Paolo Rizzon - Academia.edu (original) (raw)

Papers by Paolo Rizzon

Research paper thumbnail of Color Doppler findings in ventricular septal dissection following myocardial infarction

American Heart Journal, 1989

Research paper thumbnail of Detection of coronary artery disease by digital stress echocardiography: Comparison of exercise, transesophageal atrial pacing and dipyridamole echocardiography

Journal of the American College of Cardiology, 1994

~chocardiographic rno~~tori~g of left ventricular wall diography is planned, alternative stresses... more ~chocardiographic rno~~tori~g of left ventricular wall diography is planned, alternative stresses need to be used not only in patients for whom exercise is unfeasible, inadequate or contraindicated but alsc in those with poor quality echocardiographic images during exercise, making interpretation of the stress exam difficult if not impossible.

Research paper thumbnail of Combined atrial septal aneurysm and mitral valve prolapse: Detection by two-dimensional echocardiography

The American Journal of Cardiology, 1984

Because cardiac symptoms did not develop in our patients during follow-up, we believe that the si... more Because cardiac symptoms did not develop in our patients during follow-up, we believe that the significance of these findings lies not in any short-term prognostic value of cardiac pyrophosphate scintigraphy, but rather as an aid to diagnosis in the patient with an obscure familial polyneuropathy and abnormal echocardiogram. A positive scintigram in such a patient indicates the need for further diagnostic studies with appropriate tissue staining, such as abdominal fat aspiration or peripheral nerve biopsy. 5

Research paper thumbnail of Dynamic intracavitary left atrial echoes in mitral stenosis

The American Journal of Cardiology, 1985

... LA = left atrium; RA = right atrium. ... Invest Radiol 1981:16:71-76. 3. Wolverson MK, Nouri ... more ... LA = left atrium; RA = right atrium. ... Invest Radiol 1981:16:71-76. 3. Wolverson MK, Nouri S, Joist Jh, Sundaram M, Heiberg E. The direct visu-alization of blood flow by real-time ultrasound: clinical observation and underlying mechanism. Radiology 1981;140:443-448. ...

Research paper thumbnail of tilt-Induced syncope Enhanced reflex response to baroreceptor deactivation in subjects with

Research paper thumbnail of Group multicenter clinical trial. The Studio della Ticlopidina nell'Angina Instabile Antiplatelet treatment with ticlopidine in unstable angina. A controlled

We conducted a controlled multicenter trial with central randomization and evaluation of events u... more We conducted a controlled multicenter trial with central randomization and evaluation of events under blind conditions involving 652 patients with unstable angina. Patients were treated either with conventional therapy alone (group C) (n =338) or with conventional therapy combined with an inhibitor of platelet aggregation, ticlopidine 250 mg b.i.d. (group C+T) (n=314). Patients were assigned randomly within 48 hours of admission and followed up for 6 months. With the "intention-to-treat" approach, the primary end points, vascular death and nonfatal myocardial infarction, were observed in 13.6% of the patients in group C and in 7.3% of the patients in group C+T, which is a reduction in risk of 46.3% (p=0.009). Vascular mortality was 4.7% in patients in group C and 2.5% in patients in group C+T, which is a reduction in risk of 46.8% (p=0.139). The risk of nonfatal myocardial infarction was reduced by 46.1% (p=0.039), with a frequency of 8.9o in patients in group C and 4.8% in patients in group C+T. New Q wave myocardial infarction occurred with a frequency of 6.8% in patients in group C and 3.8% in patients in group C+T, which is a reduction in risk of 44.1% (p=0.091). Fatal and nonfatal myocardial infarction was 10.91% in patients in group C and 5.1% in patients in group C+T, which is a reduction in risk of 53.2% (p=0.006). These findings confirm the importance of platelets in the pathogenesis of unstable angina and the usefulness of antiplatelet treatment for the prevention of cardiovascular events.

Research paper thumbnail of 443 Beta1-adrenergic receptor polymorphisms predict heart failure progression in idiopathic dilated cardiomyopathy

European Journal of Heart Failure Supplements, 2003

Background: Mitochondria is known to represent the main intracellular source of ROS. However, the... more Background: Mitochondria is known to represent the main intracellular source of ROS. However, the role that the mitochondrial KATP (mKATP) channel could play in the oxidative stress during myocardial hypoxiareoxygenation remains unclear. Methods: Spontaneously beating hearts were dissected from 4-day-old chick embryos, mounted in vitro and submitted successively to 45 min normoxia (21% O2), 30 min anoxia (0% O2) and 60 min reoxygenation at 37°C. The time-course of ROS production in the ventricle was determined by measuring changes in fluorescence resulting from oxidation of the intracellular probe DCFH (10 µM) and expressed as arbitrary units per second (a.u./s). In order to determine the contribution of the mitochondria-derived ROS and its dependence on O2 concentration during reoxygenation, hearts were reoxygenated with 21% or 98% O2 in the absence (control) or in the presence of the complex III inhibitor myxothiazol (10µM). The involvement of the mKATP channel in ROS production has been assessed by using an opener (diazoxide, 50µM) or a blocker (5-hydroxydecanoate, 500 µM) of this channel. Results: In control hearts, ROS production was 0.18±0.04 (n=6) a.u./s under steady normoxia (mean±SD), was suppressed by anoxia and peaked after 9±3 min of reoxygenation, reaching 1.02±0.37 (n=6) and 1.63±0.34 (n=3) a.u./s with 21 and 98% O2, respectively (mean±SD). In myxothiazol-treated hearts, the peak of ROS at reoxygenation was reduced to 0.29±0.18 (n=3) and 0.41±0.08 (n=3) a.u./s with 21 and 98% O2, respectively. With respect to control, 5-hydroxydecanoate (n=5) and diazoxide (n=5) had no effect on DCFH signal measured under normoxia. By contrast, the peak of ROS production during the phase of reoxygenation was doubled by diazoxide (p<0.03) whereas 5-hydroxydecanoate had no effect. Furthermore, although the mKATP channel opener was markedly prooxidant during reoxygenation, it did not significantly alter the chrono-, dromo-and inotropic disturbances observed during oxygen deprivation and readmission.

Research paper thumbnail of Free testosterone plasma levels are negatively associated with the intima-media thickness of the common carotid artery in overweight and obese glucose-tolerant young adult men

International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 2003

To evaluate the relation between free testosterone (FT) levels and the intima-media thickness of ... more To evaluate the relation between free testosterone (FT) levels and the intima-media thickness of the common carotid artery (IMT-CCA) in overweight and obese glucose-tolerant (NGT) young adult men. Cross-sectional study of FT and IMT-CCA in obese men. A total of 127 overweight and obese NGT male individuals, aged 18-45 y. FT plasma levels; IMT-CCA, as measured by high-resolution B-mode ultrasound imaging; central fat accumulation, as evaluated by waist circumference; body composition, as measured by bioimpedance analysis; insulin resistance, as calculated by homeostatic model assessment (HOMA(IR)); systolic and diastolic blood pressure; and fasting concentrations of glucose, insulin, and lipids. IMT-CCA was positively correlated with age, body mass index (BMI), fat mass (FM), waist circumference, and fasting glucose concentrations, and inversely associated with FT levels. After multivariate analysis, IMT-CCA maintained an independent association with BMI, FM, and FT levels. This stud...

Research paper thumbnail of Lisinopril in the treatment of congestive heart failure in elderly patients: comparison versus captopril

Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy, 1997

The present study was performed in order to compare the efficacy, safety, and tolerability of lis... more The present study was performed in order to compare the efficacy, safety, and tolerability of lisinopril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, with captopril, the shorter acting ACE inhibitor available, in the treatment of elderly patients (mean age 70 +/- 0.5 years) with congestive heart failure (mean left ventricular ejection fraction 33.5 +/- 1%). The study was organized according to a double-blind, parallel-group, randomized multicenter protocol. After a 14-day placebo run-in period, patients were randomized to receive either lisinopril 5 mg orally once per day or captopril 12.5 mg orally once per day. The dose of the study drug could be doubled at 2-week intervals for 6 weeks. The maximal dose was lisinopril 20 mg once per day or captopril 25 mg twice per day. The addition of either captopril or lisinopril to a regimen of diuretics caused a significant increase in exercise tolerance assessed by bicycle ergometry after 12 weeks of treatment (530 +/- 21 se...

Research paper thumbnail of Tachycardia and coronary blood flow: non-invasive estimation during Valsalva manoeuvre and exercise

Clinical physiology (Oxford, England), 1993

Simultaneous changes in cycle length and coronary blood flow were studied during Valsalva manoeuv... more Simultaneous changes in cycle length and coronary blood flow were studied during Valsalva manoeuvre and supine cycloergometer exercise test in 10 male patients (mean age 48 +/- 12 years) who had successfully undergone myocardial revascularization by surgical anastomosis of the left internal mammary artery on the left anterior descending coronary artery. Blood velocity curves in the left internal mammary artery were obtained by a non-invasive continuous-wave Doppler probe at rest, in the last phase of the expiratory effort of the Valsalva manoeuvre and at the maximum load attained during the exercise test. Mean arterial pressure by sphygmomanometer, and cardiac cycle length on the basis of Doppler recording were measured. Mean blood velocity, the length of the blood column entering the coronary bed at each cycle (cardiac cycle times mean velocity), an index of blood cell acceleration (the ratio of mean velocity to cardiac cycle), and an index of coronary resistance (the ratio of mean...

Research paper thumbnail of New algorithm for QT dispersion analysis in XYZ-lead Holter ECG. Performance and applications

Computers in Cardiology 1998. Vol. 25 (Cat. No.98CH36292), 1998

Abstract In this paper a new algorithm for automatic analysis of QT dispersion (QTd) in three-lea... more Abstract In this paper a new algorithm for automatic analysis of QT dispersion (QTd) in three-lead (X, Y, Z) Holter ECG records is presented. To evaluate its performance the authors have compared automatic with manual annotations using a set of 1000 beats of Holter ECG records from the IDEAL Data Base. The signals have been automatically analyzed and the same beats have been analyzed by two cardiologists. The results obtained show that the reproducibility of the automatic QTd measurement is comparable to manual. QTd has ...

Research paper thumbnail of Effect of lercanidipine, felodipine, and nifedipine gits on blood pressure and heart rate: lercanidipine in adults study

ABSTRACT The aim of the Lercanidipine in Adults (LEAD) study was to compare the efficacy and tole... more ABSTRACT The aim of the Lercanidipine in Adults (LEAD) study was to compare the efficacy and tolerability of lercanidipine, felodipine, and nifedipine gastrointestinal therapeutic system (GITS) in adults (aged 31 to 74 years) with mild-to-moderate essential hypertension (SBP 140-180 mm Hg and DBP 95-109 mm Hg). A total of 325 patients were randomized in this multicenter, double-blind, parallel-group trial. After a 1-week washout period and a 2-week placebo run-in, patients received 1 of the following 8-week treatments: lercanidipine 10 mg/d (n=109), felodipine 10 mg/d (n=110), or nifedipine GITS 30 mg/d (n=106). After 4 weeks of treatment, the dosage was doubled in nonresponders (DBP ≥95 mm Hg and DBP reduction

Research paper thumbnail of Lower insulin sensitivity as an independent risk factor for carotid wall thickening in normotensive, non-diabetic, non-smoking normal weight and obese premenopausal women

International Journal of Obesity, 2000

OBJECTIVE: Increased thickness of the intima ± media complex of the common carotid artery (IMT-CC... more OBJECTIVE: Increased thickness of the intima ± media complex of the common carotid artery (IMT-CCA) is an early marker of atherosclerosis. The aim of the present study was to investigate the relationship between insulin resistance and IMT-CCA in premenopausal women. SUBJECTS: 86 young women, aged 18 ± 31 y, were recruited for the study: 28 were normal weight (BMI`25 kgam 2 ), 23 were overweight (BMI 25 ± 30 kgam 2 ) and 35 were obese (BMI b 30 kgam 2 ). MEASUREMENTS: The IMT-CCA was measured by high resolution`B-mode' ultrasonography; insulin sensitivity was determined by insulin tolerance test (ITT) and quantitated by calculation of K ITT. Fasting plasma glucose and lipids (triglycerides, total and HDL-cholesterol) were also measured by enzymatic methods. Central fat accumulation was evaluated by measuring waist circumference (WC). RESULTS: IMT-CCA showed an inverse association with K ITT (P`0.05). When the IMT-CCA was considered as the dependent variable in a forward stepwise multiple regression analysis, it maintained an independent association with K ITT (P`0.05), after adjusting data for age, BMI, WC, mean blood pressure levels and plasma glucose and lipids. CONCLUSION: These results suggest that IMT-CCA is signi®cantly associated with insulin resistance, independent of other well-known CVD risk factors. Since the IMT-CCA is an earlier asymptomatic sign of atherosclerosis, this study indicates that insulin resistance per se may accelerate atherogenesis.

Research paper thumbnail of Noninvasive Estimation of the Internal Mammary Artery Bypass Graft Patency: A Six-Year Follow-up

Vascular and Endovascular Surgery, 1994

ABSTRACT

Research paper thumbnail of 510 Role of Doppler tissue imaging in the assessment of diastolic dysfunction in hypertensive patients with and without concentric geometric remodeling

European Journal of Echocardiography, 2003

It has been shown that in patients with essential hypertension and cardiac hypertrophy Tissue Dop... more It has been shown that in patients with essential hypertension and cardiac hypertrophy Tissue Doppler Imaging (TDI) is able to detect impairment of diastolic function more accurately than pulsed transmitralic Doppler (TD). The aim of this study was to assess if, in hypertensive patients without cardiac hypertrophy, there are differences in diastolic function evaluated by using TDI or TD. We studied 17 patients (46±9 years, 11 male) with never treated essential hypertension. Echocardiographic evaluation was used to assess the following parameters: concentric remodelling (CR) pattern, defined as a normal left ventricular mass index with a relative wall thickness >0.45; global diastolic dysfunction (GDD), detected by correcting for age the TD flow early to atrial (E/A) ratio values; regional diastolic dysfunction (RDD) evaluated by TDI, with the sample volume positioned within the basal septum and defined according to the age-corrected tissue E/A ratio values. CR was found in 12 patients (70%); among these, 4 showed both GDD and RDD, while 5 patients showed only RDD. In the absence of CR, no patient showed either GDD or RDD. At Fisher test analysis, RDD was significantly associated with the presence of CR (p=0.019), whereas no significant association was found between CR and GDD. TDI showed a higher sensitivity in detecting diastolic dysfunction than TD (75% vs 33%) and a higher negative predictive value (63% vs 38%); both TDI and TD had a specificity and positive predictive value of 100%. In conclusion, in hypertensive patients with cardiac remodeling an abnormal regional diastolic function can be observed more frequently than a global diastolic dysfunction, thus suggesting that TDI is able to detect early impairment of diastolic function more accurately than pulsed transmitralic Doppler even in the absence of cardiac hypertrophy.

Research paper thumbnail of 313 Left ventricular ejection fraction and b2-adrenergic receptor polymorphism in dilated cardiomyopathy

European Journal of Echocardiography, 2003

Background: Left ventricular ejection fraction (LVEF) is the parameter commonly used to evaluate ... more Background: Left ventricular ejection fraction (LVEF) is the parameter commonly used to evaluate systolic function and stratify prognosis in patients with idiopathic dilated cardiomyopathy (DCM). There are few data concerning the genetic determinants of systolic function in these patients. The aim of this study was to evaluate the association between b2-adrenergic receptor (b2-AR) polymorphisms and LVEF in DCM patients before and after optimal medical treatment. Patients and Methods: We enrolled 22 consecutive unrelated patients (age 45±14 years, 17 males, NYHA functional class 1.6 ± 0.6) with DCM (WHO Criteria) in wash out from beta-blockers (BB), ACE-inhibitors (ACE-i) and Angiotensin II receptor inhibitors (ARB). LVEF was evaluated by echocardiography at the time of the enrolment and after one year, when all patients were receiving optimal treatment with BB and ACE-i or ARB. The genotyping for the 5' leader cistron (5'LC) Arg19Cys, Arg16Gly, Gln27Glu and Thr164Ile polymorphism of the b2-AR was performed on the basis of PCR amplified DNA using RFLP. Results: LVEF significantly improved after optimization of therapy (from 37 ± 10 to 41 ± 10). We found a significant association between the Arg16Gly polymorphism and LVEF before and after one year follow-up. In particular, homozygosity for the Gly16 allele identified a subgroup of patients showing lower LVEF values than the other patients. No association was found with the other studied polymorphisms.

Research paper thumbnail of 829 Baseline left ventricular asynchrony predicts long-term benefit of resynchronisation therapy

European Journal of Echocardiography, 2003

Research paper thumbnail of 514 Prognostic significance of bioelectrical evaluation of body composition in chronic heart failure

European Journal of Heart Failure Supplements, 2003

Research paper thumbnail of Plasma leptin is independently associated with the intima-media thickness of the common carotid artery

International Journal of Obesity, 2001

OBJECTIVE: To investigate whether intima-media thickness (IMT) of the common carotid artery (CCA)... more OBJECTIVE: To investigate whether intima-media thickness (IMT) of the common carotid artery (CCA), an early marker of asymptomatic atherosclerosis, is signi®cantly and independently associated with plasma concentrations of leptin, an adipose tissue hormone that has recently been proposed as a cardiovascular risk factor in obese patients. DESIGN: Cross-sectional sample of normal-weight and obese men and women. SUBJECTS: One-hundred and twenty healthy subjects (52 men and 68 women), aged 18 ± 45 y and with a wide range of BMI, were recruited for the study. MEASUREMENTS: Fasting plasma leptin concentrations and the IMT of the CCA were measured in all subjects. Leptin concentrations were measured by radioimmunoassay and the IMT of the CCA was quanti®ed by high resolution B-mode ultrasound imaging. Central fat (measured by waist circumference), smoking habits, blood pressure, insulin sensitivity (measured by the insulin tolerance test), and fasting plasma glucose, insulin and lipid pattern (cholesterol, HDL-cholesterol, triglycerides, LDL-cholesterol) were also measured. RESULTS: IMT of the CCA was positively correlated with log leptin concentrations (P`0.005 in men and P`0.001 in women), body mass index (P`0.001 in men and women), waist circumference (P`0.001 in men and women), age (P`0.001 in men and P`0.05 in women), and negatively associated with insulin sensitivity in both sexes (P`0.05). IMT was also directly correlated with cholesterol (P`0.05), LDL-cholesterol (P`0.01) and systolic blood pressure in men (P`0.05), and with diastolic blood pressure levels in women (P`0.05). When a multiple linear regression model was used without body mass index (BMI), the correlation between leptin and IMT was maintained in both men (P`0.01) and women (P`0.005), independent of age, insulin sensitivity, smoking habits, systolic blood pressure, fasting glucose, triglycerides, cholesterol, LDL-cholesterol and HDL-cholesterol. By contrast, BMI-adjusted leptin concentrations were not signi®cantly associated with IMT (Pc (partial correlation): 0.41 in men and 0.15 in women). Moreover, when BMI was entered into a multiple linear regression model without leptin, the correlation between BMI and IMT was maintained in both men (P`0.005) and women (P`0.01), independent of the same parameters. CONCLUSION: Plasma leptin concentrations are independently associated with the IMT of the CCA, suggesting that the increase of adipose tissue mass (or leptin per se) may have an unfavourable in¯uence on the development of atherosclerosis. However, the association between IMT and leptin seems to be dependent andaor confounded by the relationship between IMT and obesity.

Research paper thumbnail of Different Trends of Changes in Heart Rate Variability in Patients with Anterior and Inferior Acute Myocardial Infarction

Pacing and Clinical Electrophysiology, 1998

Modifications in heart rate variability (HRV) parameters occur after acute myocardial infarction.... more Modifications in heart rate variability (HRV) parameters occur after acute myocardial infarction. The aim of this study was to evaluate the trend of HRV change during the acute phase and the first month after myocardial infarction, and establish whether they were affected by the anterior or inferior location of the infarction. The time-domain HRV measures of 59 patients with a first uncomplicated acute myocardial infarction were computed from 24-hour ECG recordings made on days 1, 2, 10, and 28 after hospital admission. At day 1, the mean RR cycle length (NN), the standard deviation of the NN intervals (SDNN), and the root mean square successive difference of NN intervals (RMSSD) were lower in the patients with anterior myocardial infarction. Although the parameters were similar in all of the patients at day 28, their behavior over time was different (P = 0.01): the SDNN in the patients with inferior myocardial infarction had decreased to the values found in anterior myocardial infarction patients by day 2 but, at day 10, both NN and SDNN tended to recover in both groups; RMSSD had diminished in both groups by day 2, but at day 10, had increased in the patients with anterior, but not in those with inferior myocardial infarction. These findings suggest that (1) in the very early phase of myocardial infarction, HRV is different in the two locations, (2) during the first hours of myocardial infarction patients with inferior location showed a greater vagal activity than patients with anterior location that became lower at day 10, and (3) the recovery of HRV is an early phenomenon in both groups, being already evident by the second week after myocardial infarction.

Research paper thumbnail of Color Doppler findings in ventricular septal dissection following myocardial infarction

American Heart Journal, 1989

Research paper thumbnail of Detection of coronary artery disease by digital stress echocardiography: Comparison of exercise, transesophageal atrial pacing and dipyridamole echocardiography

Journal of the American College of Cardiology, 1994

~chocardiographic rno~~tori~g of left ventricular wall diography is planned, alternative stresses... more ~chocardiographic rno~~tori~g of left ventricular wall diography is planned, alternative stresses need to be used not only in patients for whom exercise is unfeasible, inadequate or contraindicated but alsc in those with poor quality echocardiographic images during exercise, making interpretation of the stress exam difficult if not impossible.

Research paper thumbnail of Combined atrial septal aneurysm and mitral valve prolapse: Detection by two-dimensional echocardiography

The American Journal of Cardiology, 1984

Because cardiac symptoms did not develop in our patients during follow-up, we believe that the si... more Because cardiac symptoms did not develop in our patients during follow-up, we believe that the significance of these findings lies not in any short-term prognostic value of cardiac pyrophosphate scintigraphy, but rather as an aid to diagnosis in the patient with an obscure familial polyneuropathy and abnormal echocardiogram. A positive scintigram in such a patient indicates the need for further diagnostic studies with appropriate tissue staining, such as abdominal fat aspiration or peripheral nerve biopsy. 5

Research paper thumbnail of Dynamic intracavitary left atrial echoes in mitral stenosis

The American Journal of Cardiology, 1985

... LA = left atrium; RA = right atrium. ... Invest Radiol 1981:16:71-76. 3. Wolverson MK, Nouri ... more ... LA = left atrium; RA = right atrium. ... Invest Radiol 1981:16:71-76. 3. Wolverson MK, Nouri S, Joist Jh, Sundaram M, Heiberg E. The direct visu-alization of blood flow by real-time ultrasound: clinical observation and underlying mechanism. Radiology 1981;140:443-448. ...

Research paper thumbnail of tilt-Induced syncope Enhanced reflex response to baroreceptor deactivation in subjects with

Research paper thumbnail of Group multicenter clinical trial. The Studio della Ticlopidina nell'Angina Instabile Antiplatelet treatment with ticlopidine in unstable angina. A controlled

We conducted a controlled multicenter trial with central randomization and evaluation of events u... more We conducted a controlled multicenter trial with central randomization and evaluation of events under blind conditions involving 652 patients with unstable angina. Patients were treated either with conventional therapy alone (group C) (n =338) or with conventional therapy combined with an inhibitor of platelet aggregation, ticlopidine 250 mg b.i.d. (group C+T) (n=314). Patients were assigned randomly within 48 hours of admission and followed up for 6 months. With the "intention-to-treat" approach, the primary end points, vascular death and nonfatal myocardial infarction, were observed in 13.6% of the patients in group C and in 7.3% of the patients in group C+T, which is a reduction in risk of 46.3% (p=0.009). Vascular mortality was 4.7% in patients in group C and 2.5% in patients in group C+T, which is a reduction in risk of 46.8% (p=0.139). The risk of nonfatal myocardial infarction was reduced by 46.1% (p=0.039), with a frequency of 8.9o in patients in group C and 4.8% in patients in group C+T. New Q wave myocardial infarction occurred with a frequency of 6.8% in patients in group C and 3.8% in patients in group C+T, which is a reduction in risk of 44.1% (p=0.091). Fatal and nonfatal myocardial infarction was 10.91% in patients in group C and 5.1% in patients in group C+T, which is a reduction in risk of 53.2% (p=0.006). These findings confirm the importance of platelets in the pathogenesis of unstable angina and the usefulness of antiplatelet treatment for the prevention of cardiovascular events.

Research paper thumbnail of 443 Beta1-adrenergic receptor polymorphisms predict heart failure progression in idiopathic dilated cardiomyopathy

European Journal of Heart Failure Supplements, 2003

Background: Mitochondria is known to represent the main intracellular source of ROS. However, the... more Background: Mitochondria is known to represent the main intracellular source of ROS. However, the role that the mitochondrial KATP (mKATP) channel could play in the oxidative stress during myocardial hypoxiareoxygenation remains unclear. Methods: Spontaneously beating hearts were dissected from 4-day-old chick embryos, mounted in vitro and submitted successively to 45 min normoxia (21% O2), 30 min anoxia (0% O2) and 60 min reoxygenation at 37°C. The time-course of ROS production in the ventricle was determined by measuring changes in fluorescence resulting from oxidation of the intracellular probe DCFH (10 µM) and expressed as arbitrary units per second (a.u./s). In order to determine the contribution of the mitochondria-derived ROS and its dependence on O2 concentration during reoxygenation, hearts were reoxygenated with 21% or 98% O2 in the absence (control) or in the presence of the complex III inhibitor myxothiazol (10µM). The involvement of the mKATP channel in ROS production has been assessed by using an opener (diazoxide, 50µM) or a blocker (5-hydroxydecanoate, 500 µM) of this channel. Results: In control hearts, ROS production was 0.18±0.04 (n=6) a.u./s under steady normoxia (mean±SD), was suppressed by anoxia and peaked after 9±3 min of reoxygenation, reaching 1.02±0.37 (n=6) and 1.63±0.34 (n=3) a.u./s with 21 and 98% O2, respectively (mean±SD). In myxothiazol-treated hearts, the peak of ROS at reoxygenation was reduced to 0.29±0.18 (n=3) and 0.41±0.08 (n=3) a.u./s with 21 and 98% O2, respectively. With respect to control, 5-hydroxydecanoate (n=5) and diazoxide (n=5) had no effect on DCFH signal measured under normoxia. By contrast, the peak of ROS production during the phase of reoxygenation was doubled by diazoxide (p<0.03) whereas 5-hydroxydecanoate had no effect. Furthermore, although the mKATP channel opener was markedly prooxidant during reoxygenation, it did not significantly alter the chrono-, dromo-and inotropic disturbances observed during oxygen deprivation and readmission.

Research paper thumbnail of Free testosterone plasma levels are negatively associated with the intima-media thickness of the common carotid artery in overweight and obese glucose-tolerant young adult men

International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 2003

To evaluate the relation between free testosterone (FT) levels and the intima-media thickness of ... more To evaluate the relation between free testosterone (FT) levels and the intima-media thickness of the common carotid artery (IMT-CCA) in overweight and obese glucose-tolerant (NGT) young adult men. Cross-sectional study of FT and IMT-CCA in obese men. A total of 127 overweight and obese NGT male individuals, aged 18-45 y. FT plasma levels; IMT-CCA, as measured by high-resolution B-mode ultrasound imaging; central fat accumulation, as evaluated by waist circumference; body composition, as measured by bioimpedance analysis; insulin resistance, as calculated by homeostatic model assessment (HOMA(IR)); systolic and diastolic blood pressure; and fasting concentrations of glucose, insulin, and lipids. IMT-CCA was positively correlated with age, body mass index (BMI), fat mass (FM), waist circumference, and fasting glucose concentrations, and inversely associated with FT levels. After multivariate analysis, IMT-CCA maintained an independent association with BMI, FM, and FT levels. This stud...

Research paper thumbnail of Lisinopril in the treatment of congestive heart failure in elderly patients: comparison versus captopril

Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy, 1997

The present study was performed in order to compare the efficacy, safety, and tolerability of lis... more The present study was performed in order to compare the efficacy, safety, and tolerability of lisinopril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, with captopril, the shorter acting ACE inhibitor available, in the treatment of elderly patients (mean age 70 +/- 0.5 years) with congestive heart failure (mean left ventricular ejection fraction 33.5 +/- 1%). The study was organized according to a double-blind, parallel-group, randomized multicenter protocol. After a 14-day placebo run-in period, patients were randomized to receive either lisinopril 5 mg orally once per day or captopril 12.5 mg orally once per day. The dose of the study drug could be doubled at 2-week intervals for 6 weeks. The maximal dose was lisinopril 20 mg once per day or captopril 25 mg twice per day. The addition of either captopril or lisinopril to a regimen of diuretics caused a significant increase in exercise tolerance assessed by bicycle ergometry after 12 weeks of treatment (530 +/- 21 se...

Research paper thumbnail of Tachycardia and coronary blood flow: non-invasive estimation during Valsalva manoeuvre and exercise

Clinical physiology (Oxford, England), 1993

Simultaneous changes in cycle length and coronary blood flow were studied during Valsalva manoeuv... more Simultaneous changes in cycle length and coronary blood flow were studied during Valsalva manoeuvre and supine cycloergometer exercise test in 10 male patients (mean age 48 +/- 12 years) who had successfully undergone myocardial revascularization by surgical anastomosis of the left internal mammary artery on the left anterior descending coronary artery. Blood velocity curves in the left internal mammary artery were obtained by a non-invasive continuous-wave Doppler probe at rest, in the last phase of the expiratory effort of the Valsalva manoeuvre and at the maximum load attained during the exercise test. Mean arterial pressure by sphygmomanometer, and cardiac cycle length on the basis of Doppler recording were measured. Mean blood velocity, the length of the blood column entering the coronary bed at each cycle (cardiac cycle times mean velocity), an index of blood cell acceleration (the ratio of mean velocity to cardiac cycle), and an index of coronary resistance (the ratio of mean...

Research paper thumbnail of New algorithm for QT dispersion analysis in XYZ-lead Holter ECG. Performance and applications

Computers in Cardiology 1998. Vol. 25 (Cat. No.98CH36292), 1998

Abstract In this paper a new algorithm for automatic analysis of QT dispersion (QTd) in three-lea... more Abstract In this paper a new algorithm for automatic analysis of QT dispersion (QTd) in three-lead (X, Y, Z) Holter ECG records is presented. To evaluate its performance the authors have compared automatic with manual annotations using a set of 1000 beats of Holter ECG records from the IDEAL Data Base. The signals have been automatically analyzed and the same beats have been analyzed by two cardiologists. The results obtained show that the reproducibility of the automatic QTd measurement is comparable to manual. QTd has ...

Research paper thumbnail of Effect of lercanidipine, felodipine, and nifedipine gits on blood pressure and heart rate: lercanidipine in adults study

ABSTRACT The aim of the Lercanidipine in Adults (LEAD) study was to compare the efficacy and tole... more ABSTRACT The aim of the Lercanidipine in Adults (LEAD) study was to compare the efficacy and tolerability of lercanidipine, felodipine, and nifedipine gastrointestinal therapeutic system (GITS) in adults (aged 31 to 74 years) with mild-to-moderate essential hypertension (SBP 140-180 mm Hg and DBP 95-109 mm Hg). A total of 325 patients were randomized in this multicenter, double-blind, parallel-group trial. After a 1-week washout period and a 2-week placebo run-in, patients received 1 of the following 8-week treatments: lercanidipine 10 mg/d (n=109), felodipine 10 mg/d (n=110), or nifedipine GITS 30 mg/d (n=106). After 4 weeks of treatment, the dosage was doubled in nonresponders (DBP ≥95 mm Hg and DBP reduction

Research paper thumbnail of Lower insulin sensitivity as an independent risk factor for carotid wall thickening in normotensive, non-diabetic, non-smoking normal weight and obese premenopausal women

International Journal of Obesity, 2000

OBJECTIVE: Increased thickness of the intima ± media complex of the common carotid artery (IMT-CC... more OBJECTIVE: Increased thickness of the intima ± media complex of the common carotid artery (IMT-CCA) is an early marker of atherosclerosis. The aim of the present study was to investigate the relationship between insulin resistance and IMT-CCA in premenopausal women. SUBJECTS: 86 young women, aged 18 ± 31 y, were recruited for the study: 28 were normal weight (BMI`25 kgam 2 ), 23 were overweight (BMI 25 ± 30 kgam 2 ) and 35 were obese (BMI b 30 kgam 2 ). MEASUREMENTS: The IMT-CCA was measured by high resolution`B-mode' ultrasonography; insulin sensitivity was determined by insulin tolerance test (ITT) and quantitated by calculation of K ITT. Fasting plasma glucose and lipids (triglycerides, total and HDL-cholesterol) were also measured by enzymatic methods. Central fat accumulation was evaluated by measuring waist circumference (WC). RESULTS: IMT-CCA showed an inverse association with K ITT (P`0.05). When the IMT-CCA was considered as the dependent variable in a forward stepwise multiple regression analysis, it maintained an independent association with K ITT (P`0.05), after adjusting data for age, BMI, WC, mean blood pressure levels and plasma glucose and lipids. CONCLUSION: These results suggest that IMT-CCA is signi®cantly associated with insulin resistance, independent of other well-known CVD risk factors. Since the IMT-CCA is an earlier asymptomatic sign of atherosclerosis, this study indicates that insulin resistance per se may accelerate atherogenesis.

Research paper thumbnail of Noninvasive Estimation of the Internal Mammary Artery Bypass Graft Patency: A Six-Year Follow-up

Vascular and Endovascular Surgery, 1994

ABSTRACT

Research paper thumbnail of 510 Role of Doppler tissue imaging in the assessment of diastolic dysfunction in hypertensive patients with and without concentric geometric remodeling

European Journal of Echocardiography, 2003

It has been shown that in patients with essential hypertension and cardiac hypertrophy Tissue Dop... more It has been shown that in patients with essential hypertension and cardiac hypertrophy Tissue Doppler Imaging (TDI) is able to detect impairment of diastolic function more accurately than pulsed transmitralic Doppler (TD). The aim of this study was to assess if, in hypertensive patients without cardiac hypertrophy, there are differences in diastolic function evaluated by using TDI or TD. We studied 17 patients (46±9 years, 11 male) with never treated essential hypertension. Echocardiographic evaluation was used to assess the following parameters: concentric remodelling (CR) pattern, defined as a normal left ventricular mass index with a relative wall thickness >0.45; global diastolic dysfunction (GDD), detected by correcting for age the TD flow early to atrial (E/A) ratio values; regional diastolic dysfunction (RDD) evaluated by TDI, with the sample volume positioned within the basal septum and defined according to the age-corrected tissue E/A ratio values. CR was found in 12 patients (70%); among these, 4 showed both GDD and RDD, while 5 patients showed only RDD. In the absence of CR, no patient showed either GDD or RDD. At Fisher test analysis, RDD was significantly associated with the presence of CR (p=0.019), whereas no significant association was found between CR and GDD. TDI showed a higher sensitivity in detecting diastolic dysfunction than TD (75% vs 33%) and a higher negative predictive value (63% vs 38%); both TDI and TD had a specificity and positive predictive value of 100%. In conclusion, in hypertensive patients with cardiac remodeling an abnormal regional diastolic function can be observed more frequently than a global diastolic dysfunction, thus suggesting that TDI is able to detect early impairment of diastolic function more accurately than pulsed transmitralic Doppler even in the absence of cardiac hypertrophy.

Research paper thumbnail of 313 Left ventricular ejection fraction and b2-adrenergic receptor polymorphism in dilated cardiomyopathy

European Journal of Echocardiography, 2003

Background: Left ventricular ejection fraction (LVEF) is the parameter commonly used to evaluate ... more Background: Left ventricular ejection fraction (LVEF) is the parameter commonly used to evaluate systolic function and stratify prognosis in patients with idiopathic dilated cardiomyopathy (DCM). There are few data concerning the genetic determinants of systolic function in these patients. The aim of this study was to evaluate the association between b2-adrenergic receptor (b2-AR) polymorphisms and LVEF in DCM patients before and after optimal medical treatment. Patients and Methods: We enrolled 22 consecutive unrelated patients (age 45±14 years, 17 males, NYHA functional class 1.6 ± 0.6) with DCM (WHO Criteria) in wash out from beta-blockers (BB), ACE-inhibitors (ACE-i) and Angiotensin II receptor inhibitors (ARB). LVEF was evaluated by echocardiography at the time of the enrolment and after one year, when all patients were receiving optimal treatment with BB and ACE-i or ARB. The genotyping for the 5' leader cistron (5'LC) Arg19Cys, Arg16Gly, Gln27Glu and Thr164Ile polymorphism of the b2-AR was performed on the basis of PCR amplified DNA using RFLP. Results: LVEF significantly improved after optimization of therapy (from 37 ± 10 to 41 ± 10). We found a significant association between the Arg16Gly polymorphism and LVEF before and after one year follow-up. In particular, homozygosity for the Gly16 allele identified a subgroup of patients showing lower LVEF values than the other patients. No association was found with the other studied polymorphisms.

Research paper thumbnail of 829 Baseline left ventricular asynchrony predicts long-term benefit of resynchronisation therapy

European Journal of Echocardiography, 2003

Research paper thumbnail of 514 Prognostic significance of bioelectrical evaluation of body composition in chronic heart failure

European Journal of Heart Failure Supplements, 2003

Research paper thumbnail of Plasma leptin is independently associated with the intima-media thickness of the common carotid artery

International Journal of Obesity, 2001

OBJECTIVE: To investigate whether intima-media thickness (IMT) of the common carotid artery (CCA)... more OBJECTIVE: To investigate whether intima-media thickness (IMT) of the common carotid artery (CCA), an early marker of asymptomatic atherosclerosis, is signi®cantly and independently associated with plasma concentrations of leptin, an adipose tissue hormone that has recently been proposed as a cardiovascular risk factor in obese patients. DESIGN: Cross-sectional sample of normal-weight and obese men and women. SUBJECTS: One-hundred and twenty healthy subjects (52 men and 68 women), aged 18 ± 45 y and with a wide range of BMI, were recruited for the study. MEASUREMENTS: Fasting plasma leptin concentrations and the IMT of the CCA were measured in all subjects. Leptin concentrations were measured by radioimmunoassay and the IMT of the CCA was quanti®ed by high resolution B-mode ultrasound imaging. Central fat (measured by waist circumference), smoking habits, blood pressure, insulin sensitivity (measured by the insulin tolerance test), and fasting plasma glucose, insulin and lipid pattern (cholesterol, HDL-cholesterol, triglycerides, LDL-cholesterol) were also measured. RESULTS: IMT of the CCA was positively correlated with log leptin concentrations (P`0.005 in men and P`0.001 in women), body mass index (P`0.001 in men and women), waist circumference (P`0.001 in men and women), age (P`0.001 in men and P`0.05 in women), and negatively associated with insulin sensitivity in both sexes (P`0.05). IMT was also directly correlated with cholesterol (P`0.05), LDL-cholesterol (P`0.01) and systolic blood pressure in men (P`0.05), and with diastolic blood pressure levels in women (P`0.05). When a multiple linear regression model was used without body mass index (BMI), the correlation between leptin and IMT was maintained in both men (P`0.01) and women (P`0.005), independent of age, insulin sensitivity, smoking habits, systolic blood pressure, fasting glucose, triglycerides, cholesterol, LDL-cholesterol and HDL-cholesterol. By contrast, BMI-adjusted leptin concentrations were not signi®cantly associated with IMT (Pc (partial correlation): 0.41 in men and 0.15 in women). Moreover, when BMI was entered into a multiple linear regression model without leptin, the correlation between BMI and IMT was maintained in both men (P`0.005) and women (P`0.01), independent of the same parameters. CONCLUSION: Plasma leptin concentrations are independently associated with the IMT of the CCA, suggesting that the increase of adipose tissue mass (or leptin per se) may have an unfavourable in¯uence on the development of atherosclerosis. However, the association between IMT and leptin seems to be dependent andaor confounded by the relationship between IMT and obesity.

Research paper thumbnail of Different Trends of Changes in Heart Rate Variability in Patients with Anterior and Inferior Acute Myocardial Infarction

Pacing and Clinical Electrophysiology, 1998

Modifications in heart rate variability (HRV) parameters occur after acute myocardial infarction.... more Modifications in heart rate variability (HRV) parameters occur after acute myocardial infarction. The aim of this study was to evaluate the trend of HRV change during the acute phase and the first month after myocardial infarction, and establish whether they were affected by the anterior or inferior location of the infarction. The time-domain HRV measures of 59 patients with a first uncomplicated acute myocardial infarction were computed from 24-hour ECG recordings made on days 1, 2, 10, and 28 after hospital admission. At day 1, the mean RR cycle length (NN), the standard deviation of the NN intervals (SDNN), and the root mean square successive difference of NN intervals (RMSSD) were lower in the patients with anterior myocardial infarction. Although the parameters were similar in all of the patients at day 28, their behavior over time was different (P = 0.01): the SDNN in the patients with inferior myocardial infarction had decreased to the values found in anterior myocardial infarction patients by day 2 but, at day 10, both NN and SDNN tended to recover in both groups; RMSSD had diminished in both groups by day 2, but at day 10, had increased in the patients with anterior, but not in those with inferior myocardial infarction. These findings suggest that (1) in the very early phase of myocardial infarction, HRV is different in the two locations, (2) during the first hours of myocardial infarction patients with inferior location showed a greater vagal activity than patients with anterior location that became lower at day 10, and (3) the recovery of HRV is an early phenomenon in both groups, being already evident by the second week after myocardial infarction.