female, Hypertrophy, Left Ventricular, medicine.medical_specialty, Systole, Prehypertension, 03 medical and health sciences, Internal medicine, Diabetes mellitus, Humans, blood pressure control, systoli hypertension, Proportional Hazards Models, Intention-to-treat analysis, business.industry, medicine.disease, Surgery, Logistic Models, Blood pressure, Linear Models, business, Risk Reduction Behavior, Follow-Up Studies
Abstract

The level to which systolic blood pressure should be controlled in hypertensive patients without diabetes remains unknown. We tested the hypothesis that tight control compared with usual control of systolic blood pressure would be beneficial in such patients.In this randomised open-label trial undertaken in 44 centres in Italy, 1111 non-diabetic patients with systolic blood pressure 150 mm Hg or greater were randomly assigned to a target systolic blood pressure of less than 140 mm Hg (usual control; n=553) or less than 130 mm Hg (tight control; n=558). After stratification by centre, we used a computerised random function to allocate patients to either group. Observers who were unaware of randomisation read electrocardiograms and adjudicated events. Open-label agents were used to reach the randomised targets. The primary endpoint was the rate of electrocardiographic left ventricular hypertrophy 2 years after randomisation. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00421863.Over a median follow-up of 2.0 years (IQR 1.93-2.03), systolic and diastolic blood pressure were reduced by a mean of 23.5/8.9 mm Hg (SD 10.6/7.0) in the usual-control group and by 27.3/10.4 mm Hg (11.0/7.5) in the tight-control group (between-group difference 3.8 mm Hg systolic [95% CI 2.4-5.2], p0.0001; and 1.5 mm Hg diastolic [0.6-2.4]; p=0.041). The primary endpoint occurred in 82 of 483 patients (17.0%) in the usual-control group and in 55 of 484 patients (11.4%) of the tight-control group (odds ratio 0.63; 95% CI 0.43-0.91; p=0.013). A composite cardiovascular endpoint occurred in 52 (9.4%) patients in the usual-control group and in 27 (4.8%) in the tight-control group (hazard ratio 0.50, 95% CI 0.31-0.79; p=0.003). Side-effects were rare and did not differ significantly between the two groups.Our findings lend support to a lower blood pressure goal than is recommended at present in non-diabetic patients with hypertension.Boehringer-Ingelheim, Sanofi-Aventis, Pfizer.

Published
2009

10. Randomized study of traditional versus aggressive systolic blood pressure control (Cardio-Sis): rationale, design and characteristics of the study population

Author

VERDECCHIA P, CARDIO SIS STUDY G. R. O. U. P., Staessen, Ja, Achilli, A, DE SIMONE, G, Ganau, A, Mureddu, G, Pede, S, Porcellati, C, Fornari, G, Repaci, S, Castellani, C, Achilli, P, Jaspers, C, Cucchiara, G, Panzano, C, Angeli, F, Aillon, C, Sclavo, Mg, Scherillo, M, Raucci, D, DI DONATO, M, Cas, Ld, Faggiano, P, Porcu, M, Calamida, R, Pistia, L, Vancheri, F, Alletto, M, Curcio, M, Pettinati, G, Ieva, M, Muscella, A, Guerrieri, M, Denbek, C, Gulizia, M, Francese, Gm, Perticone, F, Iemma, G, Fariello, R, Sala, N, Mezzetti, A, Pierdomenico, Sd, Bucci, M, Benemio, G, Gattobigio, R, Sacchi, N, Cocchieri, M, Prosciutti, L, Battocchi, P, Garognoli, O, Arcelli, G, Pirelli, S, Emanuelli, C, Braschi, Gb, Abrignani, M, DE FERRARI, G, Ponremoli, R, Igidbashian, D, Marini, R, Scarpino, L, Mandorla, S, Buccolieri, M, Picchi, L, Casolo, G, Pardini, M, Marracci, G, Strazzullo, P, Galletti, F, Barbato, A, Cavallini, C, Borgioni, C, Seghieri, G, Cipollini, F, Arcangeli, E, Boddi, W, Palermo, C, Savelli, F, Lembo, G, Vecchione, C, Malatino, Lorenzo, Belluardo, P, Zoccali, C, Leonerdis, D, Mallamaci, F, Lacchè, A, Gentile, C, Boccanelli, A, Mureddu, Gf, Santini, M, Colivicchi, F, Ficili, S, Uguccioni, M, Nardozi, C, Tedeschi, A, Martin, G, Zanata, G, Mos, L, Dialti, V, Martina, S, Renna, A, Farina, G, Tripodi, E, Miserrafiti, B, Scali, R, Stornello, M, Valvo, E, Bernardinangeli, M, Proietti, G, Poddighe, G, Biscottini, B, Panciarola, R, Boccali, A, Veglio, F, Rabbia, F, Caserta, M, Chiatto, M, Stefenelli, C, Cioffi, G, Bonazza, G, Scabbia, Ev, and Bottoni, D.

Published
2008

11. Randomized study of traditional versus aggressive systolic blood pressure control (Cardio-Sis): rationale, design and characteristics of the study population

Author

Cardio Sis Study Group, Verdecchia, P, Staessen, Ja, Achilli, A, de Simone, G, Ganau, A, Mureddu, G, Pede, S, Porcellati, C, Fornari, G, Repaci, S, Castellani, C, Achilli, P, Jaspers, C, Cucchiara, G, Panzano, C, Angeli, F, Aillon, C, Sclavo, Mg, Scherillo, M, Raucci, D, Di Donato, M, DEI CAS, Livio, Faggiano, P, Porcu, M, Calamida, R, Pistia, L, Vancheri, F, Alletto, M, Curcio, M, Pettinati, G, Ieva, M, Muscella, A, Guerrieri, M, Denbek, C, Gulizia, M, Francese, Gm, Perticone, F, Iemma, G, Fariello, R, Sala, N, Mezzetti, A, Pierdomenico, Sd, Bucci, M, Benemio, G, Gattobigio, R, Sacchi, N, Cocchieri, M, Prosciutti, L, Battocchi, P, Garognoli, O, Arcelli, G, Pirelli, S, Emanuelli, C, Braschi, Gb, Abrignani, M, De Ferrari, G, Ponremoli, R, Igidbashian, D, Marini, R, Scarpino, L, Mandorla, S, Buccolieri, M, Picchi, L, Casolo, G, Pardini, M, Marracci, G, Strazzullo, P, Galletti, F, Barbato, A, Cavallini, C, Borgioni, C, Seghieri, G, Cipollini, F, Arcangeli, E, Boddi, W, Palermo, C, Savelli, F, Lembo, G, Vecchione, C, Malatino, L, Belluardo, P, Zoccali, C, Leonardis, D, Mallamaci, F, Lacchè, A, Gentile, C, Boccanelli, A, Mureddu, Gf, Santini, M, Colivicchi, F, Ficili, S, Uguccioni, M, Nardozi, C, Tedeschi, A, Martin, G, Zanata, G, Mos, L, Dialti, V, Martina, S, Renna, A, Farina, G, Tripodi, E, Miserrafiti, B, Scali, R, Stornello, M, Valvo, E, Bernardinangeli, M, Proietti, G, Poddighe, G, Biscottini, B, Panciarola, R, Boccali, A, Veglio, F, Rabbia, F, Caserta, M, Chiatto, M, Stefenelli, C, Cioffi, G, Bonazza, G, Scabbia, Ev, and Bottoni, D.

Published
2008

12. [Ambulatory blood pressure monitoring in clinical practice]

Author

Fabio Angeli, Reboldi G, Repaci S, Garofoli M, Casavecchia M, Ambrosio G, and Verdecchia P

Subjects
Blood Pressure Monitoring, Ambulatory, Humans, Hypertension, Blood Pressure Monitoring, Ambulatory
Abstract

Traditionally, diagnosis and management of arterial hypertension are based on blood pressure (BP) measurements taken in the physician's office. However, 24-h noninvasive ambulatory BP monitoring is increasingly used in patients with essential hypertension. Several prospective studies provided unequivocal evidence of an independent association between ambulatory BP and risk of cardiovascular disease in the general population and hypertensive patients. Ambulatory BP is a better predictor of cardiovascular morbidity and mortality than office BP after adjustment for traditional cardiovascular risk factors such as age, sex, smoking status, baseline office BP, and use of antihypertensive drugs. The more accurate prognostic value of ambulatory BP may be related to the closer association with hypertension-related organ damage such as left ventricular mass, intima-media thickness, and microalbuminuria. The superiority of ambulatory over clinic BP in predicting clinical outcome and the most appropriate way of interpreting results of ambulatory BP monitoring will be discussed in this review.

Published
2008

13. Beta-blockers and arterial hypertension

Author

Verdecchia, P., Angeli, F., Achilli, P., Castellani, C., Repaci, S., and Ambrosio, G.

Subjects
Beta-blockers, Myocardial infarction, Atenolol, Angina pectoris, Carvedilol, Heart failure, Hypertension, Metoprolol, Nebivolol
Published
2007

14. Beta-blockers and arterial hypertension. Evidence-based medicine or excessive perseverance?]

Author

Verdecchia P, Fabio Angeli, Achilli P, Castellani C, Repaci S, and Ambrosio G

Subjects
cardiologia, beta bloccanti, ipertensione arteriosa, Evidence-Based Medicine, Treatment Outcome, Adrenergic beta-Antagonists, Hypertension, Humans
Abstract

For more than 30 years, beta-blockers have widely been used in the treatment of patients with myocardial infarction, angina pectoris, heart failure, certain cardiac arrhythmias and hypertension. Quite recently, however, beta-blockers have been put under trial by results of some controlled studies and meta-analyses conducted in patients with essential hypertension. In summary, beta-blockers proved not better, or even worse, than alternative treatments and only marginally better than placebo. However, some arguments of caveat must be remarked. First, most of these studies have been conducted in hypertensive subjects of old age or complicated by several concomitant risk factors. A considerable portion of hypertensive patients most frequently examined in the usual practice would have not meet inclusion criteria for the above trials. In addition, several methodological issues of meta-analyses raised concern. Results were mainly driven from two major trials (LIFE and ASCOT). Unexpectedly, recent hypertension guidelines issued by the British Hypertension Society fully endorsed these results and recommended beta-blockers as fourth-line drugs in hypertensive patients with blood pressure not adequately controlled by angiotensin-converting enzyme inhibitors, calcium channel blockers and diuretics in combination. Because most of the above trials used atenolol, several lines of evidence warn against extending limitations to beta-blockers to the entire class of these drugs. Some new-generation beta-blockers, although not yet widely tested in outcome-based studies, induce peripheral vasodilatation and do not exert the detrimental effect of atenolol on central blood pressure and arterial distensibility. The present review addresses facts and theories related to the actual concern on the role of beta-blockers in the modern management of hypertensive patients.

Published
2007

19. Randomized study of traditional versus aggressive systolic blood pressure control (Cardio-Sis): rationale, design and characteristics of the study population

Author

Ceseri, M., Angeli, F., Achilli, A., Achilli, P., Panzano, C., Lucci, D., Porcellati, C., Lorimer, A., Maggioni, Ap, Castellani, C., Cucchiari, G., Staessen, Jan A., Mureddu, G., Repaci, S., Jaspers, C., Fornari, G., Simone, G., Pede, S., the Cardio-Sis Study Group, Verdecchia, P., Ganau, A., Cardio Sis Study, Group, and Strazzullo, Pasquale

Subjects
Male, medicine.medical_specialty, hypertension, electrocardiography, ipertrofia cardiaca, left ventricular hypertrophy, pressione arteriosa, prognosi, prognosis, systolic blood pressure, Systole, population, Blood Pressure, 030204 cardiovascular system & hematology, Severity of Illness Index, Prehypertension, law.invention, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Internal Medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, cardiovascular diseases, Antihypertensive Agents, Aged, business.industry, Blood Pressure Determination, Prognosis, 3. Good health, Pulse pressure, Blood pressure, Aortic pressure, Cardiology, Population study, Female, Hypertrophy, Left Ventricular, business, Follow-Up Studies
Abstract

The hypothesis that a therapeutic strategy aimed at lowering systolic blood pressure (SBP) below 130 mm Hg is superior to a conventional strategy targeted at below 140 mm Hg in hypertensive subjects has never been tested in randomized intervention studies. The Studio Italiano Sugli Effetti Cardiovascolari del Controllo della Pressione Arteriosa Sistolica (Cardio-Sis) is a multi-centre study in non-diabetic, treated hypertensive subjects aged >55 years with uncontrolled SBP (>or=150 mm Hg) and at least one additional cardiovascular risk factor (ClinicalTrials.gov identifier: NCT00421863). Subjects are randomized to an SBP goal

21. Metabolic complications in liver transplant

Author

FAENZA, STEFANO, REPACI, SIMONE, SINISCALCHI, ANTONIO, Bernardi E., Cimatti M., Dante A., Pierucci E., Riganello I., Spedicato S., Zanoni A., Faenza S., Repaci S., Bernardi E., Cimatti M., Dante A., Pierucci E., Riganello I., Siniscalchi A., Spedicato S., and Zanoni A.

Subjects
LIVER TRANSPLANTATION, METABOLISM, Complication
Abstract

The majority of the complications we are going to describe are linked to a graft malfunction. In the liver transplant a graft recovery defect has a multifactorial origin and can have clinical features that range from some transitory signs of functional deficit all the way to a fully-fledged primary non-function after orthotopic liver transplant (OLT). In such cases our treatment protocol provides for the use of prostaglandine in order to improve organ perfusion.Although the analysis of the efficacy of this pharmacological therapy is stil in progress, as it lies within the scope of our group’s experience we can state that in a certain number of cases it allows us to achieve a remission in the dysfunction symptoms. In the cases in which this treatment proves to be ineffective, there is a progressive deterioration in the hemocoagulative capacities, the protein synthesis, the neurological situation, the ventilatory exchange and the kidney function. The picture is completed by an increase in the enzymes of hepatic cytonecrosis, with an increase in the bilirubin, within a picture of hyperdynamic syndrome, characterised by an elevated cardiac index and a collapse in the vascular systemic resistances. In an overall dysfunction appears, during the wait for a new organ, one can turn to extracorporeal purification systems.

Published
2007

22. Beta-blockers and risk of all-cause mortality in non-cardiac surgery.

Author

Angeli F, Verdecchia P, Karthikeyan G, Mazzotta G, Repaci S, del Pinto M, Gentile G, Cavallini C, and Reboldi G

Subjects
Humans, Myocardial Ischemia etiology, Perioperative Care methods, Postoperative Complications mortality, Postoperative Complications prevention & control, Randomized Controlled Trials as Topic, Risk Factors, Adrenergic beta-Antagonists therapeutic use, Myocardial Ischemia prevention & control, Surgical Procedures, Operative mortality
Abstract

Myocardial ischemia is a frequent complication in patients undergoing non-cardiac surgery and beta-blockers may exert a protective effect. The main benefit of beta-blockers in perioperative cardiovascular morbidity and mortality is believed to be linked to specific effects on myocardial oxygen supply and demand. beta-blockers may exert anti-inflammatory and anti-arrhythmic effects. Randomized clinical trials which evaluated the effects of beta-blockers on all-cause mortality in patients undergoing non-cardiac surgery have yielded conflicting results. In 9 trials, 10,544 patients with non-cardiac surgery were randomized to beta-blockers (n = 5274) or placebo (n = 5270) and there were a total of 304 deaths. Patients randomized to beta-blockers group showed a 19% increased risk of all-cause mortality (odds ratio [OR] 1.19, 95% confidence interval (CI) 0.95-1.50; p = 0.135). However, trials included in the meta-analysis differed in several aspects, and a significant degree of heterogeneity (I( 2) = 46.5%) was noted. A recent analysis showed that the surgical risk category had a substantial influence on the overall estimate of the effect of beta-blockers. Compared with patients in the intermediate-high-surgical-risk category, those in the high-risk category showed a 73% reduction in the risk of total mortality with beta-blockers compared with placebo (OR 0.27, 95% CI 0.10-0.71, p = 0.016). These data suggest that perioperative beta-blockers confer a benefit which is mostly limited to patients undergoing high-risk surgery.

Published
2010
Full Text
View/download PDF

23. New-onset hyperglycemia and acute coronary syndrome: a systematic overview and meta-analysis.

Author

Angeli F, Verdecchia P, Karthikeyan G, Mazzotta G, Del Pinto M, Repaci S, Gatteschi C, Gentile G, Cavallini C, and Reboldi G

Subjects
Acute Coronary Syndrome blood, Adult, Aged, Aged, 80 and over, Blood Glucose analysis, Diabetes Complications diagnosis, Humans, Hyperglycemia diagnosis, Patient Admission, Prognosis, Acute Coronary Syndrome mortality, Diabetes Complications epidemiology, Hospital Mortality, Hyperglycemia epidemiology
Abstract

Background: Patients without a history of diabetes often develop hyperglycemia during an acute coronary syndrome (ACS). New onset of hyperglycemia (NH) is associated with higher mortality both in the short and long-term., Aim: We performed a systematic review and meta-analysis of observational studies to investigate the association between NH and mortality in patients with ACS. In-hospital, 30-day and long-term mortality were analyzed separately., Methods: We searched MEDLINE for prospective studies of patients with ACS reporting the association between NH and mortality, using Research Methodology Filters. This was supplemented by hand searching reference lists of retrieved articles. We determined study eligibility and conducted data abstraction independently and disagreements were resolved by consensus. We pooled odds ratios (OR) from individual studies using a random effects model., Results: Our search strategy identified 24 studies. The prevalence of NH varied widely 3% to 71% depending on the definition of NH used. NH significantly increased the risk of in-hospital (OR 3.62, 95% CI: 3.09 - 4.24; p < 0.0001, I2=0.0%; 15 studies, 10673 patients), 30-day (OR 4.81, 95% CI: 2.18 - 10.61, p < 0.0001, I2=92.2%; 4 studies, 101447 patients), and long-term (up to 108 months) mortality (OR 2.02, 95% CI: 1.62-2.51; p < 0.0001, I2=79.4%; 12 studies, 102099 patients)., Conclusions: In patients without a prior diagnosis of diabetes who are admitted to hospital for ACS, NH increases the risk of both short and long-term mortality. These data highlight the need for further studies addressing the control of blood glucose levels in patients with ACS., Summary: Patients without history of diabetes may develop new hyperglycemia (NH) on admission to hospital for AMI. We systematically reviewed the prognostic impact of NH on short- and long-term mortality in patients without prior diagnosis of diabetes who attended the hospital for ACS. We identified 24 outcome studies which met a set of pre-specified criteria. Prevalence of NH ranged from 3% to 71% according to different thresholds of blood glucose concentrations. NH significantly increased the risk of in-hospital (OR 3.62, 95% CI: 3.09 - 4.24; p < 0.0001, I2=0.0%; 15 studies, 10673 patients), 30-day (OR 4.81, 95% CI: 2.18 - 10.61, p < 0.0001, I2=92.2%; 4 studies, 101447 patients)), and long-term (up to 108 months) mortality (OR 2.02, 95% CI: 1.62-2.51; p < 0.0001, I2=79.4%; 12 studies, 102,099 patients).

Published
2010
Full Text
View/download PDF

24. Effects of barnidipine on blood pressure and left ventricular diastolic function in patients with hypertension and metabolic syndrome: A 12-week, open-label noncomparison study.

Author

Angeli F, Repaci S, Borgioni C, Sardone M, Scotti A, and Verdecchia P

Abstract

Background: Barnidipine is one of a new generation of dihydropyridine calcium-channel blockers. Despite evidence of favorable effects on blood pressure (BP) and insulin sensitivity, this drug has rarely been tested in hypertensive patients with metabolic syndrome (MS)., Objective: The aim of this study was to evaluate the effects of barnidipine on BP and left ventricular (LV) diastolic function in patients with hypertension and MS., Methods: Consecutive subjects aged 18 to 75 years with systolic BP (SBP) of 140 to 179 mm Hg and/or diastolic BP (DBP) of 90 to 109 mm Hg and MS (based on Adult Treatment Panel III criteria) were assessed for inclusion in the study. Lifestyle changes according to current guidelines were recommended and barnidipine monotherapy 10 mg daily was initiated. All patients entered a 2-week run-in period. After a 6-week treatment period, the daily dosage was doubled for the remainder of the study in patients whose BP remained uncontrolled (≥140/≥90 mm Hg). We assessed the glycolipidic profile and LV structure and function using standard Doppler and tissue Doppler imaging (TDI) echocardiography before and after 12 weeks of treatment. Ambulatory BP records and electrocardiographic and echocardiographic tracings were coded and shipped to a central laboratory for blinded analysis. Possible adverse events (AEs) were recorded at predetermined intervals throughout the follow-up period and at unplanned intervals whenever an AE became known to the investigators., Results: Thirty-four consecutive patients were assessed for inclusion. Thirty consecutive patients (20 men, 10 women; mean {SD| age, 55.9 {10.3| years; 5 current smokers) were included in the study. At study entry, mean office SBP was 146 mm Hg, DBP was 87 mm Hg, and heart rate was 72 beats/min. At the study end, mean office SBP/DBP was <140/90 mm Hg in 20 patients (66.7%). From baseline to study end, 24-hour ambulatory BP decreased significantly by 12 and 8 mm Hg for SBP and DBP, respectively (both, P = 0.001). The smoothness index was 0.92 for SBP and 0.82 for DBP. Fasting plasma glucose concentration decreased significantly from 110 to 104 mg/dL (P = 0.001). Total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol concentrations did not change significantly. From baseline to study end, there were no significant changes in LV structure or systolic function (LV mass, 50.7 vs 50.6 g/ht(2.7); LV diastolic/systolic diameters, 47.50/29.80 vs 48.40/30.76 mm; wall motion score index, 1.0 vs 1.0; ejection fraction, 61% vs 60%), while the peak E/A velocity ratio on TDI increased from 1.078 to 1.245 (P = 0.009). No AEs (including AEs reflected by chemistry values) either unrelated or related to treatment were noted during the 12-week duration of the study., Conclusions: In these hypertensive patients with MS, a 12-week treatment period with barnidipine in addition to lifestyle modifications was associated with significant reductions in 24-hour BP and BP variability, reduction in plasma glucose concentration, and improvement in LV diastolic relaxation. No significant changes in lipid concentrations, LV structure, or systolic function were found.

Published
2008
Full Text
View/download PDF

25. [Ambulatory blood pressure monitoring in clinical practice].

Author

Angeli F, Reboldi G, Repaci S, Garofoli M, Casavecchia M, Ambrosio G, and Verdecchia P

Subjects
Humans, Blood Pressure Monitoring, Ambulatory, Hypertension diagnosis
Abstract

Traditionally, diagnosis and management of arterial hypertension are based on blood pressure (BP) measurements taken in the physician's office. However, 24-h noninvasive ambulatory BP monitoring is increasingly used in patients with essential hypertension. Several prospective studies provided unequivocal evidence of an independent association between ambulatory BP and risk of cardiovascular disease in the general population and hypertensive patients. Ambulatory BP is a better predictor of cardiovascular morbidity and mortality than office BP after adjustment for traditional cardiovascular risk factors such as age, sex, smoking status, baseline office BP, and use of antihypertensive drugs. The more accurate prognostic value of ambulatory BP may be related to the closer association with hypertension-related organ damage such as left ventricular mass, intima-media thickness, and microalbuminuria. The superiority of ambulatory over clinic BP in predicting clinical outcome and the most appropriate way of interpreting results of ambulatory BP monitoring will be discussed in this review.

Published
2008

26. Prognostic value of circadian blood pressure changes in relation to differing measures of day and night.

Author

Verdecchia P, Angeli F, Borgioni C, Repaci S, Guerrieri M, Andreani F, Garofoli M, and Reboldi G

Abstract

Although the prognostic value of the day-night blood pressure (BP) changes is established, the most appropriate method for defining day and night is undefined. We assessed the prognostic value of the day-night BP changes by using three definitions of day and night in 2,934 initially untreated hypertensive subjects who underwent 24-hour ambulatory BP monitoring. Over a median follow-up period of 7 years, there were 356 cardiovascular events and 176 deaths. Total cardiovascular events and all-cause mortality were similarly higher in non-dippers (night/day ratio of systolic BP >10% or >0%) than in dippers regardless of the definition of day and night. In a receiver-operated characteristic (ROC) curve analysis of the night/day ratio of systolic BP on the occurrence of events, the area under the ROC curve did not differ among the different definitions of day and night (large fixed-clock intervals, narrow fixed-clock intervals, diary) for both total cardiovascular events (0.61 [95% confidence interval (CI): 0.58 to 0.64], 0.61 [95% CI: 0.57 to 0.63], 0.62 [95% CI: 0.58 to 0.65], respectively; P = 0.20) and all-cause mortality (0.65 [95% CI: 0.61 to 0.70], 0.64 [95% CI: 0.60 to 0.69], 0.65 [95% CI: 0.61 to 0.70], respectively; P = 0.78). The prognostic value of the diurnal BP changes is comparable when using different clock-dependent or independent definitions of day and night.

Published
2008
Full Text
View/download PDF

27. Validation of the A&D wrist-cuff UB-511 (UB-512) device for self-measurement of blood pressure.

Author

Angeli F, Sardone M, Angeli E, Repaci S, Gattobigio R, and Verdecchia P

Subjects
Adult, Aged, Female, Humans, Italy, Male, Middle Aged, Reproducibility of Results, Societies, Medical, United Kingdom, Wrist physiopathology, Blood Pressure Monitoring, Ambulatory instrumentation, Blood Pressure Monitors, Clinical Protocols, Hypertension physiopathology
Abstract

Objectives: To determine the accuracy of the A&D UB-511 (UB-512) oscillometric wrist-cuff device for self-measurement of blood pressure, the only difference between the two devices being the size of storage memory., Methods: Device evaluation was performed according to the modified British Hypertension Society protocol released in 1993. Eighty-five study participants with characteristics outlined in the British Hypertension Society protocol were recruited among those attending our out-patient clinic. The device was evaluated according to the various steps of the protocol. The non-dominant arm was used for blood pressure measurement. To maintain the wrist at cardiac level during validation, the arm was kept horizontal at the mid-sternum level and supported by a soft table. The wrist was kept extended. Sequential readings were taken for the main validation test. Outcome was classified according to the criteria of the British Hypertension Society recommendations, which are based on four strata of accuracy differing from the mercury standard by 5, 10 and 15 mmHg, or more., Results: The device achieved a British Hypertension Society grade B for systolic and a grade B for diastolic blood pressure. The device tended to overestimate arm blood pressure, the mean difference (+/-1 SD) between device and observers being 4.3+/-8.7 mmHg for systolic blood pressure and 3.7+/-8.1 mmHg for diastolic blood pressure for observer 2, and 4.4+/-8.6 mmHg for systolic blood pressure and 3.8+/-7.9 mmHg for diastolic blood pressure for observer 1. In a logistic regression analysis, age was the sole predictor of an achieved difference between device and mercury column by 5 mmHg or less (hazard ratio 1.020; 95% confidence interval 1.003-1.04; P=0.024)., Conclusions: These data show that the A&D UB-511 (UB-512) device satisfies the British Hypertension Society recommendations with a grade B/B. The device tends to overestimate cuff blood pressure and its accuracy increases with age.

Published
2006
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results