12,628 research outputs found
Effect of zofenopril and ramipril on cardiovascular mortality in patients with chronic heart failure.
No full textA head-to-head evaluation of the effect of ramipril and zofenopril on the cardiovascular mortality rate of patients with chronic heart failure (HF) in the setting of clinical practice is not yet available. We prospectively enrolled 224 patients with all-cause HF, who were untreated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. These patients were then assigned to zofenopril 15 to 30 mg/day or ramipril 5 to 10 mg/day on the basis of a prospective, randomized, open, blinded, end point trial. The primary outcome of the trial was patient survival during the follow-up period. The groups were similar in a large number of clinical parameters. The mean follow-up of this cohort was 6.1 ± 1.2 years. Overall, during the follow-up period, we observed 45 deaths in the zofenopril-treated group and 48 in the ramipril-treated group (p = 0.251). Zofenopril and ramipril appears to be equivalent regarding the effects on cardiovascular mortality in the entire sample. Zofenopril was a significant predictor of better survival in patients who were the median age or older (odds ratio 0.56, 95% confidence interval 0.35 to 0.91), in men (odds ratio 0.57, 95% confidence interval 0.30 to 0.98), and in patients with a lower ejection fraction (odds ratio 0.52, 95% confidence interval 0.26 to 0.97). In conclusion, in the clinical practice setting, ramipril and zofenopril seem to have similar effects on cardiovascular mortality. However zofenopril might be more efficacious in elderly patients, male patients, and patients with a lower ejection fraction
CORRELATION BETWEEN SERUM URIC ACID AND LEFT VENTRICULAR MASS IN ESSENTIAL HYPERTENSION
No full textDownload PDFPDF
Poster Presentations
Bone diseases other than osteoporosis, metabolic diseases and crystal diseases
SAT0317 Correlation Between Serum Uric Acid and Left Ventricular Mass in Essential Hypertension
E.R. Rinaldi, C. Bentivenga, E. Cosentino, S. Corvaglia, M. Rosticci, L. Magnani, I. Ricci Iamino, A.F. Cicero, N. Malavolta, C. Borghi
Abstract
Background Left ventricular hypertrophy (LVH) is an independent and powerful risk factor for cardiovascular events and death. Serum uric acid (SUA) may induce LVH, on one hand, through an inflammatory effect which promotes cardiac hypertrophy and, on the other, through an activation of the renin-angiotensin-aldosterone system which generates hypertrophy and hyperplasia of myocytes and fibrosis of the heart
Objectives Aim of the study was to investigate the correlation between SUA levels and left ventricular mass in a group of hypertensive patients
Methods We evaluated 51 patients (mean age 74±10 years; range 49-87, F 37.7%; M 62.3%) with essential hypertension. Each patient underwent a standardized medical history and clinical examination, laboratory tests and echocardiographic assessment with the determination of left ventricular mass index (LVMI)
Results Mean value of SUA was 6.68±2 mg/dl. Mean blood pressure (MAP) was 95±12 mmHg. A positive significant correlation between SUA and LVMI (P=0.029) was observed. After adjusting for MAP and age in standard multiple linear regression analysis, SUA level remains independently associated with LVMI suggesting that increased urate levels are associated with a higher myocardial mass.
Conclusions Our results demonstrate that SUA is independently associated with LVMI and suggest that the combination of hyperuricemia with LVH could be a powerful predictor of cardiovascular event
The maintenance of anthelmintic efficacy in sheep in a Mediterranean climate.
No full textTo determine how far management practices on small ruminant dairy flocks in southern Italy have influenced the development of anthelmintic resistance (AR), faecal egg count (FEC) reduction tests were run on 54 sheep farms using the FLOTAC technique with a sensitivity of 2 eggs per gram of faeces. Tests were run on groups of sheep (12-20 animals per group) using six anthelmintics administered orally: levamisole on 8 farms, ivermectin (half and full dose) on 8 farms, moxidectin on 3 farms, monepantel on 8 farms, netobimin on 22 farms (pooled samples) and albendazole on 5 farms (pooled samples). Different formulae and statistics were used to calculate FEC reductions and confidence intervals based on the presence of a control group and/or the use of pooled samples. A very high average efficacy was obtained with all anthelmintics tested as follows: levamisole 99.3% (range across farms 98-100%), ivermectin half dose 99.5% (98.0-100%), ivermectin full dose 99.9% (99.3-100%), moxidectin 100% (99.9-100%), monepantel 99.4% (97-100%), netobimin 99.1% (92-100%) and albendazole 100%. The results suggest that the development of AR in small ruminants could be limited in countries with a Mediterranean type of climate provided that refugia of the nematode populations are maintained, anthelmintic use is restricted and movement of animals is not permitted to spread resistance
The formation and function of ER-endosome membrane contact sites
No full textRecent advances in membrane contact site (MCS) biology have revealed key roles for MCSs in inter-organellar exchange, the importance of which is becoming increasingly apparent. Roles for MCSs in many essential physiological processes including lipid transfer, calcium exchange, receptor tyrosine kinase signalling, lipid droplet formation, autophagosome formation, organelle dynamics and neurite outgrowth have been reported. The ER forms an extensive and dynamic network of MCSs with a diverse range of functionally distinct organelles. MCSs between the ER and endocytic pathway are particularly abundant, suggesting important physiological roles. Here, our current knowledge of the formation and function of ER contact sites with endocytic organelles from studies in mammalian systems is reviewed. Their relatively poorly defined molecular composition and recently identified functions are discussed. In addition, likely, but yet to be established, roles for these contacts in lipid transfer and calcium signalling are considered. This article is part of a Special Issue entitled: The cellular lipid landscape edited by Tim Levine and Anant K. Menon
Uricaemia and ejection fraction in elderly heart failure outpatients.
No full textBACKGROUND:
Preliminary data suggest that serum uric acid (SUA) could be involved in the prognosis of chronic heart failure (HF). The aim of our study was to test the relationship between SUA and left ventricular ejection fraction (EF%) in a cohort of elderly hypertensive outpatients with chronic HF.
DESIGN:
We consecutively enrolled 487 elderly outpatients (M = 59·8%; F = 40·2%; mean age: 72 ± 11 years old) affected by mild-to-moderate hypertensive and/or ischaemic HF, evaluating the relationship between SUA and EF%.
RESULTS:
In an univariate analysis, SUA was inversely related with EF%: B = -4·392, 95% CI -5·427 to -3·357, P < 0·001. After adjustment for a large number of variables in a multivariate analysis, the value of EF% was best predicted by SUA (B = -3·005, 95% CI -4·386 to -1·623, P < 0·001), log brain natriuretic peptide (BNP: B = -2·341, 95% CI -3·137 to -1·248, P < 0·001) and mean arterial pressure (MAP: B = 0·241, 95% CI 0·047 to 0·435, P = 0·015). A separate analysis by estimated glomerular filtration rate (eGFR) levels confirmed the inverse relationship between SUA and EF% in patients with normal renal function. A separate analysis by sex confirmed that SUA and log BNP were significant strong predictors of EF% in men, but not in women where the best predictors were log BNP, MAP and body mass index. The predicting role of SUA was apparently independent of eGFR and use of diuretics.
CONCLUSION:
Serum uric acid seems to be inversely related to EF% in male elderly patients with HF after adjustment for the several confounding factors. This observation supports a primary negative effect of SUA on left ventricular function that warrants further investigation
IMPACT OF AGEING AND CARDIOVASCULAR RISK FACTORS ON VENTRICULAR REPOLARIZATION STUDIED WITH STANDARD ECG
No full textObjective:
Clinical and experimental studies have shown that electrical and structural remodeling of left ventricle is associated with an increase of QT dispersion values (QTd) and that this index might provide prognostic informations. However the real value of QTd is hampered by an high inter observer and intra observer variability, and the impact of aging that by itself significantly increases QTd. Recently, new indexes of temporal dispersion of QT interval like QTVI (QT variability index) and STV (short term variability) have therefore been developed.
The aim of this study was to evaluate QTd, QTVI and STV in elderly patients.
Design and method:
Only patients aged over eighty were enrolled in the study; patients without sinus rhythm, with previous myocardial infarction or known coronary artery disease, with electrolyte abnormalities or taking drugs known to modify the QT interval were excluded. QTd was calculated from standard good quality ECG while QTVI and STV were calculated from a longer ECG registration. For each patient we evaluated the presence/absence of traditional cardiovascular risk factors.
Results:
The study enrolled 40 individuals (20 men and 20 women aged between 80 and 103 years - medium age 86,3). Based on clinical history, 26 were affected by arterial hypertension, 7 by diabetes mellitus and, after accounting for other common cardiovascular risk factors like smoking or dyslipidemia, 5 subjects could be classified at high risk (3 or more risk factors), 28 at medium risk (1–2 risk factors), and 7 at low risk (0 risk factors). The mean QT dispersion value resulted respectively 80 ms, 69,2 ms and 40 ms in the three groups, and was higher in patients with arterial hypertension (74,6 ms) than in normotensive subjects (48,6 ms). Similar differences were identified also with the other indexes.
Conclusions:
The study shows that even in very old subjects, and therefore beyond the known effects of age, changes in ventricular repolarization studied both with QTd index and with new indexes of temporal variability like QTVI and STV reflect the cardiovascular risk profile of the patients
Gedragsinzichten bieden meer beleidskansen dan er nu worden benut
No full textGedragsinzichten zijn onontbeerlijk om te komen tot effectief beleid, de mens is immers geen homo economicus. Dat geldt echter niet alleen voor uitvoeringsvraagstukken, maar ook voor het ontwerpen van beleid. Hier ligt er nog een groot onbenut potentieel.Policy Analysi
- …
