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1. COVID-19 lockdown and the rate of central precocious puberty

Author: Goggi, G., Moro, M., Chilà, A., Fatti, L., Cangiano, B., Federici, S., Galazzi, E., Carbone, E., Soranna, D., Vezzoli, V., Persani, L., and Bonomi, M.
Published: 2024
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2. Rationale and design of the CV-PREVITAL study: an Italian multiple cohort randomised controlled trial investigating innovative digital strategies in primary cardiovascular prevention

Author: Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., Protti G., Baldassarre, D, Iacoviello, L, Baetta, R, Roncaglioni, M, Condorelli, G, Remuzzi, G, Gensini, G, Frati, L, Ricciardi, W, Conaldi, P, Uccelli, A, Blandini, F, Bosari, S, Scambia, G, Fini, M, Di Malta, A, Amato, M, Veglia, F, Bonomi, A, Klersy, C, Colazzo, F, Pengo, M, Gorini, F, Auteri, L, Ferrante, G, Baviera, M, Ambrosio, G, Catapano, A, Gialluisi, A, Malavazos, A, Castelvecchio, S, Corsi-Romanelli, M, Cardani, R, La Rovere, M, Agnese, V, Pane, B, Prati, D, Spinardi, L, Liuzzo, G, Arbustini, E, Volterrani, M, Visconti, M, Werba, J, Genovese, S, Bilo, G, Invitti, C, Di Blasio, A, Lombardi, C, Faini, A, Rosa, D, Ojeda-Fernandez, L, Foresta, A, De Curtis, A, Di Castelnuovo, A, Scalvini, S, Pierobon, A, Gorini, A, Valenti, L, Luzi, L, Racca, A, Bandi, M, Tremoli, E, Menicanti, L, Parati, G, Pompilio, G, Colombo, G, Vavassori, C, Biondi, M, Frigerio, B, Ravani, A, Sansaro, D, Coggi, D, Romandini, A, Giroli, M, Giuliani, M, Bonmi, A, Rondinelli, M, Trudu, C, Cinieri, C, Monturano, M, Colazo, F, Inviti, C, Di Blasi, A, Torlasco, C, Gilardini, L, Soranna, D, Zambon, A, Perger, E, Zanotti, L, Badano, L, Cova, L, Gentilini, D, Grappiolo, L, Condoreli, G, Ferante, G, Papa, L, Savevski, V, Ieva, F, Romano, I, Remzzi, G, Ojeda, L, Clerici, F, Palumbo, A, Genini, G, Catpano, A, Mattioli, R, Longhi, E, Mantovani, L, Madotto, F, Bonaccio, M, Gianfagna, F, Ghulam, A, Magnacca, S, Noro, F, Costanzo, S, Esposito, S, Orlandi, S, Persichillo, M, Bracone, F, Panzera, T, Ruggiero, E, Parisi, R, Franciosa, S, Morelli, M, De Rita, F, Cerletti, C, de Gaetano, G, Donati, M, Mencanti, L, Romanelli, M, Cerri, A, Dubini, C, Trevisan, M, Renna, L, Milani, V, Boveri, S, Giubbilini, P, Ramputi, L, Baroni, I, De Angeli, G, Riciardi, W, Olmetti, F, Bussotti, M, Gaetano, C, Baiardi, P, Bachetti, T, Balbi, M, Comini, L, Lorenzoni, M, Olivares, A, Traversi, E, Garre, C, Sideri, R, Clemenza, F, Gentile, G, Caruana, G, Cuscino, N, Di Gesaro, G, Greco, A, Loddo, I, Tuzzolino, F, Ucelli, A, Palombo, D, Spinella, G, Mozzetta, G, Ameri, P, Zoppoli, G, Finotello, A, Porto, I, Pratesi, G, Bladini, F, Spnardi, L, Clerici, M, Pelusi, S, Bianco, C, Carpani, R, Periti, G, Margarita, S, Lanza, G, Severino, A, Pedicino, D, D'Amario, D, D'Aiello, A, Vinci, R, Bonanni, A, Brecciaroli, M, Filomia, S, Pastorino, R, Boccia, S, Urbani, A, Sanguinetti, M, Santoliquido, A, Proto, L, Tarquini, D, Grimaldi, M, Leonardi, S, Elia, A, Currao, A, Urtis, M, Di Toro, A, Giuliani, L, Caminiti, G, Marcolongo, F, Sposato, B, Guadagni, F, Morsella, V, Marziale, A, Protti, G, Baldassarre D., Iacoviello L., Baetta R., Roncaglioni M. C., Condorelli G., Remuzzi G., Gensini G., Frati L., Ricciardi W., Conaldi P. G., Uccelli A., Blandini F., Bosari S., Scambia G., Fini M., Di Malta A., Amato M., Veglia F., Bonomi A., Klersy C., Colazzo F., Pengo M., Gorini F., Auteri L., Ferrante G., Baviera M., Ambrosio G., Catapano A., Gialluisi A., Malavazos A. E., Castelvecchio S., Corsi-Romanelli M. M., Cardani R., La Rovere M. T., Agnese V., Pane B., Prati D., Spinardi L., Liuzzo G., Arbustini E., Volterrani M., Visconti M., Werba J. P., Genovese S., Bilo G., Invitti C., Di Blasio A., Lombardi C., Faini A., Rosa D., Ojeda-Fernandez L., Foresta A., De Curtis A., Di Castelnuovo A., Scalvini S., Pierobon A., Gorini A., Valenti L., Luzi L., Racca A., Bandi M., Tremoli E., Menicanti L., Parati G., Pompilio G., Colombo G., Vavassori C., Biondi M. L., Frigerio B., Ravani A., Sansaro D., Coggi D., Romandini A., Giroli M., Giuliani M., Bonmi A., Rondinelli M., Trudu C., Cinieri C., Monturano M., Colazo F., Inviti C., Di Blasi A., Torlasco C., Gilardini L., Soranna D., Zambon A., Perger E., Zanotti L., Badano L., Cova L., Gentilini D., Grappiolo L., Condoreli G., Ferante G., Papa L., Savevski V., Ieva F., Romano I., Remzzi G., Ojeda L., Clerici F., Palumbo A., Genini G. F., Catpano A., Mattioli R., Longhi E., Mantovani L. G., Madotto F., Bonaccio M., Gianfagna F., Ghulam A., Magnacca S., Noro F., Costanzo S., Esposito S., Orlandi S., Persichillo M., Bracone F., Panzera T., Ruggiero E., Parisi R., Franciosa S., Morelli M., De Rita F., Cerletti C., de Gaetano G., Donati M. B., Mencanti L., Romanelli M. M. C., Cerri A., Dubini C., Trevisan M. B., Renna L. V., Milani V., Boveri S., Giubbilini P., Ramputi L., Baroni I., De Angeli G., Riciardi W., Olmetti F., Bussotti M., Gaetano C., Baiardi P., Bachetti T., Balbi M., Comini L., Lorenzoni M., Olivares A., Traversi E., Garre C., Sideri R., Clemenza F., Gentile G., Caruana G., Cuscino N., Di Gesaro G., Greco A., Loddo I., Tuzzolino F., Ucelli A., Palombo D., Spinella G., Mozzetta G., Ameri P., Zoppoli G., Finotello A., Porto I., Pratesi G., Bladini F., Spnardi L., Clerici M., Pelusi S., Bianco C., Carpani R., Periti G., Margarita S., Lanza G. A., Severino A., Pedicino D., D'Amario D., D'Aiello A., Vinci R., Bonanni A., Brecciaroli M., Filomia S., Pastorino R., Boccia S., Urbani A., Sanguinetti M., Santoliquido A., Proto L., Tarquini D., Grimaldi M. C., Leonardi S., Elia A., Currao A., Urtis M., Di Toro A., Giuliani L., Caminiti G., Marcolongo F., Sposato B., Guadagni F., Morsella V., Marziale A., and Protti G.
Abstract: Introduction Prevention of cardiovascular disease (CVD) is of key importance in reducing morbidity, disability and mortality worldwide. Observational studies suggest that digital health interventions can be an effective strategy to reduce cardiovascular (CV) risk. However, evidence from large randomised clinical trials is lacking. Methods and analysis The CV-PREVITAL study is a multicentre, prospective, randomised, controlled, open-label interventional trial designed to compare the effectiveness of an educational and motivational mobile health (mHealth) intervention versus usual care in reducing CV risk. The intervention aims at improving diet, physical activity, sleep quality, psycho-behavioural aspects, as well as promoting smoking cessation and adherence to pharmacological treatment for CV risk factors. The trial aims to enrol approximately 80 000 subjects without overt CVDs referring to general practitioners' offices, community pharmacies or clinics of Scientific Institute for Research, Hospitalization and Health Care (Italian acronym IRCCS) affiliated with the Italian Cardiology Network. All participants are evaluated at baseline and after 12 months to assess the effectiveness of the intervention on short-term endpoints, namely improvement in CV risk score and reduction of major CV risk factors. Beyond the funded life of the study, a long-term (7 years) follow-up is also planned to assess the effectiveness of the intervention on the incidence of major adverse CV events. A series of ancillary studies designed to evaluate the effect of the mHealth intervention on additional risk biomarkers are also performed. Ethics and dissemination This study received ethics approval from the ethics committee of the coordinating centre (Monzino Cardiology Center; R1256/20-CCM 1319) and from all other relevant IRBs and ethics committees. Findings are disseminated through scientific meetings and peer-reviewed journals and via social media. Partners are informed about the study's
Published: 2023

3. Shedding Light on Latent Pulmonary Vascular Disease in Heart Failure With Preserved Ejection Fraction

Author: Caravita, S, Baratto, C, Filippo, A, Soranna, D, Dewachter, C, Zambon, A, Perego, G, Muraru, D, Senni, M, Badano, L, Parati, G, Vachiery, J, Fudim, M, Caravita S., Baratto C., Filippo A., Soranna D., Dewachter C., Zambon A., Perego G. B., Muraru D., Senni M., Badano L. P., Parati G., Vachiery J. -L., Fudim M., Caravita, S, Baratto, C, Filippo, A, Soranna, D, Dewachter, C, Zambon, A, Perego, G, Muraru, D, Senni, M, Badano, L, Parati, G, Vachiery, J, Fudim, M, Caravita S., Baratto C., Filippo A., Soranna D., Dewachter C., Zambon A., Perego G. B., Muraru D., Senni M., Badano L. P., Parati G., Vachiery J. -L., and Fudim M.
Abstract: Background: Among patients with heart failure with preserved ejection fraction (HFpEF), a distinct hemodynamic phenotype has been recently described, ie, latent pulmonary vascular disease (HFpEF-latentPVD), defined by exercise pulmonary vascular resistance (PVR) >1.74 WU. Objectives: This study aims to explore the pathophysiological significance of HFpEF-latentPVD. Methods: The authors analyzed a cohort of patients who had undergone supine exercise right heart catheterization with cardiac output (CO) measured by direct Fick method, between 2016 and 2021. HFpEF-latentPVD patients were compared with HFpEF control patients. Results: Out of 86 HFpEF patients, 21% qualified as having HFpEF-latentPVD, 78% of whom had PVR >2 WU at rest. Patients with HFpEF-latentPVD were older, with a higher pretest probability of HFpEF, and more frequently experienced atrial fibrillation and at least moderate tricuspid regurgitation (P < 0.05). PVR trajectories differed between HFpEF-latentPVD patients and HFpEF control patients (Pinteraction = 0.008), slightly increasing in the former and reducing in the latter. HFpEF-latentPVD patients displayed more frequent hemodynamically significant tricuspid regurgitation during exercise (P = 0.002) and had more impaired CO and stroke volume reserve (P < 0.05). Exercise PVR was correlated with mixed venous O2 tension (R2 = 0.33) and stroke volume (R2 = 0.31) in HFpEF-latentPVD patients. The HFpEF-latentPVD patients had had higher dead space ventilation during exercise and higher PaCO2 (P < 0.05), which correlated with resting PVR (R2 = 0.21). Event-free survival was reduced in HFpEF-latentPVD patients (P < 0.05). Conclusions: The results suggest that when CO is measured by direct Fick, few HFpEF patients have isolated latent PVD (ie, normal PVR at rest, becoming abnormal during exercise). HFpEF-latentPVD patients present with CO limitation to exercise, associated with dynamic tricuspid regurgitation, altered ventilatory control, a
Published: 2023

4. Effect of Continuous Positive Airway Pressure on Glucose and Lipid Profiles in Patients With Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author: Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, Fava, C, Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., Fava C., Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, Fava, C, Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., and Fava C.
Abstract: Background and aim: Continuous Positive Airway Pressure (CPAP) is the most effective therapy for symptomatic obstructive sleep apnoea (OSA). However, uncertainty remains about the effectiveness of CPAP in improving OSA-related metabolic dysregulation. This meta-analysis of randomized controlled trials (RCTs) aimed to investigate whether CPAP, compared to other control treatments, could improve glucose or lipid metabolism in OSA patients. Methods: Relevant articles were searched in three different databases (MEDLINE, EMBASE and Web of Science) from inception to 6th Feb 2022 through specific search terms and selection criteria. Results: From a total of 5553 articles, 31 RCTs were included. CPAP modestly improved insulin sensitivity as determined by mean fasting plasma insulin and Homeostasis Model Assessment of Insulin Resistance reduction of 1.33 mU/L and 0.287, respectively. In subgroup analyses pre-diabetic/type 2 diabetic patients as well as those with sleepy OSA showed a greater response to CPAP. Regarding lipid metabolism, CPAP was associated with a mean total cholesterol reduction of 0.064 mmol/L. In subgroup analyses, the benefit was higher in patients that showed more severe OSA and oxygen desaturations at the baseline sleep study as well as in younger and obese subjects. Neither glycated haemoglobin nor triglycerides, HDL- and LDL-cholesterol were reduced by CPAP. Conclusion: CPAP treatment may improve insulin sensitivity and total cholesterol levels in OSA patients but with low effect size. Our results suggest that CPAP does not substantially improve metabolic derangements in an unselected OSA population, but the effect may be higher in specific subgroups of OSA patients.
Published: 2023

5. Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment

Author: Cancello, R, Brunani, A, Brenna, E, Soranna, D, Bertoli, S, Zambon, A, Lukaski, H, Capodaglio, P, Cancello R., Brunani A., Brenna E., Soranna D., Bertoli S., Zambon A., Lukaski H. C., Capodaglio P., Cancello, R, Brunani, A, Brenna, E, Soranna, D, Bertoli, S, Zambon, A, Lukaski, H, Capodaglio, P, Cancello R., Brunani A., Brenna E., Soranna D., Bertoli S., Zambon A., Lukaski H. C., and Capodaglio P.
Abstract: Phase angle (PhA) is a recently proposed marker of nutritional status in many clinical conditions. Its use in patients with obesity presents different critical concerns due to the higher variability of the two measured parameters (resistance, R, and reactance, Xc) that contribute to the determination of PhA. Controversial is the relation between PhA and BMI that might vary with graded levels of obesity due to the variation in fat and free fat mass. Obesity is frequently associated with metabolic, hepatic, cardiovascular and kidney diseases that introduce variations in PhA values, in relation to multimorbidity and severity degree of these diseases. It is reported that the improvement of clinical condition is associated with a positive change in PhA. Also, the treatment of obesity with weight loss might confirm this effect, but with different responses in relation to the type and duration of the intervention applied. In fact, the effect appears not only related to the percentage of weight loss but also the possible loss of free fat mass and the nutritional, metabolic and structural modifications that might follow each therapeutic approach to decrease body weight. We can conclude that the PhA could be used as marker of health status in patients with obesity supporting an appropriate weight loss intervention to monitor efficacy and fat free mass preservation.
Published: 2023

6. Impact of severe secondary tricuspid regurgitation on rest and exercise hemodynamics of patients with heart failure and a preserved left ventricular ejection fraction

Author: Baratto, C, Caravita, S, Corbetta, G, Soranna, D, Zambon, A, Dewachter, C, Gavazzoni, M, Heilbron, F, Tomaselli, M, Radu, N, Perelli, F, Perego, G, Vachiery, J, Parati, G, Badano, L, Muraru, D, Baratto C., Caravita S., Corbetta G., Soranna D., Zambon A., Dewachter C., Gavazzoni M., Heilbron F., Tomaselli M., Radu N., Perelli F. P., Perego G. B., Vachiery J. -L., Parati G., Badano L., Muraru D., Baratto, C, Caravita, S, Corbetta, G, Soranna, D, Zambon, A, Dewachter, C, Gavazzoni, M, Heilbron, F, Tomaselli, M, Radu, N, Perelli, F, Perego, G, Vachiery, J, Parati, G, Badano, L, Muraru, D, Baratto C., Caravita S., Corbetta G., Soranna D., Zambon A., Dewachter C., Gavazzoni M., Heilbron F., Tomaselli M., Radu N., Perelli F. P., Perego G. B., Vachiery J. -L., Parati G., Badano L., and Muraru D.
Abstract: Background: Both secondary tricuspid regurgitation (STR) and heart failure with preserved ejection fraction (HFpEF) are relevant public health problems in the elderly population, presenting with potential overlaps and sharing similar risk factors. However, the impact of severe STR on hemodynamics and cardiorespiratory adaptation to exercise in HFpEF remains to be clarified. Aim: To explore the impact of STR on exercise hemodynamics and cardiorespiratory adaptation in HFpEF. Methods: We analyzed invasive hemodynamics and gas-exchange data obtained at rest and during exercise from HFpEF patients with severe STR (HFpEF-STR), compared with 1:1 age-, sex-, and body mass index (BMI)- matched HFpEF patients with mild or no STR (HFpEF-controls). Results: Twelve HFpEF with atrial-STR (mean age 72 years, 92% females, BMI 28 Kg/m2) and 12 HFpEF-controls patients were analyzed. HFpEF-STR had higher (p < 0.01) right atrial pressure than HFpEF-controls both at rest (10 ± 1 vs. 5 ± 1 mmHg) and during exercise (23 ± 2 vs. 14 ± 2 mmHg). Despite higher pulmonary artery wedge pressure (PAWP) at rest in HFpEF-STR than in HFpEF-controls (17 ± 2 vs. 11 ± 2, p = 0.04), PAWP at peak exercise was no more different (28 ± 2 vs. 29 ± 2). Left ventricular transmural pressure and cardiac output (CO) increased less in HFpEF-STR than in HFpEF-controls (interaction p-value < 0.05). This latter was due to lower stroke volume (SV) values both at rest (48 ± 9 vs. 77 ± 9 mL, p < 0.05) and at peak exercise (54 ± 10 vs. 93 ± 10 mL, p < 0.05). Despite these differences, the two groups of patients laid on the same oxygen consumption isophlets because of the increased peripheral oxygen extraction in HFpEF-STR (p < 0.01). We found an inverse relationship between pulmonary vascular resistance and SV, both at rest and at peak exercise (R2 = 0.12 and 0.19, respectively). Conclusions: Severe STR complicating HFpEF impairs SV and CO reserve, leading to pulmonary vascular de-recruitment and relative
Published: 2023

7. Detection of impending reflex syncope by means of an integrated multisensor patch-type recorder

Author: Groppelli, A, Rafanelli, M, Testa, G, Agusto, S, Rivasi, G, Carbone, E, Soranna, D, Zambon, A, Castiglioni, P, Ungar, A, Brignole, M, Parati, G, Groppelli A., Rafanelli M., Testa G. D., Agusto S., Rivasi G., Carbone E., Soranna D., Zambon A., Castiglioni P., Ungar A., Brignole M., Parati G., Groppelli, A, Rafanelli, M, Testa, G, Agusto, S, Rivasi, G, Carbone, E, Soranna, D, Zambon, A, Castiglioni, P, Ungar, A, Brignole, M, Parati, G, Groppelli A., Rafanelli M., Testa G. D., Agusto S., Rivasi G., Carbone E., Soranna D., Zambon A., Castiglioni P., Ungar A., Brignole M., and Parati G.
Abstract: We assessed the capability of an integrated multisensory patch-type monitor (RootiRx®) in detecting episodes of reflex (pre)syncope induced by tilt table test (TTT). Firstly, we performed an intrapatient comparison of cuffless systolic blood pressure (SBP), R–R interval (RRI) and variability (power spectrum analysis) obtained by means of the RootiRx® with those obtained with conventional methods (CONV) with validated finger pressure devices at baseline in supine position and repeatedly during TTT in 32 patients affected by likely reflex syncope. Secondly, the LF/HF values obtained with RootiRx® during TTT were analyzed in 50 syncope patients. Compared with baseline supine recordings, during TTT a decrement of median SBP was observed with CONV (−53.5 mmHg) but not with RootiRx® ®(−1 mmHg). Conversely, RRI reduction (CONV: 102 ms; RootiRx®: 127 ms) and RRI Low Frequency/High Frequency powers ratio (LF/HF) increase (CONV: 1.6; RootiRx®: 2.5) were similar. The concordance was good for RRI (0.97 [95% CI 0.96–0.98]) and fair for LF/HF ratio (0.69 [95% CI 0.46-0.83]). During the first 5 min of TTT the LF/HF ratio was higher in patients who later developed syncope than in no-syncope patients. This ratio was significantly different among patients with syncope, presyncope or without symptoms at the time of syncope (p value = 0.02). In conclusion, cuffless RootiRx® was unable to detect rapid drops of SBP occurring during impending reflex syncope and thus cannot be used as a diagnostic tool for hypotensive syncope. On the other hand, RRI mean values and LF/HF power ratios obtained with RootiRx® were consistent with those simultaneously obtained using conventional methods.
Published: 2023

8. Correction to: Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment

Author: Cancello, R., Cancello, R, Brunani, A, Brenna, E, Soranna, D, Bertoli, S, Zambon, A, Lukaski, H, Capodaglio, P, Cancello, R., Brunani, A., Brenna, E., Soranna, D., Bertoli, S., Zambon, A., Lukaski, H. C., Capodaglio, P., Cancello, R., Cancello, R, Brunani, A, Brenna, E, Soranna, D, Bertoli, S, Zambon, A, Lukaski, H, Capodaglio, P, Cancello, R., Brunani, A., Brenna, E., Soranna, D., Bertoli, S., Zambon, A., Lukaski, H. C., and Capodaglio, P.
Published: 2023

9. Corrigendum to “Syncope in hypertrophic cardiomyopathy (part I): An updated systematic review and meta-analysis” [International Journal of Cardiology Volume 357, 15 June 2022, Pages 88–94]. (International Journal of Cardiology (2022) 357 (88–94), (S0167527322003850), (10.1016/j.ijcard.2022.03.028))

Author: Mascia G., Mascia, G, Crotti, L, Groppelli, A, Canepa, M, Merlo, A, Benenati, S, Di Donna, P, Bona, R, Soranna, D, Zambon, A, Porto, I, Olivotto, I, Parati, G, Brignole, M, Cecchi, F, Mascia G., Crotti L., Groppelli A., Canepa M., Merlo A. C., Benenati S., Di Donna P., Bona R. D., Soranna D., Zambon A., Porto I., Olivotto I., Parati G., Brignole M., Cecchi F., Mascia G., Mascia, G, Crotti, L, Groppelli, A, Canepa, M, Merlo, A, Benenati, S, Di Donna, P, Bona, R, Soranna, D, Zambon, A, Porto, I, Olivotto, I, Parati, G, Brignole, M, Cecchi, F, Mascia G., Crotti L., Groppelli A., Canepa M., Merlo A. C., Benenati S., Di Donna P., Bona R. D., Soranna D., Zambon A., Porto I., Olivotto I., Parati G., Brignole M., and Cecchi F.
Abstract: The author Lia Crotti would like to integrate her affiliation as follows, since in the original version of the article the university affiliation was not present. Affiliations. b Department of Cardiology, IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, Ospedale San Luca, Milan, Italy. f Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. The authors would like to apologise for any inconvenience caused.
Published: 2023

10. Long-term effects of GH therapy in adult patients with Prader-Willi syndrome: a longitudinal study

Author: Grugni, G, Sartorio, A, Soranna, D, Zambon, A, Grugni, L, Zampino, G, Crinò, A, Grugni G., Sartorio A., Soranna D., Zambon A., Grugni L., Zampino G., Crinò A., Grugni, G, Sartorio, A, Soranna, D, Zambon, A, Grugni, L, Zampino, G, Crinò, A, Grugni G., Sartorio A., Soranna D., Zambon A., Grugni L., Zampino G., and Crinò A.
Abstract: Introduction: Prader-Willi syndrome (PWS) is a complex disorder resulting from the failure of expression of paternal alleles in the PWS region of chromosome 15. The PWS phenotype resembles that observed in the classic non-PWS GH deficiency (GHD), including short stature, excessive fat mass, and reduced muscle mass. To date, a small number of studies on the long-term effects of GH treatment are available in adult subjects with PWS. Methods: In this longitudinal study, 12 obese subjects with PWS (GHD/non-GHD 6/6) were treated for a median of 17 years, with a median GH dose of 0.35 mg/day. The median age was 27.1 years. Anthropometric, body composition, hormonal, biochemical, and blood pressure variables were analyzed in all subjects. Results: Waist circumference was significantly lower at the end of the treatment period (p-value=0.0449), while body mass index (BMI) did not differ significantly. Compared to the baseline, a highly significant reduction of Fat Mass % (FM%) was observed (p-value=0.0005). IGF-I SDS values significantly increased during GH therapy (p-value=0.0005). A slight impairment of glucose homeostasis was observed after GH therapy, with an increase in the median fasting glucose levels, while insulin, HOMA-IR, and HbA1c values remained unchanged. Considering GH secretory status, both subjects with and without GHD showed a significant increase in IGF-I SDS and a reduction of FM% after GH therapy (p-value= 0.0313 for all). Discussion: Our results indicate that long-term GH treatment has beneficial effects on body composition and body fat distribution in adults with PWS associated with obesity. However, the increase in glucose values during GH therapy should be considered, and continuous surveillance of glucose metabolism is mandatory during long-term GH therapy, especially in subjects with obesity.
Published: 2023

11. COVID-19 lockdown and the rate of central precocious puberty

Author: Goggi, G., primary, Moro, M., additional, Chilà, A., additional, Fatti, L., additional, Cangiano, B., additional, Federici, S., additional, Galazzi, E., additional, Carbone, E., additional, Soranna, D., additional, Vezzoli, V., additional, Persani, L., additional, and Bonomi, M., additional
Published: 2023
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12. Effect of Continuous Positive Airway Pressure on Glucose and Lipid Profiles in Patients With Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author: Cattazzo F., Pengo M. F., Giontella A., Soranna D., Bilo G., Zambon A., Karalliedde J., Gnudi L., Martinez-Garcia M. A., Minuz P., Lombardi C., Parati G., Fava C., Cattazzo, F, Pengo, M, Giontella, A, Soranna, D, Bilo, G, Zambon, A, Karalliedde, J, Gnudi, L, Martinez-Garcia, M, Minuz, P, Lombardi, C, Parati, G, and Fava, C
Subjects: OSA, Pulmonary and Respiratory Medicine, Glucose level, CPAP, Insulin resistance, Meta-analysi, Lipids level
Abstract: Background and aim: Continuous Positive Airway Pressure (CPAP) is the most effective therapy for symptomatic obstructive sleep apnoea (OSA). However, uncertainty remains about the effectiveness of CPAP in improving OSA-related metabolic dysregulation. This meta-analysis of randomized controlled trials (RCTs) aimed to investigate whether CPAP, compared to other control treatments, could improve glucose or lipid metabolism in OSA patients. Methods: Relevant articles were searched in three different databases (MEDLINE, EMBASE and Web of Science) from inception to 6th Feb 2022 through specific search terms and selection criteria. Results: From a total of 5553 articles, 31 RCTs were included. CPAP modestly improved insulin sensitivity as determined by mean fasting plasma insulin and Homeostasis Model Assessment of Insulin Resistance reduction of 1.33 mU/L and 0.287, respectively. In subgroup analyses pre-diabetic/type 2 diabetic patients as well as those with sleepy OSA showed a greater response to CPAP. Regarding lipid metabolism, CPAP was associated with a mean total cholesterol reduction of 0.064 mmol/L. In subgroup analyses, the benefit was higher in patients that showed more severe OSA and oxygen desaturations at the baseline sleep study as well as in younger and obese subjects. Neither glycated haemoglobin nor triglycerides, HDL- and LDL-cholesterol were reduced by CPAP. Conclusion: CPAP treatment may improve insulin sensitivity and total cholesterol levels in OSA patients but with low effect size. Our results suggest that CPAP does not substantially improve metabolic derangements in an unselected OSA population, but the effect may be higher in specific subgroups of OSA patients.
Published: 2023

13. Feasibility of Blood Pressure Measurement With a Wearable (Watch-Type) Monitor During Impending Syncopal Episodes

Author: Groppelli, A, Rafanelli, M, Testa, G, Agusto, S, Rivasi, G, Ungar, A, Carbone, E, Soranna, D, Zambon, A, Brignole, M, Parati, G, Groppelli A., Rafanelli M., Testa G. D., Agusto S., Rivasi G., Ungar A., Carbone E., Soranna D., Zambon A., Brignole M., Parati G., Groppelli, A, Rafanelli, M, Testa, G, Agusto, S, Rivasi, G, Ungar, A, Carbone, E, Soranna, D, Zambon, A, Brignole, M, Parati, G, Groppelli A., Rafanelli M., Testa G. D., Agusto S., Rivasi G., Ungar A., Carbone E., Soranna D., Zambon A., Brignole M., and Parati G.
Abstract: BACKGROUND: We assessed the reliability and feasibility of blood pressure (BP) measurements by means of a new wearable watch-type BP monitor (HeartGuide) in detecting episodes of hypotensive (pre)syncope induced by tilt table test. METHODS AND RESULTS: An intrapatient comparison between systolic BP (SBP) measured by means of the HeartGuide device and noninvasive finger beat-to-beat BP monitoring was undertaken both at baseline in supine position and repeatedly during tilt table test in patients evaluated for reflex syncope. Intrapatient fall of systolic BP from baseline was measured. Eighty-one patients (mean age, 61±19 years; 46 women) were included. Overall, HeartGuide was able to yield BP values at the time of BP nadir in 58 (72%) patients (average HeartGuide SBP 102±18 mm Hg, versus finger SBP 101±19 mm Hg). Compared with baseline, the maximum SBP decrease was on average −28.5±27.8 and −30.3±33.9 mm Hg respectively (Lin’s concordance correlation coefficient=0.78, r=0.79, P=0.001). In the subgroup of 38 patients with tilt table test induced (pre)syncope, the average HeartGuide SBP during symptoms was 97±16 mm Hg, and the finger SBP was 94±18 mm Hg. Compared with baseline, the maximum SBP decrease was on average −35.2±29.3 and −43.3±31.8 mm Hg, respectively (Lin’s concordance correlation coefficient=0.83, r=0.87, P=0.001). CONCLUSIONS: Our data indicate that the HeartGuide BP monitor can detect low BP during presyncope and that its measure of SBP change is consistent with that simultaneously obtained through continuous BP monitoring, despite some intrapatient variability. Thus, this device might be useful in determining the hypotensive nature of spontaneous (pre)syncopal symptoms, a possibility that should be verified by field studies.
Published: 2022

14. Algorithm of the major and minor diagnostic criteria for active myopic choroidal neovascularization

Author: Milani, P, Mazzola, M, Cigada, M, Massacesi, A, Setaccioli, M, Moschini, S, Ciaccia, S, Scotti, F, Mantovani, E, Soranna, D, Zambon, A, Bergamini, F, Milani P., Mazzola M., Cigada M., Massacesi A., Setaccioli M., Moschini S., Ciaccia S., Scotti F., Mantovani E., Soranna D., Zambon A., Bergamini F., Milani, P, Mazzola, M, Cigada, M, Massacesi, A, Setaccioli, M, Moschini, S, Ciaccia, S, Scotti, F, Mantovani, E, Soranna, D, Zambon, A, Bergamini, F, Milani P., Mazzola M., Cigada M., Massacesi A., Setaccioli M., Moschini S., Ciaccia S., Scotti F., Mantovani E., Soranna D., Zambon A., and Bergamini F.
Abstract: Purpose: To propose an algorithm of the major and minor diagnostic criteria for macular myopic choroidal neovascularization (mCNV). Methods: This single-center, retrospective, cross-sectional study was based in Istituto Auxologico Italiano, Milan, Italy. Two authors evaluated the clinical and imaging parameters of eyes with high myopia (spherical equivalent of -6D or less) and suspected to have naïve, recurrent, or inactive mCNV. Recordings of the eyes that met the inclusion criteria were then independently evaluated by two other senior retinal specialists. Fluorescein angiography (FA), spectral domain optical coherence tomography (SD-OCT), and OCT angiography were used for multimodal imaging. Results: One-hundred and twenty-two eyes (n = 107; 39 men, 68 women) were included in the study. The mean patient age was 66 years (range, 22–89 years). There were 83 and 39 eyes in the active mCNV and control groups, respectively. The best diagnostic algorithm had positive- and negative-predictive values of 89% and 85%, respectively, and was based on four criteria: leakage/staining on FA, retinal thickening, fuzzy area on SD-OCT, and recent metamorphopsia. When excluding FA-derived findings, retinal pigment epithelium (RPE) features played a diagnostic role in 33 eyes (27%). Twenty-seven eyes with active mCNV (32%) did not have the fuzzy area. Taken singularly, no clinical or imaging parameter had both sensitivity and specificity greater than 78%. Matching of 2 or 3 biomarkers did not yield a sensitivity or specificity greater than 79%. Sensitivities and specificities ≥ 90% were found in ten criteria combinations that included four to five biomarkers. The most frequent were metamorphopsia, fuzzy area, retinal thickening, and leakage. Less frequently, they included hemorrhage, staining, and RPE features such as elevation, flattening, and focal interruption. For all the parameters, the agreement between the investigators was good (Cohen k ≥ 0.66), being the lowest wh
Published: 2022

15. An updated meta-analysis of hemodynamics markers of prognosis in patients with pulmonary hypertension due to left heart disease

Author: Baratto, C, Caravita, S, Soranna, D, Dewachter, C, Bondue, A, Zambon, A, Badano, L, Parati, G, Vachiery, J, Baratto C., Caravita S., Soranna D., Dewachter C., Bondue A., Zambon A., Badano L., Parati G., Vachiery J. -L., Baratto, C, Caravita, S, Soranna, D, Dewachter, C, Bondue, A, Zambon, A, Badano, L, Parati, G, Vachiery, J, Baratto C., Caravita S., Soranna D., Dewachter C., Bondue A., Zambon A., Badano L., Parati G., and Vachiery J. -L.
Abstract: Pulmonary hypertension (PH) is associated with a poor prognosis in left heart disease (LHD). We sought to provide an updated analysis on the association of hemodynamic variables, such as pulmonary vascular resistance (PVR), pulmonary artery compliance (PAC), and diastolic pressure gradient (DPG), with prognosis in PH-LHD, through a systematic literature review. Sixteen articles were identified, including 9600 patients with LHD, heterogeneous in terms of age, sex, and etiology of cardiac disease. In this large population, PVR (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.05−1.0), DPG (HR, 1.02; 95% CI: 1.01−1.02) and PAC (HR, 0.76; 95% CI: 0.69−0.84) were associated with an increased risk of adverse outcome, albeit with a less solid performance of DPG. Similar results were found when hemodynamic variables were analyzed according to the thresholds commonly applied in clinical practice, or subdividing cohorts according to the underlying LHD. Furthermore, cumulative metanalysis indicated that these results are consistently stable since 2018. Thus, PVR, DPG and PAC have an established prognostic value in PH-LHD. These results are consistent through the years and unlikely to change with further studies.
Published: 2022

16. Psychological complications in patients with acromegaly: relationships with sex, arthropathy, and quality of life

Author: Cangiano, B, Giusti, E, Premoli, C, Soranna, D, Vitale, G, Grottoli, S, Cambria, V, Mantovani, G, Mungari, R, Maffei, P, Dassie, F, Giampietro, A, Chiloiro, S, Tanda, M, Ippolito, S, Cannavo, S, Ragonese, M, Zambon, A, Persani, L, Fatti, L, Scacchi, M, Cavagnini, F, Ferone, D, Corbetta, S, Bartalena, L, Peccoz, P, Arosio, M, Lania, A, Colao, A, Pivonello, R, Uberti, E, Ghigo, E, Giustina, A, Martino, E, Pontecorvi, A, Sicolo, N, Trimarchi, F, Cangiano B., Giusti E., Premoli C., Soranna D., Vitale G., Grottoli S., Cambria V., Mantovani G., Mungari R., Maffei P., Dassie F., Giampietro A., Chiloiro S., Tanda M. L., Ippolito S., Cannavo S., Ragonese M., Zambon A., Persani L., Fatti L. M., Scacchi M., Cavagnini F., Ferone D., Corbetta S., Bartalena L., Peccoz P. B., Arosio M., Lania A., Colao A., Pivonello R., Uberti E. D., Ghigo E., Giustina A., Martino E., Pontecorvi A., Sicolo N., Trimarchi F., Cangiano, B, Giusti, E, Premoli, C, Soranna, D, Vitale, G, Grottoli, S, Cambria, V, Mantovani, G, Mungari, R, Maffei, P, Dassie, F, Giampietro, A, Chiloiro, S, Tanda, M, Ippolito, S, Cannavo, S, Ragonese, M, Zambon, A, Persani, L, Fatti, L, Scacchi, M, Cavagnini, F, Ferone, D, Corbetta, S, Bartalena, L, Peccoz, P, Arosio, M, Lania, A, Colao, A, Pivonello, R, Uberti, E, Ghigo, E, Giustina, A, Martino, E, Pontecorvi, A, Sicolo, N, Trimarchi, F, Cangiano B., Giusti E., Premoli C., Soranna D., Vitale G., Grottoli S., Cambria V., Mantovani G., Mungari R., Maffei P., Dassie F., Giampietro A., Chiloiro S., Tanda M. L., Ippolito S., Cannavo S., Ragonese M., Zambon A., Persani L., Fatti L. M., Scacchi M., Cavagnini F., Ferone D., Corbetta S., Bartalena L., Peccoz P. B., Arosio M., Lania A., Colao A., Pivonello R., Uberti E. D., Ghigo E., Giustina A., Martino E., Pontecorvi A., Sicolo N., and Trimarchi F.
Abstract: Purpose: Current treatment of acromegaly restores a normal life expectancy in most cases. So, the study of persistent complications affecting patients’ quality of life (QoL) is of paramount importance, especially motor disability and depression. In a large cohort of acromegalic patients we aimed at establishing the prevalence of depression, to look for clinical and sociodemographic factors associated with it, and to investigate the respective roles (and interactions) of depression and arthropathy in influencing QoL. Methods: One hundred and seventy-one acromegalic patients (95 women and 76 men, aged 20–85 years) among those recruited in a cross-sectional Italian multicentric study were investigated. Each patient filled in three validated questionnaires: AcroQoL, WOMAC (measuring articular pain, stiffness and functionality), and AIMS (evaluating articular symptoms and depression). Results: A very high (up to 28%) depression rate was detected in acromegalic subjects. Two patients showing pathological AIMS depression scores, committed suicide during the three years observational period. In our population poor psychological status was significantly associated with female sex. Furthermore, a significant strong correlation was found between AIMS depression score and WOMAC score. Both depression and arthropathy-related motor disability turned out to independently contribute with similar strength to the impairment of QoL. Conclusions: We report a high prevalence of depression in acromegaly, which is associated with female sex and arthropathy. Both depression and arthropathy strongly and independently contribute to the impaired QoL of patients. Our study shows that assessment and monitoring of psychological status is mandatory in acromegaly, also suggesting an inexpensive tool for this assessment.
Published: 2022

17. Association between hypotension during 24 h ambulatory blood pressure monitoring and reflex syncope: the SynABPM 1 study

Author: Rivasi, G, Groppelli, A, Brignole, M, Soranna, D, Zambon, A, Bilo, G, Pengo, M, Sharad, B, Hamrefors, V, Rafanelli, M, Testa, G, Rice, C, Kenny, R, Sutton, R, Ungar, A, Fedorowski, A, Parati, G, Rivasi G., Groppelli A., Brignole M., Soranna D., Zambon A., Bilo G., Pengo M., Sharad B., Hamrefors V., Rafanelli M., Testa G. D., Rice C., Kenny R. A., Sutton R., Ungar A., Fedorowski A., Parati G., Rivasi, G, Groppelli, A, Brignole, M, Soranna, D, Zambon, A, Bilo, G, Pengo, M, Sharad, B, Hamrefors, V, Rafanelli, M, Testa, G, Rice, C, Kenny, R, Sutton, R, Ungar, A, Fedorowski, A, Parati, G, Rivasi G., Groppelli A., Brignole M., Soranna D., Zambon A., Bilo G., Pengo M., Sharad B., Hamrefors V., Rafanelli M., Testa G. D., Rice C., Kenny R. A., Sutton R., Ungar A., Fedorowski A., and Parati G.
Abstract: Aims: Diagnostic criteria for ambulatory blood pressure monitoring (ABPM) in patients with suspected reflex syncope are lacking. The study hypothesis was that patients with reflex syncope have a higher prevalence of systolic blood pressure (SBP) drops on ABPM. Methods and results: ABPM data from reflex syncope patients and controls, matched by average 24h SBP, age, sex, and hypertension were compared. Patients with constitutional hypotension, orthostatic hypotension, and predominant cardioinhibition during carotid sinus massage or prolonged electrocardiogram monitoring or competing causes of syncope were excluded. Daytime and nighttime SBP drops (<110, 100, 90, 80mmHg) were assessed. Findings were validated in an independent sample. In the derivation sample, daytime SBP drops were significantly more common in 158 syncope patients than 329 controls. One or more daytime drops <90mmHg achieved 91% specificity and 32% sensitivity [odds ratio (OR) 4.6, P < 0.001]. Two or more daytime drops <100mmHg achieved 84% specificity and 40% sensitivity (OR 3.5, P = 0.001). Results were confirmed in the validation sample of 164 syncope patients and 164 controls: one or more daytime SBP drops <90mmHg achieved 94% specificity and 29% sensitivity (OR 6.2, P < 0.001), while two or more daytime SBP drops <100mmHg achieved 83% specificity and 35% sensitivity (OR 2.6, P < 0.001) Conclusion: SBP drops during ABPM are more common in reflex syncope patients than in controls. Cut-off values that may be applied in clinical practice are defined. This study expands the current indications for ABPM to patients with reflex syncope.
Published: 2022

18. Syncope in hypertrophic cardiomyopathy (part I): An updated systematic review and meta-analysis

Author: Mascia, G, Crotti, L, Groppelli, A, Canepa, M, Merlo, A, Benenati, S, Di Donna, P, Della Bona, R, Soranna, D, Zambon, A, Porto, I, Olivotto, I, Parati, G, Brignole, M, Cecchi, F, Mascia G., Crotti L., Groppelli A., Canepa M., Merlo A. C., Benenati S., Di Donna P., Della Bona R., Soranna D., Zambon A., Porto I., Olivotto I., Parati G., Brignole M., Cecchi F., Mascia, G, Crotti, L, Groppelli, A, Canepa, M, Merlo, A, Benenati, S, Di Donna, P, Della Bona, R, Soranna, D, Zambon, A, Porto, I, Olivotto, I, Parati, G, Brignole, M, Cecchi, F, Mascia G., Crotti L., Groppelli A., Canepa M., Merlo A. C., Benenati S., Di Donna P., Della Bona R., Soranna D., Zambon A., Porto I., Olivotto I., Parati G., Brignole M., and Cecchi F.
Abstract: Aims: To describe the proportion of patients with syncope among those affected by hypertrophic cardiomyopathy (HCM) and the relevance of syncope as risk factor for sudden cardiac death and life-threatening arrhythmic events. Method and results: Systematic review of original articles that assessed syncope in HCM patients. Literature search of PubMed including all English publications from 1973 to 2021.We found 57 articles for a total of 21.791 patients; of these, 14 studies reported on arrhythmic events in the follow-up. Syncope was reported in 15.8% (3.452 of 21.791) patients. It was considered unexplained in 91% of cases. Life-threatening arrhythmic events occurred in 3.6% of non-syncopal patients and in 7.7% of syncopal patients during a mean follow-up of 5.6 years. A relative risk of 1.99 (95%CI 1.39 to 2.86) was estimated for syncope patients by the random effect model using Haldane continuity correction for 0 events. Conclusions: In the current practice, the cause of syncope remained unexplained in most patients affected by HCM. The management of patients seems mainly driven by risk stratification rather than identification of the aetiology of syncope. There is a need of precise instructions how to apply the recommendations of current guidelines to this disease, which tests are indicated and how to interpret their findings. The protocol was registered in Prospero (ID: 275963).
Published: 2022

19. Nocturnal hypoxemia, blood pressure, vascular status and chronic mountain sickness in the highest city in the world

Author: Perger, E, Baillieul, S, Esteve, F, Pichon, A, Bilo, G, Soranna, D, Doutreleau, S, Savina, Y, Ulliel-Roche, M, Brugniaux, J, Stauffer, E, Oberholzer, L, Howe, C, Hannco, I, Lombardi, C, Tamisier, R, Pepin, J, Verges, S, Parati, G, Perger E., Baillieul S., Esteve F., Pichon A., Bilo G., Soranna D., Doutreleau S., Savina Y., Ulliel-Roche M., Brugniaux J. V., Stauffer E., Oberholzer L., Howe C., Hannco I., Lombardi C., Tamisier R., Pepin J. -L., Verges S., Parati G., Perger, E, Baillieul, S, Esteve, F, Pichon, A, Bilo, G, Soranna, D, Doutreleau, S, Savina, Y, Ulliel-Roche, M, Brugniaux, J, Stauffer, E, Oberholzer, L, Howe, C, Hannco, I, Lombardi, C, Tamisier, R, Pepin, J, Verges, S, Parati, G, Perger E., Baillieul S., Esteve F., Pichon A., Bilo G., Soranna D., Doutreleau S., Savina Y., Ulliel-Roche M., Brugniaux J. V., Stauffer E., Oberholzer L., Howe C., Hannco I., Lombardi C., Tamisier R., Pepin J. -L., Verges S., and Parati G.
Abstract: Introduction: Chronic mountain sickness (CMS) is a condition characterized by excessive erythrocytosis in response to chronic hypobaric hypoxia. CMS frequently triggers cardiorespiratory diseases such as pulmonary hypertension and right or left heart failure. Ambient hypoxia might be further amplified night-time by intermittent hypoxia related to sleep-disordered breathing (SDB) so that sleep disturbance may be an important feature of CMS. Our aim was to characterize in a cross-sectional study nocturnal hypoxaemia, SDB, blood pressure (BP), arterial stiffness and carotid intima-media thickness (CIMT) in highlanders living at extreme altitude. Methods: Men aged 18 to 55 years were prospectively recruited. Home sleep apnoea test, questionnaires (short-form health survey; Montreal cognitive assessment; Pittsburgh Sleep Questionnaire Index and the Insomnia severity index), 24-h ambulatory BP monitoring, CIMT and arterial stiffness were evaluated in 3 groups: i) Andean lowlanders (sea-level); ii) highlanders living at 3,800 m and iii) highlanders living at 5,100 m. Analyses were conducted in sub-groups according to 1) CMS severity 2) healthy subjects living at the three different altitude. Results: Ninety-two males were evaluated at their living altitudes. Among the 54 highlanders living at 5,100 m, subjects with CMS showed lower mean nocturnal oxygen saturation (SpO2), SpO2 nadir, lower pulse wave velocity and higher nocturnal BP variability than those with no-CMS. Lower nocturnal SpO2 nadir was associated with higher CMS severity (ß= −0.14, p=.009). Among the 55 healthy subjects, healthy highlanders at 5,100 m were characterized by lower scores on quality of life and sleep quality scales and lower mean SpO2 compared to lowlanders. Conclusions: Lower nocturnal SpO2 and higher nocturnal BP variability are associated with CMS severity in individuals living permanently at high altitude. The role of lower SpO2 and higher nocturnal BP variability in the cardiovascular progre
Published: 2022

20. Postoperative and mid-term hemodynamic changes after replacement of the ascending aorta

Author: Salvi, L, Alfonsi, J, Grillo, A, Pini, A, Soranna, D, Zambon, A, Pacini, D, Di Bartolomeo, R, Salvi, P, Parati, G, Salvi L., Alfonsi J., Grillo A., Pini A., Soranna D., Zambon A., Pacini D., Di Bartolomeo R., Salvi P., Parati G., Salvi, L, Alfonsi, J, Grillo, A, Pini, A, Soranna, D, Zambon, A, Pacini, D, Di Bartolomeo, R, Salvi, P, Parati, G, Salvi L., Alfonsi J., Grillo A., Pini A., Soranna D., Zambon A., Pacini D., Di Bartolomeo R., Salvi P., and Parati G.
Abstract: Objectives: To evaluate aortic distensibility and pulse waveform patterns associated with the ascending aortic aneurysm, and to analyze the postoperative and mid-term hemodynamic changes induced by prosthetic replacement of the ascending aorta. Methods: Central blood pressure waves were recorded at the carotid artery level by means of a validated transcutaneous arterial tonometer in 30 patients undergoing prosthetic replacement of ascending aortic aneurysm and in 30 control patients. Measurements were obtained the day before surgery and 5 to 7 days and 16 to 20 months after surgery. Results: The ascending aortic aneurysm was associated with a less steep slope of early systolic phase of the pressure curve (pulsus tardus) compared with a control group (0.54 ± 0.18 mm Hg/ms vs 0.69 ± 0.26 mm Hg/ms; P = .011). Replacing the ascending aorta with a noncompliant vascular prosthesis steepened the pulse pressure slope during the early systolic phase in the postoperative period (0.77 ± .29 mm Hg/ms), providing values comparable with those of the control group in the mid-term (0.67 ± .20 mm Hg/ms). No change in aortic stiffness was found either postoperatively or in the mid-term after ascending aorta surgical replacement (carotid-femoral pulse wave velocity: preoperative, 9.0 ± 2.6 m/s; postoperative, 9.0 ± 2.9 m/s; mid-term postoperative, 9.3 ± 2.8 m/s). Conclusions: This study does not confirm the assumption that substitution of the viscoelastic ascending aorta with a rigid prosthesis can cause serious hemodynamic alterations downstream, because we did not observe a worsening of global aortic distensibility after insertion of a rigid prosthetic aorta. The ascending aortic aneurysm is associated with a pulsus tardus.
Published: 2022

21. Development of a questionnaire on nutritional knowledge for the obese hospitalized patient: the NUTRIKOB questionnaire

Author: Mambrini, S, Soranna, D, Averna, E, Di Guglielmo, G, Lucchetti, E, Tinozzi, T, Vinci, C, Barbieri, V, Zambon, A, Bertoli, S, Scacchi, M, Mambrini, SP, Mambrini, S, Soranna, D, Averna, E, Di Guglielmo, G, Lucchetti, E, Tinozzi, T, Vinci, C, Barbieri, V, Zambon, A, Bertoli, S, Scacchi, M, and Mambrini, SP
Abstract: Introduction: Different approaches, involving different areas and figures, are useful for the rehabilitation of obese subjects through a multidisciplinary hospital path. A focal point of rehabilitation is represented by education on healthy eating by increasing the dietary knowledge patients. Few tools investigating food knowledge are available in Italy: therefore, the need has emerged to develop easy-to-use tools for clinical practice that allow to detect food knowledge to set up a more targeted food re-education. The following work aimed at building and validating a questionnaire capable of investigating the dietary knowledge of the population affected by obesity. Methods: A pool of experts carried out a review of the literature, gathering all the information necessary to select and construct the best set of questions and the format of the final project of the questionnaire. During statistical analysis the validity, reproducibility and stability of the questionnaire were investigate in a sample of 450 subjects with obesity. Results: Early analysis disclosed that 5 questions of the original questionnaire had no discriminating power. The successive validation phases were successful, confirming good content validity, stability and reproducibility over time. Discussion: The questionnaire has all the characteristics to be considered a valid tool for investigating dietary knowledge in the obese population. The psychometric tests confirmed a good internal consistency of the structure, a validity of the content, a good reproducibility and stability over time.
Published: 2023

22. THE IMPACT OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURE VARIABILITY ON MORTALITY IS MODIFIED BY AGEING. DATA FROM THE DUBLIN OUTCOME STUDY

Author: Bilo, G., Dolan, E., O’Brien, E., Facchetti, R., Soranna, D., Zambon, A., Mancia, G., and Parati, G.
Published: 2019
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23. BLOOD PRESSURE EFFECTS OF OBSTRUCTIVE SLEEP APNEA TREATMENT BY CONTINUOUS POSITIVE AIRWAY PRESSURE: SYSTEMATIC REVIEW, METAANALYSIS AND EVALUATION OF PHENOTYPES PREDICTING RESPONSE

Author: Pengo, M., Soranna, D., Giontella, A., Perger, E., Schwarz, E.I., Lombardi, C., Bilo, G., Zambon, A., Steier, J., Minuz, P., Parati, G., and Fava, C.
Published: 2019
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24. RELATIONSHIP BETWEEN SLEEP BREATHING PATTERNS AND BLOOD PRESSURE CHANGES DURING ACUTE HIGH ALTITUDE EXPOSURE. DATA FROM HIGHCARE STUDIES

Author: Dehò, G., Bilo, G., Lombardi, C., Soranna, D., Zambon, A., Faini, A., and Parati, G.
Published: 2019
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25. A meta-analysis of exercise hemodynamics in heart failure with preserved ejection fraction: the relevance of PAWP/CO slope

Author: Baratto, C, primary, Caravita, S, additional, Soranna, D, additional, Dewachter, C, additional, Bondue, A, additional, Zambon, A, additional, Badano, L P, additional, Parati, G, additional, and Vachiery, J L, additional
Published: 2022
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26. New definition of hypotension in patients with reflex syncope using 24-hour ambulatory blood pressure monitoring (SynABPM Study)

Author: Rivasi, G, primary, Brignole, M, additional, Groppelli, A, additional, Soranna, D, additional, Zambon, A, additional, Sutton, R, additional, Kenny, R A, additional, Ungar, A, additional, Fedorowski, A, additional, and Parati, G, additional
Published: 2022
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27. Effect of CPAP therapy on blood pressure in patients with OSA: a worldwide individual patient data meta-analysis

Author: Pengo, M, primary, Schwarz, E I, additional, Barbe, F, additional, Drager, L, additional, Fava, C, additional, Ip, M S M, additional, Martinez Garcia, M A, additional, McEvoy, D, additional, Peker, Y, additional, Phillips, C L, additional, Soranna, D, additional, Steier, J, additional, Stradling, J, additional, Zambon, A, additional, and Parati, G, additional
Published: 2022
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28. An updated meta-analysis of hemodynamics markers of prognosis in patients with pulmonary hypertension due to left heart disease

Author: Caravita, S, primary, Baratto, C, additional, Soranna, D, additional, Dewachter, C, additional, Bondue, A, additional, Zambon, A, additional, Badano, L P, additional, and Parati, G, additional
Published: 2022
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29. Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical Outcomes

Author: Chiodini, I, Gatti, D, Soranna, D, Merlotti, D, Mingiano, C, Fassio, A, Adami, G, Falchetti, A, Eller-Vainicher, C, Rossini, M, Persani, L, Zambon, A, Gennari, L, Chiodini I., Gatti D., Soranna D., Merlotti D., Mingiano C., Fassio A., Adami G., Falchetti A., Eller-Vainicher C., Rossini M., Persani L., Zambon A., Gennari L., Chiodini, I, Gatti, D, Soranna, D, Merlotti, D, Mingiano, C, Fassio, A, Adami, G, Falchetti, A, Eller-Vainicher, C, Rossini, M, Persani, L, Zambon, A, Gennari, L, Chiodini I., Gatti D., Soranna D., Merlotti D., Mingiano C., Fassio A., Adami G., Falchetti A., Eller-Vainicher C., Rossini M., Persani L., Zambon A., and Gennari L.
Abstract: Background: Several studies suggest an association between serum 25-hydroxyvitamin D (25OHD) and the outcomes of Severe Acute Respiratory Syndrome Corona-Virus-2 (SARS-CoV-2) infection, in particular Coronavirus Disease-2019 (COVID-19) related severity and mortality. The aim of the present meta-analysis was to investigate whether vitamin D status is associated with the COVID-19 severity, defined as ARDS requiring admission to intensive care unit (ICU) or mortality (primary endpoints) and with the susceptibility to SARS-CoV-2 and COVID-19-related hospitalization (secondary endpoints). Methods: A search in PubMed, ScienceDirect, Web of Science, Google Scholar, Scopus, and preprints repositories was performed until March 31th 2021 to identify all original observational studies reporting association measures, or enough data to calculate them, between Vitamin D status (insufficiency <75, deficiency <50, or severe deficiency <25 nmol/L) and risk of SARS-CoV-2 infection, COVID-19 hospitalization, ICU admission, or death during COVID-19 hospitalization. Findings: Fifty-four studies (49 as fully-printed and 5 as pre-print publications) were included for a total of 1,403,715 individuals. The association between vitamin D status and SARS-CoV2 infection, COVID-19 related hospitalization, COVID-19 related ICU admission, and COVID-19 related mortality was reported in 17, 9, 27, and 35 studies, respectively. Severe deficiency, deficiency and insufficiency of vitamin D were all associated with ICU admission (odds ratio [OR], 95% confidence intervals [95%CIs]: 2.63, 1.45–4.77; 2.16, 1.43–3.26; 2.83, 1.74–4.61, respectively), mortality (OR, 95%CIs: 2.60, 1.93–3.49; 1.84, 1.26–2.69; 4.15, 1.76–9.77, respectively), SARS-CoV-2 infection (OR, 95%CIs: 1.68, 1.32–2.13; 1.83, 1.43–2.33; 1.49, 1.16–1.91, respectively) and COVID-19 hospitalization (OR, 95%CIs 2.51, 1.63–3.85; 2.38, 1.56–3.63; 1.82, 1.43–2.33). Considering specific subgroups (i.e., Caucasian patients, high quality stu
Published: 2021

30. AV junction ablation and cardiac resynchronization for patients with permanent atrial fibrillation and narrow QRS: The APAF-CRT mortality trial

Author: Brignole, M, Pentimalli, F, Palmisano, P, Landolina, M, Quartieri, F, Occhetta, E, Calo, L, Mascia, G, Mont, L, Vernooy, K, Van Dijk, V, Allaart, C, Fauchier, L, Gasparini, M, Parati, G, Soranna, D, Rienstra, M, Van Gelder, I, Brignole M., Pentimalli F., Palmisano P., Landolina M., Quartieri F., Occhetta E., Calo L., Mascia G., Mont L., Vernooy K., Van Dijk V., Allaart C., Fauchier L., Gasparini M., Parati G., Soranna D., Rienstra M., Van Gelder I. C., Brignole, M, Pentimalli, F, Palmisano, P, Landolina, M, Quartieri, F, Occhetta, E, Calo, L, Mascia, G, Mont, L, Vernooy, K, Van Dijk, V, Allaart, C, Fauchier, L, Gasparini, M, Parati, G, Soranna, D, Rienstra, M, Van Gelder, I, Brignole M., Pentimalli F., Palmisano P., Landolina M., Quartieri F., Occhetta E., Calo L., Mascia G., Mont L., Vernooy K., Van Dijk V., Allaart C., Fauchier L., Gasparini M., Parati G., Soranna D., Rienstra M., and Van Gelder I. C.
Abstract: Aims : In patients with atrial fibrillation (AF) and heart failure (HF), strict and regular rate control with atrioventricular junction ablation and biventricular pacemaker (Ablation + CRT) has been shown to be superior to pharmacological rate control in reducing HF hospitalizations. However, whether it also improves survival is unknown. Methods and results : In this international, open-label, blinded outcome trial, we randomly assigned patients with severely symptomatic permanent AF >6 months, narrow QRS (≤110 ms) and at least one HF hospitalization in the previous year to Ablation + CRT or to pharmacological rate control. We hypothesized that Ablation + CRT is superior in reducing the primary endpoint of all-cause mortality. A total of 133 patients were randomized. The mean age was 73 ± 10 years, and 62 (47%) were females. The trial was stopped for efficacy at interim analysis after a median of 29 months of follow-up per patient. The primary endpoint occurred in 7 patients (11%) in the Ablation + CRT arm and in 20 patients (29%) in the Drug arm [hazard ratio (HR) 0.26, 95% confidence interval (CI) 0.10-0.65; P = 0.004]. The estimated death rates at 2 years were 5% and 21%, respectively; at 4 years, 14% and 41%. The benefit of Ablation + CRT of all-cause mortality was similar in patients with ejection fraction (EF) ≤35% and in those with >35%. The secondary endpoint combining all-cause mortality or HF hospitalization was significantly lower in the Ablation + CRT arm [18 (29%) vs. 36 (51%); HR 0.40, 95% CI 0.22-0.73; P = 0.002]. Conclusions : Ablation + CRT was superior to pharmacological therapy in reducing mortality in patients with permanent AF and narrow QRS who were hospitalized for HF, irrespective of their baseline EF. Study registration: ClinicalTrials.gov Identifier: NCT02137187.
Published: 2021

31. When to Suspect Hidden Hypercortisolism in Type 2 Diabetes: A Meta-Analysis

Author: Aresta, C, Soranna, D, Giovanelli, L, Favero, V, Parazzoli, C, Gennari, L, Persani, L, Scillitani, A, Blevins, L, Brown, D, Einhorn, D, Pivonello, R, Pantalone, K, Lunde Jorgensen, J, Zambon, A, Chiodini, I, Aresta C., Soranna D., Giovanelli L., Favero V., Parazzoli C., Gennari L., Persani L., Scillitani A., Blevins L. S., Brown D., Einhorn D., Pivonello R., Pantalone K. M., Lunde Jorgensen J. O., Zambon A., Chiodini I., Aresta, C, Soranna, D, Giovanelli, L, Favero, V, Parazzoli, C, Gennari, L, Persani, L, Scillitani, A, Blevins, L, Brown, D, Einhorn, D, Pivonello, R, Pantalone, K, Lunde Jorgensen, J, Zambon, A, Chiodini, I, Aresta C., Soranna D., Giovanelli L., Favero V., Parazzoli C., Gennari L., Persani L., Scillitani A., Blevins L. S., Brown D., Einhorn D., Pivonello R., Pantalone K. M., Lunde Jorgensen J. O., Zambon A., and Chiodini I.
Abstract: Objective: To investigate whether the available literature helps to identify the characteristics of patients with type 2 diabetes (T2D) more frequently associated with hidden hypercortisolism (HidHyCo). Methods: A meta-analysis was performed using studies that assessed both the prevalence of HidHyCo in patients with T2D and the characteristics of these patients with and without HidHyCo. The DerSimonian and Laird (DSL) and Hartung-Knapp-Sidik-Jonkman (HKSJ) methods were utilized. Results: Among the 18 available studies, 6 provided the necessary data. The association between HidHyCo and advanced T2D (based on the patients’ description given in each study in the presence of microvascular/macrovascular complications or insulin treatment plus hypertension or hypertension treated with 2 or more drugs), hypertension, insulin treatment, and dyslipidemia was reported in 5 (2184 patients), 6 (2283 patients), 3 (1440 patients), and 3 (987 patients) studies, respectively. HidHyCo was associated with advanced T2D as assessed by both the DSL (odds ratio [OR], 3.4; 95% confidence interval [95% CI], 2.12-5.67) and HKSJ (OR, 3.60; 95% CI, 2.03-6.41) methods and with the prevalence of hypertension or insulin treatment as assessed by the DSL method (OR, 1.92; 95% CI, 1.05-3.50 and OR, 2.29; 95% CI, 1.07-4.91, respectively) but not as assessed by the HKSJ method. Conclusion: Patients with advanced T2D have a higher prevalence of HidHyCo. These data inform about the selection of patients with T2D for HidHyCo screening.
Published: 2021

32. Cerebrospinal fluid phosphorylated neurofilament heavy chain and chitotriosidase in primary lateral sclerosis

Author: Verde, F, Zaina, G, Bodio, C, Borghi, M, Soranna, D, Peverelli, S, Ticozzi, N, Morelli, C, Doretti, A, Messina, S, Maderna, L, Colombrita, C, Gumina, V, Tiloca, C, Meroni, P, Zambon, A, Ratti, A, Silani, V, Verde F., Zaina G., Bodio C., Borghi M. O., Soranna D., Peverelli S., Ticozzi N., Morelli C., Doretti A., Messina S., Maderna L., Colombrita C., Gumina V., Tiloca C., Meroni P. L., Zambon A., Ratti A., Silani V., Verde, F, Zaina, G, Bodio, C, Borghi, M, Soranna, D, Peverelli, S, Ticozzi, N, Morelli, C, Doretti, A, Messina, S, Maderna, L, Colombrita, C, Gumina, V, Tiloca, C, Meroni, P, Zambon, A, Ratti, A, Silani, V, Verde F., Zaina G., Bodio C., Borghi M. O., Soranna D., Peverelli S., Ticozzi N., Morelli C., Doretti A., Messina S., Maderna L., Colombrita C., Gumina V., Tiloca C., Meroni P. L., Zambon A., Ratti A., and Silani V.
Published: 2021

33. The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure [El proyecto ANDANTE: un metanálisis a nivel mundial de datos individuales sobre el efecto del tratamiento de la apnea del sueño en la presión arterial]

Author: Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, Zambra, G, Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., Zambra G., Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, Zambra, G, Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., and Zambra G.
Published: 2021

34. Low-blood pressure phenotype underpins the tendency to reflex syncope

Author: Brignole, M, Rivasi, G, Sutton, R, Kenny, R, Morillo, C, Sheldon, R, Raj, S, Ungar, A, Furlan, R, van Dijk, G, Hamdan, M, Hamrefors, V, Engstrom, G, Park, C, Soranna, D, Zambon, A, Parati, G, Fedorowski, A, Brignole M., Rivasi G., Sutton R., Kenny R. A., Morillo C. A., Sheldon R., Raj S. R., Ungar A., Furlan R., van Dijk G., Hamdan M., Hamrefors V., Engstrom G., Park C., Soranna D., Zambon A., Parati G., Fedorowski A., Brignole, M, Rivasi, G, Sutton, R, Kenny, R, Morillo, C, Sheldon, R, Raj, S, Ungar, A, Furlan, R, van Dijk, G, Hamdan, M, Hamrefors, V, Engstrom, G, Park, C, Soranna, D, Zambon, A, Parati, G, Fedorowski, A, Brignole M., Rivasi G., Sutton R., Kenny R. A., Morillo C. A., Sheldon R., Raj S. R., Ungar A., Furlan R., van Dijk G., Hamdan M., Hamrefors V., Engstrom G., Park C., Soranna D., Zambon A., Parati G., and Fedorowski A.
Abstract: Background:We hypothesized that cardiovascular physiology differs in reflex syncope patients compared with the general population, predisposing such individuals to vasovagal reflex.Methods:In this multicohort cross-sectional study, we compared aggregate data of resting SBP, DBP, pulse pressure (PP) and heart rate (HR), collected from six community-based cohort studies (64 968 observations) with those from six databases of reflex syncope patients (6516 observations), subdivided by age decades and sex.Results:Overall, in male individuals with reflex syncope, SBP (-3.4 mmHg) and PP (-9.2 mmHg) were lower and DBP (+2.8 mmHg) and HR (+5.1 bpm) were higher than in the general population; the difference in SBP was higher at ages above 60 years. In female individuals, PP (-6.0 mmHg) was lower and DBP (+4.7 mmHg) and HR (+4.5 bpm) were higher than in the general population; differences in SBP were less pronounced, becoming evident only above 60 years. Compared with male individuals, SBP in female individuals exhibited slower increase until age 40 years, and then demonstrated steeper increase that continued throughout remaining life.Conclusion:The patients prone to reflex syncope demonstrate a different resting cardiovascular haemodynamic profile as compared with a general population, characterized by lower SBP and PP, reflecting reduced venous return and lower stroke volume, and a higher HR and DBP, suggesting the activation of compensatory mechanisms. Our data contribute to a better understanding why some individuals with similar demographic characteristics develop reflex syncope and others do not.Video abstract:http://links.lww.com/HJH/B580.
Published: 2021

35. Body composition assessment using bioelectrical impedance analysis (BIA) in a wide cohort of patients affected with mild to severe obesity

Author: Brunani, A, Perna, S, Soranna, D, Rondanelli, M, Zambon, A, Bertoli, S, Vinci, C, Capodaglio, P, Lukaski, H, Cancello, R, Brunani A., Perna S., Soranna D., Rondanelli M., Zambon A., Bertoli S., Vinci C., Capodaglio P., Lukaski H., Cancello R., Brunani, A, Perna, S, Soranna, D, Rondanelli, M, Zambon, A, Bertoli, S, Vinci, C, Capodaglio, P, Lukaski, H, Cancello, R, Brunani A., Perna S., Soranna D., Rondanelli M., Zambon A., Bertoli S., Vinci C., Capodaglio P., Lukaski H., and Cancello R.
Abstract: Background & aims: Obesity is characterized by fat mass excess (FM), extra cellular water increase (ECW) and, with ageing, decrease in fat free mass (FFM). The validity of body impedance analysis (BIA) in patients with mild to severe obesity is still debated. The purpose of this study is to describe the Resistance (Rz) and Reactance (Xc) values obtained by Body Impedance Analysis (BIA) in a wide cohort of Italian patients with mild to severe obesity. The secondary endpoint is to describe the resulting body composition values (as percentage and indexes) in this population. Methods: The study enrolled adult in-patients with mild to severe obesity (classified with class I, II and III obesity) undergoing clinical care rehabilitation program for obesity complications and weight loss. BIA values were grouped by sex, BMI and age classes. Results: A total of 8303 patients with obesity, aged 18 to 90 y, were studied. The Resistance (Rz) and Reactance (Xc) were reported by sex, age and BMI classes. In women and men both, the phase angle (PhA) decreases with increasing BMI (kg/m2) and the resulting BIA vector was significantly shifted. The FM index (FMI) was higher (p < 0.0001) in women while FFM index (FFMI) was higher in men (p < 0.0001) and significantly associated with BMI. FFMI decreased with age in both sex (p < 0.0001). Skeletal mass (SM) presents a progressive reduction in relation to age and gender both. Conclusions: The present BIA-based body composition analysis in a wide cohort of mild to severe obese patients revealed a significantly decreased Rz and Xc values with a consequent significant decrease of PhA in a BMI-dependent manner. The body compartments estimation with available equations was BMI, sex and age dependent. These observational results could be the basis for the development of new equations adapted for patients suffering from obesity.
Published: 2021

36. Efficacy Profile and Safety of Very Low-Dose Rituximab in Patients with Graves' Orbitopathy

Author: Vannucchi, G, Campi, I, Covelli, D, Curro, N, Lazzaroni, E, Palomba, A, Soranna, D, Zambon, A, Fugazzola, L, Muller, I, Guastella, C, Salvi, M, Vannucchi G., Campi I., Covelli D., Curro N., Lazzaroni E., Palomba A., Soranna D., Zambon A., Fugazzola L., Muller I., Guastella C., Salvi M., Vannucchi, G, Campi, I, Covelli, D, Curro, N, Lazzaroni, E, Palomba, A, Soranna, D, Zambon, A, Fugazzola, L, Muller, I, Guastella, C, Salvi, M, Vannucchi G., Campi I., Covelli D., Curro N., Lazzaroni E., Palomba A., Soranna D., Zambon A., Fugazzola L., Muller I., Guastella C., and Salvi M.
Abstract: Background: Rituximab (RTX), a chimeric human-murine anti-CD20 monoclonal antibody, has been used for treatment of active moderate-severe Graves' orbitopathy (GO) since 2004 as second-line therapy in patients unresponsive to intravenous steroids. We conducted an open-label prospective study (EUDRACT 2012-001980-53) in which patients were treated with a single infusion of only 100 mg RTX to analyze the efficacy and safety of this low dose. Methods: Seventeen patients, of whom nine had disease that was unresponsive to intravenous methylprednisolone and eight with newly diagnosed GO, were enrolled. Disease activity was assessed with the clinical activity score (CAS) and severity with a composite ophthalmic score. Long-term surgical treatment and quality of life were also assessed, as well as treatment-related adverse events. Results: Mean baseline CAS was 4.56 ± 0.96 and decreased to 1.25 ± 1.14 at 24 weeks (p = 0.001). Disease inactivation occurred within 24 weeks in >90% of patients and was unrelated to disease duration. Severity improved in about 60% of patients, with no relapses. All patients showed peripheral depletion of CD20+ and CD19+ cells at the end of RTX infusion (60 minutes). Two patients required surgical orbital decompression because of optic neuropathy (ON). Among adverse events observed, there was one patient who developed a cytokine release syndrome. Conclusions: A dose of 100 mg RTX is effective in patients with active moderate-severe GO. Low doses are better tolerated, expose patients to immune suppression for a shorter period of time, and are extremely cost effective, compared with higher doses. This dose, consistently with all other immunosuppressants, does not prevent the progression of GO to dysthyroid ON.
Published: 2021

37. Association between renin-angiotensin-aldosterone system inhibitors and risk of dementia: A meta-analysis

Author: Scotti, L, Bassi, L, Soranna, D, Verde, F, Silani, V, Torsello, A, Parati, G, Zambon, A, Scotti L., Bassi L., Soranna D., Verde F., Silani V., Torsello A., Parati G., Zambon A., Scotti, L, Bassi, L, Soranna, D, Verde, F, Silani, V, Torsello, A, Parati, G, Zambon, A, Scotti L., Bassi L., Soranna D., Verde F., Silani V., Torsello A., Parati G., and Zambon A.
Abstract: Objective: To evaluate the association of all RAAS inhibitors, ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on dementia onset (any dementia, Alzheimer's disease and vascular dementia) using a meta-analytic approach. Methods: A systematic MEDLINE search was carried out to identify all observational studies published up to the 30th September 2020 evaluating the association between RAAS inhibitors and risk of dementia. Studies were included if original investigations considering incident dementia cases, with ACEIs and/or ARBs as exposure and other antihypertensives (AHs) use as reference, and if reporting association estimates and relative variability measures. Random effect pooled relative risks (pRR) and the corresponding 95% confidence intervals (95%CI) were calculated according to DerSimonian and Laird's (DL) or to Hartung Knapp Sidik Jonkman (HKSJ) method depending on the number of studies and between-studies heterogeneity. A linear mixed meta-regression model (MM) was applied to take into account correlation among association estimates from the same study. Results: 15 studies were included in the meta-analysis. ARBs but not ACEIs’ use led to a significant reduction of the risk of any dementia (pRR 0.78, 95%CIMM 0.70–0.87) and Alzheimer's disease (pRR 0.73, 95%CIMM 0.60–0.90). Moreover, when compared to ACEIs, ARBs reduced of 14% the risk of any dementia (pRR 0.86, 95%CIDL 0.79–0.94). Conclusions: ARBs but not ACEIs led to a reduction in the risk of any dementia. The difference between ARBs and ACEIs in terms of preventive effectiveness could be due to distinct profiles of antagonism towards independent receptor pathways or to differential influences on amyloid metabolism.
Published: 2021

38. Haemodynamic characteristics of COVID-19 patients with acute respiratory distress syndrome requiring mechanical ventilation. An invasive assessment using right heart catheterization

Author: Caravita, S, Baratto, C, Di Marco, F, Calabrese, A, Balestrieri, G, Russo, F, Faini, A, Soranna, D, Perego, G, Badano, L, Grazioli, L, Lorini, F, Parati, G, Senni, M, Caravita S., Baratto C., Di Marco F., Calabrese A., Balestrieri G., Russo F., Faini A., Soranna D., Perego G. B., Badano L, Grazioli L., Lorini F. L., Parati G., Senni M., Caravita, S, Baratto, C, Di Marco, F, Calabrese, A, Balestrieri, G, Russo, F, Faini, A, Soranna, D, Perego, G, Badano, L, Grazioli, L, Lorini, F, Parati, G, Senni, M, Caravita S., Baratto C., Di Marco F., Calabrese A., Balestrieri G., Russo F., Faini A., Soranna D., Perego G. B., Badano L, Grazioli L., Lorini F. L., Parati G., and Senni M.
Abstract: Aims: Interstitial pneumonia due to coronavirus disease 2019 (COVID-19) is often complicated by severe respiratory failure. In addition to reduced lung compliance and ventilation/perfusion mismatch, a blunted hypoxic pulmonary vasoconstriction has been hypothesized, that could explain part of the peculiar pathophysiology of the COVID-19 cardiorespiratory syndrome. However, no invasive haemodynamic characterization of COVID-19 patients has been reported so far. Methods and results: Twenty-one mechanically-ventilated COVID-19 patients underwent right heart catheterization. Their data were compared both with those obtained from non-mechanically ventilated paired control subjects matched for age, sex and body mass index, and with pooled data of 1937 patients with ‘typical’ acute respiratory distress syndrome (ARDS) from a systematic literature review. Cardiac index was higher in COVID-19 patients than in controls [3.8 (2.7–4.5) vs. 2.4 (2.1–2.8) L/min/m2, P < 0.001], but slightly lower than in ARDS patients (P = 0.024). Intrapulmonary shunt and lung compliance were inversely related in COVID-19 patients (r = −0.57, P = 0.011) and did not differ from ARDS patients. Despite this, pulmonary vascular resistance of COVID-19 patients was normal, similar to that of control subjects [1.6 (1.1–2.5) vs. 1.6 (0.9–2.0) WU, P = 0.343], and lower than reported in ARDS patients (P < 0.01). Pulmonary hypertension was present in 76% of COVID-19 patients and in 19% of control subjects (P < 0.001), and it was always post-capillary. Pulmonary artery wedge pressure was higher in COVID-19 than in ARDS patients, and inversely related to lung compliance (r = −0.46, P = 0.038). Conclusions: The haemodynamic profile of COVID-19 patients needing mechanical ventilation is characterized by combined cardiopulmonary alterations. Low pulmonary vascular resistance, coherent with a blunted hypoxic vasoconstriction, is associated with high c
Published: 2020

39. Determinants of the lifestyle changes during covid-19 pandemic in the residents of northern italy

Author: Cancello, R, Soranna, D, Zambra, G, Zambon, A, Invitti, C, Cancello R., Soranna D., Zambra G., Zambon A., Invitti C., Cancello, R, Soranna, D, Zambra, G, Zambon, A, Invitti, C, Cancello R., Soranna D., Zambra G., Zambon A., and Invitti C.
Abstract: Background: The confinement recommended during COVID-19 pandemic could affect behavior and health. Methods: We conducted a self-reported survey in northern Italy to observe the lockdown effects on lifestyle changes and to assess their determinants. Prevalence Odds Ratio and Prevalence Risk Ratio were determined. Results: 490 adults (84% female) completed the survey: 13% and 43% reported improved and unchanged sleep quality, respectively, while 43% had insomnia symptoms. Among the 272 active subjects in pre-lockdown, 14% continued habitual exercising, 18% increased it and 68% reduced it; 27% of sedentary subjects started physical exercise; 34% reported an improvement in diet quality; 42% increased food intake and 13% decreased it; and 38% of the smokers increased cigarette consumption. Age and the pre-lockdown habit of regular physical exercising were the mainly determinants of lifestyle changes whereas BMI, gender, and the presence of chronic diseases did not. Living with other people increased the likelihood of increasing the food intake (p= 0.002). Conclusions: More than a third of people were able to positively reorganize their lives during the forced home confinement. It is worth to disseminate information to preserve a healthy lifestyle even when confined at home.
Published: 2020

40. Office and Ambulatory Arterial Hypertension in Highlanders: HIGHCARE-ANDES Highlanders Study

Author: Bilo, G, Acone, L, Anza-Ramire, C, Macarlupu, J, Soranna, D, Zambon, A, Vizcardo-Galindo, G, Pengo, M, Villafuerte, F, Parati, G, Bilo G., Acone L., Anza-Ramire C., MacArlupu J. L., Soranna D., Zambon A., Vizcardo-Galindo G., Pengo M. F., Villafuerte F. C., Parati G., Bilo, G, Acone, L, Anza-Ramire, C, Macarlupu, J, Soranna, D, Zambon, A, Vizcardo-Galindo, G, Pengo, M, Villafuerte, F, Parati, G, Bilo G., Acone L., Anza-Ramire C., MacArlupu J. L., Soranna D., Zambon A., Vizcardo-Galindo G., Pengo M. F., Villafuerte F. C., and Parati G.
Abstract: Millions of people worldwide live at high altitude, being chronically exposed to hypobaric hypoxia. Hypertension is a major cardiovascular risk factor but data on its prevalence and determinants in highlanders are limited, and systematic studies with ambulatory blood pressure monitoring are not available. Aim of this study was to assess the prevalence of clinic and ambulatory hypertension and the associated factors in a sample of Andean highlanders. Hypertension prevalence and phenotypes were assessed with office and ambulatory blood pressure measurement in a sample of adults living in Cerro de Pasco, Peru (altitude 4340 m). Basic clinical data, blood oxygen saturation, hematocrit, and Qinghai Chronic Mountain Sickness score were obtained. Participants were classified according to the presence of excessive erythrocytosis and chronic mountain sickness diagnosis. Data of 289 participants (143 women, 146 men, mean age 38.3 years) were analyzed. Office hypertension was present in 20 (7%) participants, while ambulatory hypertension was found in 58 (20%) participants. Masked hypertension was common (15%), and white coat hypertension was rare (2%). Among participants with ambulatory hypertension, the most prevalent phenotypes included isolated nocturnal hypertension, isolated diastolic hypertension, and systodiastolic hypertension. Ambulatory hypertension was associated with male gender, age, overweight/obesity, 24-hour heart rate, and excessive erythrocytosis. Prevalence of hypertension among Andean highlanders may be significantly underestimated when based on conventional blood pressure measurements, due to the high prevalence of masked hypertension. In highlanders, ambulatory hypertension may be independently associated with excessive erythrocytosis.
Published: 2020

41. Obstructive sleep apnoea treatment and blood pressure: Which phenotypes predict a response? A systematic review and meta-analysis

Author: Pengo, M, Soranna, D, Giontella, A, Perger, E, Mattaliano, P, Schwarz, E, Lombardi, C, Bilo, G, Zambon, A, Steier, J, Parati, G, Minuz, P, Fava, C, Pengo M. F., Soranna D., Giontella A., Perger E., Mattaliano P., Schwarz E. I., Lombardi C., Bilo G., Zambon A., Steier J., Parati G., Minuz P., Fava C., Pengo, M, Soranna, D, Giontella, A, Perger, E, Mattaliano, P, Schwarz, E, Lombardi, C, Bilo, G, Zambon, A, Steier, J, Parati, G, Minuz, P, Fava, C, Pengo M. F., Soranna D., Giontella A., Perger E., Mattaliano P., Schwarz E. I., Lombardi C., Bilo G., Zambon A., Steier J., Parati G., Minuz P., and Fava C.
Abstract: The treatment for obstructive sleep apnoea (OSA) with continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs) is associated with blood pressure (BP) reduction; however, the overall effect is modest. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effect of such treatments on BP was to identify subgroups of patients who respond best to treatment. The article search was performed in three different databases with specific search terms and selection criteria. From 2289 articles, we included 68 RCTs that compared CPAP or MADs with either passive or active treatment. When all the studies were pooled together, CPAP and MADs were associated with a mean BP reduction of 2.09 (95% CI 2.78-1.40) mmHg for systolic BP and 1.92 (95% CI 2.40-1.43) mmHg for diastolic BP and 1.27 (95% CI 2.34-0.20) mmHg for systolic BP and 1.11 (95% CI 1.82-0.41) mmHg for diastolic BP, respectively. The subgroups of patients who showed a greater response were those aged <60 years (systolic BP 2.93 mmHg), with uncontrolled BP at baseline (systolic BP 4.14 mmHg) and with severe oxygen desaturations (minimum arterial oxygen saturation measured by pulse oximetry <77%) at baseline (24-h systolic BP 7.57 mmHg). Although this meta-analysis shows that the expected reduction of BP by CPAP/MADs is modest, it identifies specific characteristics that may predict a pronounced benefit from CPAP in terms of BP control. These findings should be interpreted with caution; however, they are particularly important in identifying potential phenotypes associated with BP reduction in patients treated for OSA.
Published: 2020

42. Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database

Author: Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J. -L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O. K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J. A., Levy P., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Pataka A., Penzel T., Petiet E., Pepin J. L., Plywaczewski R., Pretl M., Riha R. L., Ryan S., Saaresranta T., Schulz R., Tasbakan M. S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Verbraecken J., Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, Verbraecken, J, Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J. -L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M. R., Basoglu O. K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J. A., Levy P., Marrone O., Masa J. F., McNicholas W. T., Montserrat J. M., Pataka A., Penzel T., Petiet E., Pepin J. L., Plywaczewski R., Pretl M., Riha R. L., Ryan S., Saaresranta T., Schulz R., Tasbakan M. S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., and Verbraecken J.
Abstract: Background and objective: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort. Methods: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency). Results: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP. Conclusion: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.
Published: 2020

43. Comorbidities, cardiovascular therapies, and COVID-19 mortality: A nationwide, italian observational study (ItaliCO)

Author: Polverino, F, Stern, D, Ruocco, G, Balestro, E, Bassetti, M, Candelli, M, Cirillo, B, Contoli, M, Corsico, A, D'Amico, F, D'Elia, E, Falco, G, Gasparini, S, Guerra, S, Harari, S, Kraft, M, Mennella, L, Papi, A, Parrella, R, Pelosi, P, Poletti, V, Polverino, M, Tana, C, Terribile, R, Woods, J, Di Marco, F, Martinez, F, Zhang, S, Geelhoed, B, Sinning, C, Agarossi, A, Agati, S, Agosteo, E, Ando', F, Andreoni, M, Angelillo, I, Arcoleo, G, Arena, C, Baiamonte, P, Ball, L, Banfi, P, Bartoletti, G, Bartolotta, R, Battaglini, D, Bellan, M, Benzoni, I, Bertolini, R, Bevilacqua, M, Bezzi, M, Bianco, A, Bisbano, A, Bobbio, F, Bocchialini, G, Bonetti, F, Boni, F, Bonifazi, M, Borgonovo, G, Borre', S, Bosio, M, Brachini, G, Brunetti, I, Calagna, L, Calo, F, Capuozzo, A, Carr, T, Castellani, A, Catalano, F, Catania, G, Catena, E, Cattaneo, M, Cattelan, A, Ceruti, V, Chiumiento, F, Cicchitto, G, Confalonieri, M, Confalonieri, P, Coppola, N, Cosentina, R, Costantino, R, Crimi, C, Curra, A, D'Abbraccio, M, Dalbeni, A, Daleffe, F, Davide, R, Del Donno, M, Di Pastena, F, Di Perna, F, Di Rosa, Z, Di Sabatino, A, Elesbani, O, Elia, D, Esposito, V, Fabiani, L, Falo, G, Fanelli, C, Fantin, A, Ferrigno, F, Fiorentino, G, Franceschi, F, Fronza, M, Gardenghi, G, Giacobbe, D, Giannotti, C, Giannotti, G, Gidari, A, Giovanardi, F, Gnerre, P, Gonnelli, F, Graziano, M, Greco, S, Grosso, A, Guarino, S, Iannarelli, A, Imitazione, P, Inglese, F, Iodice, V, Izzo, A, La Greca, C, Lax, A, Legittimo, F, Leo, A, Leone, S, Lepidini, V, Leto, M, Licata, F, Locati, F, Lorini, L, Lucchetti, B, Maida, I, Macera, M, Manzillo, E, March, A, Mascheroni, D, Mastroianni, A, Mauro, I, Mazzitelli, M, Mazzuca, E, Micheletto, C, Mingoli, A, Minuz, P, Moioli, M, Monti, L, Morgagni, R, Mucci, L, Muselli, M, Negri, S, Nobile, C, Oldani, S, Olivieri, C, Parati, G, Parodi, L, Pastorelli, E, Patruno, V, Pellegrino, F, Pengo, M, Pepe, D, Perotti, A, Petrino, R, Petrucci, M, Piane, R, Pignataro, G, Pino, M, Pirisi, M, Porru, F, Pugliese, F, Punzi, R, Ramaroli, D, Robba, C, Rostagno, R, Sabatini, U, Sainaghi, P, Salton, F, Salzano, C, Sanduzzi, A, Zamparelli, S, Sangiovanni, V, Santopuoli, D, Sapienza, P, Sarmati, L, Schiaroli, E, Scienza, F, Senni, M, Serchisu, L, Sgherzi, S, Soddu, D, Soranna, D, Sorino, C, Spadaro, S, Stirpe, E, Tardivo, S, Tartaglia, S, Teopompi, E, Tomchaney, M, Torelli, E, Torlasco, C, Torti, C, Tupputi, E, Ugolinelli, C, Vatrella, A, Versace, A, Villani, M, Vincenzo, L, Volta, C, Voraphani, N, Zekaj, E, Zoppellari, R, Polverino F., Stern D. A., Ruocco G., Balestro E., Bassetti M., Candelli M., Cirillo B., Contoli M., Corsico A., D'Amico F., D'Elia E., Falco G., Gasparini S., Guerra S., Harari S., Kraft M., Mennella L., Papi A., Parrella R., Pelosi P., Poletti V., Polverino M., Tana C., Terribile R., Woods J. C., Di Marco F., Martinez F. D., Zhang S., Geelhoed B., Sinning C., Agarossi A., Agati S., Agosteo E., Ando' F., Andreoni M., Angelillo I. F., Arcoleo G., Arena C., Baiamonte P., Ball L., Banfi P., Bartoletti G., Bartolotta R., Battaglini D., Bellan M., Benzoni I., Bertolini R., Bevilacqua M., Bezzi M., Bianco A., Bisbano A., Bobbio F., Bocchialini G., Bonetti F., Boni F., Bonifazi M., Borgonovo G., Borre' S., Bosio M., Brachini G., Brunetti I., Calagna L., Calo F., Capuozzo A., Carr T., Castellani A., Catalano F., Catania G., Catena E., Cattaneo M., Cattelan A., Ceruti V., Chiumiento F., Cicchitto G., Confalonieri M., Confalonieri P., Coppola N., Cosentina R., Costantino R., Crimi C., Curra A., D'Abbraccio M., Dalbeni A., Daleffe F., Davide R., Del Donno M., Di Pastena F., Di Perna F., Di Rosa Z., Di Sabatino A., Elesbani O., Elia D., Esposito V., Fabiani L., Falo G., Fanelli C., Fantin A., Ferrigno F., Fiorentino G., Franceschi F., Fronza M., Gardenghi G. G., Giacobbe D. R., Giannotti C., Giannotti G., Gidari A., Giovanardi F., Gnerre P., Gonnelli F., Graziano M., Greco S., Grosso A., Guarino S., Iannarelli A., Imitazione P., Inglese F., Iodice V., Izzo A., La Greca C., Lax A., Legittimo F., Leo A., Leone S., Lepidini V., Leto M., Licata F., Locati F., Lorini L., Lucchetti B., Maida I., Macera M., Manzillo E., March A., Mascheroni D., Mastroianni A., Mauro I., Mazzitelli M., Mazzuca E., Micheletto C., Mingoli A., Minuz P., Moioli M., Monti L., Morgagni R., Mucci L., Muselli M., Negri S., Nobile C. G. A., Oldani S., Olivieri C., Parati G., Parodi L., Pastorelli E., Patruno V., Pellegrino F., Pengo M. F., Pepe D., Perotti A., Petrino R., Petrucci M., Piane R. M., Pignataro G., Pino M., Pirisi M., Porru F., Pugliese F., Punzi R., Ramaroli D. A., Robba C., Rostagno R., Sabatini U., Sainaghi P. P., Salton F., Salzano C., Sanduzzi A., Zamparelli S. S., Sangiovanni V., Santopuoli D., Sapienza P., Sarmati L., Schiaroli E., Scienza F., Senni M., Serchisu L., Sgherzi S., Soddu D., Soranna D., Sorino C., Spadaro S., Stirpe E., Tardivo S., Tartaglia S., Teopompi E., Tomchaney M., Torelli E., Torlasco C., Torti C., Tupputi E., Ugolinelli C., Vatrella A., Versace A. G., Villani M., Vincenzo L., Volta C. A., Voraphani N., Zekaj E., Zoppellari R., Polverino, F, Stern, D, Ruocco, G, Balestro, E, Bassetti, M, Candelli, M, Cirillo, B, Contoli, M, Corsico, A, D'Amico, F, D'Elia, E, Falco, G, Gasparini, S, Guerra, S, Harari, S, Kraft, M, Mennella, L, Papi, A, Parrella, R, Pelosi, P, Poletti, V, Polverino, M, Tana, C, Terribile, R, Woods, J, Di Marco, F, Martinez, F, Zhang, S, Geelhoed, B, Sinning, C, Agarossi, A, Agati, S, Agosteo, E, Ando', F, Andreoni, M, Angelillo, I, Arcoleo, G, Arena, C, Baiamonte, P, Ball, L, Banfi, P, Bartoletti, G, Bartolotta, R, Battaglini, D, Bellan, M, Benzoni, I, Bertolini, R, Bevilacqua, M, Bezzi, M, Bianco, A, Bisbano, A, Bobbio, F, Bocchialini, G, Bonetti, F, Boni, F, Bonifazi, M, Borgonovo, G, Borre', S, Bosio, M, Brachini, G, Brunetti, I, Calagna, L, Calo, F, Capuozzo, A, Carr, T, Castellani, A, Catalano, F, Catania, G, Catena, E, Cattaneo, M, Cattelan, A, Ceruti, V, Chiumiento, F, Cicchitto, G, Confalonieri, M, Confalonieri, P, Coppola, N, Cosentina, R, Costantino, R, Crimi, C, Curra, A, D'Abbraccio, M, Dalbeni, A, Daleffe, F, Davide, R, Del Donno, M, Di Pastena, F, Di Perna, F, Di Rosa, Z, Di Sabatino, A, Elesbani, O, Elia, D, Esposito, V, Fabiani, L, Falo, G, Fanelli, C, Fantin, A, Ferrigno, F, Fiorentino, G, Franceschi, F, Fronza, M, Gardenghi, G, Giacobbe, D, Giannotti, C, Giannotti, G, Gidari, A, Giovanardi, F, Gnerre, P, Gonnelli, F, Graziano, M, Greco, S, Grosso, A, Guarino, S, Iannarelli, A, Imitazione, P, Inglese, F, Iodice, V, Izzo, A, La Greca, C, Lax, A, Legittimo, F, Leo, A, Leone, S, Lepidini, V, Leto, M, Licata, F, Locati, F, Lorini, L, Lucchetti, B, Maida, I, Macera, M, Manzillo, E, March, A, Mascheroni, D, Mastroianni, A, Mauro, I, Mazzitelli, M, Mazzuca, E, Micheletto, C, Mingoli, A, Minuz, P, Moioli, M, Monti, L, Morgagni, R, Mucci, L, Muselli, M, Negri, S, Nobile, C, Oldani, S, Olivieri, C, Parati, G, Parodi, L, Pastorelli, E, Patruno, V, Pellegrino, F, Pengo, M, Pepe, D, Perotti, A, Petrino, R, Petrucci, M, Piane, R, Pignataro, G, Pino, M, Pirisi, M, Porru, F, Pugliese, F, Punzi, R, Ramaroli, D, Robba, C, Rostagno, R, Sabatini, U, Sainaghi, P, Salton, F, Salzano, C, Sanduzzi, A, Zamparelli, S, Sangiovanni, V, Santopuoli, D, Sapienza, P, Sarmati, L, Schiaroli, E, Scienza, F, Senni, M, Serchisu, L, Sgherzi, S, Soddu, D, Soranna, D, Sorino, C, Spadaro, S, Stirpe, E, Tardivo, S, Tartaglia, S, Teopompi, E, Tomchaney, M, Torelli, E, Torlasco, C, Torti, C, Tupputi, E, Ugolinelli, C, Vatrella, A, Versace, A, Villani, M, Vincenzo, L, Volta, C, Voraphani, N, Zekaj, E, Zoppellari, R, Polverino F., Stern D. A., Ruocco G., Balestro E., Bassetti M., Candelli M., Cirillo B., Contoli M., Corsico A., D'Amico F., D'Elia E., Falco G., Gasparini S., Guerra S., Harari S., Kraft M., Mennella L., Papi A., Parrella R., Pelosi P., Poletti V., Polverino M., Tana C., Terribile R., Woods J. C., Di Marco F., Martinez F. D., Zhang S., Geelhoed B., Sinning C., Agarossi A., Agati S., Agosteo E., Ando' F., Andreoni M., Angelillo I. F., Arcoleo G., Arena C., Baiamonte P., Ball L., Banfi P., Bartoletti G., Bartolotta R., Battaglini D., Bellan M., Benzoni I., Bertolini R., Bevilacqua M., Bezzi M., Bianco A., Bisbano A., Bobbio F., Bocchialini G., Bonetti F., Boni F., Bonifazi M., Borgonovo G., Borre' S., Bosio M., Brachini G., Brunetti I., Calagna L., Calo F., Capuozzo A., Carr T., Castellani A., Catalano F., Catania G., Catena E., Cattaneo M., Cattelan A., Ceruti V., Chiumiento F., Cicchitto G., Confalonieri M., Confalonieri P., Coppola N., Cosentina R., Costantino R., Crimi C., Curra A., D'Abbraccio M., Dalbeni A., Daleffe F., Davide R., Del Donno M., Di Pastena F., Di Perna F., Di Rosa Z., Di Sabatino A., Elesbani O., Elia D., Esposito V., Fabiani L., Falo G., Fanelli C., Fantin A., Ferrigno F., Fiorentino G., Franceschi F., Fronza M., Gardenghi G. G., Giacobbe D. R., Giannotti C., Giannotti G., Gidari A., Giovanardi F., Gnerre P., Gonnelli F., Graziano M., Greco S., Grosso A., Guarino S., Iannarelli A., Imitazione P., Inglese F., Iodice V., Izzo A., La Greca C., Lax A., Legittimo F., Leo A., Leone S., Lepidini V., Leto M., Licata F., Locati F., Lorini L., Lucchetti B., Maida I., Macera M., Manzillo E., March A., Mascheroni D., Mastroianni A., Mauro I., Mazzitelli M., Mazzuca E., Micheletto C., Mingoli A., Minuz P., Moioli M., Monti L., Morgagni R., Mucci L., Muselli M., Negri S., Nobile C. G. A., Oldani S., Olivieri C., Parati G., Parodi L., Pastorelli E., Patruno V., Pellegrino F., Pengo M. F., Pepe D., Perotti A., Petrino R., Petrucci M., Piane R. M., Pignataro G., Pino M., Pirisi M., Porru F., Pugliese F., Punzi R., Ramaroli D. A., Robba C., Rostagno R., Sabatini U., Sainaghi P. P., Salton F., Salzano C., Sanduzzi A., Zamparelli S. S., Sangiovanni V., Santopuoli D., Sapienza P., Sarmati L., Schiaroli E., Scienza F., Senni M., Serchisu L., Sgherzi S., Soddu D., Soranna D., Sorino C., Spadaro S., Stirpe E., Tardivo S., Tartaglia S., Teopompi E., Tomchaney M., Torelli E., Torlasco C., Torti C., Tupputi E., Ugolinelli C., Vatrella A., Versace A. G., Villani M., Vincenzo L., Volta C. A., Voraphani N., Zekaj E., and Zoppellari R.
Abstract: Background: Italy has one of the world’s oldest populations, and suffered one the highest death tolls from Coronavirus disease 2019 (COVID-19) worldwide. Older people with cardiovascular diseases (CVDs), and in particular hypertension, are at higher risk of hospitalization and death for COVID-19. Whether hypertensionmedicationsmay increase the risk for death in older COVID 19 inpatients at the highest risk for the disease is currently unknown. Methods: Data from 5,625 COVID-19 inpatients were manually extracted from medical charts from 61 hospitals across Italy. From the initial 5,625 patients, 3,179 were included in the study as they were either discharged or deceased at the time of the data analysis. Primary outcome was inpatient death or recovery. Mixed effects logistic regression models were adjusted for sex, age, and number of comorbidities, with a random effect for site. Results: A large proportion of participating inpatients were ≥65 years old (58%), male (68%), non-smokers (93%) with comorbidities (66%). Each additional comorbidity increased the risk of death by 35% [adjOR = 1.35 (1.2, 1.5) p < 0.001]. Use of ACE inhibitors, ARBs, beta-blockers or Ca-antagonists was not associated with significantly increased risk of death. There was a marginal negative association between ARB use and death, and a marginal positive association between diuretic use and death. Conclusions: This Italian nationwide observational study of COVID-19 inpatients, the majority of which ≥65 years old, indicates that there is a linear direct relationship between the number of comorbidities and the risk of death. Among CVDs, hypertension and pre-existing cardiomyopathy were significantly associated with risk of death. The use of hypertension medications reported to be safe in younger cohorts, do not contribute significantly to increased COVID-19 related deaths in an older population that suffered one of the highest death tolls worldwide.
Published: 2020

44. Comorbidities, cardiovascular therapies, and COVID-19 mortality: A nationwide, italian observational study (ItaliCO)

Author: Polverino, F., Phd, Md, Stern, D., Polverino, M., D'Amico, F., D'Elia, E., Agarossi, A., Agati, S., Agosteo, E., Ando', F., Andreoni, M., Angelillo, If., Dds, Mph, Arcoleo, G., Arena, C., Baiamonte, P., Balestro, E., Ball, L., Banfi, P., Bartoletti, G., Bartolotta, R., Bassetti, M., Battaglini, D., Bellan, M., Benzoni, I., Bertolini, R., Bevilacqua, M., Bezzi, M., Bianco, A., Bisbano, A., Bobbio, F., Bocchialini, G., Bonetti, F., Boni, F., Bonifazi, M., Borgonovo, G., Borre', S., Bosio, M., Brachini, G., Brunetti, I., Calagna, L., Calò, F., Candelli, M., Capuozzo, A., Carr, T., Castellani, A., Catalano, F., Catania, G., Catena, E., Cattaneo, M., Cattelan, A., Ceruti, V., Chiumiento, F., Cicchitto, G., Cirillo, B., Confalonieri, M., Confalonieri, P., Contoli, M., Coppola, N., Corsico, A., Cosentina, R., Costantino, R., Crimi, C., Currà, A., D'Abbraccio, M., Dalbeni, A., Daleffe, F., Davide, R., Del Donno, M., Di Marco, F., Di Pastena, F., Di Perna, F., Di Rosa, Z., Di Sabatino, A., Elesbani, O., Elia, D., Esposito, V., Fabiani, L., Falco, G., Falo, G., Fanelli, C., Fantin, A., Ferrigno, F., Fiorentino, G., Franceschi, F., Fronza, M., Gardini Gardenghi, G., Gasparini, S., Giacobbe, D. R., Giannotti, C., Giannotti, G., Gidari, A., Giovanardi, F., Gnerre, P., Gonnelli, F., Graziano, M., Greco, S., Grosso, A., Phd, Guarino, S., Guerra, S., Harari, S., Iannarelli, A., Imitazione, P., Inglese, F., Iodice, V., Izzo, A., La Greca, C., Kraft, M., Lax, A., Legittimo, F., Leo, A., Leone, S., Lepidini, V., Leto, M., Licata, F., Locati, F., Lorini, L., Lucchetti, B., Maida, I., Macera, M., Manzillo, E., March, A., Mascheroni, D., Mastroianni, A., Mauro, I., Mazzitelli, M., Mazzuca, E., Mennella, L., Micheletto, C., Mingoli, A., Minuz, P., Moioli, M., Monti, L., Morgagni, R., Mucci, L., Muselli, M., Negri, S., Nobile, C. G. A., Oldani, S., Olivieri, C., Papi, A., Parati, G., Parodi, L., Parrella, R., Pastorelli, E., Patruno, V., Pellegrino, F., Pelosi, P., Fers, Md, Pengo, M. F., Pepe, D., Perotti, A., Petrino, R., Petrucci, M., Piane, R. M., Pignataro, G., Pino, M., Pirisi, M., Poletti, V., Porru, F., Pugliese, F., Punzi, R., Ramaroli, D. A., Robba, C., Rostagno, R., Ruocco, G., Sabatini, U., Sainaghi, P. P., Salton, F., Salzano, C., Sanduzzi, A., Sanduzzi Zamparelli, S., Sangiovanni, V., Santopuoli, D., Sapienza, P., Sarmati, L., Schiaroli, E., Scienza, F., Senni, M., Serchisu, L., Sgherzi, S., Soddu, D., Soranna, D., Sorino, C., Spadaro, S., Stirpe, E., Tana, C., Tardivo, S., Tartaglia, S., Teopompi, E., Terribile, R., Tomchaney, M., Torelli, E., Torlasco, C., Torti, C., Tupputi, E., Ugolinelli, C., Vatrella, A., Versace, A. G., Villani, M., Vincenzo, L., Volta, C. A., Voraphani, N., Woods, J. C., Zekaj, E., Zoppellari, R., Martinez, and F. D., Polverino, Francesca, Stern, Debra A, Ruocco, Gaetano, Balestro, Elisabetta, Bassetti, Matteo, Candelli, Marcello, Cirillo, Bruno, Contoli, Marco, Corsico, Angelo, D'Amico, Filippo, D'Elia, Emilia, Falco, Giuseppe, Gasparini, Stefano, Guerra, Stefano, Harari, Sergio, Kraft, Monica, Mennella, Luigi, Papi, Alberto, Parrella, Roberto, Pelosi, Paolo, Poletti, Venerino, Polverino, Mario, Tana, Claudio, Terribile, Roberta, Woods, Jason C, Di Marco, Fabiano, Martinez, Fernando D, Angelillo, Italo Francesco, Stern, Debra A., C Woods, Jason, Martinez, Fernando D., Polverino, F., Stern, D., Polverino, M., D'Amico, F., D'Elia, E., Agarossi, A., Agati, S., Agosteo, E., Ando', F., Andreoni, M., Angelillo, If., Arcoleo, G., Arena, C., Baiamonte, P., Balestro, E., Ball, L., Banfi, P., Bartoletti, G., Bartolotta, R., Bassetti, M., Battaglini, D., Bellan, M., Benzoni, I., Bertolini, R., Bevilacqua, M., Bezzi, M., Bianco, A., Bisbano, A., Bobbio, F., Bocchialini, G., Bonetti, F., Boni, F., Bonifazi, M., Borgonovo, G., Borre', S., Bosio, M., Brachini, G., Brunetti, I., Calagna, L., Calò, F., Candelli, M., Capuozzo, A., Carr, T., Castellani, A., Catalano, F., Catania, G., Catena, E., Cattaneo, M., Cattelan, A., Ceruti, V., Chiumiento, F., Cicchitto, G., Cirillo, B., Confalonieri, M., Confalonieri, P., Contoli, M., Coppola, N., Corsico, A., Cosentina, R., Costantino, R., Crimi, C., Currà, A., D'Abbraccio, M., Dalbeni, A., Daleffe, F., Davide, R., Del Donno, M., Di Marco, F., Di Pastena, F., Di Perna, F., Di Rosa, Z., Di Sabatino, A., Elesbani, O., Elia, D., Esposito, V., Fabiani, L., Falco, G., Falo, G., Fanelli, C., Fantin, A., Ferrigno, F., Fiorentino, G., Franceschi, F., Fronza, M., Gardini Gardenghi, G., Gasparini, S., Giacobbe, D. R., Giannotti, C., Giannotti, G., Gidari, A., Giovanardi, F., Gnerre, P., Gonnelli, F., Graziano, M., Greco, S., Grosso, A., Guarino, S., Guerra, S., Harari, S., Iannarelli, A., Imitazione, P., Inglese, F., Iodice, V., Izzo, A., La Greca, C., Kraft, M., Lax, A., Legittimo, F., Leo, A., Leone, S., Lepidini, V., Leto, M., Licata, F., Locati, F., Lorini, L., Lucchetti, B., Maida, I., Macera, M., Manzillo, E., March, A., Mascheroni, D., Mastroianni, A., Mauro, I., Mazzitelli, M., Mazzuca, E., Mennella, L., Micheletto, C., Mingoli, A., Minuz, P., Moioli, M., Monti, L., Morgagni, R., Mucci, L., Muselli, M., Negri, S., Nobile, C. G. A., Oldani, S., Olivieri, C., Papi, A., Parati, G., Parodi, L., Parrella, R., Pastorelli, E., Patruno, V., Pellegrino, F., Pelosi, P., Pengo, M. F., Pepe, D., Perotti, A., Petrino, R., Petrucci, M., Piane, R. M., Pignataro, G., Pino, M., Pirisi, M., Poletti, V., Porru, F., Pugliese, F., Punzi, R., Ramaroli, D. A., Robba, C., Rostagno, R., Ruocco, G., Sabatini, U., Sainaghi, P. P., Salton, F., Salzano, C., Sanduzzi, A., Sanduzzi Zamparelli, S., Sangiovanni, V., Santopuoli, D., Sapienza, P., Sarmati, L., Schiaroli, E., Scienza, F., Senni, M., Serchisu, L., Sgherzi, S., Soddu, D., Soranna, D., Sorino, C., Spadaro, S., Stirpe, E., Tana, C., Tardivo, S., Tartaglia, S., Teopompi, E., Terribile, R., Tomchaney, M., Torelli, E., Torlasco, C., Torti, C., Tupputi, E., Ugolinelli, C., Vatrella, A., Versace, A. G., Villani, M., Vincenzo, L., Volta, C. A., Voraphani, N., Woods, J. C., Zekaj, E., Zoppellari, R., Martinez, F. D., Public Health, Polverino, F, Stern, D, Ruocco, G, Balestro, E, Bassetti, M, Candelli, M, Cirillo, B, Contoli, M, Corsico, A, D'Amico, F, D'Elia, E, Falco, G, Gasparini, S, Guerra, S, Harari, S, Kraft, M, Mennella, L, Papi, A, Parrella, R, Pelosi, P, Poletti, V, Polverino, M, Tana, C, Terribile, R, Woods, J, Di Marco, F, Martinez, F, Zhang, S, Geelhoed, B, Sinning, C, Agarossi, A, Agati, S, Agosteo, E, Ando', F, Andreoni, M, Angelillo, I, Arcoleo, G, Arena, C, Baiamonte, P, Ball, L, Banfi, P, Bartoletti, G, Bartolotta, R, Battaglini, D, Bellan, M, Benzoni, I, Bertolini, R, Bevilacqua, M, Bezzi, M, Bianco, A, Bisbano, A, Bobbio, F, Bocchialini, G, Bonetti, F, Boni, F, Bonifazi, M, Borgonovo, G, Borre', S, Bosio, M, Brachini, G, Brunetti, I, Calagna, L, Calo, F, Capuozzo, A, Carr, T, Castellani, A, Catalano, F, Catania, G, Catena, E, Cattaneo, M, Cattelan, A, Ceruti, V, Chiumiento, F, Cicchitto, G, Confalonieri, M, Confalonieri, P, Coppola, N, Cosentina, R, Costantino, R, Crimi, C, Curra, A, D'Abbraccio, M, Dalbeni, A, Daleffe, F, Davide, R, Del Donno, M, Di Pastena, F, Di Perna, F, Di Rosa, Z, Di Sabatino, A, Elesbani, O, Elia, D, Esposito, V, Fabiani, L, Falo, G, Fanelli, C, Fantin, A, Ferrigno, F, Fiorentino, G, Franceschi, F, Fronza, M, Gardenghi, G, Giacobbe, D, Giannotti, C, Giannotti, G, Gidari, A, Giovanardi, F, Gnerre, P, Gonnelli, F, Graziano, M, Greco, S, Grosso, A, Guarino, S, Iannarelli, A, Imitazione, P, Inglese, F, Iodice, V, Izzo, A, La Greca, C, Lax, A, Legittimo, F, Leo, A, Leone, S, Lepidini, V, Leto, M, Licata, F, Locati, F, Lorini, L, Lucchetti, B, Maida, I, Macera, M, Manzillo, E, March, A, Mascheroni, D, Mastroianni, A, Mauro, I, Mazzitelli, M, Mazzuca, E, Micheletto, C, Mingoli, A, Minuz, P, Moioli, M, Monti, L, Morgagni, R, Mucci, L, Muselli, M, Negri, S, Nobile, C, Oldani, S, Olivieri, C, Parati, G, Parodi, L, Pastorelli, E, Patruno, V, Pellegrino, F, Pengo, M, Pepe, D, Perotti, A, Petrino, R, Petrucci, M, Piane, R, Pignataro, G, Pino, M, Pirisi, M, Porru, F, Pugliese, F, Punzi, R, Ramaroli, D, Robba, C, Rostagno, R, Sabatini, U, Sainaghi, P, Salton, F, Salzano, C, Sanduzzi, A, Zamparelli, S, Sangiovanni, V, Santopuoli, D, Sapienza, P, Sarmati, L, Schiaroli, E, Scienza, F, Senni, M, Serchisu, L, Sgherzi, S, Soddu, D, Soranna, D, Sorino, C, Spadaro, S, Stirpe, E, Tardivo, S, Tartaglia, S, Teopompi, E, Tomchaney, M, Torelli, E, Torlasco, C, Torti, C, Tupputi, E, Ugolinelli, C, Vatrella, A, Versace, A, Villani, M, Vincenzo, L, Volta, C, Voraphani, N, Zekaj, E, and Zoppellari, R
Subjects: 0301 basic medicine, COVID-19, comorbidities, ACE inhibitors, mortality, cohort study, medicine.medical_specialty, comorbiditie, lcsh:Diseases of the circulatory (Cardiovascular) system, ACE inhibitors, Coronavirus disease 2019 (COVID-19), COVID-19, cohort study, comorbidities, mortality, Cardiomyopathy, Socio-culturale, Disease, 030204 cardiovascular system & hematology, Cardiovascular Medicine, Logistic regression, Older population, Comorbidities, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Internal medicine, ACE inhibitor, medicine, Mortality, Original Research, business.industry, Cohort study, medicine.disease, Comorbidity, 030104 developmental biology, lcsh:RC666-701, Observational study, Erratum, Cardiology and Cardiovascular Medicine, business
Abstract: Background: Italy has one of the world’s oldest populations, and suffered one the highest death tolls from Coronavirus disease 2019 (COVID-19) worldwide. Older people with cardiovascular diseases (CVDs), and in particular hypertension, are at higher risk of hospitalization and death for COVID-19. Whether hypertensionmedicationsmay increase the risk for death in older COVID 19 inpatients at the highest risk for the disease is currently unknown. Methods: Data from 5,625 COVID-19 inpatients were manually extracted from medical charts from 61 hospitals across Italy. From the initial 5,625 patients, 3,179 were included in the study as they were either discharged or deceased at the time of the data analysis. Primary outcome was inpatient death or recovery. Mixed effects logistic regression models were adjusted for sex, age, and number of comorbidities, with a random effect for site. Results: A large proportion of participating inpatients were ≥65 years old (58%), male (68%), non-smokers (93%) with comorbidities (66%). Each additional comorbidity increased the risk of death by 35% [adjOR = 1.35 (1.2, 1.5) p < 0.001]. Use of ACE inhibitors, ARBs, beta-blockers or Ca-antagonists was not associated with significantly increased risk of death. There was a marginal negative association between ARB use and death, and a marginal positive association between diuretic use and death. Conclusions: This Italian nationwide observational study of COVID-19 inpatients, the majority of which ≥65 years old, indicates that there is a linear direct relationship between the number of comorbidities and the risk of death. Among CVDs, hypertension and pre-existing cardiomyopathy were significantly associated with risk of death. The use of hypertension medications reported to be safe in younger cohorts, do not contribute significantly to increased COVID-19 related deaths in an older population that suffered one of the highest death tolls worldwide.
Published: 2020

45. Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database

Author: Lombardi C, Parati G, Soranna D, Zambon A, Sliwinski P, Roisman G, Pepin JL, Schiza S, Riha R, Joppa P, Fietze I, Hedner J, Grote L, European Sleep Apnoea Database (ESADA) Collaborators (ESADA Collaborators: Anttalainen U, Barbé F, Bonsignore MR, Basoglu OK, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Hein H, Kvamme JA, Levy P, Marrone O, Masa JF, McNicholas WT, Montserrat JM, Pataka A, Penzel T, Petiet E, Pépin JL, Plywaczewski R, Pretl M, Riha RL, Ryan S, Saaresranta T, Schulz R, Tasbakan MS, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J), Lombardi C., Parati G., Soranna D., Zambon A., Sliwinski P., Roisman G., Pepin J.-L., Schiza S., Riha R., Joppa P., Fietze I., Hedner J., Grote L., Anttalainen U., Barbe F., Bonsignore M.R., Basoglu O.K., Bielicki P., Dogas Z., Dorkova Z., Escourrou P., Hein H., Kvamme J.A., Levy P., Marrone O., Masa J.F., McNicholas W.T., Montserrat J.M., Pataka A., Penzel T., Petiet E., Pepin J.L., Plywaczewski R., Pretl M., Riha R.L., Ryan S., Saaresranta T., Schulz R., Tasbakan M.S., Tkacova R., Staats R., Steiropoulos P., Varoneckas G., Verbraecken J., Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Institute of Tuberculosis and Lung Diseases [Warsaw, Poland] (ITLD), AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), University of Crete [Heraklion] (UOC), Royal Infirmary of Edinburgh, Univerzitnej nemocnice L. Pasteura Košice [Košice, Slovakia]. (UNLPK), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Gothenburg (GU), Sahlgrenska Academy at University of Gothenburg [Göteborg], European Sleep Apnoea Database (ESADA) Collaborators: Anttalainen U, Barbé F, Bonsignore Mr, Basoglu Ok, Bielicki P, Dogas Z, Dorkova Z, Escourrou P, Fietze I, Grote L, Hedner J, Hein H, Joppa P, Kvamme Ja, Levy P, Lombardi C, Marrone O, Masa Jf, McNicholas Wt, Montserrat Jm, Parati G, Pataka A, Penzel T, Petiet E, Pépin Jl, Plywaczewski R, Pretl M, Riha Rl, Roisman G, Ryan S, Saaresranta T, Schiza S, Schulz R, Sliwinski P, Pepin Jl, Tasbakan Ms, Tkacova R, Staats R, Steiropoulos P, Varoneckas G, Verbraecken J, SALAS, Danielle, Lombardi, C, Parati, G, Soranna, D, Zambon, A, Sliwinski, P, Roisman, G, Pepin, J, Schiza, S, Riha, R, Joppa, P, Fietze, I, Hedner, J, Grote, L, Anttalainen, U, Barbe, F, Bonsignore, M, Basoglu, O, Bielicki, P, Dogas, Z, Dorkova, Z, Escourrou, P, Hein, H, Kvamme, J, Levy, P, Marrone, O, Masa, J, Mcnicholas, W, Montserrat, J, Pataka, A, Penzel, T, Petiet, E, Plywaczewski, R, Pretl, M, Ryan, S, Saaresranta, T, Schulz, R, Tasbakan, M, Tkacova, R, Staats, R, Steiropoulos, P, Varoneckas, G, and Verbraecken, J
Subjects: Male, Pulmonary and Respiratory Medicine, Multivariate statistics, medicine.medical_specialty, obstructive sleep apnoea, Systole, Movement, [SDV]Life Sciences [q-bio], Blood Pressure, Comorbidity, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Cohort Studies, 03 medical and health sciences, Sleep Apnea Syndromes, 0302 clinical medicine, Diastole, cardiovascular disease, Diabetes mellitus, Internal medicine, medicine, Humans, 030212 general & internal medicine, sleep disorder, Sleep disorder, Univariate analysis, business.industry, Confounding, Extremities, clinical epidemiology, Middle Aged, medicine.disease, Sleep in non-human animals, Europe, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Blood pressure, Databases as Topic, 030228 respiratory system, Cohort, Female, Sleep, business
Abstract: International audience; Background and objective: OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort.Methods: This cross-sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2 ) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency).Results: The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP.Conclusion: PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.
Published: 2020

46. Exercise haemodynamics in heart failure with preserved ejection fraction: a systematic review and meta-analysis

Author: Baratto, C, Caravita, S, Soranna, D, Dewachter, C, Bondue, A, Zambon, A, Badano, L, Parati, G, Vachiéry, J, Baratto, Claudia, Caravita, Sergio, Soranna, Davide, Dewachter, Céline, Bondue, Antoine, Zambon, Antonella, Badano, Luigi, Parati, Gianfranco, Vachiéry, Jean-Luc, Baratto, C, Caravita, S, Soranna, D, Dewachter, C, Bondue, A, Zambon, A, Badano, L, Parati, G, Vachiéry, J, Baratto, Claudia, Caravita, Sergio, Soranna, Davide, Dewachter, Céline, Bondue, Antoine, Zambon, Antonella, Badano, Luigi, Parati, Gianfranco, and Vachiéry, Jean-Luc
Abstract: Aims: Exercise right heart catheterization (RHC) is considered the gold-standard test to diagnose heart failure with preserved ejection fraction (HFpEF). However, exercise RHC is an insufficiently standardized technique, and current haemodynamic thresholds to define HFpEF are not universally accepted. We sought to describe the exercise haemodynamics profile of HFpEF cohorts reported in literature, as compared with control subjects. Methods and results: We performed a systematic literature review until December 2020. Studies reporting pulmonary artery wedge pressure (PAWP) at rest and peak exercise were extracted. Summary estimates of all haemodynamic variables were evaluated, stratified according to body position (supine/upright exercise). The PAWP/cardiac output (CO) slope during exercise was extrapolated. Twenty-seven studies were identified, providing data for 2180 HFpEF patients and 682 controls. At peak exercise, patients with HFpEF achieved higher PAWP (30 [29–31] vs. 16 [15–17] mmHg, P < 0.001) and mean right atrial pressure (P < 0.001) than controls. These differences persisted after adjustment for age, sex, body mass index, and body position. However, peak PAWP values were highly heterogeneous among the cohorts (I2 = 93%), with a relative overlap with controls. PAWP/CO slope was steeper in HFpEF than in controls (3.75 [3.20–4.28] vs. 0.95 [0.30–1.59] mmHg/L/min, P value < 0.0001), even after adjustment for covariates (P = 0.007). Conclusions: Despite methodological heterogeneity, as well as heterogeneity of pooled haemodynamic estimates, the exercise haemodynamic profile of HFpEF patients is consistent across studies and characterized by a steep PAWP rise during exercise. More standardization of exercise haemodynamics may be advisable for a wider application in clinical practice.
Published: 2022

47. Home blood pressure during COVID-19-related lockdown in patients with hypertension

Author: Pengo, M, Albini, F, Guglielmi, G, Mollica, C, Soranna, D, Zambra, G, Zambon, A, Bilo, G, Parati, G, Pengo, M, Albini, F, Guglielmi, G, Mollica, C, Soranna, D, Zambra, G, Zambon, A, Bilo, G, and Parati, G
Published: 2022

48. Effective Study: Development and Application of a Question-Driven, Time-Effective Cardiac Magnetic Resonance Scanning Protocol

Author: Torlasco, C, Castelletti, S, Soranna, D, Volpato, V, Figliozzi, S, Menacho, K, Cernigliaro, F, Zambon, A, Kellman, P, Moon, J, Badano, L, Parati, G, Torlasco, Camilla, Castelletti, Silvia, Soranna, Davide, Volpato, Valentina, Figliozzi, Stefano, Menacho, Katia, Cernigliaro, Franco, Zambon, Antonella, Kellman, Peter, Moon, James C, Badano, Luigi, Parati, Gianfranco, Torlasco, C, Castelletti, S, Soranna, D, Volpato, V, Figliozzi, S, Menacho, K, Cernigliaro, F, Zambon, A, Kellman, P, Moon, J, Badano, L, Parati, G, Torlasco, Camilla, Castelletti, Silvia, Soranna, Davide, Volpato, Valentina, Figliozzi, Stefano, Menacho, Katia, Cernigliaro, Franco, Zambon, Antonella, Kellman, Peter, Moon, James C, Badano, Luigi, and Parati, Gianfranco
Abstract: BACKGROUND: Long scanning times impede cardiac magnetic resonance (CMR) clinical uptake. A “one-size-fits-all” shortened, focused protocol (eg, only function and late-gadolinium enhancement) reduces scanning time and costs, but provides less information. We developed 2 question-driven CMR and stress-CMR protocols, including tailored advanced tissue characterization, and tested their effectiveness in reducing scanning time while retaining the diagnostic performances of standard protocols. METHODS AND RESULTS: Eighty three consecutive patients with cardiomyopathy or ischemic heart disease underwent the tailored CMR. Each scan consisted of standard cines, late-gadolinium enhancement imaging, native T1-mapping, and extracellular volume. Fat/edema modules, right ventricle cine, and in-line quantitative perfusion mapping were performed as clinically required. Workflow was optimized to avoid gaps. Time target was <30 minutes for a CMR and [removed]30% (CMR: from 42±8 to 28±6 minutes; stress-CMR: from 50±10 to 34±6 minutes, both P[removed]45% of cases. Quality grading was similar between the 2 protocols. Tailored protocols did not require additional staff. CONCLUSIONS: Tailored CMR and stress-CMR protocols including advanced tissue characterization are accurate and timeeffective for cardiomyopathies and ischemic heart disease.
Published: 2022

49. The ANDANTE Project: A Worldwide Individual Data Meta-Analysis of the Effect of Sleep Apnea Treatment on Blood Pressure [El proyecto ANDANTE: un metanálisis a nivel mundial de datos individuales sobre el efecto del tratamiento de la apnea del sueño en la presión arterial]

Author: Pengo M. F., Steier J., Parati G., Ayas N. T., Barbe F., Barnes M., Campos-Rodriguez F., Cistulli P., Lloberes P., Craig S., Drager L. F., Duran-Cantolla J., Litvin and Evgeniya Elfimova A., Esra T., Giontella A., Fava C., Fuchs S. C., Fuchs F. D., Gagnadoux F., Garcia-Rio F., Javaheri and Daniel J Gottlieb S., Hong G. -R., Grunstein R. R., Hoyos C. M., Joyeux-Faure M., Liu P. Y., Lorenzi-Filho G., Ip M. S. M., Lui M. M. S., Martinez-Garcia M. A., McEvoy D., Mehra R., Monasterio C., McMillan A., Morrell M. J., Pamidi S., Pengo M., Bilo G., Lombardi C., Peker Y., Glos M., Penzel T., Pepin J. -L., Pepperell J. C. T., Phillips C. L., Quan S. F., Quinnell T., Salles G. F., Salord N., Sanchez-de-la-Torre M., Irene Schwarz E., Shaw J. E., Shukla G., Stradling J., Thunstrom E., Wang J. -G., Weaver T. E., Zambon A., Soranna D., Zambra G., Pengo, M, Steier, J, Parati, G, Ayas, N, Barbe, F, Barnes, M, Campos-Rodriguez, F, Cistulli, P, Lloberes, P, Craig, S, Drager, L, Duran-Cantolla, J, Litvin and Evgeniya Elfimova, A, Esra, T, Giontella, A, Fava, C, Fuchs, S, Fuchs, F, Gagnadoux, F, Garcia-Rio, F, Javaheri and Daniel J Gottlieb, S, Hong, G, Grunstein, R, Hoyos, C, Joyeux-Faure, M, Liu, P, Lorenzi-Filho, G, Ip, M, Lui, M, Martinez-Garcia, M, Mcevoy, D, Mehra, R, Monasterio, C, Mcmillan, A, Morrell, M, Pamidi, S, Bilo, G, Lombardi, C, Peker, Y, Glos, M, Penzel, T, Pepin, J, Pepperell, J, Phillips, C, Quan, S, Quinnell, T, Salles, G, Salord, N, Sanchez-de-la-Torre, M, Irene Schwarz, E, Shaw, J, Shukla, G, Stradling, J, Thunstrom, E, Wang, J, Weaver, T, Zambon, A, Soranna, D, and Zambra, G
Subjects: hypertension, blood pressure, sleep apnea
Published: 2021

50. Arthropathy in acromegaly: a questionnaire-based estimation of motor disability and its relation with quality of life and work productivity

Author: Fatti, L, Cangiano, B, Vitale, G, Persani, L, Mantovani, G, Sala, E, Arosio, M, Maffei, P, Dassie, F, Mormando, M, Giampietro, A, Tanda, L, Masiello, E, Nazzari, E, Ferone, D, Corbetta, S, Passeri, E, Guaraldi, F, Grottoli, S, Cannavo, S, Torre, M, Soranna, D, Zambon, A, Cavagnini, F, Scacchi, M, Fatti L. M., Cangiano B., Vitale G., Persani L., Mantovani G., Sala E., Arosio M., Maffei P., Dassie F., Mormando M., Giampietro A., Tanda L., Masiello E. R., Nazzari E., Ferone D., Corbetta S., Passeri E., Guaraldi F., Grottoli S., Cannavo S., Torre M. L. T., Soranna D., Zambon A., Cavagnini F., Scacchi M., Fatti, L, Cangiano, B, Vitale, G, Persani, L, Mantovani, G, Sala, E, Arosio, M, Maffei, P, Dassie, F, Mormando, M, Giampietro, A, Tanda, L, Masiello, E, Nazzari, E, Ferone, D, Corbetta, S, Passeri, E, Guaraldi, F, Grottoli, S, Cannavo, S, Torre, M, Soranna, D, Zambon, A, Cavagnini, F, Scacchi, M, Fatti L. M., Cangiano B., Vitale G., Persani L., Mantovani G., Sala E., Arosio M., Maffei P., Dassie F., Mormando M., Giampietro A., Tanda L., Masiello E. R., Nazzari E., Ferone D., Corbetta S., Passeri E., Guaraldi F., Grottoli S., Cannavo S., Torre M. L. T., Soranna D., Zambon A., Cavagnini F., and Scacchi M.
Abstract: Purpose: Arthropathy is a common and disabling complication of acromegaly. Since in this condition radiological findings rarely correspond to functional impairment, we elected to quantify in a large cohort of acromegalic patients: the degree of motor disability compared with data from general population, the impact of joint involvement on quality of life and work productivity, and to look for associated factors. Methods: In 211 acromegalic patients, 131 with controlled disease and 80 with active disease, eight validated scales were used to evaluate the (i) prevalence and distribution of arthropathy, (ii) degree of motor disability and joint symptoms (VAS, AIMS symptoms and WOMAC), (iii) quality of life (AcroQoL and PASQ) and work capability (WPAI:GH) as consequences of joint complications. Results: Using the WOMAC questionnaire, for which population based normative values are available, a significantly higher prevalence and severity of motor disability was detected in acromegalics compared to the general population from literature. The results provided by the different questionnaires turned out to be highly concordant. All measures of motor disability correlated both with impaired quality of life and motor disability and were worse in females and in patients with higher BMI. Conclusions: The questionnaires VAS, AIMS symptoms, and WOMAC (this latter both as a whole and with its functionality subscale), with their scores, proved to be the most adequate tools to evaluate motor disability and its consequences on both quality of life and work productivity in acromegaly. Female gender and higher BMI are associated with worse articular symptoms.
Published: 2019

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