Graziamaria Corbi - Academia.edu (original) (raw)

Papers by Graziamaria Corbi

Immunity & ageing : I & A, 2017

An exercise-based Cardiac Rehabilitation Programme (CRP) is established as adjuvant therapy in he... more An exercise-based Cardiac Rehabilitation Programme (CRP) is established as adjuvant therapy in heart failure (HF), nevertheless it is underutilized, especially in the elderly. While the functional and hemodynamic effects of CRP are well known, its underlying molecular mechanisms have not been fully clarified. The present study aims to evaluate the effects of a well-structured 4-week CRP in patients with stable HF from a molecular point of view. A prospective longitudinal observational study was conducted on patients consecutively admitted to cardiac rehabilitation. In fifty elderly HF patients with preserved ejection fraction (HFpEF), levels of sirtuin 1 (Sirt1) in peripheral blood mononuclear cells (PBMCs) and of its targets, the antioxidants catalase (Cat) and superoxide dismutase (SOD) in serum were measured before (Patients, P) and at the end of the CRP (Rehabilitated Patients, RP), showing a rise of their activities after rehabilitation. Endothelial cells (ECs) were conditioned...

Sedentary lifestyle along with high blood pressure, abnormal values for blood lipids, smoking, an... more Sedentary lifestyle along with high blood pressure, abnormal values for blood lipids, smoking, and obesity are recognized risk factors for cardiovascular diseases and for many other chronic diseases, such as diabetes, osteoporosis, breast and colon cancer. Several studies conducted on large cohort of individuals have documented the protective effects of physical activity for both vascular and nonvascular syndromes. Exercise training is an integral part of cardiac rehabilitation, a complex therapeutic approach, effective both in young and elderly patients. Despite the number of evidences underling the benefits associated with physical fitness, the cardiac rehabilitation is still an underused medical resource. The molecular mechanism behind physical activity protective effect is presently unresolved, and further studies are also needed to establish the best protocol in terms of specificity, volume and duration of the training.

Medicine, 2015

To evaluate the impact of an educational strategy on potentially inappropriate medications (PIMs)... more To evaluate the impact of an educational strategy on potentially inappropriate medications (PIMs) and length of stay in hospitalized elderly patients. An open study, with two cross-sectional surveys interspersed with an educational program (PRE phase and POST phase), has been performed in order to compare the PIMs number before and after the introduction of an educational strategy. The study included 2 phases: PRE, in which patients were enrolled as control group; POST, in which an educational strategy on the PIMs use was introduced among physicians, and patients were enrolled as intervention group. Italian residential rehabilitation Centre.Inclusion criteria were ≥2 active chronic diseases and the current use of ≥4 medications.The educational strategy consisted of a 3-day course on strategies to prevent PIMs and a computerized tool running on a Personal Digital Assistant (PDA) device to check for PIMs. The primary was the PIMs number, the secondary the length of stay. A total of 79...

Studies in health technology and informatics, 2009

Non-linear parameters obtained from heart rate variability (HRV) analysis has recently been recog... more Non-linear parameters obtained from heart rate variability (HRV) analysis has recently been recognized to provide valuable information for physiological interpretation of heart rate fluctuation. Among the numerous non-linear parameters related to the fractal behaviour of the HRV signal, two classes have gained wide interest in the last years: the beta exponent based on the 1/f-like relationship, starting from the spectral power, and that based on fractal dimension. In order to evaluate the relationship between lesion's severity and fractal behaviour, 20 first-ever stroke subjects and 10 healthy subjects were studied. Patients were divided in two groups according to single or multiple medium cerebral artery lesions. All subjects underwent 24-hour Holter recording analysed by fractal and 1/f-like techniques. Differently from methods usually used in literature to evaluate the fractal dimension (FD), in this work the FD was extracted by using the Higuchi's algorithm that permits...

American Journal of Hypertension, 2005

The aim was to investigate the ability of insulin to modulate the response to ␤-adrenergic action... more The aim was to investigate the ability of insulin to modulate the response to ␤-adrenergic action on myocardial contractility, assessed as percentage changes of developed tension, in isolated rat papillary muscle.

2010 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC'10, 2010

Cardiovascular oscillations following spontaneous ventricular premature complexes (VPC) are chara... more Cardiovascular oscillations following spontaneous ventricular premature complexes (VPC) are characterized by a short-term heart rate fluctuation known as heart rate turbulence (HRT) described by the so-called turbulence onset (TO) and slope (TS). Despite a recent written consensus on the standard of HRT measurement, reproducibility data are lacking. Aim of the paper was a reproducibility study of HRT indexes in heart failure patients (HF). Eleven HF patients underwent two 24h ECG Holter recordings, spaced 7 ± 5 days. A paired t test was used to assess the clinical stability of patients during the study period and the number of PVC in Holter recordings' couples. Both TO and TS indexes were calculated for each isolated VPC, and due to their skewed distribution, reproducibility of median and mean TO and TS was studied by Bland-Altman technique. Results showed that median HRT indexes might be preferred to commonly suggested mean values and that, although TO showed lower bias value than TS, TS can be considered much more reproducible than TO, comparing limits of agreements with normal values. This preliminary results suggest the use of medians instead of mean HRT indexes values and a reliability of the turbulence slope greater than the turbulence onset index.

IFMBE Proceedings, 2010

Higher neurohormonal activation levels are known markers of severity and adverse prognosis in hea... more Higher neurohormonal activation levels are known markers of severity and adverse prognosis in heart failure (HF) patients. Classical linear indexes of heart rate variability (HRV) have been shown to be associated with neurohormonal activation. Whether and to what extent non-linear properties of HRV, as expressed by the fractal dimension (FD) index, also reflect neurohormonal activation is not known. Aim of

The development of atherosclerosis is a multi-step process, at least in part controlled by the va... more The development of atherosclerosis is a multi-step process, at least in part controlled by the vascular endothelium function. Observations in humans and experimental models of atherosclerosis have identified monocyte recruitment as an early event in atherogenesis. Chronic inflammation is associated with ageing and its related diseases (e.g., atherosclerosis and chronic obstructive pulmonary disease). Recently it has been discovered that Sirtuins (NAD + -dependent deacetylases) represent a pivotal regulator of longevity and health. They appear to have a prominent role in vascular biology and regulate aspects of age-dependent atherosclerosis. Many studies demonstrate that SIRT1 OPEN ACCESS

Elderly abuse is still a hidden problem, often underestimated. It is much more common than the da... more Elderly abuse is still a hidden problem, often underestimated. It is much more common than the data available suggest. Unfortunately, the incidence is expected to grow with the progressive increase in the elderly population in the future. The aim was to examine the available literature in the last 5 years to define the state of art on this phenomenon, with particular regard to the nursing role in elderly abuse, focusing on the possible types of mistreatment, the motivations and preventive interventions. Articles published in the last 5 years regarding the mistreatment of the elderly were selected, by using scientifically recognized databases such as PubMed, Cochrane Library, Medline, Scopus, and Web of Knowledge. Several keywords were used for the query among which were: ''elderly abuse'' and ''elderly abuse in nursing home''. Moreover, to better understand the entity of the phenomenon, we also searched the corresponding keywords for child abuse. Considering the Scopus database, only 78 out of 1,342 published articles in the last 5 years deal with abuse of the elderly in relation to nursing, representing a very small part (5.81 %) of the considered sample. Comparing the number of articles, the ratio child/elderly is equal to 1/0.04, underlying the poor interest of research on this phenomenon. Moreover, it was observed that elderly abuse in nursing homes is still underreported in both original articles and reviews. Despite the aging of the population, elderly abuse and neglect still remain hidden problems, overlooked and also underestimated in the literature.

Elderly healthy individuals have a reduced exercise tolerance and a decreased left ventricle inot... more Elderly healthy individuals have a reduced exercise tolerance and a decreased left ventricle inotropic reserve related to increased vascular afterload, arterial-ventricular load mismatching, physical deconditioning and impaired autonomic regulation (the so called "β-adrenergic desensitization"). Adrenergic responsiveness is altered with aging and the age-related changes are limited to the β-adrenergic receptor density reduction and to the β-adrenoceptor-G-protein(s)-adenylyl cyclase system abnormalities, while the type and level of abnormalities change with species and tissues. Epidemiological studies have shown an high incidence and prevalence of heart failure in the elderly and a great body of evidence correlate the changes of β-adrenergic system with heart failure pathogenesis. In particular it is well known that: (a) levels of cathecolamines are directly correlated with mortality and functional status in heart failure, (b) β 1 -adrenergic receptor subtype is down-regulated in heart failure, (c) heart failure-dependent cardiac adrenergic responsiveness reduction is related to changes in G proteins activity. In this review we focus on the cardiovascular β-adrenergic changes involvement in the aging process and on similarities and differences between aging heart and heart failure.

Frontiers in Physiology, 2013

The adrenergic system plays a central role in stress signaling and stress is often associated wit... more The adrenergic system plays a central role in stress signaling and stress is often associated with increased production of ROS. However, ROS overproduction generates oxidative stress, that occurs in response to several stressors. β-adrenergic signaling is markedly attenuated in conditions such as heart failure, with downregulation and desensitization of the receptors and their uncoupling from adenylyl cyclase. Transgenic activation of β2-adrenoceptor leads to elevation of NADPH oxidase activity, with greater ROS production and p38MAPK phosphorylation. Inhibition of NADPH oxidase or ROS significantly reduced the p38MAPK signaling cascade. Chronic β2-adrenoceptor activation is associated with greater cardiac dilatation and dysfunction, augmented pro-inflammatory and profibrotic signaling, while antioxidant treatment protected hearts against these abnormalities, indicating ROS production to be central to the detrimental signaling of β2-adrenoceptors. It has been demonstrated that sirtuins are involved in modulating the cellular stress response directly by deacetylation of some factors. Sirt1 increases cellular stress resistance, by an increased insulin sensitivity, a decreased circulating free fatty acids and insulin-like growth factor (IGF-1), an increased activity of AMPK, increased activity of PGC-1a, and increased mitochondrial number. Sirt1 acts by involving signaling molecules such P-I-3-kinase-Akt, MAPK and p38-MAPK-β. βAR stimulation antagonizes the protective effect of the AKT pathway through inhibiting induction of Hif-1α and Sirt1 genes, key elements in cell survival. More studies are needed to better clarify the involvement of sirtuins in the β-adrenergic response and, overall, to better define the mechanisms by which tools such as exercise training are able to counteract the oxidative stress, by both activation of sirtuins and inhibition of GRK2 in many cardiovascular conditions and can be used to prevent or treat diseases such as heart failure.

Rheumatology, 2007

Objective. To assess the effectiveness of rehabilitation in a group of patients with active ankyl... more Objective. To assess the effectiveness of rehabilitation in a group of patients with active ankylosing spondylitis (AS) by the Assessment in Ankylosing Spondylitis (ASAS) Working Group response criteria. Methods. Fifty-two active AS patients consecutively admitted to a rehabilitation inpatient clinic were enrolled. Patients underwent a 3-week intensive rehabilitation programme and were then discharged with home exercises. The primary outcome measure was the proportion of patients achieving a response based on ASAS 20 at discharge, and at 6 and 12 weeks after. Secondary outcome measures included an improvement in the Revised Leeds Disability Questionnaire (RLDQ) and function expressed as anthropometric measures. Results. The ASAS 20 was achieved in 46 patients (88.5%) at the end of the rehabilitation, in 31 (59.6%) and in 17 (32.7%) patients at 6 and 12 weeks follow-up, respectively. The percentage of ASAS 20 responders statistically declined over time measured from the end of rehabilitation compared with 6 (P < 0.001) and 12 weeks follow-up (P < 0.001).

Rejuvenation Research, 2008

The objective of this study was to determine the effects of aging and exercise training on SIRT1 ... more The objective of this study was to determine the effects of aging and exercise training on SIRT1 activity and to identify a pathway linking SIRT1 to antioxidant response and cell cycle regulation in rats. SIRT1 is a NAD ؉ -dependent deacetylase involved in the oxidative stress response and aging. The effects of aging and of moderate and prolonged exercise training in rats are unknown. We measured SIRT1 activity in heart and adipose tissue of young (6 months old), sedentary old (24 months), and trained old (24 months) rats using an assay kit. Peroxidative damage was determined by measuring levels of thiobarbituric reactive substances (TBARS) and the protein-

Rejuvenation Research, 2008

The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elde... more The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elderly with congestive heart failure (CHF) admitted to the Rehabilitative Cardiology Unit of S. Maugeri Foundation Scientific Institute of Telese/Campoli. All elderly patients Ն 65 years old with a diagnosis of CHF underwent clinical and instrumental examination, and their demographics, co-morbidity, and in-hospital and 3-year mortality rates were recorded. Hypomagnesemia was found in 4.8%, normomagnesemia in 67.5%, and hypermagnesemia in 27.8% of subjects. The hypomagnesemic group was excluded for numerical exiguity; the analysis was performed on a total of 199 elderly patients. Hypermagnesemia was found in 29.1% and normomagnesemia in 70.9%. At the univariate analysis no differences were found in hypermagnesemia in respect to normomagnesemia group, except for slightly higher levels of creatininemia (1.35 ؎ 0.61 vs. 1.13 ؎ 0.55 mg/dL, respectively; p Ͻ 0.02), greater disability (lost ADL, 2.69 ؎ 1.57 vs. 2.15 ؎ 1.56, respectively; p Ͻ 0.05), more mortality for CHF (32.6 vs. 48.3%; p Ͻ 0.05), and higher antacid and laxative use (82.7 vs. 24.8%, respectively; p Ͻ 0.0001). Patients with higher magnesium showed less probability to survive at a 3-year follow-up than did patients with lower levels (17.32 ؎ 15.93 vs. 22.46 ؎ 16.16 months; p Ͻ 0.05), and this finding remained significant in the multivariate analysis after adjusting for some confounders. Finally hypermagnesemia should also be considered in the absence of pre-existing renal failure clinical evidence because of its negative prognostic value, especially in elderly patients with CHF. The shown relationship between hypermagnesemia and laxative/antacid use should induce physicians to pay more attention to abuse of these drugs.

Nutrients, 2013

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be ... more Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be complicated by development of co-morbidities including metabolic disorders. Metabolic disorders commonly associated with this disease contribute to lung function impairment and mortality. Systemic inflammation appears to be a major factor linking COPD to metabolic alterations. Adipose tissue seems to interfere with systemic inflammation in COPD patients by producing a large number of proteins, known as "adipokines", involved in various processes such as metabolism, immunity and inflammation. There is evidence that adiponectin is an important modulator of inflammatory processes

Journal of Electrocardiology, 2011

Experimental Gerontology, 2006

The aim of this study was to test the effects of age and chronic exercise training on antioxidant... more The aim of this study was to test the effects of age and chronic exercise training on antioxidant and heat shock protein (Hsp) expression by comparing the hearts of young (Y), sedentary old (SO) and trained old (TO) rats. In SO rats, there were: (a) changes in myocardial structure and function; (b) increased malondialdehyde levels; (c) no changes in superoxide-dismutase (SOD) enzymes; (d) reduced Hsp70 expression; and (e) increased Hsp27 expression. In TO rats, SOD enzymes and Hsp70 expression were increased and Hsp27 was further increased. Malondialdehyde level did not differ between TO and SO rats, which shows that chronic exercise did not affect the peroxidation index. In summary, by increasing Hsp27 and Hs70 levels, prolonged exercise partially counterbalanced the heart age-related effects in the antioxidant system without altering peroxidation levels. These findings suggest that the beneficial effects on aged-related cardiovascular changes could be connected to the ''anti-oxidant'' effects of prolonged exercise training.

Cardiovascular Drugs and Therapy, 2004

The study evaluated the effect of Losartan in preventing nitrate tolerance during continuous tran... more The study evaluated the effect of Losartan in preventing nitrate tolerance during continuous transdermal nitroglycerin (TD-GTN) therapy in patients with coronary disease.

Immunity & ageing : I & A, 2017

An exercise-based Cardiac Rehabilitation Programme (CRP) is established as adjuvant therapy in he... more An exercise-based Cardiac Rehabilitation Programme (CRP) is established as adjuvant therapy in heart failure (HF), nevertheless it is underutilized, especially in the elderly. While the functional and hemodynamic effects of CRP are well known, its underlying molecular mechanisms have not been fully clarified. The present study aims to evaluate the effects of a well-structured 4-week CRP in patients with stable HF from a molecular point of view. A prospective longitudinal observational study was conducted on patients consecutively admitted to cardiac rehabilitation. In fifty elderly HF patients with preserved ejection fraction (HFpEF), levels of sirtuin 1 (Sirt1) in peripheral blood mononuclear cells (PBMCs) and of its targets, the antioxidants catalase (Cat) and superoxide dismutase (SOD) in serum were measured before (Patients, P) and at the end of the CRP (Rehabilitated Patients, RP), showing a rise of their activities after rehabilitation. Endothelial cells (ECs) were conditioned...

Sedentary lifestyle along with high blood pressure, abnormal values for blood lipids, smoking, an... more Sedentary lifestyle along with high blood pressure, abnormal values for blood lipids, smoking, and obesity are recognized risk factors for cardiovascular diseases and for many other chronic diseases, such as diabetes, osteoporosis, breast and colon cancer. Several studies conducted on large cohort of individuals have documented the protective effects of physical activity for both vascular and nonvascular syndromes. Exercise training is an integral part of cardiac rehabilitation, a complex therapeutic approach, effective both in young and elderly patients. Despite the number of evidences underling the benefits associated with physical fitness, the cardiac rehabilitation is still an underused medical resource. The molecular mechanism behind physical activity protective effect is presently unresolved, and further studies are also needed to establish the best protocol in terms of specificity, volume and duration of the training.

Medicine, 2015

To evaluate the impact of an educational strategy on potentially inappropriate medications (PIMs)... more To evaluate the impact of an educational strategy on potentially inappropriate medications (PIMs) and length of stay in hospitalized elderly patients. An open study, with two cross-sectional surveys interspersed with an educational program (PRE phase and POST phase), has been performed in order to compare the PIMs number before and after the introduction of an educational strategy. The study included 2 phases: PRE, in which patients were enrolled as control group; POST, in which an educational strategy on the PIMs use was introduced among physicians, and patients were enrolled as intervention group. Italian residential rehabilitation Centre.Inclusion criteria were ≥2 active chronic diseases and the current use of ≥4 medications.The educational strategy consisted of a 3-day course on strategies to prevent PIMs and a computerized tool running on a Personal Digital Assistant (PDA) device to check for PIMs. The primary was the PIMs number, the secondary the length of stay. A total of 79...

Studies in health technology and informatics, 2009

Non-linear parameters obtained from heart rate variability (HRV) analysis has recently been recog... more Non-linear parameters obtained from heart rate variability (HRV) analysis has recently been recognized to provide valuable information for physiological interpretation of heart rate fluctuation. Among the numerous non-linear parameters related to the fractal behaviour of the HRV signal, two classes have gained wide interest in the last years: the beta exponent based on the 1/f-like relationship, starting from the spectral power, and that based on fractal dimension. In order to evaluate the relationship between lesion's severity and fractal behaviour, 20 first-ever stroke subjects and 10 healthy subjects were studied. Patients were divided in two groups according to single or multiple medium cerebral artery lesions. All subjects underwent 24-hour Holter recording analysed by fractal and 1/f-like techniques. Differently from methods usually used in literature to evaluate the fractal dimension (FD), in this work the FD was extracted by using the Higuchi's algorithm that permits...

American Journal of Hypertension, 2005

The aim was to investigate the ability of insulin to modulate the response to ␤-adrenergic action... more The aim was to investigate the ability of insulin to modulate the response to ␤-adrenergic action on myocardial contractility, assessed as percentage changes of developed tension, in isolated rat papillary muscle.

2010 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC'10, 2010

Cardiovascular oscillations following spontaneous ventricular premature complexes (VPC) are chara... more Cardiovascular oscillations following spontaneous ventricular premature complexes (VPC) are characterized by a short-term heart rate fluctuation known as heart rate turbulence (HRT) described by the so-called turbulence onset (TO) and slope (TS). Despite a recent written consensus on the standard of HRT measurement, reproducibility data are lacking. Aim of the paper was a reproducibility study of HRT indexes in heart failure patients (HF). Eleven HF patients underwent two 24h ECG Holter recordings, spaced 7 ± 5 days. A paired t test was used to assess the clinical stability of patients during the study period and the number of PVC in Holter recordings&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; couples. Both TO and TS indexes were calculated for each isolated VPC, and due to their skewed distribution, reproducibility of median and mean TO and TS was studied by Bland-Altman technique. Results showed that median HRT indexes might be preferred to commonly suggested mean values and that, although TO showed lower bias value than TS, TS can be considered much more reproducible than TO, comparing limits of agreements with normal values. This preliminary results suggest the use of medians instead of mean HRT indexes values and a reliability of the turbulence slope greater than the turbulence onset index.

IFMBE Proceedings, 2010

Higher neurohormonal activation levels are known markers of severity and adverse prognosis in hea... more Higher neurohormonal activation levels are known markers of severity and adverse prognosis in heart failure (HF) patients. Classical linear indexes of heart rate variability (HRV) have been shown to be associated with neurohormonal activation. Whether and to what extent non-linear properties of HRV, as expressed by the fractal dimension (FD) index, also reflect neurohormonal activation is not known. Aim of

The development of atherosclerosis is a multi-step process, at least in part controlled by the va... more The development of atherosclerosis is a multi-step process, at least in part controlled by the vascular endothelium function. Observations in humans and experimental models of atherosclerosis have identified monocyte recruitment as an early event in atherogenesis. Chronic inflammation is associated with ageing and its related diseases (e.g., atherosclerosis and chronic obstructive pulmonary disease). Recently it has been discovered that Sirtuins (NAD + -dependent deacetylases) represent a pivotal regulator of longevity and health. They appear to have a prominent role in vascular biology and regulate aspects of age-dependent atherosclerosis. Many studies demonstrate that SIRT1 OPEN ACCESS

Elderly abuse is still a hidden problem, often underestimated. It is much more common than the da... more Elderly abuse is still a hidden problem, often underestimated. It is much more common than the data available suggest. Unfortunately, the incidence is expected to grow with the progressive increase in the elderly population in the future. The aim was to examine the available literature in the last 5 years to define the state of art on this phenomenon, with particular regard to the nursing role in elderly abuse, focusing on the possible types of mistreatment, the motivations and preventive interventions. Articles published in the last 5 years regarding the mistreatment of the elderly were selected, by using scientifically recognized databases such as PubMed, Cochrane Library, Medline, Scopus, and Web of Knowledge. Several keywords were used for the query among which were: ''elderly abuse'' and ''elderly abuse in nursing home''. Moreover, to better understand the entity of the phenomenon, we also searched the corresponding keywords for child abuse. Considering the Scopus database, only 78 out of 1,342 published articles in the last 5 years deal with abuse of the elderly in relation to nursing, representing a very small part (5.81 %) of the considered sample. Comparing the number of articles, the ratio child/elderly is equal to 1/0.04, underlying the poor interest of research on this phenomenon. Moreover, it was observed that elderly abuse in nursing homes is still underreported in both original articles and reviews. Despite the aging of the population, elderly abuse and neglect still remain hidden problems, overlooked and also underestimated in the literature.

Elderly healthy individuals have a reduced exercise tolerance and a decreased left ventricle inot... more Elderly healthy individuals have a reduced exercise tolerance and a decreased left ventricle inotropic reserve related to increased vascular afterload, arterial-ventricular load mismatching, physical deconditioning and impaired autonomic regulation (the so called "β-adrenergic desensitization"). Adrenergic responsiveness is altered with aging and the age-related changes are limited to the β-adrenergic receptor density reduction and to the β-adrenoceptor-G-protein(s)-adenylyl cyclase system abnormalities, while the type and level of abnormalities change with species and tissues. Epidemiological studies have shown an high incidence and prevalence of heart failure in the elderly and a great body of evidence correlate the changes of β-adrenergic system with heart failure pathogenesis. In particular it is well known that: (a) levels of cathecolamines are directly correlated with mortality and functional status in heart failure, (b) β 1 -adrenergic receptor subtype is down-regulated in heart failure, (c) heart failure-dependent cardiac adrenergic responsiveness reduction is related to changes in G proteins activity. In this review we focus on the cardiovascular β-adrenergic changes involvement in the aging process and on similarities and differences between aging heart and heart failure.

Frontiers in Physiology, 2013

The adrenergic system plays a central role in stress signaling and stress is often associated wit... more The adrenergic system plays a central role in stress signaling and stress is often associated with increased production of ROS. However, ROS overproduction generates oxidative stress, that occurs in response to several stressors. β-adrenergic signaling is markedly attenuated in conditions such as heart failure, with downregulation and desensitization of the receptors and their uncoupling from adenylyl cyclase. Transgenic activation of β2-adrenoceptor leads to elevation of NADPH oxidase activity, with greater ROS production and p38MAPK phosphorylation. Inhibition of NADPH oxidase or ROS significantly reduced the p38MAPK signaling cascade. Chronic β2-adrenoceptor activation is associated with greater cardiac dilatation and dysfunction, augmented pro-inflammatory and profibrotic signaling, while antioxidant treatment protected hearts against these abnormalities, indicating ROS production to be central to the detrimental signaling of β2-adrenoceptors. It has been demonstrated that sirtuins are involved in modulating the cellular stress response directly by deacetylation of some factors. Sirt1 increases cellular stress resistance, by an increased insulin sensitivity, a decreased circulating free fatty acids and insulin-like growth factor (IGF-1), an increased activity of AMPK, increased activity of PGC-1a, and increased mitochondrial number. Sirt1 acts by involving signaling molecules such P-I-3-kinase-Akt, MAPK and p38-MAPK-β. βAR stimulation antagonizes the protective effect of the AKT pathway through inhibiting induction of Hif-1α and Sirt1 genes, key elements in cell survival. More studies are needed to better clarify the involvement of sirtuins in the β-adrenergic response and, overall, to better define the mechanisms by which tools such as exercise training are able to counteract the oxidative stress, by both activation of sirtuins and inhibition of GRK2 in many cardiovascular conditions and can be used to prevent or treat diseases such as heart failure.

Rheumatology, 2007

Objective. To assess the effectiveness of rehabilitation in a group of patients with active ankyl... more Objective. To assess the effectiveness of rehabilitation in a group of patients with active ankylosing spondylitis (AS) by the Assessment in Ankylosing Spondylitis (ASAS) Working Group response criteria. Methods. Fifty-two active AS patients consecutively admitted to a rehabilitation inpatient clinic were enrolled. Patients underwent a 3-week intensive rehabilitation programme and were then discharged with home exercises. The primary outcome measure was the proportion of patients achieving a response based on ASAS 20 at discharge, and at 6 and 12 weeks after. Secondary outcome measures included an improvement in the Revised Leeds Disability Questionnaire (RLDQ) and function expressed as anthropometric measures. Results. The ASAS 20 was achieved in 46 patients (88.5%) at the end of the rehabilitation, in 31 (59.6%) and in 17 (32.7%) patients at 6 and 12 weeks follow-up, respectively. The percentage of ASAS 20 responders statistically declined over time measured from the end of rehabilitation compared with 6 (P < 0.001) and 12 weeks follow-up (P < 0.001).

Rejuvenation Research, 2008

The objective of this study was to determine the effects of aging and exercise training on SIRT1 ... more The objective of this study was to determine the effects of aging and exercise training on SIRT1 activity and to identify a pathway linking SIRT1 to antioxidant response and cell cycle regulation in rats. SIRT1 is a NAD ؉ -dependent deacetylase involved in the oxidative stress response and aging. The effects of aging and of moderate and prolonged exercise training in rats are unknown. We measured SIRT1 activity in heart and adipose tissue of young (6 months old), sedentary old (24 months), and trained old (24 months) rats using an assay kit. Peroxidative damage was determined by measuring levels of thiobarbituric reactive substances (TBARS) and the protein-

Rejuvenation Research, 2008

The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elde... more The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elderly with congestive heart failure (CHF) admitted to the Rehabilitative Cardiology Unit of S. Maugeri Foundation Scientific Institute of Telese/Campoli. All elderly patients Ն 65 years old with a diagnosis of CHF underwent clinical and instrumental examination, and their demographics, co-morbidity, and in-hospital and 3-year mortality rates were recorded. Hypomagnesemia was found in 4.8%, normomagnesemia in 67.5%, and hypermagnesemia in 27.8% of subjects. The hypomagnesemic group was excluded for numerical exiguity; the analysis was performed on a total of 199 elderly patients. Hypermagnesemia was found in 29.1% and normomagnesemia in 70.9%. At the univariate analysis no differences were found in hypermagnesemia in respect to normomagnesemia group, except for slightly higher levels of creatininemia (1.35 ؎ 0.61 vs. 1.13 ؎ 0.55 mg/dL, respectively; p Ͻ 0.02), greater disability (lost ADL, 2.69 ؎ 1.57 vs. 2.15 ؎ 1.56, respectively; p Ͻ 0.05), more mortality for CHF (32.6 vs. 48.3%; p Ͻ 0.05), and higher antacid and laxative use (82.7 vs. 24.8%, respectively; p Ͻ 0.0001). Patients with higher magnesium showed less probability to survive at a 3-year follow-up than did patients with lower levels (17.32 ؎ 15.93 vs. 22.46 ؎ 16.16 months; p Ͻ 0.05), and this finding remained significant in the multivariate analysis after adjusting for some confounders. Finally hypermagnesemia should also be considered in the absence of pre-existing renal failure clinical evidence because of its negative prognostic value, especially in elderly patients with CHF. The shown relationship between hypermagnesemia and laxative/antacid use should induce physicians to pay more attention to abuse of these drugs.

Nutrients, 2013

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be ... more Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be complicated by development of co-morbidities including metabolic disorders. Metabolic disorders commonly associated with this disease contribute to lung function impairment and mortality. Systemic inflammation appears to be a major factor linking COPD to metabolic alterations. Adipose tissue seems to interfere with systemic inflammation in COPD patients by producing a large number of proteins, known as "adipokines", involved in various processes such as metabolism, immunity and inflammation. There is evidence that adiponectin is an important modulator of inflammatory processes

Journal of Electrocardiology, 2011

Experimental Gerontology, 2006

The aim of this study was to test the effects of age and chronic exercise training on antioxidant... more The aim of this study was to test the effects of age and chronic exercise training on antioxidant and heat shock protein (Hsp) expression by comparing the hearts of young (Y), sedentary old (SO) and trained old (TO) rats. In SO rats, there were: (a) changes in myocardial structure and function; (b) increased malondialdehyde levels; (c) no changes in superoxide-dismutase (SOD) enzymes; (d) reduced Hsp70 expression; and (e) increased Hsp27 expression. In TO rats, SOD enzymes and Hsp70 expression were increased and Hsp27 was further increased. Malondialdehyde level did not differ between TO and SO rats, which shows that chronic exercise did not affect the peroxidation index. In summary, by increasing Hsp27 and Hs70 levels, prolonged exercise partially counterbalanced the heart age-related effects in the antioxidant system without altering peroxidation levels. These findings suggest that the beneficial effects on aged-related cardiovascular changes could be connected to the ''anti-oxidant'' effects of prolonged exercise training.

Cardiovascular Drugs and Therapy, 2004

The study evaluated the effect of Losartan in preventing nitrate tolerance during continuous tran... more The study evaluated the effect of Losartan in preventing nitrate tolerance during continuous transdermal nitroglycerin (TD-GTN) therapy in patients with coronary disease.