Gaspare Parrinello - Academia.edu (original) (raw)

Papers by Gaspare Parrinello

Clinical Science

The aim of the present study was to evaluate the effects of a normal-sodium (120 mmol sodium) die... more The aim of the present study was to evaluate the effects of a normal-sodium (120 mmol sodium) diet compared with a low-sodium diet (80 mmol sodium) on readmissions for CHF (congestive heart failure) during 180 days of follow-up in compensated patients with CHF. A total of 232 compensated CHF patients (88 female and 144 male; New York Heart Association class II-IV; 55-83 years of age, ejection fraction <35% and serum creatinine <2 mg/dl) were randomized into two groups: group 1 contained 118 patients (45 females and 73 males) receiving a normal-sodium diet plus oral furosemide [250-500 mg, b.i.d. (twice a day)]; and group 2 contained 114 patients (43 females and 71 males) receiving a low-sodium diet plus oral furosemide (250-500 mg, b.i.d.). The treatment was given at 30 days after discharge and for 180 days, in association with a fluid intake of 1000 ml per day. Signs of CHF, body weight, blood pressure, heart rate, laboratory parameters, ECG, echocardiogram, levels of BNP (br...

The American journal of cardiology

Studies have shown that patients with compensated heart failure (HF) receiving high diuretic dose... more Studies have shown that patients with compensated heart failure (HF) receiving high diuretic doses associated with normal sodium diet and fluid intake restrictions demonstrated significant reductions in readmissions and mortality compared with those who received low-sodium diets, and over a 6-month observation period, a reduction in neurohormonal activation was also observed. The aim of this study was to evaluate the effects of different sodium diets associated with different diuretic doses and different levels of fluid intake on hospital readmissions and neurohormonal changes after 6-month follow-up in patients with compensated HF. Four hundred ten consecutive patients with compensated HF (New York Heart Association class II to IV) aged 53 to 86 years, with ejection fractions <35% and serum creatinine <2 mg/dl, were randomized into 8 groups: group A (n = 52): 1,000 ml/day of fluid intake, 120 mmol/day, and 250 mg furosemide twice daily; group B (n = 51): 1,000 ml/day of fluid...

International journal of immunopathology and pharmacology

A 23-year-old man was admitted to hospital with a 12-day history of daily fever. A clinical histo... more A 23-year-old man was admitted to hospital with a 12-day history of daily fever. A clinical history revealed that 10 months previously, the patient had been splenectomized and polytransfused for a severe blunt trauma. On admission, laboratory data revealed significant leukocytosis (33,230/ul). The patient's general clinical conditions rapidly worsened into a severe systemic inflammatory response syndrome in four days. After 10 days of broad-spectrum antibiotic treatment, the temperature curve was unmodified and severe leukocytosis persisted (44,300 ul) with absolute lymphocytosis. Laboratory tests ruled out hematological diseases, pneumonia, abscesses and endocarditis. In the light of IgM positivity for CMV (unconfirmed by PCR) and with the support of a PubMed search, we commenced a salvage treatment with intravenous ganciclovir, suspecting a viral infection or reactivation. After two days of therapy, an immediate defervescence was observed with a remarkable clinical improvement...

International angiology : a journal of the International Union of Angiology, 2010

Patients with heterozygous familial hypercholesterolemia (FH) have an increased risk of premature... more Patients with heterozygous familial hypercholesterolemia (FH) have an increased risk of premature myocardial infarction, stroke, and surgical revascularization, and an increased rate of progression of carotid intima-media thickness (IMT). The most commonly used drugs for cholesterol lowering, statins, have a limited action in these patients. Ezetimibe, a novel compound, selectively inhibits cholesterol uptake and when associated with statins has an additional low-density lipoprotein cholesterol (LDL-C) reducing effect. The aim of this study is to evaluate the effects of long-term combined Ezetimibe/Simvastatin (EZE/SIMVA) therapy (30 months) on the lipidic pattern, inflammatory markers, and carotid IMT in patients with FH subdivided into two groups: one with a history of acute myocardial infarction (IMA) and the other with carotid atherosclerotic plaques but no history of cardiovascular events. All patients enrolled in this study (group A: patients with a history of IMA; group B, pa...

Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy, 2000

In this study the efficacy and safety of long-term losartan administration on renal haemodynamics... more In this study the efficacy and safety of long-term losartan administration on renal haemodynamics were evaluated in mild to moderate hypertension. After a run-in period with placebo, 18 hypertensives without renal or cardiovascular disease were allocated to losartan (50 mg/die for one year) treatment. Renal haemodynamic measurements included renal plasma flow (ERPF) and glomerular filtration rate (GFR) by standardized radioisotope study. Effective renal blood flow (ERBF), filtration fraction (FF), and renal vascular resistance (RVR) were also calculated. Blood pressure was evaluated monthly, whereas renal haemodynamics and function were detected at baseline and after 6 and 12 months of losartan administration. Losartan induced a significant (p < 0.001) decrease in SBP, DBP, and MBP versus baseline values both at 6 months and at 12 months. In addition a significant decrease in RVR (p < 0.001) and in FF (p < 0.05) was also seen. In addition RVR values at 1 year of treatment w...

Journal of human hypertension, 1993

Clinical and renal haemodynamic parameters were evaluated in 20 mild hypertensive patients after ... more Clinical and renal haemodynamic parameters were evaluated in 20 mild hypertensive patients after rilmenidine (RIL) administration during a one month double-blind randomised study compared with hydrochlorothiazide (HCT). At the beginning and at the end of the study, BP, heart rate and renal haemodynamic parameters were evaluated. Renal haemodynamic parameters included effective renal plasma flow (ERPF) evaluated by radionuclide study utilising 131I-Hippuran according to Schlegel's method, effective renal blood flow (ERBF = ERPF/(1-Ht)), glomerular filtration rate (GFR) by creatinine clearance, filtration fraction (FF = GFR/ERPF) and renal vascular resistances (RVR = DBP x 80/ERBF). RIL and HCT significantly (P < 0.01) reduced systolic, diastolic and mean blood pressure without relevant change in ERPF, ERBF, GFR and FF. RVR was significantly reduced both in the RIL group (P < 0.002 vs. baseline) and in the HCT group (P < 0.001 vs. baseline). No relevant side-effects were ...

International angiology : a journal of the International Union of Angiology, 1993

Hypertension and obesity are associated with an increased risk of clinical cardiovascular complic... more Hypertension and obesity are associated with an increased risk of clinical cardiovascular complications due to atherosclerosis. Moreover has been reported that hypertension may predispose to atheroma development. In the present review some common aspects to hypertension and atherosclerosis including smooth muscle cell proliferation, endothelial damage and intervention of growth factors have been analyzed. Additional data have to be provided to explain if the connections between hypertension and atherosclerosis could be considered two effects with one unknown cause. In addition some aspects related to obesity and atherosclerosis have been dissected. In particular we have reported our results indicating that young obese subjects without risk factors for cardiovascular disease have already several markers of cardiovascular damage i.e. atherogenetic lipid pattern, pro-thrombotic and hypofibrinolitic pattern without sign of coagulation and/or platelet in vivo activation, increased plasma...

European heart journal, 1994

This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptor (BAR) dens... more This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptor (BAR) density and their relationship with central haemodynamics and left ventricular function in young subjects with central or peripheral obesity. A total of 31 obese subjects (BMI > or = 30.5 kg.m-2 for males and > or = 27.3 kg.m-2 for females) aged less than 40 years and without other risk factors for cardiovascular diseases (smoking, hypertension, diabetes and lipid abnormalities) were studied. Nine had peripheral obesity and 22 central obesity according to WHR values; there were 20 lean controls (BMI < 25 kg.m-2 for males and < 24.7 kg.m-2 for females). Casual (c) and 24 h ambulatory mean blood pressures (MBP-24 h) were determined. BAR density was evaluated according to Böyum and De Blasi methods. Plasma catecholamines by high perfusion liquid chromatography and fasting immunoreactive plasma insulin (IRI) were also measured by RIA. Radionuclide angiocardiography was used to determ...

International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1995

To investigate the role of alterations in renal haemodynamics and function and in plasma renin ac... more To investigate the role of alterations in renal haemodynamics and function and in plasma renin activity on obesity-induced hypertension. Renal haemodynamics and function, salt-regulating hormones and structural cardiac parameters were evaluated in 20 lean normotensives and in 64 obese subjects with central or peripheral fat distribution, 43 of them were normotensives and 21 of them were hypertensives. Obesity and central fat distribution were defined according to sex-specific 85th percentile respectively of Body Mass Index (BMI) and Waist to Hip Ratio (WHR). Serum immunoreactive insulin (IRI), plasma renin activity (PRA), plasma aldosterone (PA), microalbuminuria (UAE) and 24h urinary excretion of sodium (NaU) were evaluated by current methods. Renal haemodynamics was evaluated by radionuclide study according to Schlegel's and Gate's methods. By radionuclide study, effective renal plasma flow (ERPF), effective renal blood flow (ERBF), glomerular filtration rate (GFR), filtra...

International journal of obesity, 1991

Several studies have shown a significant association of obesity with cardiovascular morbidity and... more Several studies have shown a significant association of obesity with cardiovascular morbidity and mortality. The present study was carried out to investigate central and systemic haemodynamics in overweight and moderate obese, but otherwise healthy subjects, and in a lean control group to determine whether obesity can influence left ventricular performance per se. In this study an attempt has been made to eliminate misleading factors, such as diabetes, lipid abnormalities and hypertension. A total of 67 subjects, 44 with overweight or moderate obesity and 23 lean healthy subjects, were included. Patients were divided into three groups according to BMI levels and Garrow's criteria as follows: lean control group (BMI less than 25 kg/m2); overweight (BMI from 25 to 30 kg/m2); moderate obese (BMI greater than 30 less than 40 kg/m2). Overweight and moderate obese subjects were further subgrouped according to duration of obesity (DO) in subgroup A (DO less than 98 months) and in subgr...

European heart journal, 1992

The present study was carried out to evaluate systolic and diastolic parameters in overweight and... more The present study was carried out to evaluate systolic and diastolic parameters in overweight and moderately obese, but otherwise healthy subjects, and in a lean control group, to determine whether degree and duration of obesity can influence left ventricular function. A total of 27 subjects, 17 overweight or with moderate obesity and 10 lean, healthy subjects were included. Patients were divided into three groups according to their body mass index (BMI) and to Garrow's criteria as follows: lean control group (BMI less than 25 kg.m-2); overweight subjects (BMI from 25 to 30 kg.m-2); moderately obese subjects (BMI greater than 30 less than 40 kg.m-2). Systolic and diastolic parameters were measured using blood pool gated radionuclide angiography. Left ventricular (LV) ejection fraction (EF), peak ejection rate (PER), time to PER (tPER), peak filling rate (PFR) and time to PFR (tPFR) were evaluated. PER and PFR values were normalized for end-diastolic volume (EDV). EF and PFR were...

American Journal of Hypertension, 2001

This study has been addressed to investigate the relationship among genetic variants of angiotens... more This study has been addressed to investigate the relationship among genetic variants of angiotensin-converting enzyme (ACE), blood pressure, left ventricular structure and function in young subjects with central obesity. Casual and ambulatory blood pressure (ABP)left ventricular structure and function were evaluated in 87 young subjects with central obesity subgrouped according to their ACE genotype (DD group; DI group;II group). ACE

ABSTRACT Am J Hypertens (2005) 18, 123A–123A; doi:10.1016/j.amjhyper.2005.03.342 P-324: Evaluatio... more ABSTRACT Am J Hypertens (2005) 18, 123A–123A; doi:10.1016/j.amjhyper.2005.03.342 P-324: Evaluation of BNP plasma levels and Bioelectrical Impedance Analysis (BIA) in decompensated heart failure. A double blind study Gaspare Parrinello1, Daniela Colomba1, Daniele Torres1, Antonio Fatta1, Salvatore Paterna1, Pietro Di Pasquale1 and Giuseppe Licata11Department of Internal Medicine, Univesity of Palermo, Palermo, Palermo, Italy; Department of Emergency Care, University of Palermo, Palermo, Italy; Cardiology and Intensive Care Unit, G.F. Ingrassia Hospital, Palermo, Palermo, Italy.

ABSTRACT The present prospective long-term study was conducted to evaluate whether the DD genotyp... more ABSTRACT The present prospective long-term study was conducted to evaluate whether the DD genotype could also be associated with a higher prevalence of hypertension in healthy subjects over 6 years of follow-up. We also investigated the effects of the ACE-I/D genotypes on diastolic function by echocardiographic method in healthy subjects without any risk factors and without any events after 6 years of follow-up. 684 healthy volunteers (aged 25–55 years) with acceptable echocardio-graphic window were enrolled. Physical examination,12-lead ECG, echocardiograms and venous blood samples for DNA analysis were performed. All subjects had a clinical evaluation each year for the 6 year. In addition,275 subjects without any risk factors underwent an ECHO every year of the follow-up, to check the influence of genotypes on myocardial diastolic performances. All 684 subjects completed 6 years of follow up. We obtained 3 genetically distinct groups. ACE-DD group,(n=225,80F/145M,mean age 43.4±7.6 years),had 42 hypertensive subjects (18.3%), 5 heart failure (HF) subjects and 6 subjects with acute coronary syndromes (ACS).There was not association between family history,smoking habit,hypercholesterolemia and events.ACE-ID group: (n=335, 116F/219M, mean age 43.6±7 years),had 16 hypertensive subjects (4.7%),and 3 subjects with ACS. ACE-II group:(n=124,45/79 F/M, mean age 42.5±6.9 years),had 2 hypertensive subjects (1.6%), and 1 HF subject. The incidence of hypertension and cardiovascular events, were significantly higher in ACE-DD (53 cases, 23%) than ACE-ID and ACE-II groups (20 and 3 cases,5.9% and 2.4%, respectively), p=0.0001. The higher incidence of hypertension was observed in the older age groups (36–45 and 46–55 years) with ACE-DD and ACE-ID genotypes. Moreover, ACE-DD significantly and early affected myocardial diastolic properties in the whole examined group, also when stratified for the age. There was a reduction of E/A ratio and it was more evident in subjects aged 36–45 and 46–55 years, p=0.0001.Our data suggest that ACE-DD polymorphism is associated to a higher incidence of hypertension and appears to affect the diastolic function.

Background: There are several new strategies proposed to improve the outcome of patients with STe... more Background: There are several new strategies proposed to improve the outcome of patients with STelevation myocardial infarction (STEMI). One approach is the resurgent use of facilitated percutaneous coronary interventions (PCI). Until recently, deciding whether immediate PCI after combined treatment (facilitated PCI) is more appropriate than delayed PCI (short time) has not been investigated. The aim of this study, therefore, was to investigate the outcomes in patients initially successfully treated pharmacologically and immediate PCI < 2 hr, and in patients initially successfully treated with pharmacological therapy and with delayed PCI (12-72 h).

Background and objectives: Hypertension is a significant cause of chronic renal injury and its ef... more Background and objectives: Hypertension is a significant cause of chronic renal injury and its effective treatment is capable of reducing the rate of renal failure. b-Adrenoceptor antagonists (b-blockers) have been reported to induce a deterioration in renal function, while several data have indicated a renoprotective effect of treatment with the angiotensin II type 1 receptor antagonist losartan. Previous studies of the interaction between the selective b 1 -blocker bisoprolol and kidney function were performed only for shortand medium-term periods. The aim of this study was to compare the antihypertensive efficacy and renal and cardiac haemodynamic effects of bisoprolol with those of losartan over a 1-year time period in patients with essential hypertension. Methods: Seventy-two patients (40 males) with recently diagnosed uncomplicated (European Society of Hypertension [ESH] criteria stage 1-2) hypertension (mean -SD age 52 -12 years) were enrolled in the study. After a run-in period of 14 days on placebo, the patients were randomized in a double-blind, prospective study to receive either bisoprolol 5 mg or losartan 50 mg, administered once daily for 1 year. At recruitment and 12 months after treatment, cardiac output and renal haemodynamics and function were evaluated by echocardiography and radionuclide studies, respectively. Results: There were no significant differences in baseline clinical data, including glomerular filtration rate and blood pressure, between the two treatment groups. At 1 year, blood pressure had decreased significantly (p < 0.001) with both treatments, and heart rate was reduced only in the group taking bisoprolol. The long-term effects on renal haemodynamics and cardiac function were similar with both drugs, the only change being a significant reduction in the filtration fraction for each group.

Internal and emergency medicine, 2009