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Conte M, Poggio P, Monti M, Petraglia L, Cabaro S, Bruzzese D, Comentale G, Caruso A, Grimaldi M, Zampella E, Gencarelli A, Cervasio MR, Cozzolino F, Monaco V, Myasoedova V, Valerio V, Ferro A, Insabato L, Bellino M, Galasso G, Graziani F, Pucci P, Formisano P, Pilato E, Cuocolo A, Perrone Filardi P, Leosco D, Parisi V. Isolated Valve Amyloid Deposition in Aortic Stenosis: Potential Clinical and Pathophysiological Relevance. Int J Mol Sci 2024; 25:1171. [PMID: 38256243 PMCID: PMC10815971 DOI: 10.3390/ijms25021171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Amyloid deposition within stenotic aortic valves (AVs) also appears frequent in the absence of cardiac amyloidosis, but its clinical and pathophysiological relevance has not been investigated. We will elucidate the rate of isolated AV amyloid deposition and its potential clinical and pathophysiological significance in aortic stenosis (AS). In 130 patients without systemic and/or cardiac amyloidosis, we collected the explanted AVs during cardiac surgery: 57 patients with calcific AS and 73 patients with AV insufficiency (41 with AV sclerosis and 32 without, who were used as controls). Amyloid deposition was found in 21 AS valves (37%), 4 sclerotic AVs (10%), and none of the controls. Patients with and without isolated AV amyloid deposition had similar clinical and echocardiographic characteristics and survival rates. Isolated AV amyloid deposition was associated with higher degrees of AV fibrosis (p = 0.0082) and calcification (p < 0.0001). Immunohistochemistry analysis suggested serum amyloid A1 (SAA1), in addition to transthyretin (TTR), as the protein possibly involved in AV amyloid deposition. Circulating SAA1 levels were within the normal range in all groups, and no difference was observed in AS patients with and without AV amyloid deposition. In vitro, AV interstitial cells (VICs) were stimulated with interleukin (IL)-1β which induced increased SAA1-mRNA both in the control VICs (+6.4 ± 0.5, p = 0.02) and the AS VICs (+7.6 ± 0.5, p = 0.008). In conclusion, isolated AV amyloid deposition is frequent in the context of AS, but it does not appear to have potential clinical relevance. Conversely, amyloid deposition within AV leaflets, probably promoted by local inflammation, could play a role in AS pathophysiology.
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Affiliation(s)
- Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
- Casa di Cura San Michele, 81024 Caserta, Italy; (A.C.)
| | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (P.P.)
| | - Maria Monti
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
- CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Serena Cabaro
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, 5, 80131 Naples, Italy
| | - Giuseppe Comentale
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | | | | | - Emilia Zampella
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Annarita Gencarelli
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Maria Rosaria Cervasio
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Flora Cozzolino
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
- CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | - Vittoria Monaco
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
- CEINGE Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | | | | | - Adele Ferro
- Institute of Biostructure and Bioimaging, CNR, 80145 Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Michele Bellino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - Francesca Graziani
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Pietro Pucci
- Dipartimento di Scienze Chimiche, University of Naples Federico II, 5, 80131 Naples, Italy (F.C.); (V.M.)
| | - Pietro Formisano
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Emanuele Pilato
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Alberto Cuocolo
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Pasquale Perrone Filardi
- Department of Advanced Biomedical Science, University of Naples Federico II, 5, 80131 Naples, Italy (A.C.)
| | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
| | - Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5, 80131 Naples, Italy
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Conte M, Petraglia L, Cabaro S, Valerio V, Poggio P, Pilato E, Attena E, Russo V, Ferro A, Formisano P, Leosco D, Parisi V. Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation. Front Cardiovasc Med 2022; 9:932262. [PMID: 35845044 PMCID: PMC9280076 DOI: 10.3389/fcvm.2022.932262] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/13/2022] [Indexed: 01/02/2023] Open
Abstract
Atrial Fibrillation (AF) is the most frequent cardiac arrhythmia and its prevalence increases with age. AF is strongly associated with an increased risk of stroke, heart failure and cardiovascular mortality. Among the risk factors associated with AF onset and severity, obesity and inflammation play a prominent role. Numerous recent evidence suggested a role of epicardial adipose tissue (EAT), the visceral fat depot of the heart, in the development of AF. Several potential arrhythmogenic mechanisms have been attributed to EAT, including myocardial inflammation, fibrosis, oxidative stress, and fat infiltration. EAT is a local source of inflammatory mediators which potentially contribute to atrial collagen deposition and fibrosis, the anatomical substrate for AF. Moreover, the close proximity between EAT and myocardium allows the EAT to penetrate and generate atrial myocardium fat infiltrates that can alter atrial electrophysiological properties. These observations support the hypothesis of a strong implication of EAT in structural and electrical atrial remodeling, which underlies AF onset and burden. The measure of EAT, through different imaging methods, such as echocardiography, computed tomography and cardiac magnetic resonance, has been proposed as a useful prognostic tool to predict the presence, severity and recurrence of AF. Furthermore, EAT is increasingly emerging as a promising potential therapeutic target. This review aims to summarize the recent evidence exploring the potential role of EAT in the pathogenesis of AF, the main mechanisms by which EAT can promote structural and electrical atrial remodeling and the potential therapeutic strategies targeting the cardiac visceral fat.
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Affiliation(s)
- Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Serena Cabaro
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | | | - Emanuele Pilato
- Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy
| | - Emilio Attena
- Department of Cardiology, Monaldi Hospital, Naples, Italy
| | - Vincenzo Russo
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" - Monaldi and Cotugno Hospital, Naples, Italy
| | - Adele Ferro
- Institute of Biostructure and Bioimaging, Consiglio Nazionale delle Ricerche, Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
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Cabaro S, Conte M, Moschetta D, Petraglia L, Valerio V, Romano S, Di Tolla MF, Campana P, Comentale G, Pilato E, D’Esposito V, Di Mauro A, Cantile M, Poggio P, Parisi V, Leosco D, Formisano P. Epicardial Adipose Tissue-Derived IL-1β Triggers Postoperative Atrial Fibrillation. Front Cell Dev Biol 2022; 10:893729. [PMID: 35721500 PMCID: PMC9198900 DOI: 10.3389/fcell.2022.893729] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims: Post-operative atrial fibrillation (POAF), defined as new-onset AF in the immediate period after surgery, is associated with poor adverse cardiovascular events and a higher risk of permanent AF. Mechanisms leading to POAF are not completely understood and epicardial adipose tissue (EAT) inflammation could be a potent trigger. Here, we aim at exploring the link between EAT-secreted interleukin (IL)-1β, atrial remodeling, and POAF in a population of coronary artery disease (CAD) patients. Methods: We collected EAT and atrial biopsies from 40 CAD patients undergoing cardiac surgery. Serum samples and EAT-conditioned media were screened for IL-1β and IL-1ra. Atrial fibrosis was evaluated at histology. The potential role of NLRP3 inflammasome activation in promoting fibrosis was explored in vitro by exposing human atrial fibroblasts to IL-1β and IL-18. Results: 40% of patients developed POAF. Patients with and without POAF were homogeneous for clinical and echocardiographic parameters, including left atrial volume and EAT thickness. POAF was not associated with atrial fibrosis at histology. No significant difference was observed in serum IL-1β and IL-1ra levels between POAF and no-POAF patients. EAT-mediated IL-1β secretion and expression were significantly higher in the POAF group compared to the no-POAF group. The in vitro study showed that both IL-1β and IL-18 increase fibroblasts’ proliferation and collagen production. Moreover, the stimulated cells perpetuated inflammation and fibrosis by producing IL-1β and transforming growth factor (TGF)-β. Conclusion: EAT could exert a relevant role both in POAF occurrence and in atrial fibrotic remodeling.
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Affiliation(s)
- Serena Cabaro
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- URT Genomic of Diabetes, Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- Casa di Cura San Michele, Maddaloni, Italy
| | - Donato Moschetta
- Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Serena Romano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- URT Genomic of Diabetes, Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Michele Francesco Di Tolla
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- URT Genomic of Diabetes, Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Pasquale Campana
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Comentale
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Emanuele Pilato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Vittoria D’Esposito
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- URT Genomic of Diabetes, Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Annabella Di Mauro
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- Pathology Unit, INT-IRCCS Fondazione Pascale, Naples, Italy
| | - Monica Cantile
- Pathology Unit, INT-IRCCS Fondazione Pascale, Naples, Italy
| | - Paolo Poggio
- Centro Cardiologico Monzino IRCCS, Milan, Italy
- *Correspondence: Paolo Poggio, ; Valentina Parisi, ,
| | - Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- *Correspondence: Paolo Poggio, ; Valentina Parisi, ,
| | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- URT Genomic of Diabetes, Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
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Myasoedova VA, Conte M, Valerio V, Moschetta D, Massaiu I, Petraglia L, Leosco D, Poggio P, Parisi V. Red Flags, Prognostic Impact, and Management of Patients With Cardiac Amyloidosis and Aortic Valve Stenosis: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:858281. [PMID: 35355593 PMCID: PMC8959832 DOI: 10.3389/fmed.2022.858281] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cardiac amyloidosis (CA) has been recently recognized as a condition frequently associated with aortic stenosis (AS). The aim of this study was to evaluate: the main characteristics of patients with AS with and without CA, the impact of CA on patients with AS mortality, and the effect of different treatment strategies on outcomes of patients with AS with concomitant CA. Materials and Methods A detailed search related to CA in patients with AS and outcomes was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seventeen studies enrolling 1,988 subjects (1,658 AS alone and 330 AS with CA) were included in the qualitative and quantitative analysis of main patients with AS characteristics with and without CA, difference in mortality, and treatment strategy. Results The prevalence of CA resulted in a mean of 15.4% and it was even higher in patients with AS over 80 years old (18.2%). Patients with the dual diagnosis were more often males, had lower body mass index (BMI), were more prone to have low flow, low gradient with reduced left ventricular ejection fraction AS phenotype, had higher E/A and E/e', and greater interventricular septum hypertrophy. Lower Sokolow–Lyon index, higher QRS duration, higher prevalence of right bundle branch block, higher levels of N-terminal pro-brain natriuretic peptide, and high-sensitivity troponin T were significantly associated with CA in patients with AS. Higher overall mortality in the 178 patients with AS + CA in comparison to 1,220 patients with AS alone was observed [odds ratio (OR) 2.25, p = 0.004]. Meta-regression analysis showed that younger age and diabetes were associated with overall mortality in patients with CS with CA (Z-value −3.0, p = 0.003 and Z-value 2.5, p = 0.013, respectively). Finally, patients who underwent surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) had a similar overall mortality risk, but lower than medication-treated only patients. Conclusion Results from our meta-analysis suggest that several specific clinical, electrocardiographic, and echocardiographic features can be considered “red flags” of CA in patients with AS. CA negatively affects the outcome of patients with AS. Patients with concomitant CA and AS benefit from SAVR or TAVI.
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Affiliation(s)
- Veronika A Myasoedova
- Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Maddalena Conte
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Vincenza Valerio
- Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Donato Moschetta
- Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.,Dipartimento di Scienze farmacologiche e biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Ilaria Massaiu
- Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.,Developmental Biology of the Immune System, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany
| | - Laura Petraglia
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Dario Leosco
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Paolo Poggio
- Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Valentina Parisi
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
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Conte M, Petraglia L, Poggio P, Valerio V, Cabaro S, Campana P, Comentale G, Attena E, Russo V, Pilato E, Formisano P, Leosco D, Parisi V. Inflammation and Cardiovascular Diseases in the Elderly: The Role of Epicardial Adipose Tissue. Front Med (Lausanne) 2022; 9:844266. [PMID: 35242789 PMCID: PMC8887867 DOI: 10.3389/fmed.2022.844266] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/13/2022] [Indexed: 01/08/2023] Open
Abstract
Human aging is a complex phenomenon characterized by a wide spectrum of biological changes which impact on behavioral and social aspects. Age-related changes are accompanied by a decline in biological function and increased vulnerability leading to frailty, thereby advanced age is identified among the major risk factors of the main chronic human diseases. Aging is characterized by a state of chronic low-grade inflammation, also referred as inflammaging. It recognizes a multifactorial pathogenesis with a prominent role of the innate immune system activation, resulting in tissue degeneration and contributing to adverse outcomes. It is widely recognized that inflammation plays a central role in the development and progression of numerous chronic and cardiovascular diseases. In particular, low-grade inflammation, through an increased risk of atherosclerosis and insulin resistance, promote cardiovascular diseases in the elderly. Low-grade inflammation is also promoted by visceral adiposity, whose accumulation is paralleled by an increased inflammatory status. Aging is associated to increase in epicardial adipose tissue (EAT), the visceral fat depot of the heart. Structural and functional changes in EAT have been shown to be associated with several heart diseases, including coronary artery disease, aortic stenosis, atrial fibrillation, and heart failure. EAT increase is associated with a greater production and secretion of pro-inflammatory mediators and neuro-hormones, so that thickened EAT can pathologically influence, in a paracrine and vasocrine manner, the structure and function of the heart and is associated to a worse cardiovascular outcome. In this review, we will discuss the evidence underlying the interplay between inflammaging, EAT accumulation and cardiovascular diseases. We will examine and discuss the importance of EAT quantification, its characteristics and changes with age and its clinical implication.
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Affiliation(s)
- Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | | | - Serena Cabaro
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Pasquale Campana
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Comentale
- Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy
| | - Emilio Attena
- Department of Cardiology, Monaldi Hospital, Naples, Italy
| | - Vincenzo Russo
- Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Campania, Italy
| | - Emanuele Pilato
- Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
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6
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Conte M, Monti M, Poggio P, Petraglia L, Cabaro S, Bruzzese D, Campana P, Comentale G, Caruso A, Grimaldi MG, Zampella E, Cozzolino F, Monaco V, Myasoedova VV, Valerio V, Ferro A, Bellino M, Galasso G, Pucci P, Formisano P, Pilato E, Cuocolo A. ISOLATED VALVE AMYLOIDOSIS IN AORTIC STENOSIS: A NEW CLINICAL SCENARIO? J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)04467-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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7
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Petraglia L, Conte M, Comentale G, Cabaro S, Campana P, Russo C, Amaranto I, Bruzzese D, Formisano P, Pilato E, Ferrara N, Leosco D, Parisi V. Epicardial Adipose Tissue and Postoperative Atrial Fibrillation. Front Cardiovasc Med 2022; 9:810334. [PMID: 35187125 PMCID: PMC8854347 DOI: 10.3389/fcvm.2022.810334] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Atrial fibrillation (AF) often occurs after cardiac surgery and is associated with increased risk of stroke and mortality. Prior studies support the important role of inflammation in the pathogenesis of postoperative atrial fibrillation (POAF). It is known that an increased volume and a pro-inflammatory phenotype of epicardial adipose tissue (EAT) are both associated with AF onset in non surgical context. In the present study, we aim to evaluate whether also POAF occurrence may be triggered by an increased production of inflammatory mediators from EAT. Methods The study population was composed of 105 patients, with no history of paroxysmal or permanent AF, undergoing elective cardiac surgery. After clinical evaluation, all patients performed an echocardiographic study including the measurement of EAT thickness. Serum samples and EAT biopsies were collected before surgery. Levels of 10 inflammatory cytokines were measured in serum and EAT conditioned media. After surgery, cardiac rhythm was monitored for 7 days. Results Forty-four patients (41.3%) developed POAF. As regard to cardiovascular therapy, only statin use was significantly lower in POAF patients (65.1% vs. 84.7%; p-0.032). Levels of Monocyte Chemoattractant Protein-1 (MCP-1), in both serum and EAT, were significantly higher in POAF patients (130.1 pg/ml vs. 68.7 pg/ml; p = <0.001; 322.4 pg/ml vs. 153.4 pg/ml; p = 0.028 respectively). EAT levels of IL-6 were significantly increased in POAF patients compared to those in sinus rhythm (SR) (126.3 pg/ml vs. 23 pg/ml; p = <0.005). Conclusion Higher EAT levels of IL-6 and MCP-1 are significantly associated with the occurrence of POAF. Statin therapy seems to play a role in preventing POAF. These results might pave the way for a targeted use of these drugs in the perioperative period.
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Affiliation(s)
- Laura Petraglia
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Maddalena Conte
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
- Clinica San Michele, Maddaloni, Italy
| | - Giuseppe Comentale
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Serena Cabaro
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Pasquale Campana
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Carmela Russo
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Ilaria Amaranto
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Pietro Formisano
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Emanuele Pilato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Nicola Ferrara
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
| | - Dario Leosco
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
- *Correspondence: Dario Leosco
| | - Valentina Parisi
- Department of Translational Medicine, University of Naples Federico II, Naples, Italy
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8
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Campana P, Palaia ME, Conte M, Petraglia L, Ferrante L, Dario L, Parisi V. 317 Aldosterone and interleukin-6: the synergic effect in COVID-19. Eur Heart J Suppl 2021. [PMCID: PMC8689823 DOI: 10.1093/eurheartj/suab135.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aims
Several evidence have identified the role of Interleukin-6 (IL-6) in the cytokine storm induced by COVID-19. Interestingly, the correlation between the serum levels of IL-6 and the plasma aldosterone has already been demonstrated in patients affected by primary aldosteronism (PA). Thus, we suppose that hyperaldosteronism may increase IL-6 levels in COVID-19.
Methods and results
We report a case of 47-year-old female Covid-19 patient who had developed severe pneumonia complicated by Guillain–Barreé syndrome (GBS). Blood test revealed high levels of IL-6 (serum IL-6: 402 pg/ml) and of its soluble receptor (soluble IL-6 receptor >1900 pg/ml) and she required mechanical ventilation for severe hypoxaemia. Furthermore, the evidence of right adrenal adenoma, resistant hypertension, severe hypokalaemia, and high serum levels of aldosterone with high aldosterone/renin ratio were also consistent with diagnosis of PA. Thus, Spironolactone was administered with rapid improvements in clinical condition. Finally, she was diagnosed with acute motor sensitive neuropathy and started the rehabilitation phase.
Conclusions
Elevated aldosterone levels in PA may stimulate IL-6 production, inducing more severe forms of COVID-19 with the development of serious complications such as GBS. Hyperaldosteronism may also contribute to the poorest prognosis of patients with secondary aldosteronism such as heart failure and COVID-19, in which elevated IL-6 levels could exert its detrimental effects, mostly on the progression of ventricular dysfunction. Further studies are necessary to evaluate therapy with mineralocorticoid receptors antagonists such as spironolactone in COVID-19.
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Affiliation(s)
| | | | | | | | | | - Leosco Dario
- Università degli Studi di Napoli Federico II, Italy
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9
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Campana P, Conte M, Palaia ME, Petraglia L, Ferro A, Comentale G, Pilato E, Leosco D, Parisi V. 315 Cardiac surgery in the elderly: the underestimate role of frailty in the decision making. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab147.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Elders represent the most common population with indication to cardiac surgery, also presenting the highest mortality/disability after interventions. Both for valve and coronary artery surgery the estimation of the surgical risk, including the frailty assessment, is recommended to guide the decision making. However, frailty results not exhaustively assessed by the commonly used surgical risk scores such as EuroSCORE I-II and score of the Society of Thoracic Surgeons and is mostly used the Kat’s Index (included in the latest European guidelines). This study aims at establishing the feasibility and the value of a Comprehensive Geriatric Assessment (CGA) in elderly undergoing cardiac surgery.
Methods
From June 2021we consecutively enrolled 50 elderly patients undergoing cardiac surgery (age > 65 years old). All patients underwent CGA with an expert geriatrician and the demographic, biometrics, clinical and echocardiographic data were collected. We evaluated frailty and disability (Kats index, Barthel Index and Frailty Index FI), cognitive status (Montreal Cognitive Assessment MOCA, Mini Mental State Examination MMSE and Geriatric Depression Scale), physical status (Tinetti test, Short Performance Physical Battery SPPB, Physical Activity Scale for the Elderly PASE and 6-min Walking test), delirium condition, sarcopenia and nutritional status (Mini-Nutritional Assessment MNA). A clinical, echocardiographic, and geriatric 3-month follow-up is planned. In particular, we are evaluating the impact of frailty, assessed by CGA, on peri-surgical outcome and the potential additive value of a CGA on the commonly used surgical risk-scores and Kat’s Index. Furthermore, we are assessing the impact of cardiac surgery of frail elderly at GCA.
Results
The CGA was feasible in all patients and lasted 1 h/patient. In our baseline data, only 23% of the enrolled patients resulted ‘frail’ according to Kat’s Index. However, in the remaining 77% of the study population, the CGA have identified 30% of patients with increased frailty index and 30% with disability, assessed by Barthel Index and physical function indexes (PASE and SPPB). In these patient, frailty and disability were associated to impaired nutritional status, assessed at MNA. Furthermore, 40% of the patients of this group resulted sarcopenic at the hand grip test. The cognitive valuation has shown a cognitive impairment in the 20% of patients at the MMSE and the 70 % at the MOCA. Of note, the 40% of the patients resulted to suffer of depression, not diagnosed before the GCA. At mid-November 2021 the follow-up will be completed.
Conclusions
The preliminary results of the presents study suggest that in patients undergoing cardiac surgery frailty is currently underdiagnosed. The follow-up analysis will establish if a CGA has an additive value on common surgical risk estimators. This study has a potential impact on the risk stratification of elderly patients undergoing invasive procedures and defines the need of a geriatrician in the heart team.
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Affiliation(s)
| | | | | | | | - Adele Ferro
- Institute of Biostructure and Bioimaging, CNR, Naples
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10
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Campana P, Palaia ME, Conte M, Cante T, Petraglia L, Femminella GD, Parisi V, Leosco D. The elderly at risk: aldosterone as modulator of the immune response to SARS-CoV-2 infection. GeroScience 2021; 44:567-572. [PMID: 34741250 PMCID: PMC8570771 DOI: 10.1007/s11357-021-00481-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/25/2021] [Indexed: 12/12/2022] Open
Abstract
The elderly population is the most susceptible to SARS-CoV-2 infection and develops the worst clinical phenotype with severe pneumonia and cardiac complications. Older COVID-19 patients are also at higher risk of sudden death, mainly attributable to electrolyte disorders and to an uncontrolled inflammatory response. After the identification of ACE 2 as the receptor of SARS-CoV-2 in human cells, several research studies have focused on the role of the activation of Renin Angiotensin System in COVID-19 clinical course. In the present opinion paper, we discuss the role of hyperaldosteronism in the increasing risk of cardiac complications in COVID-19 older patients. In particular, we focus on the immunoregulatory activity of aldosterone, as the last mediator of the Renin Angiotensin System cascade, in activating the innate and adaptive immune response related to SARS-CoV-2 infection in the elderly. Aldosterone may stimulate dendritic cells and the recruitment of monocytes/macrophages in the endothelium of coronary vessels, favoring the production of pro-inflammatory mediators and T-cells response. Higher basal levels of aldosterone together with SARS-CoV-2-induced production may explain the unfavorable course of COVID-19 in the elderly.
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Affiliation(s)
- Pasquale Campana
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Maria Emiliana Palaia
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Teresa Cante
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Grazia Daniela Femminella
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Valentina Parisi
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Dario Leosco
- Department of Translational Medical Sciences, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
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11
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Conte M, Petraglia L, Campana P, Gerundo G, Caruso A, Grimaldi MG, Russo V, Attena E, Leosco D, Parisi V. The role of inflammation and metabolic risk factors in the pathogenesis of calcific aortic valve stenosis. Aging Clin Exp Res 2021; 33:1765-1770. [PMID: 32978752 PMCID: PMC8249252 DOI: 10.1007/s40520-020-01681-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/08/2020] [Indexed: 12/17/2022]
Abstract
Given the epidemiologic increase of aged population in the world, aortic stenosis (AS) represents now the most common valvular heart disease in industrialized countries. It is a very challenging disease, representing an important cause of morbidity, hospitalization and death in the elderly population. It is widely recognized that AS is the result of a very complex active process, driven by inflammation and involving multifactorial pathological mechanisms promoting valvular calcification and valvular bone deposition. Several evidence suggest that epicardial adipose tissue (EAT), the visceral fat depot of the heart, represents a direct source of cytokines and could mediate the deleterious effects of systemic inflammation on the myocardium. Importantly, obesity and metabolic disorders are associated with chronic systemic inflammation leading to a significant increase of EAT amount and to a pro-inflammatory phenotypic shift of this fat depot. It has been hypothesized that the EAT inflammatory state can influence the structure and function of the heart, thus contributing to the pathogenesis of several cardiac diseases, including calcific AS. The current review will discuss the recently discovered mechanisms involved in the pathogenesis of AS, with particular attention to the role of inflammation, metabolic risk factors and pro-fibrotic and pro-osteogenic signal pathways promoting the onset and progression of the disease. Moreover, it will be explored the potential role of EAT in the AS pathophysiology.
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Affiliation(s)
- Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini 5, 8031, Naples, Italy
- Casa di Cura San Michele, Maddaloni, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini 5, 8031, Naples, Italy
| | - Pasquale Campana
- Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini 5, 8031, Naples, Italy
| | - Gerardo Gerundo
- Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini 5, 8031, Naples, Italy
| | | | | | | | | | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini 5, 8031, Naples, Italy.
- Casa di Cura San Michele, Maddaloni, Italy.
| | - Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini 5, 8031, Naples, Italy
- Casa di Cura San Michele, Maddaloni, Italy
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12
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Petraglia L, Conte M, Cabaro S, Campana P, Comentale G, Pilato E, Bruzzese D, Leosco D, Parisi V. EPICARDIAL ADIPOSE TISSUE LEVELS OF PRO-INFLAMMATORY CYTOKINES IN THE ONSET OF PERI-OPERATIVE ATRIAL FIBRILLATION/THE POTENTIAL ROLE OF INTERLEUKIN-6. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01612-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Parisi V, Cabaro S, D'Esposito V, Petraglia L, Conte M, Gerundo G, Campana P, Caruso A, Grimaldi M, Pilato E, Comentale G, Leosco D. Impact of epicardial adipose tissue increase after ST elevation Myocardial Infarction (STEMI) on IL-13 and left ventricular remodelling. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The role of epicardial adipose tissue (EAT) in myocardial diseases is well established, and several evidence suggest that EAT may negatively affect left ventricular (LV) remodelling through an imbalanced production and secretion of pro and anti-inflammatory cytokines. Of these, the IL-13 it is known to play a positive activity on cardiac remodelling. Nowadays, the crosstalk between EAT and the myocardium is still poorly understood and the effects of myocardial ischemia on morphological and functional properties of EAT are almost unknown.
Purpose
In the present study we explored whether an increase of EAT thickness after STEMI might be associated with unfavourable LV remodelling at 3 months (T1). We also evaluated the relationship between changes (Δ) of EAT thickness and systemic levels of Interleukin (IL)-13 which is known to play a favourable activity on LV remodelling after STEMI.
Methods
We enrolled 66 patients with first STEMI, undergoing primary percutaneous angioplasty. At baseline and at 3 months we performed a complete echocardiogram, including EAT maximal thickness assessment, and determined circulating levels of IL-13.
Results
At 3 months after STEMI, the population was stratified into two groups according to different EAT remodelling after cardiac event: Group 1, patients with an increased EAT thickness (Δ EAT>1; 30 patients) and Group 2, patients with unchanged or decreased EAT thickness (Δ EAT<1). The two groups did not differ for age, gender and atherosclerotic risk factors. Group 1 had a worse LV remodelling at 3 months with higher LV diastolic and systolic volumes, lower LV ejection fraction (p=0.003; p=0.013; p=0.013 respectively) and worse diastolic function (E/e'; p=0.011). Of interest, EAT thickness increase was paralleled by circulating IL-13 reduction (p=0.022).
Conclusion
Myocardial injury can result in EAT increase which is associated to worse LV remodelling probably through the loss of the protective role of IL-13.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This research has been funded by the University of Naples “Federico II” and “Compagnia di San Paolo e l'Istituto Banco di Napoli” within the competitive grant STAR 2018; Valentina Parisi is the principal investigator
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Affiliation(s)
- V Parisi
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - S Cabaro
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - V D'Esposito
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - L Petraglia
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - M Conte
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - G Gerundo
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - P Campana
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
| | - A Caruso
- Casa di cura San Michele, Maddaloni, Italy
| | | | - E Pilato
- Federico II University of Naples, Division of Cardiac Surgery, Naples, Italy
| | - G Comentale
- Federico II University of Naples, Division of Cardiac Surgery, Naples, Italy
| | - D Leosco
- University of Naples Federico II, Department of Translational Medical Sciences, Naples, Italy
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14
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Parisi V, Cabaro S, D'Esposito V, Petraglia L, Conte M, Campana P, Gerundo G, Abitabile M, Tuccillo A, Accadia M, Comentale G, Pilato E, Sansone M, Leosco D, Formisano P. Epicardial Adipose Tissue and IL-13 Response to Myocardial Injury Drives Left Ventricular Remodeling After ST Elevation Myocardial Infarction. Front Physiol 2020; 11:575181. [PMID: 33178043 PMCID: PMC7593695 DOI: 10.3389/fphys.2020.575181] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/22/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Left ventricular (LV) remodeling after ST-segment elevation myocardial infarction (STEMI) is explained only in part by the infarct size, and the inter-patient variability may be ascribed to different inflammatory response to myocardial injury. Epicardial adipose tissue (EAT) is a source of inflammatory mediators which directly modulates the myocardium. EAT increase is associated to several cardiovascular diseases; however, its response to myocardial injury is currently unknown. Among inflammatory mediators, IL-13 seems to play protective role in LV regeneration, but its variations after STEMI have not been described yet. Purpose: In the present study we analyzed the association between infarct-related changes of EAT and IL-13 in post-STEMI LV remodeling. Methods We enrolled 100 patients with STEMI undergoing primary angioplasty. At the enrolment (T0) and after 3 months (T1), we measured EAT thickness by echocardiography and circulating levels of IL-13 by ELISA. Results At T1, the 60% of patients displayed increased EAT thickness (ΔEAT > 0). ΔEAT was directly associated to LV end-diastolic volume (r = 0.42; p = 0.014), LV end-systolic volume (r = 0.42; p = 0.013) and worse LV ejection fraction (LVEF) at T1 (r = −0.44; p = 0.0094), independently of the infarct size. In the overall population IL-13 levels significantly decreased at T1 (p = 0.0002). The ΔIL-13 was directly associated to ΔLVEF (r = 0.42; p = 0.017) and inversely related to ΔEAT (r = −0.51; p = 0.022), thus suggesting a protective role for IL-13. Conclusion The variability of STEMI-induced “inflammatory response” may be associated to the post-infarct LV remodeling. ΔEAT thickness and ΔIL-13 levels could be novel prognostic markers in STEMI patients.
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Affiliation(s)
- Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Serena Cabaro
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Vittoria D'Esposito
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Pasquale Campana
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Gerardo Gerundo
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | | | - Maria Accadia
- Department of Cardiology, Ospedale del Mare, Naples, Italy
| | - Giuseppe Comentale
- Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy
| | - Emanuele Pilato
- Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy
| | - Mario Sansone
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
| | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,Casa di Cura San Michele, Maddaloni, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.,URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
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15
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Campana P, Petraglia L, Leosco D, Conte M, Grieco FV, Perrotta G, Prastaro M, Franzone A, Abete P, Parisi V. Infectious endocarditis after transcatheter aortic valve implantation in a patient on oral therapy with glucocorticoids. Aging Clin Exp Res 2020; 32:539-541. [PMID: 31728844 DOI: 10.1007/s40520-019-01401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
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16
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Parisi V, Petraglia L, Cabaro S, D'Esposito V, Bruzzese D, Ferraro G, Urbani A, Grieco FV, Conte M, Caruso A, Grimaldi MG, de Bellis A, Severino S, Campana P, Pilato E, Comentale G, Raia M, Scalia G, Castaldo G, Formisano P, Leosco D. Imbalance Between Interleukin-1β and Interleukin-1 Receptor Antagonist in Epicardial Adipose Tissue Is Associated With Non ST-Segment Elevation Acute Coronary Syndrome. Front Physiol 2020; 11:42. [PMID: 32116755 PMCID: PMC7012938 DOI: 10.3389/fphys.2020.00042] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 01/20/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Interleukin-1beta (IL-1β) is crucially involved in the pathogenesis of coronary atherosclerotic diseases (CAD) and its inhibition has proven cardiovascular benefits. Epicardial adipose tissue (EAT) is a local source of inflammatory mediators which may negatively affect the surrounding coronary arteries. In the present study, we explored the relationship between serum and EAT levels of IL-1β and IL-1 receptor antagonist (IL-1ra) in patients with chronic coronary syndrome (CCS) and recent acute coronary syndrome (ACS). Methods We obtained EAT biopsies in 54 CCS (Group 1) and 33 ACS (Group 2) patients undergoing coronary artery bypass grafting. Serum and EAT levels of IL-1β and IL-1ra were measured in all patients. An immunophenotypic study was carried out on EAT biopsies and the CD86 events were studied as markers of M1 macrophages. Results Circulating levels of IL-1β were significantly higher in the overall CAD population compared to a control group [7.64 pg/ml (6.86; 8.57) vs. 1.89 pg/ml (1.81; 2.29); p < 0.001]. In contrast, no differences were observed for serum IL-1ra levels between CAD and controls. Comparable levels of serum IL-1β were found between Groups 1 and 2 [7.6 pg/ml (6.9; 8.7) vs. 7.9 pg/ml (7.2; 8.6); p = 0.618]. In contrast, significantly lower levels of serum IL-1ra were found in Group 2 compared to Group 1 [274 pg/ml (220; 577) vs. 603 pg/ml (334; 1022); p = 0.035]. No differences of EAT levels of IL-1β were found between Group 2 and Group 1 [3.4 pg/ml (2.3; 8.4) vs. 2.4 pg/ml (1.9; 8.0); p = 0.176]. In contrast, significantly lower EAT levels of IL-1ra were found in Group 2 compared to Group 1 [101 pg/ml (40; 577) vs. 1344 pg/ml (155; 5327); p = 0.002]. No correlation was found between EAT levels of IL-1β and CD86 and CD64 events. Conclusion The present study explores the levels of IL-1β and IL-1ra in the serum and in EAT of CCS and ACS patients. ACS seems to be associated to a loss of the counter-regulatory activity of IL-1ra against the pro-inflammatory effects related to IL-1β activation.
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Affiliation(s)
- Valentina Parisi
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Serena Cabaro
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Vittoria D'Esposito
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giusy Ferraro
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Andrea Urbani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | | | - Maddalena Conte
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | | | | | | | | | - Pasquale Campana
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Emanuele Pilato
- DAI Emergenze Cardiovascolari, Medicina Clinica e dell'Invecchiamento, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Giuseppe Comentale
- DAI Emergenze Cardiovascolari, Medicina Clinica e dell'Invecchiamento, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Maddalena Raia
- Ceinge Biotecnologie Avanzate s.c. a r.l., Naples, Italy
| | - Giulia Scalia
- Ceinge Biotecnologie Avanzate s.c. a r.l., Naples, Italy
| | - Giuseppe Castaldo
- Ceinge Biotecnologie Avanzate s.c. a r.l., Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy
| | - Dario Leosco
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
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17
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Parisi V, Conte M, Petraglia L, Grieco FV, Bruzzese D, Caruso A, Grimaldi MG, Campana P, Gargiulo P, Paolillo S, Attena E, Russo V, Galasso G, Rapacciuolo A, Perrone Filardi P, Leosco D. Echocardiographic Epicardial Adipose Tissue Thickness for Risk Stratification of Patients With Heart Failure. Front Physiol 2020; 11:43. [PMID: 32116756 PMCID: PMC7013047 DOI: 10.3389/fphys.2020.00043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 01/20/2020] [Indexed: 11/29/2022] Open
Abstract
Background and Aims Epicardial adipose tissue (EAT) has been shown to be involved in the pathogenesis and progression of heart failure (HF). In this study we aimed to explore the predictive value of echocardiographic EAT thickness on prognosis of a selected population of HF patients. Methods The patient population included n. 69 consecutive patients with systolic HF referred to implantable cardioverter defibrillator (ICD) implantation for primary or secondary prevention. At the time of enrolment, echocardiographic EAT thickness was assessed in all patients along with demographic and clinical data. The study had a median follow-up time of 49.8 months. We assessed the prognostic predictive value of EAT thickness on a composite clinical and arrhythmic outcome including HF related deaths, new hospital admissions for HF worsening, and atrial and life threatening ventricular arrhythmic events. Clinical and arrhythmic outcomes were also evaluated separately. Results At univariate analysis, EAT thickness significantly predicted all the three outcomes considered. Of interest, at multivariate analysis, after adjusting for known risk factor, EAT remained significantly associated to the composite [HR 1.18 (1.09–1.28); p < 0.001], arrhythmic [HR 1.14 (1.03–1.25); p = 0.008], and clinical [HR 1.14 (1.03–1.27); p = 0.010] outcomes. Conclusion Echocardiographic assessment of EAT can predict outcome of HF patients and it is significantly associated with both arrhythmic and clinical events. These preliminary findings pave the way for future and larger studies aimed to definitively recognize the prognostic value of this novel risk marker in HF.
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Affiliation(s)
- Valentina Parisi
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Aurelio Caruso
- Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni, Italy
| | | | - Pasquale Campana
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Paola Gargiulo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Emilio Attena
- Department of Cardiology, San Giuliano Hospital, Giugliano in Campania, Italy
| | - Vincenzo Russo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy
| | - Gennaro Galasso
- Department of Cardiology, San Giovanni di Dio e Ruggi d'Aragona Hospital, Salerno, Italy
| | - Antonio Rapacciuolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Dario Leosco
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
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18
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Parisi V, Petraglia L, Formisano R, Caruso A, Grimaldi MG, Bruzzese D, Grieco FV, Conte M, Paolillo S, Scatteia A, Dellegrottaglie S, Iavazzo A, Campana P, Pilato E, Lancellotti P, Russo V, Attena E, Filardi PP, Leosco D. Validation of the echocardiographic assessment of epicardial adipose tissue thickness at the Rindfleisch fold for the prediction of coronary artery disease. Nutr Metab Cardiovasc Dis 2020; 30:99-105. [PMID: 31648886 DOI: 10.1016/j.numecd.2019.08.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/09/2019] [Accepted: 08/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Echocardiography is a promising technique for the assessment of epicardial adipose tissue (EAT). Increased EAT thickness is associated with different cardiac diseases, including; coronary artery disease (CAD). Since several different echocardiographic approaches have been proposed to measure EAT, the identification of a standardized method is needed. We propose the assessment of EAT maximal thickness at the Rindfleisch fold, the reproducibility of this measurement and its correlation with EAT thickness and volume assessed at cardiac magnetic resonance (CMR). Finally, we will test the predictive role of this measurement on the presence of significant CAD. METHODS AND RESULTS In 1061 patients undergoing echocardiography, EAT thickness was measured at the level of the Rindfleisch fold. In 70 patients, we tested the relationship between echo-EAT thickness and EAT thickness and volume assessed at CMR. In 499 patients with suspected CAD, undergoing coronary artery angiography, we tested the predictive value of EAT on the presence of significant CAD. Echo-EAT thickness measurements had an excellent reliability as indicated by the inter-observer (ICC:0.97; 95% C.I. 0.96 to 0.98) and intra-observer (ICC:0.99; 95% C.I. 0.98 to 0.99) reliability rates. Echo-EAT thickness significantly correlated with CMR-EAT thickness and volume (p < 0.001). An EAT thickness value >10 mm discriminated patients with significant CAD at coronary angiography (p < 0.001). At multivariable analysis, including demographic data and cardiovascular risk factors, EAT thickness was an independent predictor of significant CAD and showed an additive predictive value over common atherosclerotic risk factors. CONCLUSIONS Echocardiographic assessment of EAT thickness at the level of the Rindfleisch fold represents a simple and trustworthy method. An increased EAT thickness shows an additive predictive value on CAD over common atherosclerotic risk factors, thus suggesting its potential clinical use for CAD risk stratification.
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Affiliation(s)
- Valentina Parisi
- Department of Translational Medical Sciences, University Federico II, Naples, Italy; Italian Society of Gerontology and Geriatrics, Italy.
| | - Laura Petraglia
- Department of Translational Medical Sciences, University Federico II, Naples, Italy; Italian Society of Gerontology and Geriatrics, Italy
| | | | | | | | - Dario Bruzzese
- Department of Public Health, University Federico II, Naples, Italy
| | - Fabrizio V Grieco
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Stefania Paolillo
- Italy SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
| | | | | | - Annarita Iavazzo
- Dipartimento di Scienze, Biomediche Avanzate, University Federico II, Naples, Italy
| | - Pasquale Campana
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Emanuele Pilato
- Dipartimento di Emergenze Cardiovascolari, Medicina Clinica e dell'Invecchiamento, University Federico II, Naples, Italy
| | - Patrizio Lancellotti
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium; Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Vincenzo Russo
- University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy
| | | | - Pasquale P Filardi
- Dipartimento di Scienze, Biomediche Avanzate, University Federico II, Naples, Italy
| | - Dario Leosco
- Department of Translational Medical Sciences, University Federico II, Naples, Italy; Italian Society of Gerontology and Geriatrics, Italy
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19
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de Lucia C, Gambino G, Petraglia L, Elia A, Komici K, Femminella GD, D'Amico ML, Formisano R, Borghetti G, Liccardo D, Nolano M, Houser SR, Leosco D, Ferrara N, Koch WJ, Rengo G. Long-Term Caloric Restriction Improves Cardiac Function, Remodeling, Adrenergic Responsiveness, and Sympathetic Innervation in a Model of Postischemic Heart Failure. Circ Heart Fail 2019. [PMID: 29535114 DOI: 10.1161/circheartfailure.117.004153] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Caloric restriction (CR) has been described to have cardioprotective effects and improve functional outcomes in animal models and humans. Chronic ischemic heart failure (HF) is associated with reduced cardiac sympathetic innervation, dysfunctional β-adrenergic receptor signaling, and decreased cardiac inotropic reserve. We tested the effects of a long-term CR diet, started late after myocardial infarction on cardiac function, sympathetic innervation, and β-adrenergic receptor responsiveness in a rat model of postischemic HF. METHODS AND RESULTS Adult male rats were randomly assigned to myocardial infarction or sham operation and 4 weeks later were further randomized to a 1-year CR or normal diet. One year of CR resulted in a significant reduction in body weight, heart weight, and heart weight/tibia length ratio when compared with normal diet in HF groups. At the end of the study period, echocardiography and histology revealed that HF animals under the CR diet had ameliorated left ventricular remodeling compared with HF rats fed with normal diet. Invasive hemodynamic showed a significant improvement of cardiac inotropic reserve in CR HF rats compared with HF-normal diet animals. Importantly, CR dietary regimen was associated with a significant increase of cardiac sympathetic innervation and with normalized cardiac β-adrenergic receptor levels in HF rats when compared with HF rats on the standard diet. CONCLUSIONS We demonstrate, for the first time, that chronic CR, when started after HF established, can ameliorate cardiac dysfunction and improve inotropic reserve. At the molecular level, we find that chronic CR diet significantly improves sympathetic cardiac innervation and β-adrenergic receptor levels in failing myocardium.
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Affiliation(s)
- Claudio de Lucia
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Giuseppina Gambino
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Laura Petraglia
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Andrea Elia
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Klara Komici
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Grazia Daniela Femminella
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Maria Loreta D'Amico
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Roberto Formisano
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Giulia Borghetti
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Daniela Liccardo
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Maria Nolano
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Steven R Houser
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Dario Leosco
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Nicola Ferrara
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.)
| | - Walter J Koch
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.).
| | - Giuseppe Rengo
- From the Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Italy (C.d.L., G.G., L.P., A.E., K.K., G.D.F., M.L.D., R.F., D. Liccardo, D. Leosco, N.F., G.R.); Center for Translational Medicine (C.d.L., D. Liccardo, W.J.K.), Department of Pharmacology (C.d.L., D. Liccardo, W.J.K.) and Cardiovascular Research Center (G.B., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA; Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy (G.G., A.E., M.L.D., M.N., N.F., G.R.); and Neurology Imaging Unit, Imperial College London, United Kingdom (G.D.F.).
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20
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Parisi V, Paolillo S, Rengo G, Formisano R, Petraglia L, Grieco F, D'Amore C, Dellegrottaglie S, Marciano C, Ferrara N, Leosco D, Filardi PP. Sleep-disordered breathing and epicardial adipose tissue in patients with heart failure. Nutr Metab Cardiovasc Dis 2018; 28:126-132. [PMID: 29198416 DOI: 10.1016/j.numecd.2017.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/11/2017] [Accepted: 09/28/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND AIMS Sleep-disordered breathing (SDB) is common in patients with heart failure (HF), contributes to the progression of cardiac disease, and is associated with adverse prognosis. Previous evidence indicates that epicardial adipose tissue (EAT) is independently associated with sleep apnea in obese individuals. We explored the relationship between SDB and EAT in HF patients. METHODS AND RESULTS EAT thickness was assessed by echocardiography in 66 patients with systolic HF undergoing nocturnal cardiorespiratory monitoring. A significantly higher EAT thickness was found in patients with SDB than in those without SDB (10.7 ± 2.8 mm vs. 8.3 ± 1.8 mm; p = 0.001). Among SDB patients, higher EAT thickness was found in both those with prevalent obstructive sleep apnea (OSA) and those with prevalent central sleep apnea (CSA). Of interest, EAT thickness was significantly higher in CSA than in OSA patients (11.9 ± 2.9 vs. 10.1 ± 2.5 p = 0.022). Circulating plasma norepinephrine levels were higher in CSA than in OSA patients (2.19 ± 1.25 vs. 1.22 ± 0.92 ng/ml, p = 0.019). According to the apnea-hypopnea index (AHI), patients were then stratified in three groups of SDB severity: Group 1, mild SDB; Group 2, moderate SDB; Group 3, severe SDB. EAT thickness progressively and significantly increased from Group 1 to Group 3 (ANOVA p < 0.001). At univariate analysis, only left ventricular ejection fraction and AHI significantly correlated with EAT (p = 0.019 and p < 0.0001, respectively). At multivariate analysis, AHI was the only independent predictor of EAT (β = 0.552, p < 0.001). CONCLUSIONS Our results suggest an association between the presence and severity of sleep apneas and cardiac visceral adiposity in HF patients.
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Affiliation(s)
- V Parisi
- Department of Translational Medical Sciences, Naples, Italy
| | - S Paolillo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
| | - G Rengo
- Department of Translational Medical Sciences, Naples, Italy
| | - R Formisano
- Department of Translational Medical Sciences, Naples, Italy
| | - L Petraglia
- Department of Translational Medical Sciences, Naples, Italy
| | - F Grieco
- Department of Translational Medical Sciences, Naples, Italy
| | - C D'Amore
- Department of Advanced Biomedical Science, Naples, Italy
| | | | - C Marciano
- Istituto Diagnostico Varelli, Naples, Italy
| | - N Ferrara
- Department of Translational Medical Sciences, Naples, Italy
| | - D Leosco
- Department of Translational Medical Sciences, Naples, Italy.
| | - P P Filardi
- Department of Advanced Biomedical Science, Naples, Italy
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21
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Femminella GD, Bencivenga L, Petraglia L, Visaggi L, Gioia L, Grieco FV, de Lucia C, Komici K, Corbi G, Edison P, Rengo G, Ferrara N. Antidiabetic Drugs in Alzheimer's Disease: Mechanisms of Action and Future Perspectives. J Diabetes Res 2017; 2017:7420796. [PMID: 28656154 PMCID: PMC5471577 DOI: 10.1155/2017/7420796] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/07/2017] [Indexed: 12/24/2022] Open
Abstract
Diabetes mellitus (DM) and Alzheimer's disease (AD) are two highly prevalent conditions in the elderly population and major public health burden. In the past decades, a pathophysiological link between DM and AD has emerged and central nervous system insulin resistance might play a significant role as a common mechanism; however, other factors such as inflammation and oxidative stress seem to contribute to the shared pathophysiological link. Both preclinical and clinical studies have evaluated the possible neuroprotective mechanisms of different classes of antidiabetic medications in AD, with some promising results. Here, we review the evidence on the mechanisms of action of antidiabetic drugs and their potential use in AD.
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Affiliation(s)
| | - Leonardo Bencivenga
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Laura Petraglia
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Lucia Visaggi
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Lucia Gioia
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Fabrizio Vincenzo Grieco
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Claudio de Lucia
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
- Center for Translational Medicine and Department of Pharmacology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Klara Komici
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Paul Edison
- Neurology Imaging Unit, Imperial College London, London, UK
| | - Giuseppe Rengo
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
- Istituti Clinici Scientifici Maugeri SpA Società Benefit, Telese Terme Institute (BN), Italy
| | - Nicola Ferrara
- Division of Geriatrics, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
- *Nicola Ferrara:
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22
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Gowran A, Kulikova T, Lewis FC, Foldes G, Fuentes L, Viiri LE, Spinelli V, Costa A, Perbellini F, Sid-Otmane C, Bax NAM, Pekkanen-Mattila M, Schiano C, Chaloupka A, Forini F, Sarkozy M, De Jager SCA, Vajen T, Glezeva N, Lee HW, Golovkin A, Kucera T, Musikhina NA, Korzhenkov NP, Santuchi MDEC, Munteanu D, Garcia RG, Ang R, Usui S, Kamilova U, Jumeau C, Aberg M, Kostina DA, Brandt MM, Muntean D, Lindner D, Sadaba R, Bacova B, Nikolov A, Sedmera D, Ryabov V, Neto FP, Lynch M, Portero V, Kui P, Howarth FC, Gualdoni A, Prorok J, Diolaiuti L, Vostarek F, Wagner M, Abela MA, Nebert C, Xiang W, Kloza M, Maslenko A, Grechanyk M, Bhattachariya A, Morawietz H, Babaeva AR, Martinez Sanchez SM, Krychtiuk KA, Starodubova J, Fiorelli S, Rinne P, Ozkaramanli Gur D, Hofbauer T, Starodubova J, Stellos K, Pinon P, Tsoref O, Thaler B, Fraga-Silva RA, Fuijkschot WW, Shaaban MNS, Matthaeus C, Deluyker D, Scardigli M, Zahradnikova A, Dominguez A, Kondrat'eva D, Sosorburam T, Murarikova M, Duerr GD, Griecsova L, Portnichenko VI, Smolina N, Duicu OANAM, Elder JM, Zaglia T, Lorenzon A, Ruperez C, Woudstra L, Suffee N, De Lucia C, Tsoref O, Russell-Hallinan A, Menendez-Montes I, Kapelko VI, Emmens RW, Hetman O, Van Der Laarse WJ, Goncharov S, Adao R, Huisamen B, Sirenko O, Kamilova U, Nassiri I, Tserendavaa SUMIYA, Yushko K, Baldan Martin M, Falcone C, Vigorelli V, Nigro P, Pompilio G, Stepanova O, Valikhov M, Samko A, Masenko V, Tereschenko S, Teoh T, Domenjo-Vila E, Theologou T, Field M, Awad W, Yasin M, Nadal-Ginard B, Ellison-Hughes GM, Hellen N, Vittay O, Harding SE, Gomez-Cid L, Fernandez-Santos ME, Suarez-Sancho S, Plasencia V, Climent A, Sanz-Ruiz R, Hedhammar M, Atienza F, Fernandez-Aviles F, Kiamehr M, Oittinen M, Viiri KM, Kaikkonen M, Aalto-Setala K, Diolaiuti L, Laurino A, Sartiani L, Vona A, Zanardelli M, Cerbai E, Failli P, Hortigon-Vinagre MP, Van Der Heyden M, Burton FL, Smith GL, Watson S, Scigliano M, Tkach S, Alayoubi S, Harding SE, Terracciano CM, Ly HQ, Mauretti A, Van Marion MH, Van Turnhout MC, Van Der Schaft DWJ, Sahlgren CM, Goumans MJ, Bouten CVC, Vuorenpaa H, Penttinen K, Sarkanen R, Ylikomi T, Heinonen T, Aalto-Setala K, Grimaldi V, Aprile M, Esposito R, Maiello C, Soricelli A, Colantuoni V, Costa V, Ciccodicola A, Napoli C, Rowe GC, Johnson K, Arany ZP, Del Monte F, D'aurizio R, Kusmic C, Nicolini G, Baumgart M, Groth M, Ucciferri N, Iervasi G, Pitto L, Pipicz M, Gaspar R, Siska A, Foldesi I, Kiss K, Bencsik P, Thum T, Batkai S, Csont T, Haan JJ, Bosch L, Brans MAD, Van De Weg SM, Deddens JC, Lee SJ, Sluijter JPG, Pasterkamp G, Werner I, Projahn D, Staudt M, Curaj A, Soenmez TT, Simsekyilmaz S, Hackeng TM, Von Hundelshausen P, Koenen RR, Weber C, Liehn EA, Santos-Martinez M, Medina C, Watson C, Mcdonald K, Gilmer J, Ledwidge M, Song SH, Lee MY, Park MH, Choi JC, Ahn JH, Park JS, Oh JH, Choi JH, Lee HC, Cha KS, Hong TJ, Kudryavtsev I, Serebryakova M, Malashicheva A, Shishkova A, Zhiduleva E, Moiseeva O, Durisova M, Blaha M, Melenovsky V, Pirk J, Kautzner J, Petelina TI, Gapon LI, Gorbatenko EA, Potolinskaya YV, Arkhipova EV, Solodenkova KS, Osadchuk MA, Dutra MF, Oliveira FCB, Silva MM, Passos-Silva DG, Goncalves R, Santos RAS, Da Silva RF, Gavrilescu CM, Paraschiv CM, Manea P, Strat LC, Gomez JMG, Merino D, Hurle MA, Nistal JF, Aires A, Cortajarena AL, Villar AV, Abramowitz J, Birnbaumer L, Gourine AV, Tinker A, Takamura M, Takashima S, Inoue O, Misu H, Takamura T, Kaneko S, Alieva TOHIRA, Mougenot N, Dufilho M, Hatem S, Siegbahn A, Kostina AS, Uspensky VE, Moiseeva OM, Kostareva AA, Malashicheva AB, Van Dijk CGM, Chrifi I, Verhaar MC, Duncker DJ, Cheng C, Sturza A, Petrus A, Duicu O, Kiss L, Danila M, Baczko I, Jost N, Gotzhein F, Schon J, Schwarzl M, Hinrichs S, Blankenberg S, Volker U, Hammer E, Westermann D, Martinez-Martinez E, Arrieta V, Fernandez-Celis A, Jimenez-Alfaro L, Melero A, Alvarez-Asiain V, Cachofeiro V, Lopez-Andres N, Tribulova N, Wallukat G, Knezl V, Radosinska J, Barancik M, Tsinlikov I, Tsinlikova I, Nicoloff G, Blazhev A, Pesevski Z, Kvasilova A, Stopkova T, Eckhardt A, Buffinton CM, Nanka O, Kercheva M, Suslova T, Gusakova A, Ryabova T, Markov V, Karpov R, Seemann H, Alcantara TC, Santuchi MDEC, Fonseca SG, Da Silva RF, Barallobre-Barreiro J, Oklu R, Fava M, Baig F, Yin X, Albadawi H, Jahangiri M, Stoughton J, Mayr M, Podliesna SP, Veerman CCV, Verkerk AOV, Klerk MK, Lodder EML, Mengarelli IM, Bezzina CRB, Remme CAR, Takacs H, Polyak A, Morvay N, Lepran I, Tiszlavicz L, Nagy N, Ordog B, Farkas A, Forster T, Varro A, Farkas AS, Jayaprakash P, Parekh K, Ferdous Z, Oz M, Dobrzynski H, Adrian TE, Landi S, Bonzanni M, D'souza A, Boyett M, Bucchi A, Baruscotti M, Difrancesco D, Barbuti A, Kui P, Takacs H, Oravecz K, Hezso T, Polyak A, Levijoki J, Pollesello P, Koskelainen T, Otsomaa L, Farkas AS, Papp JGY, Varro A, Toth A, Acsai K, Dini L, Mazzoni L, Sartiani L, Cerbai E, Mugelli A, Svatunkova J, Sedmera D, Deffge C, Baer C, Weinert S, Braun-Dullaeus RC, Herold J, Cassar AC, Zahra GZ, Pllaha EP, Dingli PD, Montefort SM, Xuereb RGX, Aschacher T, Messner B, Eichmair E, Mohl W, Reglin B, Rong W, Nitzsche B, Maibier M, Guimaraes P, Ruggeri A, Secomb TW, Pries AR, Baranowska-Kuczko M, Karpinska O, Kusaczuk M, Malinowska B, Kozlowska H, Demikhova N, Vynnychenko L, Prykhodko O, Grechanyk N, Kuryata A, Cottrill KA, Du L, Bjorck HM, Maleki S, Franco-Cereceda A, Chan SY, Eriksson P, Giebe S, Cockcroft N, Hewitt K, Brux M, Brunssen C, Tarasov AA, Davidov SI, Reznikova EA, Tapia Abellan A, Angosto Bazarra D, Pelegrin Vivancos P, Montoro Garcia S, Kastl SP, Pongratz T, Goliasch G, Gaspar L, Maurer G, Huber K, Dostal E, Pfaffenberger S, Oravec S, Wojta J, Speidl WS, Osipova I, Sopotova I, Eligini S, Cosentino N, Marenzi G, Tremoli E, Rami M, Ring L, Steffens S, Gur O, Gurkan S, Mangold A, Scherz T, Panzenboeck A, Staier N, Heidari H, Mueller J, Lang IM, Osipova I, Sopotova I, Gatsiou A, Stamatelopoulos K, Perisic L, John D, Lunella FF, Eriksson P, Hedin U, Zeiher A, Dimmeler S, Nunez L, Moure R, Marron-Linares G, Flores X, Aldama G, Salgado J, Calvino R, Tomas M, Bou G, Vazquez N, Hermida-Prieto M, Vazquez-Rodriguez JM, Amit U, Landa N, Kain D, Tyomkin D, David A, Leor J, Hohensinner PJ, Baumgartner J, Krychtiuk KA, Maurer G, Huber K, Baik N, Miles LA, Wojta J, Seeman H, Montecucco F, Da Silva AR, Costa-Fraga FP, Anguenot L, Mach FP, Santos RAS, Stergiopulos N, Da Silva RF, Kupreishvili K, Vonk ABA, Smulders YM, Van Hinsbergh VWM, Stooker W, Niessen HWM, Krijnen PAJ, Ashmawy MM, Salama MA, Elamrosy MZ, Juettner R, Rathjen FG, Bito V, Crocini C, Ferrantini C, Gabbrielli T, Silvestri L, Coppini R, Tesi C, Cerbai E, Poggesi C, Pavone FS, Sacconi L, Mackova K, Zahradnik I, Zahradnikova A, Diaz I, Sanchez De Rojas De Pedro E, Hmadcha K, Calderon Sanchez E, Benitah JP, Gomez AM, Smani T, Ordonez A, Afanasiev SA, Egorova MV, Popov SV, Wu Qing P, Cheng X, Carnicka S, Pancza D, Jasova M, Kancirova I, Ferko M, Ravingerova T, Wu S, Schneider M, Marggraf V, Verfuerth L, Frede S, Boehm O, Dewald O, Baumgarten G, Kim SC, Farkasova V, Gablovsky I, Bernatova I, Ravingerova T, Nosar V, Portnychenko A, Drevytska T, Mankovska I, Gogvadze V, Sejersen T, Kostareva A, Sturza A, Wolf A, Privistirescu A, Danila M, Muntean D, O ' Gara P, Sanchez-Alonso JL, Harding SE, Lyon AR, Prando V, Pianca N, Lo Verso F, Milan G, Pesce P, Sandri M, Mongillo M, Beffagna G, Poloni G, Dazzo E, Sabatelli P, Doliana R, Polishchuk R, Carnevale D, Lembo G, Bonaldo P, Braghetta P, Rampazzo A, Cairo M, Giralt M, Villarroya F, Planavila A, Biesbroek PS, Emmens RWE, Juffermans LJM, Van Der Wall AC, Van Rossum AC, Niessen JWM, Krijnen PAJ, Moor Morris T, Dilanian G, Farahmand P, Puceat M, Hatem S, Gambino G, Petraglia L, Elia A, Komici K, Femminella GD, D'amico ML, Pagano G, Cannavo A, Liccardo D, Koch WJ, Nolano M, Leosco D, Ferrara N, Rengo G, Amit U, Landa N, Kain D, Leor J, Neary R, Shiels L, Watson C, Baugh J, Palacios B, Escobar B, Alonso AV, Guzman G, Ruiz-Cabello J, Jimenez-Borreguero LJ, Martin-Puig S, Lakomkin VL, Lukoshkova EV, Abramov AA, Gramovich VV, Vyborov ON, Ermishkin VV, Undrovinas NA, Shirinsky VP, Smilde BJ, Woudstra L, Fong Hing G, Wouters D, Zeerleder S, Murk JL, Van Ham SM, Heymans S, Juffermans LJM, Van Rossum AC, Niessen JWM, Krijnen PAJ, Krakhmalova O, Van Groen D, Bogaards SJP, Schalij I, Portnichenko GV, Tumanovska LV, Goshovska YV, Lapikova-Bryhinska TU, Nagibin VS, Dosenko VE, Mendes-Ferreira P, Maia-Rocha C, Santos-Ribeiro D, Potus F, Breuils-Bonnet S, Provencher S, Bonnet S, Rademaker M, Leite-Moreira AF, Bras-Silva C, Lopes J, Kuryata O, Lusynets T, Alikulov I, Nourddine M, Azzouzi L, Habbal R, Tserendavaa SUMIYA, Enkhtaivan ODKHUU, Enkhtaivan ODKHUU, Shagdar ZORIGO, Shagdar ZORIGO, Malchinkhuu MUNKHZ, Malchinkhuu MUNLHZ, Koval S, Starchenko T, Mourino-Alvarez L, Gonzalez-Calero L, Sastre-Oliva T, Lopez JA, Vazquez J, Alvarez-Llamas G, Ruilope LUISM, De La Cuesta F, Barderas MG, Bozzini S, D'angelo A, Pelissero G. Poster session 3Cell growth, differentiation and stem cells - Heart511The role of the endocannabinoid system in modelling muscular dystrophy cardiac disease with induced pluripotent stem cells.512An emerging role of T lymphocytes in cardiac regenerative processes in heart failure due to dilated cardiomyopathy513Canonical wnt signaling reverses the ‘aged/senescent’ human endogenous cardiac stem cell phenotype514Hippo signalling modulates survival of human induced pluripotent stem cell-derived cardiomyocytes515Biocompatibility of mesenchymal stem cells with a spider silk matrix and its potential use as scaffold for cardiac tissue regeneration516A snapshot of genome-wide transcription in human induced pluripotent stem cell-derived hepatocyte-like cells (iPSC-HLCs)517Can NOS/sGC/cGK1 pathway trigger the differentiation and maturation of mouse embryonic stem cells (ESCs)?518Introduction of external Ik1 to human-induced pluripotent stem cell-derived cardiomyocytes via Ik1-expressing HEK293519Cell therapy of the heart studied using adult myocardial slices in vitro520Enhancement of the paracrine potential of human adipose derived stem cells when cultured as spheroid bodies521Mechanosensitivity of cardiomyocyte progenitor cells: the strain response in 2D and 3D environments522The effect of the vascular-like network on the maturation of the human induced pluripotent stem cell derived cardiomyocytes.Transcriptional control and RNA species - Heart525Gene expression regulation in heart failure: from pathobiology to bioinformatics526Human transcriptome in idiopathic dilated cardiomyopathy - a novel high throughput screening527A high-throghput approach unveils putative miRNA-mediated mitochondria-targeted cardioprotective circuits activated by T3 in the post ischemia reperfusion setting528The effect of uraemia on the expression of miR-212/132 and the calcineurin pathway in the rat heartCytokines and cellular inflammation - Heart531Lack of growth differentiation factor 15 aggravates adverse cardiac remodeling upon pressure-overload in mice532Blocking heteromerization of platelet chemokines ccl5 and cxcl4 reduces inflammation and preserves heart function after myocardial infarction533Is there an association between low-dose aspirin use and clinical outcome in HFPEF? Implications of modulating monocyte function and inflammatory mediator release534N-terminal truncated intracellular matrix metalloproteinase-2 expression in diabetic heart.535Expression of CD39 and CD73 on peripheral T-cell subsets in calcific aortic stenosis536Mast cells in the atrial myocardium of patients with atrial fibrillation: a comparison with patients in sinus rhythm539Characteristics of the inflammatory response in patients with coronary artery disease and arterial hypertension540Pro-inflammatory cytokines as cardiovascular events predictors in rheumatoid arthritis and asymptomatic atherosclerosis541Characterization of FVB/N murinic bone marrow-derived macrophage polarization into M1 and M2 phenotypes542The biological expression and thoracic anterior pain syndromeSignal transduction - Heart545The association of heat shock protein 90 and TGFbeta receptor I is involved in collagen production during cardiac remodelling in aortic-banded mice546Loss of the inhibitory GalphaO protein in the rostral ventrolateral medulla of the brainstem leads to abnormalities in cardiovascular reflexes and altered ventricular excitablitiy547Selenoprotein P regulates pressure overload-induced cardiac remodeling548Study of adenylyl cyclase activity in erythrocyte membranes in patients with chronic heart failure549Direct thrombin inhibitors inhibit atrial myocardium hypertrophy in a rat model of heart failure and atrial remodeling550Tissue factor / FVIIa transactivates the IGF-1R by a Src-dependent phosphorylation of caveolin-1551Notch signaling is differently altered in endothelial and smooth muscle cells of ascending aortic aneurysm patients552Frizzled 5 expression is essential for endothelial proliferation and migration553Modulation of vascular function and ROS production by novel synthetic benzopyran analogues in diabetes mellitusExtracellular matrix and fibrosis - Heart556Cardiac fibroblasts as inflammatory supporter cells trigger cardiac inflammation in heart failure557A role for galectin-3 in calcific aortic valve stenosis558Omega-3 polyunsaturated fatty acids- can they decrease risk for ventricular fibrillation?559Serum levels of elastin derived peptides and circulating elastin-antielastin immune complexes in sera of patients with coronary artery disease560Endocardial fibroelastosis is secondary to hemodynamic alterations in the chick model of hypoplastic left heart syndrome561Dynamics of serum levels of matrix metalloproteinases in primary anterior STEMI patients564Deletion of the alpha-7 nicotinic acetylcholine receptor changes the vascular remodeling induced by transverse aortic constriction in mice.565Extracellular matrix remodelling in response to venous hypertension: proteomics of human varicose veinsIon channels, ion exchangers and cellular electrophysiology - Heart568Microtubule-associated protein RP/EB family member 1 modulates sodium channel trafficking and cardiac conduction569Investigation of electrophysiological abnormalities in a rabbit athlete's heart model570Upregulation of expression of multiple genes in the atrioventricular node of streptozotocin-induced diabetic rat571miR-1 as a regulator of sinoatrial rhythm in endurance training adaptation572Selective sodium-calcium exchanger inhibition reduces myocardial dysfunction associated with hypokalaemia and ventricular fibrillation573Effect of racemic and levo-methadone on action potential of human ventricular cardiomyocytes574Acute temperature effects on the chick embryonic heart functionVasculogenesis, angiogenesis and arteriogenesis577Clinical improvement and enhanced collateral vessel growth after monocyte transplantation in mice578The role of HIF-1 alpha, VEGF and obstructive sleep apnoea in the development of coronary collateral circulation579Initiating cardiac repair with a trans-coronary sinus catheter intervention in an ischemia/reperfusion porcine animal model580Early adaptation of pre-existing collaterals after acute arteriolar and venular microocclusion: an in vivo study in chick chorioallantoic membraneEndothelium583EDH-type responses to the activator of potassium KCa2.3 and KCa3.1 channels SKA-31 in the small mesenteric artery from spontaneously hypertensive rats584The peculiarities of endothelial dysfunction in patients with chronic renocardial syndrome585Endothelial dysfunction, atherosclerosis of the carotid arteries and level of leptin in patient with coronary heart disease in combination with hepatic steatosis depend from body mass index.586Role of non-coding RNAs in thoracic aortic aneurysm associated with bicuspid aortic valve587Cigarette smoke extract abrogates atheroprotective effects of high laminar flow on endothelial function588The prognostic value of anti-connective tissue antibodies in coronary heart disease and asymptomatic atherosclerosis589Novel potential properties of bioactive peptides from spanish dry-cured ham on the endothelium.Lipids592Intermediate density lipoprotein is associated with monocyte subset distribution in patients with stable atherosclerosis593The characteristics of dyslipidemia in rheumatoid arthritisAtherosclerosis596Macrophages differentiated in vitro are heterogeneous: morphological and functional profile in patients with coronary artery disease597Palmitoylethanolamide promotes anti-inflammatory phenotype of macrophages and attenuates plaque formation in ApoE-/- mice598Amiodarone versus esmolol in the perioperative period: an in vitro study of coronary artery bypass grafts599BMPRII signaling of fibrocytes, a mesenchymal progenitor cell population, is increased in STEMI and dyslipidemia600The characteristics of atherogenesis and systemic inflammation in rheumatoid arthritis601Role of adenosine-to-inosine RNA editing in human atherosclerosis602Presence of bacterial DNA in thrombus aspirates of patients with myocardial infarction603Novel E-selectin binding polymers reduce atherosclerotic lesions in ApoE(-/-) mice604Differential expression of the plasminogen receptor Plg-RKT in monocyte and macrophage subsets - possible functional consequences in atherogenesis605Apelin-13 treatment enhances the stability of atherosclerotic plaques606Mast cells are increased in the media of coronary lesions in patients with myocardial infarction and favor atherosclerotic plaque instability607Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasiaCalcium fluxes and excitation-contraction coupling610The coxsackie- and adenovirus receptor (CAR) regulates calcium homeostasis in the developing heart611HMW-AGEs application acutely reduces ICaL in adult cardiomyocytes612Measuring electrical conductibility of cardiac T-tubular systems613Postnatal development of cardiac excitation-contraction coupling in rats614Role of altered Ca2+ homeostasis during adverse cardiac remodeling after ischemia/reperfusion615Experimental study of sarcoplasmic reticulum dysfunction and energetic metabolism in failing myocardium associated with diabetes mellitusHibernation, stunning and preconditioning618Volatile anesthetic preconditioning attenuates ischemic-reperfusion injury in type II diabetic patients undergoing on-pump heart surgery619The effect of early and delayed phase of remote ischemic preconditioning on ischemia-reperfusion injury in the isolated hearts of healthy and diabetic rats620Post-conditioning with 1668-thioate leads to attenuation of the inflammatory response and remodeling with less fibrosis and better left ventricular function in a murine model of myocardial infarction621Maturation-related changes in response to ischemia-reperfusion injury and in effects of classical ischemic preconditioning and remote preconditioningMitochondria and energetics624Phase changes in myocardial mitochondrial respiration caused by hypoxic preconditioning or periodic hypoxic training625Desmin mutations depress mitochondrial metabolism626Methylene blue modulates mitochondrial function and monoamine oxidases-related ROS production in diabetic rat hearts627Doxorubicin modulates the real-time oxygen consumption rate of freshly isolated adult rat and human ventricular cardiomyocytesCardiomyopathies and fibrosis630Effects of genetic or pharmacologic inhibition of the ubiquitin/proteasome system on myocardial proteostasis and cardiac function631Suppression of Wnt signalling in a desmoglein-2 transgenic mouse model for arrhythmogenic cardiomyopathy632Cold-induced cardiac hypertrophy is reversed after thermo-neutral deacclimatization633CD45 is a sensitive marker to diagnose lymphocytic myocarditis in endomyocardial biopsies of living patients and in autopsies634Atrial epicardial adipose tissue derives from epicardial progenitors635Caloric restriction ameliorates cardiac function, sympathetic cardiac innervation and beta-adrenergic receptor signaling in an experimental model of post-ischemic heart failure636High fat diet improves cardiac remodelling and function after extensive myocardial infarction in mice637Epigenetic therapy reduces cardiac hypertrophy in murine models of heart failure638Imbalance of the VHL/HIF signaling in WT1+ Epicardial Progenitors results in coronary vascular defects, fibrosis and cardiac hypertrophy639Diastolic dysfunction is the first stage of the developing heart failure640Colchicine aggravates coxsackievirus B3 infection in miceArterial and pulmonary hypertension642Osteopontin as a marker of pulmonary hypertension in patients with coronary heart disease combined with chronic obstructive pulmonary disease643Myocardial dynamic stiffness is increased in experimental pulmonary hypertension partly due to incomplete relaxation644Hypotensive effect of quercetin is possibly mediated by down-regulation of immunotroteasome subunits in aorta of spontaneously hypertensive rats645Urocortin-2 improves right ventricular function and attenuates experimental pulmonary arterial hypertension646A preclinical evaluation of the anti-hypertensive properties of an aqueous extract of Agathosma (Buchu)Biomarkers648The adiponectin level in hypertensive females with rheumatoid arthritis and its relationship with subclinical atherosclerosis649Markers for identification of renal dysfunction in the patients with chronic heart failure650cardio-hepatic syndromes in chronic heart failure: North Africa profile651To study other biomarkers that assess during myocardial infarction652Interconnections of apelin levels with parameters of lipid metabolism in hypertension patients653Plasma proteomics in hypertension: prediction and follow-up of albuminuria during chronic renin-angiotensin system suppression654Soluble RAGE levels in plasma of patients with cerebrovascular events. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cannavo A, E Molina C, Komici K, Liccardo D, Gambino G, D'amico ML, Rapacciuolo A, Paolocci N, Leosco D, Koch WJ, Ferrara N, Rengo G, Ghezelbash S, Garnier A, Fischmeister R, Dobrev D, Cannavo A, Gambino G, De Lucia C, D'Amico ML, Liccardo D, Petraglia L, Formisano R, Lania G, Barone MV, Leosco D, Ferrara N, Rengo G. The Role of Microdomains in Beta-Adrenoreceptor Signalling266Metoprolol induces cardiac beta-3 adrenergic receptor and Sphingosine 1 phosphate receptor 1 signals to prevent adverse Left-ventricle remodeling and dysfunction after myocardial infarction267PDE8 is a novel regulator of cAMP signaling in human atrial fibrillation268B-blocker therapy in heart failure reduces migratory and proliferative properties of primarily cultured failing cardiac fibroblasts via reduction of g protein-coupled receptor kinase-2 expression. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Parisi V, Rengo G, Perrone-Filardi P, Pagano G, Femminella GD, Paolillo S, Petraglia L, Gambino G, Caruso A, Grimaldi MG, Baldascino F, Nolano M, Elia A, Cannavo A, De Bellis A, Coscioni E, Pellegrino T, Cuocolo A, Ferrara N, Leosco D. Increased Epicardial Adipose Tissue Volume Correlates With Cardiac Sympathetic Denervation in Patients With Heart Failure. Circ Res 2016; 118:1244-53. [PMID: 26926470 DOI: 10.1161/circresaha.115.307765] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/26/2016] [Indexed: 12/31/2022]
Abstract
RATIONALE It has been reported that epicardial adipose tissue (EAT) may affect myocardial autonomic function. OBJECTIVE The aim of this study was to explore the relationship between EAT and cardiac sympathetic nerve activity in patients with heart failure. METHODS AND RESULTS In 110 patients with systolic heart failure, we evaluated the correlation between echocardiographic EAT thickness and cardiac adrenergic nerve activity assessed by (123)I-metaiodobenzylguanidine ((123)I-MIBG). The predictive value of EAT thickness on cardiac sympathetic denervation ((123)I-MIBG early and late heart:mediastinum ratio and single-photon emission computed tomography total defect score) was tested in a multivariate analysis. Furthermore, catecholamine levels, catecholamine biosynthetic enzymes, and sympathetic nerve fibers were measured in EAT and subcutaneous adipose tissue biopsies obtained from patients with heart failure who underwent cardiac surgery. EAT thickness correlated with (123)I-MIBG early and late heart:mediastinum ratio and single-photon emission computed tomography total defect score, but not with left ventricular ejection fraction. Moreover, EAT resulted as an independent predictor of (123)I-MIBG early and late heart:mediastinum ratio and single-photon emission computed tomography total defect score and showed a significant additive predictive value on (123)I-MIBG planar and single-photon emission computed tomography results over demographic and clinical data. Although no differences were found in sympathetic innervation between EAT and subcutaneous adipose tissue, EAT showed an enhanced adrenergic activity demonstrated by the increased catecholamine levels and expression of catecholamine biosynthetic enzymes. CONCLUSIONS This study provides the first evidence of a direct correlation between increased EAT thickness and cardiac sympathetic denervation in heart failure.
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Affiliation(s)
- Valentina Parisi
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Giuseppe Rengo
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.).
| | - Pasquale Perrone-Filardi
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Gennaro Pagano
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Grazia Daniela Femminella
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Stefania Paolillo
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Laura Petraglia
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Giuseppina Gambino
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Aurelio Caruso
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Maria Gabriella Grimaldi
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Francesco Baldascino
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Maria Nolano
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Andrea Elia
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Alessandro Cannavo
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Antonio De Bellis
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Enrico Coscioni
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Teresa Pellegrino
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Alberto Cuocolo
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Nicola Ferrara
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
| | - Dario Leosco
- From the Department of Translational Medical Sciences (V.P., G.R., G.P., G.D.F., L.P., G.G., A.C., N.F., D.L.) and Department of Advanced Biomedical Science (P.P.-F., T.P., A.C.), University Federico II, Naples, Italy; Department of Cardiology (G.R., G.G.) and Department of Neurology (M.N., A.E.), Salvatore Maugeri Foundation, IRCCS, Istituto di Telese, Benevento, Italy (G.R., G.G., M.N., A.E.); SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy (S.P.); Department of Cardiology and Cardiac Surgery, Casa di Cura San Michele, Maddaloni (CE), Italy (A.C., M.G.G., F.B., A.D.B.); Department of Cardiac Surgery, Ruggi D'Aragona Hospital, Salerno, Italy (E.C.); and Institute of Biostructure and Bioimaging Italian National Research Council (CNR), Naples, Italy (T.P.)
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Vassallo E, Musella F, Mosca S, Casaretti L, Formisano R, Mattiello G, Bologna A, Fabiani I, Gambardella F, Petraglia L, Rengo G, Leosco D, Perrone-Filardi P. Clinical and therapeutic value of carotid intima-media thickness. Monaldi Arch Chest Dis 2015; 76:132-5. [DOI: 10.4081/monaldi.2011.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain.
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Musella F, Formisano R, Mattiello G, Iardino E, Petraglia L, Vitagliano A, Fabiani I, Cirillo AP, Petito M, Perrone-Filardi P. Coronary computed tomography: current role and future perspectives for cardiovascular risk stratification. Monaldi Arch Chest Dis 2015; 76:115-20. [DOI: 10.4081/monaldi.2011.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Atherosclerotic coronary artery disease (CAD) is a major cause of morbidity and mortality. The majority of cardiovascular events, more than 50% of CAD deaths, occur in previously asymptomatic individuals at intermediate cardiovascular risk, highlighting the relevance of accurate individual risk assessment to decrease cardiovascular events through more appropriate targeting of preventive measures. In the last decades, the development of non-invasive imaging techniques have prompted interest in imaging of atherosclerosis. Coronary computed tomography provides the opportunity to assess the deposition of calcium in the coronary tree and to non-invasively image coronary vessels. Both information are useful for risk stratification of asymptomatic subjects or of subjects with suspected CAD.
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Femminella GD, Rengo G, Komici K, Iacotucci P, Petraglia L, Pagano G, de Lucia C, Canonico V, Bonaduce D, Leosco D, Ferrara N. Autonomic dysfunction in Alzheimer's disease: tools for assessment and review of the literature. J Alzheimers Dis 2015; 42:369-77. [PMID: 24898649 DOI: 10.3233/jad-140513] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Autonomic dysfunction is very common in patients with dementia, and its presence might also help in differential diagnosis among dementia subtypes. Various central nervous system structures affected in Alzheimer's disease are also implicated in autonomic nervous system regulation, and it has been hypothesized that the deficit in central cholinergic function observed in Alzheimer's disease could likely lead to autonomic dysfunction. Several feasible tests can be used in clinical practice for the assessment of parasympathetic and sympathetic functions, especially in terms of cardiovascular autonomic modulation. In this review, we describe the different tests available and the evidence from the literature which indicate a definite presence of autonomic dysfunction in dementia at various degrees. Importantly, the recognition of dysautonomia, besides possibly being an early marker of dementia, would help prevent the disabling complications which increase the risk of morbidity, institutionalization, and mortality in these individuals.
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Affiliation(s)
| | - Giuseppe Rengo
- Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese, Telese Terme (BN), Italy
| | - Klara Komici
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Paola Iacotucci
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Gennaro Pagano
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Claudio de Lucia
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Vincenzo Canonico
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Dario Leosco
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese, Telese Terme (BN), Italy
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Paolillo S, Rengo G, Pellegrino T, Formisano R, Pagano G, Gargiulo P, Savarese G, Carotenuto R, Petraglia L, Rapacciuolo A, Perrino C, Piscitelli S, Attena E, Del Guercio L, Leosco D, Trimarco B, Cuocolo A, Perrone-Filardi P. Insulin resistance is associated with impaired cardiac sympathetic innervation in patients with heart failure. Eur Heart J Cardiovasc Imaging 2015; 16:1148-53. [PMID: 25845954 DOI: 10.1093/ehjci/jev061] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 02/24/2015] [Indexed: 01/07/2023] Open
Abstract
AIMS Insulin resistance (IR) represents, at the same time, cause and consequence of heart failure (HF) and affects prognosis in HF patients, but pathophysiological mechanisms remain unclear. Hyperinsulinemia, which characterizes IR, enhances sympathetic drive, and it can be hypothesized that IR is associated with impaired cardiac sympathetic innervation in HF. Yet, this hypothesis has never been investigated. Aim of the present observational study was to assess the relationship between IR and cardiac sympathetic innervation in non-diabetic HF patients. METHODS AND RESULTS One hundred and fifteen patients (87% males; 65 ± 11.3 years) with severe-to-moderate HF (ejection fraction 32.5 ± 9.1%) underwent iodine-123 meta-iodobenzylguanidine ((123)I-MIBG) myocardial scintigraphy to assess sympathetic innervation and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) evaluation to determine the presence of IR. From (123)I-MIBG imaging, early and late heart to mediastinum (H/M) ratios and washout rate were calculated. Seventy-two (63%) patients showed IR and 43 (37%) were non-IR. Early [1.68 (IQR 1.53-1.85) vs. 1.79 (IQR 1.66-1.95); P = 0.05] and late H/M ratio [1.50 (IQR 1.35-1.69) vs. 1.65 (IQR 1.40-1.85); P = 0.020] were significantly reduced in IR compared with non-IR patients. Early and late H/M ratio showed significant inverse correlation with fasting insulinemia and HOMA-IR. CONCLUSION Cardiac sympathetic innervation is more impaired in patients with IR and HF compared with matched non-IR patients. These findings shed light on the relationship among IR, HF, and cardiac sympathetic nervous system. Additional studies are needed to clarify the pathogenetic relationship between IR and HF.
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Affiliation(s)
- S Paolillo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - G Rengo
- Division of Cardiology, "Salvatore Maugeri" Foundation-IRCCS-Institute of Telese Terme (BN), Italy Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - T Pellegrino
- Department of Advanced Biomedical Sciences, Section of Imaging, Radiotherapy, Neuroradiology and Medical Physics, Federico II University, Naples, Italy Institute of Biostructures and Bioimages of the National Council of Research, Naples, Italy
| | - R Formisano
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - G Pagano
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - P Gargiulo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
| | - G Savarese
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - R Carotenuto
- Department of Advanced Biomedical Sciences, Section of Imaging, Radiotherapy, Neuroradiology and Medical Physics, Federico II University, Naples, Italy
| | - L Petraglia
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - A Rapacciuolo
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - C Perrino
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - S Piscitelli
- Department of Translational Medical Sciences, Section of Clinical Pathology, Federico II University, Naples, Italy
| | - E Attena
- Department of Cardiology Fatebenefratelli Hospital, Naples, Italy
| | - L Del Guercio
- Department of Public Health, Federico II University, Naples, Italy
| | - D Leosco
- Department of Translational Medical Sciences, Section of Geriatrics, Federico II University, Naples, Italy
| | - B Trimarco
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
| | - A Cuocolo
- SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy Department of Advanced Biomedical Sciences, Section of Imaging, Radiotherapy, Neuroradiology and Medical Physics, Federico II University, Naples, Italy
| | - P Perrone-Filardi
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples, Italy
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Rengo G, Pagano G, Paolillo S, de Lucia C, Femminella GD, Liccardo D, Cannavo A, Formisano R, Petraglia L, Komici K, Rengo F, Trimarco B, Ferrara N, Leosco D, Perrone-Filardi P. Impact of diabetes mellitus on lymphocyte GRK2 protein levels in patients with heart failure. Eur J Clin Invest 2015; 45:187-95. [PMID: 25545706 DOI: 10.1111/eci.12395] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 12/20/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is associated with impaired prognosis in patients with heart failure (HF), but pathogenic mechanisms are unclear. In the failing heart, elevated β-adrenergic receptor (β-AR) activation by catecholamines causes G-protein-coupled receptor kinase-2 (GRK2) upregulation which is responsible for β-AR signalling dysfunction. Importantly, GRK2 expression, measured in peripheral lymphocytes of HF patients, correlates with levels of this kinase in the failing myocardium reflecting the loss of hemodynamic function. Moreover, HF-related GRK2 protein overexpression promotes insulin resistance by interfering with insulin signalling. The aim of this study was to assess lymphocyte GRK2 protein levels in HF patients with and without DM. METHODS AND MATERIALS Patients with a diagnosis of HF were enrolled in the study. All subjects underwent a complete clinical examination (including NYHA functional class assessment and echocardiography) and blood draw for serum N-terminal pro-brain natriuretic peptide (NT-proBNP), lymphocyte GRK2 and plasma norepinephrine (NE) levels. Demographic data including age, sex, medications, cardiovascular risk factors and presence of comorbidities were also collected. RESULTS Two hundred and sixty-eight patients with HF (left ventricular ejection fraction [LVEF] 30.6 ± 7.6%) with and without DM were enrolled. No differences between the two groups were found in terms of demography, HF aetiology, LVEF, NYHA class, NE and NT-proBNP. GRK2 was significantly higher in patients with DM compared to non-DM. At multivariate linear regression analysis, LVEF, NE, NT-proBNP and diabetes came out to be independent predictors of GRK2 levels in the overall study population. CONCLUSION In HF patients, DM is associated with significantly more elevated lymphocyte GRK2 protein levels, likely reflecting more compromised cardiac β-AR signalling/function, despite similar hemodynamic status and neuro-hormonal activation compared to patients without DM. These findings contribute to explain the negative prognostic impact of DM in patients with HF.
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Affiliation(s)
- Giuseppe Rengo
- IRCCS, Scientific Institute of Telese Terme (BN), Salvatore Maugeri Foundation, Telese Terme, Italy
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Savarese G, Musella F, D’Amore C, Vassallo E, Losco T, Gambardella F, Cecere M, Petraglia L, Pagano G, Fimiani L, Rengo G, Leosco D, Trimarco B, Perrone-Filardi P. Changes of Natriuretic Peptides Predict Hospital Admissions in Patients With Chronic Heart Failure. JACC: Heart Failure 2014; 2:148-58. [DOI: 10.1016/j.jchf.2013.11.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 11/25/2013] [Accepted: 11/28/2013] [Indexed: 10/25/2022]
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Savarese G, Musella F, D'Amore C, Vassallo E, Losco T, Cecere M, Petraglia L, Trimarco B, Perrone-Filardi P. CHANGES OF NATRIURETIC PEPTIDES PREDICT HOSPITAL ADMISSIONS IN PATIENTS WITH CHRONIC HEART FAILURE: A META-ANALYSIS. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)60737-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Femminella GD, de Lucia C, Iacotucci P, Formisano R, Petraglia L, Allocca E, Ratto E, D'Amico L, Rengo C, Pagano G, Bonaduce D, Rengo G, Ferrara N. Neuro-hormonal effects of physical activity in the elderly. Front Physiol 2013; 4:378. [PMID: 24391595 PMCID: PMC3868730 DOI: 10.3389/fphys.2013.00378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 12/04/2013] [Indexed: 01/14/2023] Open
Abstract
Thanks to diagnostic and therapeutic advances, the elderly population is continuously increasing in the western countries. Accordingly, the prevalence of most chronic age-related diseases will increase considerably in the next decades, thus it will be necessary to implement effective preventive measures to face this epidemiological challenge. Among those, physical activity exerts a crucial role, since it has been proven to reduce the risk of cardiovascular diseases, diabetes, obesity, cognitive impairment and cancer. The favorable effects of exercise on cardiovascular homeostasis can be at least in part ascribed to the modulation of the neuro-hormonal systems implicated in cardiovascular pathophysiology. In the elderly, exercise has been shown to affect catecholamine secretion and biosynthesis, to positively modulate the renin-angiotensin-aldosterone system and to reduce the levels of plasma brain natriuretic peptides. Moreover, drugs modulating the neuro-hormonal systems may favorably affect physical capacity in the elderly. Thus, efforts should be made to actually make physical activity become part of the therapeutic tools in the elderly.
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Affiliation(s)
- Grazia D Femminella
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Claudio de Lucia
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Paola Iacotucci
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Roberto Formisano
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Elena Allocca
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Enza Ratto
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Loreta D'Amico
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Carlo Rengo
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy ; Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN) Telese Terme, Italy
| | - Gennaro Pagano
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy ; Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN) Telese Terme, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II Naples, Italy ; Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN) Telese Terme, Italy
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Leosco D, Parisi V, Femminella GD, Formisano R, Petraglia L, Allocca E, Bonaduce D. Effects of exercise training on cardiovascular adrenergic system. Front Physiol 2013; 4:348. [PMID: 24348425 PMCID: PMC3842896 DOI: 10.3389/fphys.2013.00348] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 11/12/2013] [Indexed: 12/20/2022] Open
Abstract
In heart failure (HF), exercise has been shown to modulate cardiac sympathetic hyperactivation which is one of the earliest features of neurohormonal derangement in this syndrome and correlates with adverse outcome. An important molecular alteration related to chronic sympathetic overstimulation in HF is represented by cardiac β-adrenergic receptor (β-AR) dysfunction. It has been demonstrated that exercise reverses β-AR dysfunction by restoring cardiac receptor membrane density and G-protein-dependent adenylyl cyclase activation. In particular, several evidence indicate that exercise reduces levels of cardiac G-protein coupled receptor kinase-2 (GRK2) which is known to be involved in both β1-AR and β2-AR dysregulation in HF. Similar alterations of β-AR system have been described also in the senescent heart. It has also been demonstrated that exercise training restores adrenal GRK2/α-2AR/catecholamine (CA) production axis. At vascular level, exercise shows a therapeutic effect on age-related impairment of vascular reactivity to adrenergic stimulation and restores β-AR-dependent vasodilatation by increasing vascular β-AR responsiveness and reducing endothelial GRK2 activity. Sympathetic nervous system overdrive is thought to account for >50% of all cases of hypertension and a lack of balance between parasympathetic and sympathetic modulation has been observed in hypertensive subjects. Non-pharmacological, lifestyle interventions have been associated with reductions in SNS overactivity and blood pressure in hypertension. Several evidence have highlighted the blood pressure lowering effects of aerobic endurance exercise in patients with hypertension and the significant reduction in sympathetic neural activity has been reported as one of the main mechanisms explaining the favorable effects of exercise on blood pressure control.
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Affiliation(s)
- Dario Leosco
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Valentina Parisi
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Grazia D Femminella
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Roberto Formisano
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Laura Petraglia
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Elena Allocca
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
| | - Domenico Bonaduce
- Department of Translational Medical Sciences, University of Naples "Federico II," Naples, Italy
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Paolillo S, Rengo G, Pagano G, Pellegrino T, Savarese G, Femminella GD, Tuccillo M, Boemio A, Attena E, Formisano R, Petraglia L, Scopacasa F, Galasso G, Leosco D, Trimarco B, Cuocolo A, Perrone-Filardi P. Impact of diabetes on cardiac sympathetic innervation in patients with heart failure: a 123I meta-iodobenzylguanidine (123I MIBG) scintigraphic study. Diabetes Care 2013; 36:2395-401. [PMID: 23530014 PMCID: PMC3714495 DOI: 10.2337/dc12-2147] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Impaired parasympathetic and sympathetic nervous system activity have been demonstrated in patients with diabetes mellitus (DM) and correlated with worse prognosis. Few data are available on the effect of DM on cardiac neuropathy in heart failure (HF). The aim of the current study was to assess cardiac sympathetic activity in HF patients with and without DM. RESEARCH DESIGN AND METHODS Patients with severe HF (n = 75), with (n = 37) and without DM (n = 38), and 14 diabetic patients with normal cardiac function underwent (123)I meta-iodobenzylguanidine scintigraphy from which early and late heart-to-mediastinum (H/M) ratios were calculated. Clinical, echocardiographic, and biochemical data were measured. RESULTS DM compared with non-DM patients showed significantly lower early (1.65 ± 0.21 vs. 1.75 ± 0.21; P < 0.05) and late H/M ratios (1.46 ± 0.22 vs. 1.58 ± 0.24; P < 0.03). Early and late H/M were significantly higher in DM patients without HF (2.22 ± 0.35 and 1.99 ± 0.24, respectively) than HF patients with (P < 0.0001) and without (P < 0.0001) DM. In HF patients, an inverse correlation between early or late H/M ratio and hemoglobin A1c (HbA1c) (Pearson = -0.473, P = 0.001; Pearson = -0.382, P = 0.001, respectively) was observed. In DM, in multivariate analysis, HbA1c and ejection fraction remained significant predictors of early H/M; HbA1c remained the only significant predictor of late H/M. No correlation between early or late H/M and HbA1c was found in non-DM patients. CONCLUSIONS Diabetic patients with HF show lower cardiac sympathetic activity than HF patients not having DM or than DM patients with a similar degree of autonomic dysfunction not having HF. HbA1c correlated with the degree of reduction in cardiac sympathetic activity.
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Affiliation(s)
- Stefania Paolillo
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University, Naples,Italy
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Romano R, Parisi V, Pastore F, Riccio A, Petraglia L, Allocca E, Leosco D. Genetic Test for the Channelopaties: Useful or Less Than Useful for Patients? (Part II). Transl Med UniSa 2013; 6:35-40. [PMID: 24251243 PMCID: PMC3829795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The advanced knowledge about genetic diseases and their mutations has widened the possibility to have a more precise and definitive diagnosis in many patients, but the use of genetic testing is still controversial. Actually, many cardiomyopathies show the availability of genetic testing. The clinical utility of this testing has been widely debated, but it is evident that the use of genetics must be put in a more organic diagnostic pathway that includes the evaluation of risks and benefits for the patient and his relatives, as well as the costs of the procedure. This review aims to clarify the role of genetic in clinics regarding Channelopaties, less frequent but equally important than other Cardiomyopathies because patients can often be asymptomatic until the first fatal manifestation.
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Affiliation(s)
- R Romano
- Department of Surgery and Cancer, Imperial College London
| | - V Parisi
- Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University of Naples “Federico II”
,
Corresponding author: Valentina Parisi (
)
| | - F Pastore
- Department of Cardiology, AOU “Maggiore Della Carità”, Novara
| | - A Riccio
- Department of Medicine, SUN, Naples
| | - L Petraglia
- Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University of Naples “Federico II”
| | - E Allocca
- Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University of Naples “Federico II”
| | - D Leosco
- Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University of Naples “Federico II”
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Ruggiero D, Savarese G, Formisano R, Bologna A, Mattiello G, Pirozzi E, Gambardella F, Lo Iudice F, Petraglia L, Vitagliano A, Casaretti L, Della Ratta GL, Mosca S, Filardi PP. [Endothelial dysfunction in type 2 diabetic patients with normal coronary arteries. A peripheral arterial tonometry study]. Monaldi Arch Chest Dis 2012; 78:34-9. [PMID: 22928402 DOI: 10.4081/monaldi.2012.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM to evaluate endothelial function (EF) in diabetic and non-diabetic patients without CAD by peripheral artery tonometry (PAT) technique. METHODS a cohort of 94 patients (55 men and 39 postmenopausal women; mean age 63 +/- 9 years) undergoing coronary angiography was divided into 2 groups: 58 patients with DM and (group 1) and 36 patients without DM. Endothelial dysfunction (ED) was assessed by digital pulse amplitude, using a fingertip peripheral arterial tonometry (PAT). As a measure of ED, reactive hyperemia index (RHI) was calculated as the ratio of the digital pulse volume during reactive hyperemia following 5 min ischemia and its basal value. RESULTS prevalence of cardiovascular risk factors was similar between the two groups. RHI values were significantly lower in diabetic patients compared to non-diabetics (1.72 +/- 0.34 vs 2.00 +/- 0.44; p < 0.005) and they correlated with levels of glycosylated hemoglobin (p = 0.05; r = -0.266). CONCLUSION despite similar level of other risk factors, EF was much more impaired in diabetic patients than in non-diabetics. These evidences further support the impact of DM on cardiovascular risk.
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Affiliation(s)
- Donatella Ruggiero
- Dipartimento di Medicina Interna, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli Federico II
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Casaretti L, Paolillo S, Formisano R, Bologna A, Mattiello G, Conte S, Petraglia L, Lo ludice F, Fabiani I, Cirillo AP, Vitagliano A, Gambardella F, della Ratta GL, Filardi PP. [Metabolic and cardiovascular effects of combined antiretroviral therapy in patients with HIV infection. Systematic review of literature]. Monaldi Arch Chest Dis 2012; 76:175-82. [PMID: 22567733 DOI: 10.4081/monaldi.2011.174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In HIV infected patients an increased incidence of cardiac events has been reported since the introduction of highly active antiretroviral therapy (HAART). Antiretroviral drugs' regimens are, in fact, associated with several metabolic side effects, such as dyslipidemia, impaired glucose metabolism and abnormal body fat distribution, that increase cardiovascular risk of HIV subjects. In addition, HIV infection itself, the chronic inflammatory status and the frequent presence in this population of traditional risk factors contribute to an higher incidence of cardio and cerebrovascular events. In last years several studies showed the occurrence of carotid vascular impairment in patients treated with protease inhibitors (PI). Similarly the DAD Study reported an increase of 26% of the risk of myocardial infarction in patients on HAART and that this risk was independently associated with longer exposure to PI, after multivariate adjustments. A correct evaluation of the metabolic status before starting HAART and an adequate control of drugs-related metabolic abnormalities may reduce the incidence of cardiac events and still improve HIV patients prognosis. This review will focus on the metabolic effects of antiretroviral drugs and on the contribution of combination antiretroviral therapy on cardiovascular risk.
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Affiliation(s)
- Laura Casaretti
- Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università Federico II, Napoli, Italy
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Irace L, Aiello C, Papa A, Sannino A, Petraglia L, De Lucia R, Dragonetti C. [Mid-term clinical study of the effectiveness of and tolerability to simvastatin ++ in dyslipidemic patients]. Minerva Med 1992; 83:815-8. [PMID: 1491761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The HGM-CoA reductase inhibitors, blaking up intracellular synthesis of cholesterol, support the receptorial captation of cholesterol with a reduction in plasma levels. The simvastatin efficacy was evaluated in 12 patients, mean age 59 +/- 10 years with a primary hypercholesterolemia. All the patients were on a pharmacologic wash out for at least 6 weeks and dietetic treatment (according to their weight and daily needs) for a week. Total cholesterol, HDL-cholesterol and triglycerides plasma levels were taken at time 0. Then a treatment with simvastatin 10 mg/die was begin for 4 weeks and than increased to 20 mg in patients with plasma cholesterol > 200 mg/100 ml at the end of fourth week. In some patients the dose was increased up to 40 mg for the elevated levels of plasma cholesterol at the end of the second month. All the parameters above were controlled monthly for three months. A control was performed at the end of sixth month of treatment. After 4 weeks treatment, simvastatin induced reduction in cholesterol plasma levels (p < 0.005), that continued during the whole time treatment (228 mg/dl at 24 week, p < 0.005 vs basal). The mean dosage of the simvastatin at fourth month was of 25 mg/die. During the treatment an increase of HDL plasma levels was noted, but this increment wasn't statistical significant (40 +/- 7 vs 45 +/- 9 mg/100 ml). No significant impairment of principal metabolic and laboratory parameters were observed during the treatment. These data indicate that simvastatin in small dose induce a reduction in cholesterol plasma levels with a significant increase in HDL without side effects.
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Affiliation(s)
- L Irace
- Università degli Studi di Napoli Federico II, Cattedra di Cardiologia
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