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101. Arterial Stiffness in Patients With Renal Transplantation; Associations With Co-morbid Conditions, Evolution, and Prognostic Importance for Cardiovascular and Renal Outcomes

Author

Maria Korogiannou, Efstathios Xagas, Smaragdi Marinaki, Pantelis Sarafidis, and John N. Boletis

Subjects
arterial stiffness, transplantation, chronic kidney disease, augmentation index, cardiovascular events, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Patients with chronic kidney disease (CKD), particularly those with end-stage renal disease (ESRD), are at increased risk of cardiovascular events and mortality. The spectrum of arterial remodeling in CKD and ESRD includes atheromatosis of middle-sized conduit arteries and, most importantly, the process of arteriosclerosis, characterized by increased arterial stiffness of aorta and the large arteries. Longitudinal studies showed that arterial stiffness and abnormal wave reflections are independent cardiovascular risk factors in several populations, including patients with CKD and ESRD. Kidney transplantation is the treatment of choice for patients with ESRD, associated with improved survival and better quality of life in relation to hemodialysis or peritoneal dialysis. However, cardiovascular mortality in transplanted patients remains much higher than that in general population, a finding that is at least partly attributed to adverse lesions in the vascular tree of these patients, generated during the progression of CKD, which do not fully reverse after renal transplantation. This article attempts to provide an overview of the field of arterial stiffness in renal transplantation, discussing in detail available studies on the degree and the associations of arterial stiffness with other co-morbidities in renal transplant recipients, the prognostic significance of arterial stiffness for cardiovascular events, renal events and mortality in these individuals, as well as studies examining the changes in arterial stiffness following renal transplantation.

Published
2019
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102. Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-Linked Syndrome Associated With a Novel Mutation of FOXP3 Gene

Author

Charalampos Agakidis, Eleni Agakidou, Kosmas Sarafidis, Ioannis Papoulidis, Ioannis Xinias, and Evangelia Farmaki

Subjects
autoimmune hepatitis, eczema, eosinophilia, hydrops fetalis, IgE, miscarriage, Pediatrics, RJ1-570
Abstract

The immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare, x-linked, recessive disorder characterized by dysfunction of the T regulatory (Treg) lymphocytes leading to autoimmune diseases. Herein we report a male patient with IPEX syndrome who presented with severe diarrhea, eczema, and malabsorption leading to failure to thrive and necessitating total parenteral nutrition, as well as with liver dysfunction. Laboratory investigation showed elevated liver enzymes that declined following treatment with glucocorticosteroids and immunosuppressive drugs, marked eosinophilia, increased total IgE, and decreased Treg cells. DNA analysis revealed that the patient himself was hemizygous and his mother heterozygous for the exon 10, c.1015C>T (p.Pro339Ser) mutation of the FOXP3 gene, which has not been previously reported. The current case indicates that mutations resulting in substitution of a certain amino-acid (i.e., proline 339) by different amino-acids are manifested with different IPEX phenotypes.

Published
2019
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103. 2.4 CENTRAL SYSTOLIC BLOOD PRESSURE PROVIDES ADDITIONAL INFORMATION IN RISK PREDICTION IN HEMODIALYSIS PATIENTS

Author

Christopher C. Mayer, Julia Matschkal, Pantelis A. Sarafidis, Stefan Hagmair, Georg Lorenz, Susanne Angermann, Matthias C. Braunisch, Marcus Baumann, Uwe Heemann, Christoph Schmaderer, and Siegfried Wassertheurer

Subjects
Specialties of internal medicine, RC581-951, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: Association of Ambulatory Blood Pressure Monitoring (ABPM) with mortality depends on cardiac function in hemodialysis patients. Evidence for the predictive power of central Systolic Pressure (cSBP) is inconclusive. Thus, this study aimed to investigate the additional information of ambulatory cSBP in risk prediction in a cohort of hemodialysis patients. Methods: Within the ISAR-study cohort, 344 hemodialysis patients underwent 24 h ABPM on the dialysis day. All-cause and cardiovascular mortality served as endpoints. Risk prediction was performed using Cox regression in patients with or without atrial fibrillation (AF) or heart failure (HF) for peripheral (pSBP) and central systolic pressure calibrated with peripheral systolic and diastolic pressure (cSBP1) or peripheral mean and diastolic pressure (cSBP2). Results: During a mean follow-up of 37.6 (17.5 SD) months, 115 patients died, of whom 47 due to cardiovascular reasons. In patients with AF or HF, a negative association to mortality could be observed, independent of pressure location and calibration (see Table). In patients without AF or HF, these associations were to the opposite directions and cSBP2 was superior to pSBP and cSBP1 for all-cause (pSBP: HR = 1.01, p = 0.30; cSBP1: HR = 1.00, p = 0.77; cSBP2: HR = 1.01, p = 0.06) and cardiovascular (pSBP: HR =1.03, p = 0.02; cSBP1: HR = 1.02, p = 0.06; cSBP2: HR = 1.03, p = 0.003) mortality. This circumstance was confirmed in multivariable analysis combining pSBP and differences between pSBP and cSBP (see Table). Conclusions: This study provides evidence for the additional information of central systolic blood pressure and its dependency on calibration in risk prediction in hemodialysis patients. Further studies are needed to confirm these findings.

Published
2018
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105. From WEDA to EDTA to ERA: 60 years of supporting European nephrology and counting

Author

Wanner, C., Fliser, D., Rychlik, I., Torra, R., Gansevoort, R., Ortiz, A., Sarafidis, P., Ong, A., Cozzolino, M., Rosenkranz, A., Tuglular, S.Z., Gambaro, G., Fontana, M., Azzolini, L., and Vinck, C.

Subjects
Settore MED/14 - Nefrologia, Transplantation, treatment, kidney disease, burden of disease, outcomes, kidney failure, nephrology, prevention, renal replacement therapy, Europe, Renal Dialysis, Nephrology, Humans, Edetic Acid, Societies, Medical
Published
2022

106. The association of sex differences in ambulatory blood pressure with cardiovascular events and mortality in dialysis patients

Author

Iatridi, Fotini, Theodorakopoulou, Marieta P., Georgiou, Areti, Karagiannidis, Artemios G., Haddad, Nasra, Devrikis, Nikolaos, Mayer, Christopher C., Kamperidis, Vasileios, Anastasiou, Vasileios, Karpetas, Antonios, and Sarafidis, Pantelis

Abstract

Male patients with pre-dialysis chronic kidney disease (CKD) have worse ambulatory blood pressure (BP) control than females; this is associated with higher mortality. Male hemodialysis patients have higher ambulatory BP levels than females. This analysis aimed to investigate the association of sex differences in ambulatory BP with cardiovascular events and mortality in hemodialysis individuals. 129 male and 91 female hemodialysis patients with valid 48-h BP monitoring were followed for 53.4 ± 31.1 months. The primary endpoint was cardiovascular mortality; the secondary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest, heart failure-hospitalization, coronary or peripheral revascularization. Cumulative freedom from the primary endpoint was lower for women (logrank-p= 0.032), while cumulative-freedom from the secondary endpoint did not differ significantly between-groups (logrank-p= 0.644). The crude risk for cardiovascular mortality was significantly higher in women (HR = 1.613, 95% CI [1.037, 2.509]). The crude risk for the combined endpoint was not different between the two groups (HR = 0.918, 95% CI [0.638, 1.320]). After adjusting for major risk factors (age, diabetes, dialysis vintage, coronary disease and hemoglobin) no significant differences in the risk for both the primary and the secondary endpoint were observed between women and men (primary: HR = 1.295 (95% CI [0.808, 2.078]), secondary: HR = 0.763 (95% CI [0.521, 1.118])). After additional adjustment for 44-h systolic BP the above relationships did not alter (primary: HR = 1.329 (95% CI [0.826, 2.137]), secondary: HR = 0.808 (95% CI [0.551, 1.184])). In conclusion, female hemodialysis patients have higher crude but similar adjusted cardiovascular mortality rates compared to male counterparts. In contrast to pre-dialysis CKD, the neutral relationship between gender and adverse cardiovascular outcomes in hemodialysis is not further affected by ambulatory BP.

Published
2024
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107. Kabuki Syndrome: Case Report of Severe Prenatal Midface Hypoplasia (Binder Phenotype), due to a Novel Variant in the KMT2DGene

Author

Gatsis, Athanasios, Alvanou, Maria, Christidou, Elisavet, Demertzidou, Eleftheria, Kontou, Aggeliki, Stathopoulou, Theodora, Sarafidis, Kosmas, Sotiriadis, Alexandros, and Ververi, Athina

Abstract

Introduction:Kabuki syndrome (KS) is a rare genetic disorder with a prevalence of 1/86,000–1/32,000. Pathogenic variants in the KMT2Dand KDM6Agenes are responsible for the majority of KS cases and are inherited in an autosomal dominant and X-linked manner, respectively. Despite KS being genetically pleiotropic, specific phenotypic features, such as hypotonia, developmental disorders, mental retardation, dermatoglyphic and facial abnormalities, are widely manifested among patients with KS. Only few prenatal findings have been associated with KS so far. Case Presentation:This report highlights an interesting and infrequent case of a neonate with severe midface hypoplasia and multiple congenital anomalies, which were noted on the 2nd trimester antenatal scan. The degree of hypoplasia was indicative of chondrodysplasia punctata, but there was no relevant pregnancy history or other features of a skeletal dysplasia. The pregnancy was complicated by preterm premature rupture of membranes. The neonate was born at 27 weeks of gestation and died 16 days later, due to complications of prematurity. Whole exome sequencing identified a novel de novo KMT2Dpathogenic variant. Conclusion:Although midface hypoplasia has been previously reported in individuals with KS, the severity noted in the index individual is an unusual feature of the syndrome.

Published
2024
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108. Inflammation is an amplifier of lung congestion by high lv filling pressure in hemodialysis patients: a longitudinal study

Author

Torino, Claudia, Gargani, Luna, Sicari, Rosa, Letachowicz, Krzysztof, Ekart, Robert, Fliser, Danilo, Covic, Adrian, Siamopoulos, Kostas, Stavroulopoulos, Aristeidis, Massy, Ziad A., Fiaccadori, Enrico, Regolisti, Giuseppe, Bachelet, Thomas, Slotki, Itzchak, Martinez-Castelao, Alberto, Coudert-Krier, Marie-Jeanne, Rossignol, Patrick, Hannedouche, Thierry, Wiecek, Andrzej, Sarafidis, Pantelis, Battaglia, Yuri, Prohić, Nejra, Klinger, Marian, Hojs, Radovan, Seiler-Mußler, Sarah, Lizzi, Fabio, Siriopol, Dimitrie, Balafa, Olga, Shavit, Linda, Loutradis, Charalampos, Seidowsky, Alexandre, Tripepi, Rocco, Mallamaci, Francesca, Tripepi, Giovanni, Picano, Eugenio, London, Gérard Michel, and Zoccali, Carmine

Abstract

Introduction: Since inflammation alters vascular permeability, including vascular permeability in the lung, we hypothesized that it can be an amplifier of lung congestion in a category of patients at high risk for pulmonary oedema like end stage kidney disease (ESKD) patients. Objective and methods: We investigated the effect modification by systemic inflammation (serum CRP) on the relationship between a surrogate of the filling pressure of the LV [left atrial volume indexed to the body surface area (LAVI)] and lung water in a series of 220 ESKD patients. Lung water was quantified by the number of ultrasound B lines (US-B) on lung US. Six-hundred and three recordings were performed during a 2-year follow up. Longitudinal data analysis was made by the Mixed Linear Model. Results: At baseline, 88 had absent, 101 had mild to moderate lung congestion and 31 severe congestion. The number of US B lines associated with LAVI (r= 0.23, P< 0.001) and serum CRP was a robust modifier of this relationship (P< 0.001). Similarly, in fully adjusted longitudinal analyses US-B lines associated with simultaneous estimates of LAVI (P= 0.002) and again CRP was a strong modifier of this relationship in adjusted analyses (P≤ 0.01). Overall, at comparable LAVI levels, lung congestion was more pronounced in inflamed than in non-inflamed patients. Conclusion: In ESKD systemic inflammation is a modifier of the relationship between LAVI, an integrate measure of LV filling pressure, and lung water. For any given pressure, lung water is increased with higher CRP levels, likely reflecting a higher permeability of the alveolar-capillary barrier.

Published
2024
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119. Sodium-Glucose co-Transporter-2 inhibitors for patients with diabetic and nondiabetic chronic kidney disease: A new era has already begun

Author

Sarafidis, P, Ortiz, A, Ferro, C, Halimi, J, Kreutz, R, Mallamaci, F, Mancia, G, Wanner, C, Sarafidis P., Ortiz A., Ferro C. J., Halimi J. -M., Kreutz R., Mallamaci F., Mancia G., Wanner C., Sarafidis, P, Ortiz, A, Ferro, C, Halimi, J, Kreutz, R, Mallamaci, F, Mancia, G, Wanner, C, Sarafidis P., Ortiz A., Ferro C. J., Halimi J. -M., Kreutz R., Mallamaci F., Mancia G., and Wanner C.

Abstract

Chronic kidney disease (CKD) is a major issue of public health. Hypertension control and use of renin-angiotensin system (RAS) blockers are the cornerstones of treatment for CKD of any cause. However, even under optimal RAS blockade, many individuals will progress towards more advanced CKD. Within the past few years, evidence from cardiovascular outcome trials with sodium-glucose co-Transporter-2 (SGLT-2) inhibitors clearly suggested that these agents substantially delay CKD progression in patients with diabetes mellitus on top of standard-of-care treatment. The Canagliflozin-And-Renal-Events-in-Diabetes-with-Established-Nephropathy-Clinical-Evaluation (CREDENCE) study, showed that canagliflozin substantially reduced the risk of doubling of SCr, end-stage kidney disease (ESKD), or death from renal or cardiovascular causes in 4401 patients with diabetic CKD compared with placebo (hazard ratio 0.70; 95% CI 0.59-0.82). Recently, the Study-To-Evaluate-The-Effect-of-Dapagliflozin-on-Renal-Outcomes-And-Cardiovascular-Mortality-in-Patients-With-Chronic-Kidney-Disease (DAPA-CKD), including 2510 patients with diabetic and 1803 with nondiabetic CKD, also showed an impressive reduction in the risk of ≥50% decline in eGFR, ESKD, or death from renal or cardiovascular causes (HR 0.61; 95% CI 0.51-0.72). The benefit was similar for patients with diabetic and nondiabetic CKD, including patients with glomerulonephritides. Following this conclusive evidence, relevant guidelines should accommodate their recommendations to implement treatment with SGLT-2 inhibitors for patients with diabetic and nondiabetic CKD.

Published
2021

120. Endovascular Versus Medical Management of Atherosclerotic Renovascular Disease: Update and Emerging Concepts.

Author

Pappaccogli, Marco, Robberechts, Tom, Lengelé, Jean-Philippe, Van der Niepen, Patricia, Sarafidis, Pantelis, Rabbia, Franco, and Persu, Alexandre

Abstract

Atherosclerotic renovascular disease is the most frequent cause of renovascular hypertension and its prevalence increases with age and in specific subset of patients, such as those with end-stage chronic kidney disease, heart failure, and coronary artery disease. Besides hypertension, atherosclerotic renovascular disease is responsible for several clinical manifestations, including life-threatening conditions, such as recurrent flash pulmonary edema, rapidly progressive chronic kidney disease, or acute kidney injury. Atherosclerotic renovascular disease is usually part of a more diffuse atherosclerotic process and requires a combination therapy including antihypertensive, antiplatelet and lipid-lowering agents, as well as optimization of antidiabetic treatment, if needed. Besides medical therapy, percutaneous renal angioplasty was supposed to be the most effective therapy for atherosclerotic renovascular disease, by leading to blood flow restoration. However, despite an apparently solid rationale, several randomized clinical trials failed to confirm the favorable effects of percutaneous renal angioplasty on blood pressure control, kidney function, cardiovascular and renal outcomes, previously reported in observational, retrospective and single-center cohorts, switching off the enthusiasm for this procedure. Several studies' limitations may partly account for this failure, including heterogeneity of diagnostic techniques, overestimation of the degree of renal artery stenosis, inappropriate timing of revascularization, multiple protocol revisions, frequent crossovers, and most importantly exclusion of patients at higher likelihood to respond to angioplasty. The purpose of this review is to summarize studies' potential weaknesses and provide guidance to the clinician for identification of patients who may benefit most from revascularization. [ABSTRACT FROM AUTHOR]

Published
2023
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121. Hyperkalemia in chronic kidney disease: a focus on potassium lowering pharmacotherapy

Author

Sampani, Erasmia, Theodorakopoulou, Marieta, Iatridi, Fotini, and Sarafidis, Pantelis

Abstract

ABSTRACTIntroductionHyperkalemia is one of the most common electrolyte disorders in chronic kidney disease (CKD) and is associated with serious adverse outcomes. Hyperkalemia risk is even greater when CKD patients also have additional predisposing conditions such as diabetes or heart failure. Renin-angiotensin-aldosterone-system blockers are first-line treatments for cardio- and nephroprotection, but their use is often limited due to K+elevation, resulting in high rates of discontinuation.Areas coveredThis article provides an overview of factors interfering with K+homeostasis and discusses recent data on newer therapeutic agents used for the treatment of hyperkalemia. A detailed literature search was performed in two major databases (PubMed/MEDLINE and Scopus) up to April 2023.Expert opinionMajor clinical trials have tested new and promising kidney protective therapies such as sodium/glucose-cotransporter-2 inhibitors and mineralocorticoid-receptor-antagonists, with promising results. Until recently, the only treatment option for hyperkalemia was the cation-exchanging resin sodium-polystyrene-sulfonate. However, despite its common use, the efficacy and safety data of this drug in the long-term management of hyperkalemia are scarce. During the last decade, two novel orally administered K+-exchanging compounds (patiromer and sodium-zirconium-cyclosilicate) have been approved for the treatment of adults with hyperkalemia, as they both effectively reduce elevated serum K+and maintain chronically K+balance within the normal range with an excellent tolerability and no serious adverse events.

Published
2023
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123. Elevated Asymmetric Dimethylarginine is Associated With Oxidant Stress Aggravation in Patients With Early Stage Autosomal Dominant Polycystic Kidney Disease

Author

Vassilios Raptis, Panagiotis I. Georgianos, Pantelis A. Sarafidis, Athanasios Sioulis, Kali Makedou, Areti Makedou, Dimitrios M. Grekas, and Stergios Kapoulas

Subjects
ADPKD, Asymmetric dimethylarginine, ADMA, autosomal dominated polycystic kidney disease, eGFR, Oxidative stress, Dermatology, RL1-803, Diseases of the circulatory (Cardiovascular) system, RC666-701, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Background/Aims: In experimental models of polycystic kidney disease impaired bioavailability of nitric oxide (NO) and elevated mRNA expression of oxidative stress markers at the kidney level was noted. However, clinical studies investigating the potential role of endothelial dysfunction and oxidative stress in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) are limited. We evaluated asymmetric dimethylarginine (ADMA) as marker of NO synthase inhibitor as well as 15-F2t-Isoprostane and oxidized-low density lipoprotein (oxidized-LDL) as measures of oxidative stress in patients with early stages ADPKD. Methods: We recruited 26 ADPKD patients (Group A) with modestly impaired renal function (eGFR 45-70 ml/min/1.73m2), 26 age- and sex-matched ADPKD patients (Group B) with relatively preserved renal function (eGFR)>70 ml/min/1.73m2), and 26 age- and sex-matched controls (Group C). Determination of circulating levels of ADMA, 15-F2t-Isoprostane, oxidized-LDL and routine biochemistry was performed. Results: Group A and B had significantly higher ADMA levels as compared to controls (1.68±0.7 vs 0.51±0.2 μmol/l, P2t-IsoP and oxidized-LDL levels were also significantly higher in Group B relative to controls (788.8±185.0 vs 383.1±86.0 pgr/ml, P2t-Isoprostane (r=0.811, PConclusion: This study shows elevation in circulating levels of ADMA along with aggravation of oxidative stress from the early stages of ADPKD.

Published
2014
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124. Cardiac Phenotypes in Secondary Hypertension: JACC State-of-the-Art Review

Author

Januszewicz, A., Mulatero, P., Dobrowolski, P., Monticone, S., Niepen, P. Van der, Sarafidis, P., Reincke, M., Rexhaj, E., Eisenhofer, G., Januszewicz, M., Kasiakogias, A., Kreutz, R., Lenders, J.W.M., Muiesan, M.L., Persu, A., Agabiti-Rosei, E., Soria, R., Śpiewak, M., Prejbisz, A., Messerli, F.H., Januszewicz, A., Mulatero, P., Dobrowolski, P., Monticone, S., Niepen, P. Van der, Sarafidis, P., Reincke, M., Rexhaj, E., Eisenhofer, G., Januszewicz, M., Kasiakogias, A., Kreutz, R., Lenders, J.W.M., Muiesan, M.L., Persu, A., Agabiti-Rosei, E., Soria, R., Śpiewak, M., Prejbisz, A., and Messerli, F.H.

Abstract

Item does not contain fulltext, Several forms of secondary hypertension carry a high risk of cardiac morbidity and mortality. Evaluation of cardiac phenotypes in secondary hypertension provides a unique opportunity to study underlying hormonal and biochemical mechanisms affecting the heart. We review the characteristics of cardiac dysfunction in different forms of secondary hypertension and clarify the mechanisms behind the higher prevalence of heart damage in these patients than in those with primary hypertension. Attention to the specific clinical/biochemical phenotypes of these conditions may assist clinicians to screen for and confirm secondary forms of hypertension. Thereby, early signs of heart damage can be recognized and monitored, allowing individualized treatment to delay or prevent evolution toward more advanced disease.

Published
2022

129. Toward Rare-Earth-Free Permanent Magnets: A Combinatorial Approach Exploiting the Possibilities of Modeling, Shape Anisotropy in Elongated Nanoparticles, and Combinatorial Thin-Film Approach

Author

Niarchos, D., Giannopoulos, G., Gjoka, M., Sarafidis, C., Psycharis, V., Rusz, J., Edström, A., Eriksson, O., Toson, Peter, Fidler, Josef, Anagnostopoulou, E., Sanyal, U., Ott, F., Lacroix, L.-M., Viau, G., Bran, Cristina, Vazquez, Manuel, Reichel, L., Schultz, L., and Fähler, S.

Published
2015
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133. Left Upper Lobectomy for Congenital Lobar Emphysema in a Low Weight Infant

Author

Meletios Kanakis, Konstantinos Petsios, Dimitrios Bobos, Kosmas Sarafidis, Stefanos Nikopoulos, Konstantinos Kyriakoulis, Achilleas Lioulias, and Nicholas Giannopoulos

Subjects
Surgery, RD1-811
Abstract

Congenital lobar emphysema (CLE) is a rare lung congenital malformation. Differential diagnosis of the disease remains challenging in an infant with acute respiratory distress. We report a case of a 3-week-old female infant with a weight of 2.1 kg who presented respiratory distress related to CLE. Left upper lobectomy was performed and she had an uneventful recovery.

Published
2016
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134. A Case of Pulmonary-Renal Syndrome Leading to the Diagnosis of Legionnaires’ Disease

Author

Erasmia Sabani, Pantelis A. Sarafidis, Antonios Lazaridis, Theodora Kouloukourgiotou, Konstantinos Stylianou, Afroditi Pantzaki, Aikaterini Papagianni, and Georgios Efstratiadis

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

We report a case of a 51-year-old Caucasian man referred at our department due to acute renal failure (ARF) complicating respiratory failure during hospitalization in a regional hospital. The patient was previously started on steroids due to the suspicion of rapidly progressive glomerulonephritis (RPGN) in the context of Goodpasture syndrome. However, clinical and laboratory findings did not support this diagnosis; instead a careful evaluation limited differential diagnosis of the renal insult to acute tubular necrosis or acute interstitial nephritis (AIN) following respiratory infection. With lung function fully improved but renal function not recovering, a renal biopsy revealed AIN, a finding leading to further diagnostic testing and finally to the diagnosis of Legionnaires’ disease as a cause of this patient’s pulmonary-renal syndrome. The management consisted of progressive tapering of oral steroids associated with full recovery of the patient’s renal function. This is a rare case of Legionnaires’ disease causing immune-mediated AIN and highlights the possibility of Legionella infection as a cause of pulmonary-renal syndrome.

Published
2016
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135. A randomized multicenter trial on a lung ultrasound-guided treatment strategy in patients on chronic hemodialysis with high cardiovascular risk see commentary

Author

Zoccali, C., Torino, C., Mallamaci, F., Sarafidis, P., Papagianni, A., Ekart, R., Hojs, R., Klinger, M., Letachowicz, K., Fliser, D., Seiler-Mussler, S., Lizzi, F., Wiecek, A., Miskiewicz, A., Siamopoulos, K., Balafa, O., Slotki, I., Shavit, L., Stavroulopoulos, A., Covic, A., Siriopol, D., Massy, Z.A., Seidowsky, A., Battaglia, Y., Martinez-Castelao, A., Polo-Torcal, C., Coudert-Krier, M.J., Rossignol, P., Fiaccadori, E., Regolisti, G., Hannedouche, T., Bachelet, T., Jager, K.J., Dekker, F.W., Tripepi, R., Tripepi, G., Gargani, L., Sicari, R., Picano, E., and London, G.M.

Subjects
cardiovascular risk, lung congestion, heart failure hemodialysis, chronic kidney failure, ESRD, lung ultrasound
Abstract

Lung congestion is a risk factor for all-cause and cardiovascular mortality in patients on chronic hemodialysis, and its estimation by ultrasound may be useful to guide ultrafiltration and drug therapy in this population. In an international, multi-center randomized controlled trial (NCT02310061) we investigated whether a lung ultrasound-guided treatment strategy improved a composite end point (all-cause death, non-fatal myocardial infarction, decompensated heart failure) vs usual care in patients receiving chronic hemodialysis with high cardiovascular risk. Patient-Reported Outcomes (Depression and the Standard Form 36 Quality of Life Questionnaire, SF36) were assessed as secondary outcomes. A total of 367 patients were enrolled: 183 in the active arm and 180 in the control arm. In the active arm, the pre-dialysis lung scan was used to titrate ultrafiltration during dialysis and drug treatment. Three hundred and seven patients completed the study: 152 in the active arm and 155 in the control arm. During a mean follow-up of 1.49 years, lung congestion was significantly more frequently relieved in the active (78%) than in the control (56%) arm and the intervention was safe. The primary composite end point did not significantly differ between the two study arms (Hazard Ratio 0.88; 95% Confidence Interval: 0.63-1.24). The risk for all-cause and cardiovascular hospitalization and the changes of left ventricular mass and function did not differ among the two groups. A post hoc analysis for recurrent episodes of decompensated heart failure (0.37; 0.15-0.93) and cardiovascular events (0.63; 0.41-0.97) showed a risk reduction for these outcomes in the active arm. There were no differences in patientreported outcomes between groups. Thus, in patients on chronic hemodialysis with high cardiovascular risk, a treatment strategy guided by lung ultrasound effectively relieved lung congestion but was not more effective than usual care in improving the primary or secondary end points of the trial.

Published
2021

136. Effect of patient gender on short-term blood pressure variability in hemodialysis patients

Author

Theodorakopoulou, Marieta P., Alexandrou, Maria-Eleni, Karagiannidis, Artemios G., Geladari, Virginia, Polychronidou, Georgia, Papagianni, Aikaterini, and Sarafidis, Pantelis

Abstract

Increased blood pressure variability (BPV) is strongly associated with cardiovascular events in end-stage kidney disease patients. Male hemodialysis patients present higher cardiovascular risk compared with females. The aim of this study is to investigate sex differences in short-term BPV in hemodialysis patients. 129 male and 91 female hemodialysis patients that underwent 48-h ABPM were included in this analysis. Standard deviation (SD), weighted SD (wSD), coefficient of variation (CV), and average real variability (ARV) of SBP and DBP were calculated with validated formulas. Age, dialysis vintage and history of major comorbidities did not differ between men and women. 48-h SBP/DBP (137.2 ± 17.4/81.9 ± 12.1 mmHg vs 132.2 ± 19.2/75.9 ± 11.7 mmHg, p= 0.045/<0.001) was significantly higher in men than women. During the 48-h period, all systolic BPV indices were similar between men and women (48-h SBP-ARV: 12.0 ± 2.9 vs 12.1 ± 3.2 mmHg, p= 0.683); 48-h DBP-SD, DBP-wSD and DBP-ARV (9.1 ± 1.6 vs 8.4 ± 1.8 mmHg, p= 0.005) were higher in men. In conclusion, short-term diastolic BPV indices are higher in male than female hemodialysis patients. Increased BPV may impact on the higher incidence of cardiovascular events observed in male hemodialysis patients.

Published
2023
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137. Carvedilol in hypertension treatment

Author

Panagiotis C Stafylas and Pantelis A Sarafidis

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Panagiotis C Stafylas, Pantelis A Sarafidis1st Department of Medicine, AHEPA University Hospital, Aristotle University, Thessaloniki, GreeceAbstract: Although β-blockers have been previously shown to effectively reduce blood pressure (BP) and have been used for hypertension treatment for over 40 years, their effect on cardiovascular morbidity and mortality in hypertensive patients remains controversial and its use in uncomplicated hypertension is currently under debate. However, data on the above field derive mainly from studies which were conducted with older agents, such as atenolol and metoprolol, while considerable pharamacokinetic and pharmacodynamic heterogeneity is present within the class of β-blockers. Carvedilol, a vasodilating non-cardioselective β-blocker, is a compound that seems to give the opportunity to the clinician to use a cardioprotective agent without the concerning hemodynamic and metabolic actions of traditional β-blocker therapy. In contrast with conventional β-blockers, carvedilol maintains cardiac output, has a less extended effect on heart rate and reduces BP by decreasing vascular resistance. Further, several studies has shown that carvedilol has a beneficial or at least neutral effect on metabolic parameters, such as glycemic control, insulin sensitivity, and lipid metabolism, suggesting that they could be used in subjects with the metabolic syndrome or diabetes without negative consequences. This article summarizes the distinct pharmacologic, hemodynamic, and metabolic properties of carvedilol in relation to conventional β-blockers, attempting to examine the potential use of this agent for hypertension treatment.Keywords: carvedilol, β-blockers, hypertension treatment

Published
2008

138. Current management of late onset neonatal bacterial sepsis in five European countries

Author

Lutsar, Irja, Chazallon, Corine, Carducci, Francesca Ippolita Calò, Trafojer, Ursula, Abdelkader, Ben, de Cabre, Vincent Meiffredy, Esposito, Susanna, Giaquinto, Carlo, Heath, Paul T., Ilmoja, Mari-Liis, Katragkou, Aspasia, Lascoux, Carine, Metsvaht, Tuuli, Mitsiakos, George, Netzer, Emmanuelle, Pugni, Lorenza, Roilides, Emmanuel, Saidi, Yacine, Sarafidis, Kosmas, Sharland, Mike, Usonis, Vytautas, Aboulker, Jean-Pierre, and NeoMero Consortium

Published
2014
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141. Blood Pressure and Cardiorenal Outcomes With Finerenone in Chronic Kidney Disease in Type 2 Diabetes.

Author

Ruilope, Luis M., Agarwal, Rajiv, Anker, Stefan D., Filippatos, Gerasimos, Pitt, Bertram, Rossing, Peter, Sarafidis, Pantelis, Schmieder, Roland E., Joseph, Amer, Rethemeier, Nicole, Nowack, Christina, Bakris, George L., Mentenich, Nicole, and FIDELIO-DKD Investigators

Abstract

Background: Chronic kidney disease is frequently associated with hypertension and poorly controlled blood pressure can lead to chronic kidney disease progression. Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, significantly improves cardiorenal outcomes in patients with chronic kidney disease and type 2 diabetes. This analysis explored the relationship between office systolic blood pressure (SBP) and cardiorenal outcomes with finerenone in FIDELIO-DKD trial (Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease).Methods: Patients with type 2 diabetes, urine albumin-to-creatinine ratio 30 to 5000 mg/g, and estimated glomerular filtration rate of 25 to <75 mL/min per 1.73 m2 receiving optimized renin-angiotensin system blockade, were randomized to finerenone or placebo. For this analysis, patients (N=5669) were grouped by baseline office SBP quartiles.Results: Finerenone reduced office SBP across the baseline office SBP quartiles, including patients with baseline office SBP of >148 mm Hg. Overall, patients with lower baseline office SBP quartile and greater declines from baseline in SBP were associated with better cardiorenal outcomes. The risk of primary kidney and key secondary cardiovascular composite outcomes was consistently reduced with finerenone versus placebo irrespective of baseline office SBP quartiles (P for interaction 0.87 and 0.78, respectively). A time-varying analysis revealed that 13.8% and 12.6% of the treatment effect with finerenone was attributed to the change in office SBP for the primary kidney composite outcome and the key secondary cardiovascular outcome, respectively.Conclusions: In FIDELIO-DKD, cardiorenal outcomes improved with finerenone irrespective of baseline office SBP. Reductions in office SBP accounted for a small proportion of the treatment effect on cardiorenal outcomes.Registration: URL: https://www.Clinicaltrials: gov; Unique identifier: NCT02540993. [ABSTRACT FROM AUTHOR]

Published
2022
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142. The association of interdialytic blood pressure variability with cardiovascular events and all-cause mortality in haemodialysis patients

Author

Sarafidis, P, Loutradis, C, Karpetas, A, Tzanis, G, Bikos, A, Raptis, V, Syrgkanis, C, Liakopoulos, V, Papagianni, A, Bakris, G, Parati, G, Sarafidis P. A., Loutradis C., Karpetas A., Tzanis G., Bikos A., Raptis V., Syrgkanis C., Liakopoulos V., Papagianni A., Bakris G., Parati G., Sarafidis, P, Loutradis, C, Karpetas, A, Tzanis, G, Bikos, A, Raptis, V, Syrgkanis, C, Liakopoulos, V, Papagianni, A, Bakris, G, Parati, G, Sarafidis P. A., Loutradis C., Karpetas A., Tzanis G., Bikos A., Raptis V., Syrgkanis C., Liakopoulos V., Papagianni A., Bakris G., and Parati G.

Abstract

Background. Long-term pre-dialysis blood pressure variability (BPV) in haemodialysis patients is associated with increased cardiovascular risk. The association of the main haemodynamic culprit in dialysis, that is, short-term BPV, with outcomes has not been investigated. We examine the prognostic role of short-term BPV for mortality and cardiovascular events in this population. Methods. A total of 227 haemodialysis patients underwent 44-h ambulatory monitoring during a standard interval and were followed-up for 30.17 ± 17.70 months. We calculated SD, weighted SD (wSD), coefficient of variation (CV) and average real variability (ARV) of BP with validated formulas. The primary endpoint was first occurrence of all-cause death, non-fatal myocardial infarction or non-fatal stroke. Secondary endpoints were: (i) all-cause mortality, (ii) cardiovascular mortality and (iii) a combination of cardiovascular events. Results. Cumulative freedom from the primary endpoint was similar for quartiles of pre-dialysis and 44-h systolic BP (SBP), but was progressively longer for increasing quartiles of 44-h SBP-SD (P = 0.014), wSD (P = 0.007), CV (P = 0.031) and ARV (83.9, 71.9, 70.2 and 43.9% for quartiles 1-4; P < 0.001). Higher quartiles of 44-h SBP-ARV were associated with higher risk of all studied outcomes. Among diastolic BPV indices, 44-h diastolic BP (DBP)-CV and 44-h DBP-ARV were associated with increased risk for the composite cardiovascular outcome. In Cox regression analysis, SBP-BPV was related to the primary endpoint, independently of SBP levels and interdialytic weight gain [ARV: hazard ratio (HR) 1.115, 95% confidence interval (95% CI) 1.048-1.185]. This association become insignificant after adjustment for pulse wave velocity (PWV; HR 1.061, 95% CI 0.989-1.137), and further attenuated after additional adjustment for age, dialysis vintage, gender, comorbidities and prevalent cardiovascular disease (HR 1.031, 95% CI 0.946-1.122). Conclusions. Increased BPV during the

Published
2019

143. Nebivolol reduces short-term blood pressure variability more potently than irbesartan in patients with intradialytic hypertension

Author

Loutradis, C, Bikos, A, Raptis, V, Afkou, Z, Tzanis, G, Pyrgidis, N, Panagoutsos, S, Pasadakis, P, Balaskas, E, Zebekakis, P, Liakopoulos, V, Papagianni, A, Parati, G, Sarafidis, P, Loutradis C., Bikos A., Raptis V., Afkou Z., Tzanis G., Pyrgidis N., Panagoutsos S., Pasadakis P., Balaskas E., Zebekakis P., Liakopoulos V., Papagianni A., Parati G., Sarafidis P., Loutradis, C, Bikos, A, Raptis, V, Afkou, Z, Tzanis, G, Pyrgidis, N, Panagoutsos, S, Pasadakis, P, Balaskas, E, Zebekakis, P, Liakopoulos, V, Papagianni, A, Parati, G, Sarafidis, P, Loutradis C., Bikos A., Raptis V., Afkou Z., Tzanis G., Pyrgidis N., Panagoutsos S., Pasadakis P., Balaskas E., Zebekakis P., Liakopoulos V., Papagianni A., Parati G., and Sarafidis P.

Abstract

Increased blood pressure (BP) variability (BPV) is associated with high cardiovascular risk in hemodialysis. Studies on the effects of antihypertensive drugs on BPV in hemodialysis are scarce. This study examines the effects of nebivolol and irbesartan on short-term BPV in patients with intradialytic hypertension. This randomized-cross-over study included 38 patients (age: 60.4 ± 11.1 years, male: 65.8%) with intradialytic hypertension (intradialytic-SBP increase ≥ 10 mmHg at ≥4 over 6 consecutive sessions). After the baseline evaluation, participants were randomized to nebivolol 5 mg and subsequently irbesartan 150 mg, or vice versa, with a two-week wash-out period before initiation of the second drug. Patients underwent three respective 24 h-ABPM sessions starting before a midweek-session. We calculated the standard deviation (SD), weighted SD (wSD), coefficient of variation (CV), and average real variability (ARV) of BP with validated formulas. The post-hemodialysis and 24 h-SBP and DBP levels were significantly lower after treatment with both drugs. The systolic-BPV indices were marginally lower after nebivolol but not after irbesartan compared to baseline (SD: baseline 15.70 ± 4.69; nebivolol 14.45 ± 3.37, p = 0.090; irbesartan 15.39 ± 3.85, p = 0.706; wSD: 14.62 ± 4.36 vs 13.40 ± 3.07, p = 0.053 vs 14.36 ± 3.47, p = 0.805, respectively). The diastolic-BPV indices decreased with nebivolol and increased with irbesartan, resulting in significant differences between the two drugs (SD: baseline 10.56 ± 2.50; nebivolol 9.75 ± 2.12; irbesartan 10.84 ± 1.98, between-drug p = 0.014; wSD: baseline 9.86 ± 2.12; nebivolol 9.34 ± 2.01; irbesartan 10.25 ± 2.01, between-drug p = 0.029). The diastolic-BPV during intradialytic and day-time periods was marginally lower with nebivolol than with irbesartan. During nighttime, the BPV indices were unchanged with either drug. The short-term BPV was reduced after nebivolol but not after irbesartan treatment in patients with intradial

Published
2019

145. Outcomes with Finerenone in Participants with Stage 4 CKD and Type 2 Diabetes

Author

Sarafidis, Pantelis, Agarwal, Rajiv, Pitt, Bertram, Wanner, Christoph, Filippatos, Gerasimos, Boletis, John, Tuttle, Katherine R., Ruilope, Luis M., Rossing, Peter, Toto, Robert, Anker, Stefan D., Liu, Zhi-Hong, Joseph, Amer, Ahlers, Christiane, Brinker, Meike, Lawatscheck, Robert, Bakris, George, Aizenberg, Diego, Bartolacci, Inés, Besada, Diego, Bittar, Julio, Chahin, Mariano, Elbert, Alicia, Gelersztein, Elizabeth, Liberman, Alberto, Maffei, Laura, Manghi, Federico Pérez, Sanabria, Hugo, Vallejos, Augusto, Viñes, Gloria, Wassermann, Alfredo, Abhayaratna, Walter, Acharya, Shamasunder, Ekinci, Elif, Lee, Darren, MacIsaac, Richard, Mah, Peak Mann, Nelson, Craig, Packham, David, Pape, Alexia, Roger, Simon, Stephenson, Hugo, Suranyi, Michael, Wittert, Gary, Vale, Elizabeth, Colman, Peter, Colquhoun, David, Ellis, Chris, Joshua, Kim, Pedagogos, Eugenia, Regal, Paul, Topliss, Duncan, Vandeleur, James, Verjans, Johan, Wittert, Gary, Wynne, Katie-Jane, Clodi, Martin, Ebenbichler, Christoph, Fliesser-Görzer, Evelyn, Hanusch, Ursula, Krebs, Michael, Lhotta, Karl, Ludvik, Bernhard, Mayer, Gert, Neudorfer, Peter, Paulweber, Bernhard, Prager, Rudolf, Preiß, Wolfgang, Prischl, Friedrich, Schernthaner, Gerit-Holger, Sourij, Harald, Wiesholzer, Martin, Drexel, Heinz, Oberbauer, Rainer, Schönherr, Hans-Robert, Doubel, Peter, Engelen, Wendy, Gillard, Pieter, Hougardy, Jean-Michel, Krzesinski, Jean-Marie, Maes, Bart, Speeckaert, Marijn, Stas, Koen, van Gaal, Luc, Vanbelleghem, Hilde, Duyck, Francis, Scheen, André, Antunes, Daniela, Botelho, Roberto, Brito, Claudia, Canani, Luis, Canziani, Maria Eugenia, Cerqueira, Maria, de Paula, Rogerio, Eliaschewitz, Freddy, Figueiredo, Carlos Eduardo, Forti, Adriana, Hissa, Miguel, Leite, Emerson Lima Maurilo, Noronha, Irene, Paolino, Bruno, Paschoalin, Nathalia, Paschoalin, Raphael, Filho, Roberto Pecoits, Pereira, Marcio, Portes, Evandro, Precoma, Dalton, Rea, Rosangela, Riella, Miguel, Salles, Joao Eduardo, Vasconcellos, Eduardo, Vencio, Sergio, Bacci, Marcelo, Maia, Lilia, Villacorta, Aline, Apostolova, Emiliya, Boshnyashka, Radostina, Farah, Ghassan, Georgiev, Dimitar, Gushterova, Valentina, Klyuchkova, Neli, Lucheva, Mariya, Manova, Petya, Minkova, Dotska, Nonchev, Boyan, Pichmanova, Mariyana, Prakova, Zhulieta, Rangelov, Rangel, Rashkov, Rosen, Stanchev, Pavel, Stoyanovska-Elencheva, Bilyana, Tagarev, Zhivko, Temelkova-Kurktschieva, Theodora, Vasileva, Svetla, Yoncheva-Mihaylova, Mariana, Marinchev, Angel, Miteva, Mariya, Barre, Paul, Carlson, Brian, Conway, James, Cournoyer, Serge, Dumas, Richard, Fikry, Sameh, Goluch, Richard, Hamet, Pavel, Hart, Randolph, Henein, Sam, Liutkus, Joanne, Madore, Francois, Martinho, Valdemar, Mazza, Giuseppe, McFarlane, Philip, Keefe, Dennis O′, Peterson, Sean, Schwartz, Daniel, Shu, Daniel, Steele, Andrew, Tellier, Guy, Tennankore, Karthik, Tobe, Sheldon, Tsoukas, George, Tytus, Richard, Vitou, Louise, Walsh, Michael, Weisnagel, Stanley, Wilderman, Igor, Yale, Jean-Francois, El Boreky, Fadia, Kelly, Alan, Leiter, Lawrence, Teitelbaum, Ivor, Cobos, Jorge, Godoy, Juan, González, Fernando, Lobos, Sergio, Palma, Juan Carlos, Prieto Dominguez, Juan Carlos, Reyes, Eliana, Romero, Carmen, Saavedra, Victor, Vega, Mario, Medina, Marcelo, Varleta, Paola, Bu, Ruifang, Cai, Hanqing, Chen, Nan, Chen, Qinkai, Chen, Dejun, Cheng, Jinluo, Dong, Youping, Dong, Junwu, Guan, Tianjun, Hao, Chuanming, Huang, Wen, Jiang, Fangfang, Lei, Minxiang, Li, Ling, Li, Zhonghe, Li, Xuemei, Li, Jingmei, Li, Yan, Liang, Xinling, Liang, Bo, Liu, Fang, Liu, Yinghong, Liu, Yuantao, Liu, Zhihong, Long, Gang, Lu, Guoyuan, Lu, Weiping, Lu, Yibing, Luo, Ping, Ma, Jianhua, Mo, Zhaohui, Niu, Jianying, Peng, Ai, Shen, Jiansong, Shen, Feixia, Shi, Bingyin, Su, Qing, Sun, Zhuxing, Tang, Shuifu, Tong, Nanwei, Wang, Hao, Wang, Xinjun, Wang, Guixia, Wang, Jianqin, Wang, Yangang, Wang, Li, Wei, Jiali, Wu, Tianfeng, Wu, Chaoqing, Xing, Changying, Xiong, Fei, Xu, Xudong, Xu, Ning, Yan, Tiekun, Yang, Jinkui, Yin, Aiping, Zeng, Longyi, Zhang, Hao, Zhang, Yanlin, Zhang, Ying, Zhao, Wenjing, Zhao, Zhiquan, Zheng, Hongguang, Zhong, Ling, Zhu, Dalong, Zhuang, Yongze, Du, Yuming, Fang, Yi, Guo, Weiying, Jiang, Sheng, Kuang, Jian, Li, Dongmei, Li, Hongmei, Li, Yinan, Li, Yuxiu, Liu, Jian, Liu, Yu, Miao, Heng, Peng, Wen, Wang, Lihua, Xu, Mingtong, Zhong, Liyong, Zhu, Jun, Arango, Clara, Barrera, Sandra, López, Nelly Beltrán, Benitez, Diego, Blanco, Guillermo, Cadena, Andrés, Coronel, Julian, Cure, Carlos, Durán, Carlos, González, Alexander, Guzmán, Gustavo, Hernández, Eric, Ibarra, Jaime, Jaramillo, Carlos, Jaramillo, Nicolás, Kattah, William, Molina, Dora, Sánchez, Gregorio, Terront, Mónica, Trujillo, Freddy, Urina, Miguel, Vargas, Ruben, Villegas, Iván, Yupanqui, Hernán, Arcos, Edgar, Aroca, Gustavo, Barreto, Germán, Bermudez, Andres, Botero, Rodrigo, Cárdenas, Tatiana, Figueroa, Wilmer, Jaramillo, Mónica, Liévano, Manuel, López, Mónica, Molina, Dora, Rosero, Ricardo, Trillos, Pedro, Alferi, Dino, Brada, Michal, Brezina, Jiri, Bucek, Petr, Edelsberger, Tomas, Gulakova, Drahomira, Zapletalova, Jitka Hasalova, Hola, Olga, Hornova, Lucie, Houdova, Jana, Hrmova, Helena, Karasek, David, Kopecka, Sarka, Kovar, Richard, Krcova, Eva, Kuchar, Jiri, Kutejova, Vlasta, Lubanda, Hana, Matyasek, Ivo, Mokrejsova, Magdalena, Okenka, Libor, Prazny, Martin, Pumprla, Jiri, Tomanek, Pavel, Andersen, Ulla, Andries, Alin, Bech, Jesper, Faber, Jens, Gislason, Gunnar, Hangaard, Jørgen, Pacyk, Grzegorz Jaroslaw, Juhl, Claus, Krarup, Thure, Lindhardt, Morten, Madsbad, Sten, Nielsen, Joan, Pedersen-Bjergaard, Ulrik, Poulsen, Per, Rasmussen, Ole, Rossing, Peter, Schousboe, Karoline, Gram, Jeppe, Lauridsen, Thomas, Pedersen, Erling, Thorsteinsson, Birger, Flöjt, Päivi, Honkasalo, Mikko, Honkasalo, Mikko, Humaloja, Kari, Kananen, Kristiina, Kantola, Ilkka, Koistinen, Arvo, Korsoff, Pirkko, Lahtela, Jorma, Nieminen, Sakari, Nieminen, Tuomo, Sadeharju, Karita, Strand, Jorma, Sulosaari, Sakari, Cariou, Bertrand, Chantrel, François, Clavel, Sylvaine, Combe, Christian, Fauvel, Jean-Pierre, Gallouj, Karim, Gouet, Didier, Guerci, Bruno, Guerrot, Dominique, Hourmant, Maryvonne, Klein, Alexandre, Mariat, Christophe, Marre, Michel, Mesbah, Rafik, Le Meur, Yannick, Monier, Arnaud, Moranne, Olivier, Roussel, Ronan, Serusclat, Pierre, Vendrely, Benoit, Verges, Bruno, Zaoui, Philippe, Axthelm, Christoph, Bergmann, Andreas, Birkenfeld, Andreas L., Braun, Hermann, Busch, Klaus, Contzen, Christel, Degenhardt, Stefan, Derwahl, Karl, Giebel, Thomas, Hagenow, Andreas, Haller, Hermann, Hasslacher, Christoph, Horacek, Thomas, Jungmair, Wolfgang, Kloos, Christof, Koch, Thorsten, Krüger, Thilo, Mühlfeld, Anja, Müller, Joachim, Pfützner, Andreas, Pistrosch, Frank, Rinke, Andrea, Rose, Ludger, Rump, Lars, Schettler, Volker, Schiefke, Ingolf, Schlichthaar, Heike, Schröppel, Bernd, Schöll, Norbert, Schubert, Kristin, Schürholz, Thomas, Sigal, Helena, Stemler, Lutz, Strack, Georg, Täschner, Heidrun, Toursarkissian, Nicole, Tschöpe, Diethelm, Ulmer, Achim, van der Giet, Markus, Wanner, Christoph, Winkelmann, Bernhard R., Boletis, Ioannis, Dimitriadis, George, Hatziagelaki, Erifili, Iatrou, Christos, Ioannidis, Ioannis, Kounadi, Theodora, Makriniotou, Ioanna, Papadopoulou, Dorothea, Papagianni, Aikaterini, Passadakis, Ploumis, Piaditis, George, Stefanidis, Ioannis, Ip, Tai Pang, Lee, Paul, Andrea Luk, On Yan, Ma, Ronald, Chow, Wing Sun, Wang, Angela, Yeung, Vincent, Bajcsi, Dora, Danos, Peter, Harcsa, Eleonora, Kalina, Akos, Kazup, Szilvia, Keltai, Katalin, Kirschner, Robert, Kiss, Julianna, Kovacs, Laszlo, Lamboy, Beata, Literati-Nagy, Botond, Mileder, Margit, Nagy, Laszlo, Noori, Ebrahim, Nyirati, Gabor, Petro, Gizella, Schneider, Karoly, Simon, Judit, Szocs, Albert, Vasas, Szilard, Wudi, Krisztina, Zilahi, Zsolt, Zsom, Marianna, Eustace, Joe, Holian, John, Reddan, Donal, Meara, Yvonne O′, Abramof Ness, Rosane, Adawi, Faiad, Armaly, Zaher, Atar, Shaul, Bashkin, Amir, Ben Chetrit, Sydney, Yanay, Noa Berar, Chernin, Gil, Darawsha, Mahmud, Efrati, Shai, Elias, Mazen, Farber, Evgeny, Glandt, Mariela, Grossman, Ehud, Halabi, Majdi, Harman-Boehm, Ilana, Khazim, Khaled, Liberty, Idit, Minuchin, Oscar, Mosenzon, Ofri, Nakhoul, Farid, Nimer, Assy, Schwartz, Doron, Wainstein, Julio, Yagil, Yoram, Zukermann, Robert, Avogaro, Angelo, Battaglia, Giovanni Giorgio, Bevilacqua, Maurizio Tiziano, Bonora, Enzo, Bossi, Carlo Antonio, Calabrò, Paolo, Cavalot, Franco Luigi, Cimino, Roberto, Cozzolino, Mario Gennaro, David, Salvatore, Emdin, Michele, Fiaccadori, Enrico, Fiorina, Paolo, Giorda, Carlo Bruno, Gregorini, Maria Cristina, La Manna, Gaetano, Maggi, Davide Carlo, Manti, Roberta, Meregalli, Giancarla, Pani, Antonello, Parvanova, Aneliy Ilieva, Perico, Norberto, Piatti, PierMarco, Pisani, Antonio, Pontiroli, Antonio Ettore, Ponzani, Paola, Santorelli, Gennaro, Santoro, Domenico, Scanziani, Renzo, Teatini, Ugo, Tonolo, Giancarlo, Trevisan, Roberto, Veronelli, Anna Maria, Viviani, Giorgio Luciano, Araki, Hideo, Bando, Yukihiro, Ebisui, Osamu, Fujita, Naruhiro, Fukasawa, Hirotaka, Furuya, Ryuichi, Hamamoto, Yoshiyuki, Hamasaki, Akihiro, Hasegawa, Kotaro, Hatazaki, Masahiro, Hayashi, Terumasa, Higashi, Takayuki, Hirohata, Yoshihide, Horinouchi, Shuji, Hoshi, Ayumu, Imoto, Hirofumi, Inagaki, Akemi, Inagaki, Masayuki, Inaguma, Daijo, Inoue, Toshihiko, Ishii, Masao, Ishiko, Tamayo, Isono, Motohide, Jinnouchi, Hideaki, Kanai, Hidetoshi, Kanda, Daisuke, Kanehara, Hideo, Kashima, Masayuki, Kataoka, Yuko, Katayama, Shigehiro, Kato, Kiyoe, Katsuki, Takeshi, Kawamitsu, Katsunori, Kawasaki, Satsuki, Kikuchi, Fumi, Kikuchi, Hidetoshi, Kishimoto, Rui, Kobayashi, Kunihisa, Koide, Junko, Komi, Rieko, Kubota, Miyuki, Kuriya, Genpei, Kurose, Takeshi, Kusano, Yoshiro, Hajime, Maeda, Matsubayashi, Sunao, Matsumoto, Kazunari, Matsumura, Naoya, Matsuo, Yasuto, Matsuoka, Naoki, Miyaoka, Hiroaki, Miyata, Satoshi, Morita, Takeshi, Murakami, Isao, Murao, Satoshi, Nakamura, Udai, Nakayama, Mikihiro, Nakazawa, Jun, Nohara, Sakae, Nomiyama, Takashi, Noritake, Masayuki, Oda, Yoshiaki, Ogiwara, Takayuki, Ohashi, Hiroshi, Okamoto, Hideki, Okino, Shinichi, Osonoi, Takeshi, Sasaki, Nobuhiro, Sayo, Yoshitaka, Sekigami, Taiji, Shibasaki, Taro, Shibata, Hirotaka, Shimoyama, Tatsushi, Shinoda, Junji, Sobajima, Hiroshi, Sugitatsu, Kazuya, Sugiura, Toshiyuki, Sugiyama, Toru, Suzuki, Daisuke, Suzuki, Hiroyuki, Suzuki, Masaaki, Takeda, Asami, Tanaka, Asami, Tanaka, Seiichi, Tsunematsu, Izumi, Ueda, Yasuo, Uekihara, Soichi, Ujihara, Makoto, Yajima, Ken, Yamada, Daishiro, Yamada, Masayo, Yamagata, Kazuo, Yamakawa, Ken, Yamakawa, Fumiko, Yamasaki, Yoshimitsu, Yambe, Yuko, Yanagida, Taihei, Yanai, Hidekatsu, Yanase, Toshihiko, Yasuda, Tetsuyuki, Kriauciuniene, Dovile, Lasiene, Jurate, Navickas, Antanas, Radzeviciene, Lina, Urbanaviciene, Egle, Urbonas, Gediminas, Velaviciene, Audrone, Abd Ghani, Rohana, Aziz, Nor Azizah, Lee, Li Yuan, Loh, Chek Loong, Ali, Norhaliza Mohd, Noor, Nurain Mohd, Fatnoon Nik Ahmad, Nik Nur, Ratnasingam, Jeyakantha, Halimi Bin Wan Hasan, Wan Hasnul, Izani Wan Mohamed, Wan Mohd, Khir, Rizmy Najme, Mohamad, Masni, Alexander Tan, Tong Boon, Avila Pardo, Sandro, Adrian, Miriam Bastidas, Wong, Alfredo Chew, Escobedo de la Peña, Jorge, Salmón, Guillermo Fanghänel, Gálvez, Guillermo González, Ochoa, Ramiro Gutiérrez, Santana, Saúl Irizar, Rovalo, Magdalena Madero, Machado, Gustavo Méndez, Ruiz, Luis Nevarez, Ibarra, Denisse Ramos, López, Gabriel Ramos, Reyna, Leobardo Sauque, Ortiz, Gustavo Solache, Ortiz, Rafael Valdez, Mesa, Juan Villagordoa, Salazar, Melchor Alpizar, Hernández, Pedro García, González, José, Soto, José Lazcano, Mendoza, Arturo Saldaña, Santana, Sergio Irizar, Vilchis, Elvira González, Bakker, R.C., Barendregt, J.N.M., Boonstra, A.H., Bos, Willem, Brouwer, C.B., Buren, M. van, Gansevoort, Ron, Kooy, Adriaan, Krekels, Marielle, Leendert, Ruud J.M. van, Lieverse, Louis A.G., Luik, P.T., Penne, E. Lars, Gregoor, Peter Smak, Vogt, Liffert, Born, Bert-Jan van den, Baker, John, Crawford, Veronica, Cutfield, Rick, Dunn, Peter, Krebs, Jeremy, Nirmalaraj, Kingsley, Scott, Russell, Smuts, Nine, Titchener, Janet, Eriksen, Erik, Finnes, Trine, Høivik, Hans, Karlsson, Thomas, Munk, Peter Scott, Radtke, Maria, Risberg, Knut, Rocke, Jan, Solnør, Leidulv, Stenehjem, Aud-Eldrid, Tafjord, Anne-Beathe, Asprusten, Emil, Hagemeier, Robert, Høye, Kjetil, Selsås, Hilde, Thorup, Frode, Wium, Cecilie, Pamugas, Glenda, Panelo, Araceli, Perez, Ronald, Tanque, Maribel, Tirador, Louie, Villa, Michael, Bautista, Albert, Catindig, Elizabeth, Manalo, Carlo, Mirasol, Roberto, Butrymowicz, Patrycja, Ciechanowski, Kazimierz, Cieslik, Grazyna, Franek, Edward, Gumprecht, Janusz, Hoffmann, Michal, Krzykowska, Jolanta, Kurnatowska, Ilona, Landa, Katarzyna, Madrzejewski, Adam, Madziarska, Katarzyna, Mazur, Stanislaw, Napora, Piotr, Nowicki, Michal, Ocicka-Kozakiewicz, Anna, Rewerska, Barbara, Rusicka, Teresa, Ruxer, Jan, Skokowska, Ewa, Stankiewicz, Andrzej, Stompor, Tomasz, Tiuryn-Petrulewicz, Agnieszka, Wasilewska, Katarzyna, Wierusz-Wysocka, Bogna, Wnetrzak-Michalska, Renata, Jedynasty, Krystyna, Anand, Izabela Sein, Almeida, Edgar, Ballesteros, Rosa, Barreto, Carlos, Beirao, Idalina, Birne, Rita, Esteves, Cesar, Guia, Jose, Heitor, Susana, Marques, Olinda, Melo, Pedro, Nolasco, Fernando, Pereira, Amalia, Roque, Cristina, Rosario, Francisco, Silva, Gil, Silva, Ana, Teixeira e Costa, Fernando, Lobos, Ana Vila, Alves, Ana Rita, Brandao, Ilidio, Carvalho, Rui, Coelho, Joao, Lourenco, Ana, Matos, Pedro, Rosario, Vanisa, Neves, Joao Sergio, Cortes-Maisonet, Gregorio, Roman-Miranda, Amaury, Brito-Peguero, Yudit, Colon-Vega, Gildred, Albota, Adrian, Bala, Cornelia, Barbonta, Hortensia, Caceaune, Elena, Catrinoui, Doina, Constantin, Ciprian, Dumitrescu, Adriana, Mindrescu, Nicoleta, Mistode, Cristina, Negrisanu, Gabriela, Onaca, Adriana, Paveliu, Silvia, Pintilei, Ella, Pop, Lavinia, Popa, 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Published
2023
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146. Blood pressure variability: methodological aspects, clinical relevance and practical indications for management - a European Society of Hypertension position paper∗

Author

Parati, Gianfranco, Bilo, Grzegorz, Kollias, Anastasios, Pengo, Martino, Ochoa, Juan Eugenio, Castiglioni, Paolo, Stergiou, George S., Mancia, Giuseppe, Asayama, Kei, Asmar, Roland, Avolio, Alberto, Caiani, Enrico G., De La Sierra, Alejandro, Dolan, Eamon, Grillo, Andrea, Guzik, Przemysław, Hoshide, Satoshi, Head, Geoffrey A., Imai, Yutaka, Juhanoja, Eeva, Kahan, Thomas, Kario, Kazuomi, Kotsis, Vasilios, Kreutz, Reinhold, Kyriakoulis, Konstantinos G., Li, Yan, Manios, Efstathios, Mihailidou, Anastasia S., Modesti, Pietro Amedeo, Omboni, Stefano, Palatini, Paolo, Persu, Alexandre, Protogerou, Athanasios D., Saladini, Francesca, Salvi, Paolo, Sarafidis, Pantelis, Torlasco, Camilla, Veglio, Franco, Vlachopoulos, Charalambos, and Zhang, Yuqing

Published
2023
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147. Improved tests for Granger noncausality in panel data

Author

Xiao, Jiaqi, Karavias, Yiannis, Juodis, Artūras, Sarafidis, Vasilis, and Ditzen, Jan

Abstract

In this article, we introduce the xtgrangertcommand, which implements the panel Granger noncausality testing approach developed by Juodis, Karavias, and Sarafidis (2021, Empirical Economics60: 93–112). This test offers superior size and power performance to existing tests, which stem from the use of a pooled estimator that has a faster NTconvergence rate. The test has several other useful properties: it can be used in multivariate systems; it has power against both homogeneous and heterogeneous alternatives; and it allows for cross-section dependence and cross-section heteroskedasticity.

Published
2023
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