There is growing evidence that hypertension is the most important vascular risk factor for the de... more There is growing evidence that hypertension is the most important vascular risk factor for the development and progression of cardiovascular and cerebrovascular diseases. The brain is an early target of hypertension-induced organ damage and may manifest as stroke, subclinical cerebrovascular abnormalities and cognitive decline. The pathophysiological mechanisms of these harmful effects remain to be completely clarified. Hypertension is well known to alter the structure and function of cerebral blood vessels not only through its haemodynamics effects but also for its relationships with endothelial dysfunction, oxidative stress and inflammation. In the last several years, new possible mechanisms have been suggested to recognize the molecular basis of these pathological events. Accordingly, this review summarizes the factors involved in hypertension-induced brain complications, such as haemodynamic factors, endothelial dysfunction and oxidative stress, inflammation and intervention of ...
International angiology : a journal of the International Union of Angiology, 1993
Hypertension and obesity are associated with an increased risk of clinical cardiovascular complic... more Hypertension and obesity are associated with an increased risk of clinical cardiovascular complications due to atherosclerosis. Moreover has been reported that hypertension may predispose to atheroma development. In the present review some common aspects to hypertension and atherosclerosis including smooth muscle cell proliferation, endothelial damage and intervention of growth factors have been analyzed. Additional data have to be provided to explain if the connections between hypertension and atherosclerosis could be considered two effects with one unknown cause. In addition some aspects related to obesity and atherosclerosis have been dissected. In particular we have reported our results indicating that young obese subjects without risk factors for cardiovascular disease have already several markers of cardiovascular damage i.e. atherogenetic lipid pattern, pro-thrombotic and hypofibrinolitic pattern without sign of coagulation and/or platelet in vivo activation, increased plasma...
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1994
This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptors (BAR) den... more This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptors (BAR) density and their relationships with left ventricular function in young obese subjects. BAR density, plasma insulin, catecholamines and left ventricular function were evaluated in 27 young obese subjects (BMI > 30.5 kg/m2 for males and > 27.3 kg/m2 for females) without other risk factors for cardiovascular diseases (smoking, hypertension, diabetes and lipid abnormalities) and in 20 lean controls (BMI < 25 kg/m2 for males and < 24.7 kg/m2 for females). Both groups were matched for gender, age and body height. BAR density was evaluated according to Böyum and De Blasi methods. Plasma catecholamines by high perfusion liquid chromatography and fasting immunoreactive plasma insulin (IRI) levels by RIA were also measured. Casual (c) and 24 h ambulatory mean blood pressure (MBP/24h) were determined. Radionuclide angiocardiography was used to measure left ventricular ejection fraction (L...
In this study the efficacy and safety of long-term losartan administration on renal haemodynamics... more In this study the efficacy and safety of long-term losartan administration on renal haemodynamics were evaluated in mild to moderate hypertension. After a run-in period with placebo, 18 hypertensives without renal or cardiovascular disease were allocated to losartan (50 mg/die for one year) treatment. Renal haemodynamic measurements included renal plasma flow (ERPF) and glomerular filtration rate (GFR) by standardized radioisotope
Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive su... more Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive subjects: an Italian case-control study
G. AVELLONE, V. DI GARBO, V. GUARNOTTA, R. SCAGLIONE, G. PARRINELLO, L. PURPURA,D. TORRES, D. CAM... more G. AVELLONE, V. DI GARBO, V. GUARNOTTA, R. SCAGLIONE, G. PARRINELLO, L. PURPURA,D. TORRES, D. CAMPISIDepartment of Clinical Medicine, Lipid and Thrombosis Research Cente1; University of Palermo, Palermo, ItalyAim. Patients with heterozygous familial hypercholestero- CRP) were observed in both groups compared to baseline.lemia (FU) bave an increased risk of premature myocar- Also, triglyceride and fibrinogen levels were significantlydial infarction, stroke, and surgical revascularization, and (P<O.Ol) reduced, respectively by 26% and 15% comparedan increased rate of progression of carotid intima-media to baseline. The EZEJSIMVA association resulted in signi-thickness (IMT). The most commonly used drugs far cho- ficant increases in UDL-C (P<O.Ol) of 11% and in Apo-A1lesterol lowering, statins, bave a limited action in these (P<0.05) by 9% and in significant (P<O.OOl) reductions ofpatients. Ezetimibe, a Dovei compound, selectively inhibits the mean of the carotid IMT in bot...
AbstractLeft ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) ph... more AbstractLeft ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced (< 50%) EF (HFpEF and HFrEF, respectively), were enrolled. The mean follow-up period was of 25.4 months. Patients definitively analyzed were 135. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantly associated with all-cause mortality in HFpEF (HR 2.4, p = 0.04; HR 1.06, p = 0.02; HR 1.02, p = 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06, p = 0.006). Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15, p = 0.04) in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rank p = 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rank p = 0.0046, p = 0.033) in HFrEF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular volumetric remodeling and IVCd have a prognostic role in HFpEF as well as LAV in HFrEF. Our study suggests that besides EF, other echocardiographic parameters are helpful to optimize the phenotyping and prognostic stratification of HF.
There is growing evidence that hypertension is the most important vascular risk factor for the de... more There is growing evidence that hypertension is the most important vascular risk factor for the development and progression of cardiovascular and cerebrovascular diseases. The brain is an early target of hypertension-induced organ damage and may manifest as stroke, subclinical cerebrovascular abnormalities and cognitive decline. The pathophysiological mechanisms of these harmful effects remain to be completely clarified. Hypertension is well known to alter the structure and function of cerebral blood vessels not only through its haemodynamics effects but also for its relationships with endothelial dysfunction, oxidative stress and inflammation. In the last several years, new possible mechanisms have been suggested to recognize the molecular basis of these pathological events. Accordingly, this review summarizes the factors involved in hypertension-induced brain complications, such as haemodynamic factors, endothelial dysfunction and oxidative stress, inflammation and intervention of ...
International angiology : a journal of the International Union of Angiology, 1993
Hypertension and obesity are associated with an increased risk of clinical cardiovascular complic... more Hypertension and obesity are associated with an increased risk of clinical cardiovascular complications due to atherosclerosis. Moreover has been reported that hypertension may predispose to atheroma development. In the present review some common aspects to hypertension and atherosclerosis including smooth muscle cell proliferation, endothelial damage and intervention of growth factors have been analyzed. Additional data have to be provided to explain if the connections between hypertension and atherosclerosis could be considered two effects with one unknown cause. In addition some aspects related to obesity and atherosclerosis have been dissected. In particular we have reported our results indicating that young obese subjects without risk factors for cardiovascular disease have already several markers of cardiovascular damage i.e. atherogenetic lipid pattern, pro-thrombotic and hypofibrinolitic pattern without sign of coagulation and/or platelet in vivo activation, increased plasma...
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1994
This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptors (BAR) den... more This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptors (BAR) density and their relationships with left ventricular function in young obese subjects. BAR density, plasma insulin, catecholamines and left ventricular function were evaluated in 27 young obese subjects (BMI > 30.5 kg/m2 for males and > 27.3 kg/m2 for females) without other risk factors for cardiovascular diseases (smoking, hypertension, diabetes and lipid abnormalities) and in 20 lean controls (BMI < 25 kg/m2 for males and < 24.7 kg/m2 for females). Both groups were matched for gender, age and body height. BAR density was evaluated according to Böyum and De Blasi methods. Plasma catecholamines by high perfusion liquid chromatography and fasting immunoreactive plasma insulin (IRI) levels by RIA were also measured. Casual (c) and 24 h ambulatory mean blood pressure (MBP/24h) were determined. Radionuclide angiocardiography was used to measure left ventricular ejection fraction (L...
In this study the efficacy and safety of long-term losartan administration on renal haemodynamics... more In this study the efficacy and safety of long-term losartan administration on renal haemodynamics were evaluated in mild to moderate hypertension. After a run-in period with placebo, 18 hypertensives without renal or cardiovascular disease were allocated to losartan (50 mg/die for one year) treatment. Renal haemodynamic measurements included renal plasma flow (ERPF) and glomerular filtration rate (GFR) by standardized radioisotope
Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive su... more Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive subjects: an Italian case-control study
G. AVELLONE, V. DI GARBO, V. GUARNOTTA, R. SCAGLIONE, G. PARRINELLO, L. PURPURA,D. TORRES, D. CAM... more G. AVELLONE, V. DI GARBO, V. GUARNOTTA, R. SCAGLIONE, G. PARRINELLO, L. PURPURA,D. TORRES, D. CAMPISIDepartment of Clinical Medicine, Lipid and Thrombosis Research Cente1; University of Palermo, Palermo, ItalyAim. Patients with heterozygous familial hypercholestero- CRP) were observed in both groups compared to baseline.lemia (FU) bave an increased risk of premature myocar- Also, triglyceride and fibrinogen levels were significantlydial infarction, stroke, and surgical revascularization, and (P<O.Ol) reduced, respectively by 26% and 15% comparedan increased rate of progression of carotid intima-media to baseline. The EZEJSIMVA association resulted in signi-thickness (IMT). The most commonly used drugs far cho- ficant increases in UDL-C (P<O.Ol) of 11% and in Apo-A1lesterol lowering, statins, bave a limited action in these (P<0.05) by 9% and in significant (P<O.OOl) reductions ofpatients. Ezetimibe, a Dovei compound, selectively inhibits the mean of the carotid IMT in bot...
AbstractLeft ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) ph... more AbstractLeft ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced (< 50%) EF (HFpEF and HFrEF, respectively), were enrolled. The mean follow-up period was of 25.4 months. Patients definitively analyzed were 135. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantly associated with all-cause mortality in HFpEF (HR 2.4, p = 0.04; HR 1.06, p = 0.02; HR 1.02, p = 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06, p = 0.006). Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15, p = 0.04) in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rank p = 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rank p = 0.0046, p = 0.033) in HFrEF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular volumetric remodeling and IVCd have a prognostic role in HFpEF as well as LAV in HFrEF. Our study suggests that besides EF, other echocardiographic parameters are helpful to optimize the phenotyping and prognostic stratification of HF.
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