Publications by authors named "Massimo Volpe"

564 Publications

Repurposing Cardio-Metabolic Drugs to Fight Covid19.

High Blood Press Cardiovasc Prev 2021 Sep 15. Epub 2021 Sep 15.

Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Via di Grottarossa 1035, 00189, Rome, Italy.

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http://dx.doi.org/10.1007/s40292-021-00475-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8441229PMC
September 2021

Trehalose, a natural disaccharide, reduces stroke occurrence in the stroke-prone spontaneously hypertensive rat.

Pharmacol Res 2021 Sep 6:105875. Epub 2021 Sep 6.

IRCCS Neuromed, Pozzilli, Italy; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. Electronic address:

Cerebrovascular disease, a frequent complication of hypertension, is a major public health issue for which novel therapeutic and preventive approaches are needed. Autophagy activation is emerging as a potential therapeutic and preventive strategy toward stroke. Among usual activators of autophagy, the natural disaccharide trehalose (TRE) has been reported to be beneficial in preclinical models of neurodegenerative diseases, atherosclerosis and myocardial infarction. In this study, we tested for the first time the effects of TRE in the stroke-prone spontaneously hypertensive rat (SHRSP) fed with a high-salt stroke permissive diet (JD). We found that TRE reduced stroke occurrence and renal damage in high salt-fed SHRSP. TRE was also able to decrease systolic blood pressure. Through ex-vivo studies, we assessed the beneficial effect of TRE on the vascular function of high salt-fed SHRSP. At the molecular level, TRE restored brain autophagy and reduced mitochondrial mass, along with the improvement of mitochondrial function. The beneficial effects of TRE were associated with increased nuclear translocation of TFEB, a transcriptional activator of autophagy. Our results suggest that TRE may be considered as a natural compound efficacious for the prevention of hypertension-related target organ damage, with particular regard to stroke and renal damage.
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http://dx.doi.org/10.1016/j.phrs.2021.105875DOI Listing
September 2021

Sacubitril/Valsartan as a Therapeutic Tool Across the Range of Heart Failure Phenotypes and Ejection Fraction Spectrum.

Front Physiol 2021 23;12:652163. Epub 2021 Aug 23.

Cardiology Unit, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

Heart failure (HF) is a complex syndrome caused by a variety of structural or functional cardiac abnormalities as a consequence of several involved pathophysiological pathways. In the last decades, left ventricular ejection fraction (LVEF) has represented the principal criterion used to stratify HF, to interpret ventricular function and to identify therapeutic strategies. However, this chimeric parameter oversimplifies the multiple pathways and mechanisms underlying the progression of HF. Indeed, HF should be more appropriately considered as the final stage of multiple disease states, characterized by distinct phenotypes on the basis of key clinical and molecular variables, such as underlying etiologies and conditions, demographic and structural features and specific biomarkers. Accordingly, HF should be viewed as a continuous spectrum in which the specific phenotypes need to be accurately identified with the aim to improve the disease management with a more tailored approach. In such a complex and heterogeneous scenario, the clinical benefits of an angiotensin receptor neprilysin inhibition strategy, namely in the single pill sacubitril/valsartan (S/V), have been shown across the entire HF continuum, representing a fundamental therapeutic strategy, although with different magnitudes depending on the severity and the stage of the clinical syndrome. In this viewpoint paper we have reconsidered the role of S/V in the light of different HF phenotypes and on the basis of HF considered as a whole spectrum.
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http://dx.doi.org/10.3389/fphys.2021.652163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419408PMC
August 2021

Novel Imaging and Genetic Risk Markers in Takotsubo Syndrome.

Front Cardiovasc Med 2021 17;8:703418. Epub 2021 Aug 17.

Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.

Takotsubo syndrome (TTS) is an increasingly recognized condition burdened by significant acute and long-term adverse events. The availability of novel techniques expanded the knowledge on TTS and allowed a more accurate risk-stratification, potentially guiding clinical management. The present review aims to summarize the recent advances in TTS prognostic evaluation with a specific focus on novel imaging and genetic markers. Parametric deformation analysis by speckle-tracking echocardiography, as well as tissue characterization by cardiac magnetic resonance imaging T1 and T2 mapping techniques, currently appear the most clinically valuable applications. Notwithstanding, computed tomography and nuclear imaging studies provided limited but promising data. A genetic predisposition to TTS has been hypothesized, though available evidence is still not sufficient. Although a genetic predisposition appears likely, further studies are needed to fully characterize the genetic background of TTS, in order to identify genetic markers that could assist in predicting disease recurrences and help in familial screening.
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http://dx.doi.org/10.3389/fcvm.2021.703418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8415918PMC
August 2021

Coronavirus disease 2019 in patients with cardiovascular disease: clinical features and implications on cardiac biomarkers assessment.

J Cardiovasc Med (Hagerstown) 2021 Sep 3. Epub 2021 Sep 3.

Covid-Cardiology Unit, Madre Giuseppina Vannini Hospital Internal Medicine Unit Cardiology Unit, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome Covid-Internal Medicine Unit, Madre Giuseppina Vannini Hospital Covid Unit, Heart Failure Unit, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.

Introduction: Previous cardiovascular disease (CVD) and myocardial involvement are common in coronavirus disease-19 (COVID-19). We investigated relationships between CVD, cardiac biomarkers and outcome in COVID-19.

Methods: We analyzed n = 252 patients from a multicenter study and provided comparison according to the presence or absence of underlying CVD. Cardiac biomarkers high-sensitivity Troponin [upper reference of normality (URN) 35 pg/ml for Troponin I and 14 pg/ml for Troponin T] and natriuretic peptides (Nt-pro-B-type natriuretic peptide, URN 300 pg/ml and B-type natriuretic peptide, URN 100 pg/ml) were both available in n = 136.

Results: Mean age was 69 ± 16 years (56% men, 31% with previous CVD). Raised hs-Troponin and natriuretic peptides were detected in 36 and 50% of the cases respectively. Age, chronic obstructive pulmonary disease, hemoglobin, hs-Troponin and natriuretic peptides were independently associated with underlying CVD (P < 0.05 for all). Compared with the normal biomarkers subgroups, patients with isolated hs-Troponin elevation had higher in-hospital mortality (31 vs. 4%, P < 0.05), similar CVD prevalence (15 vs. 11%) and trend towards higher D-dimer (930 vs. 397 ng/ml, P = 0.140). Patients with both biomarkers elevated had higher age, D-dimer, CVD and in-hospital mortality prevalence compared with other subgroups (all P < 0.05 for trend). Outcome analysis revealed previous CVD [model 1: OR 2.72 (95% CI 1.14-6.49), P = 0.024. model 2: OR 2.65 (95% CI 1.05-6.71), P = 0.039], hs-Troponin (log10) [OR 2.61 (95% CI 1.21-5.66), P = 0.015] and natriuretic peptides (log10) [OR 5.84 (95%CI 2.43-14), P < 0.001] to be independently associated with in-hospital mortality.

Conclusion: In our population, previous CVD was part of a vulnerable phenotype including older age, comorbidities, increased cardiac biomarkers and worse prognosis. Patients with isolated increase in hs-Troponin suffered higher mortality rates despite low prevalence of CVD, possibly explained by higher COVID-19-related systemic involvement.
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http://dx.doi.org/10.2459/JCM.0000000000001252DOI Listing
September 2021

A 'Once-and-Done' Approach to the Lifelong Reduction of Elevated Cholesterol.

Eur Heart J 2021 Aug 25. Epub 2021 Aug 25.

Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab478DOI Listing
August 2021

Hypertension Management and Control in Italy: A Real-World Survey in Elderly Patients.

High Blood Press Cardiovasc Prev 2021 Aug 23. Epub 2021 Aug 23.

Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy.

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http://dx.doi.org/10.1007/s40292-021-00471-9DOI Listing
August 2021

Sacubitril/valsartan for heart failure with preserved ejection fraction and resistant hypertension: one shot for a double strike?

Eur Heart J 2021 Sep;42(36):3753-3755

Cardiology Unit, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab489DOI Listing
September 2021

A newly designed glucagon-like peptide-1 receptor agonist reduces cardiovascular and renal events in high-risk type 2 diabetes.

Eur Heart J 2021 Aug 6. Epub 2021 Aug 6.

Department of Pharmacology, Catholic University School of Medicine, Largo Francesco Vito 1, Rome 00168, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab550DOI Listing
August 2021

Exploring RNA biomarkers in patients with acute myocarditis.

Eur Heart J 2021 Sep;42(35):3425-3426

Cardiology Department, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab435DOI Listing
September 2021

A Contemporary View of Natriuretic Peptides in the SARS-CoV-2 Era.

Front Physiol 2021 16;12:643721. Epub 2021 Jul 16.

Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

The heart releases natriuretic peptides (NPs) which represent an important hormonal axis with cardiorenal protective effects. In view of their properties, NPs have pathophysiologic, diagnostic and prognostic implications in several cardiovascular diseases (CVDs). Severe pulmonary inflammation, as induced by the SARS-COV2, may increase pulmonary pressure with potential influence on NPs release, whereby normal cardiovascular integrity becomes impaired. Moreover, pre-existing CVDs are strong negative prognostic factors since they exacerbate the effects of the viral infection and lead to worse outcomes. In this context, it may be expected that NPs exert a key protective role toward the virus infection whereas an impairment of NPs release contributes to the virus deleterious effects. In this review article we explore the potential involvement of NPs in the COVID-19 disease. To this aim, we will first focus on the interactions between NPs and the Ang II/ATIR arm of the renin-angiotensin-aldosterone system (RAAS) as well as with the protective ACE2/Ang (1-7) arm of the RAAS. Subsequently, we will review evidence that strongly supports the role of increased NT-proBNP level as a marker of cardiac damage and of worse prognosis in the COVID-19 affected patients. Finally, we will discuss the potential therapeutic benefits of these protective hormones toward the viral infection through their endothelial protective function, anti-inflammatory and anti-thrombotic effects. In conclusion, the potential implications of NPs in the SARS-CoV-2 infection, as discussed in our article, represent an important issue that deserves to be fully investigated.
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http://dx.doi.org/10.3389/fphys.2021.643721DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322647PMC
July 2021

The key role of blood pressure lowering in cardiovascular prevention irrespective of baseline blood pressure and risk profile.

Eur Heart J 2021 07;42(29):2814-2815

Department of Pharmacology, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab320DOI Listing
July 2021

Worsening of risk factor control in US diabetic patients: a call to action.

Eur Heart J 2021 Aug;42(33):3120-3121

Department of Pharmacology, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab501DOI Listing
August 2021

May Measurement Month 2019: an analysis of blood pressure screening results from Italy.

Eur Heart J Suppl 2021 May 20;23(Suppl B):B77-B81. Epub 2021 May 20.

Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan 20149, Italy.

Cardiovascular (CV) diseases are burdened by high mortality and morbidity, being responsible for half of the deaths in Europe. Although hypertension is recognized as the most important CV risk factor, hypertension awareness, and blood pressure (BP) control are still unsatisfactory. In 2017 and 2018, respectively >10 000 and >5000 individuals took part in the May Measurement Month (MMM) campaign in Italy, of whom 30.6% and 26.3% were found to have high BP, respectively. To raise public awareness on the importance of hypertension and to collect BP data on a nation-wide scale in Italy. In the frame of the MMM campaign, an opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2019. BP measurement, the definition of hypertension, and statistical analysis followed the standard MMM protocol. Screening was conducted in multiple sites by health personnel. Among the 10 182 people screened (females: 52.3%, mean age 58 ± 16years) mean BP was 127/78 mmHg, and 3171 (31.1%) participants had arterial hypertension, of whom 62.1% were aware of being hypertensive. Diabetes, body mass index >25 kg/m were associated with higher BP and previous myocardial infarction with lower BP. For the third consecutive year we collected a nation-wide snapshot of BP control in a large sample of individuals. The high participation, with some yearly fluctuations likely due to the limitations of the sampling technique, confirms the power of this kind of health campaign in reaching a significant number of people to raise awareness on health topics.
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http://dx.doi.org/10.1093/eurheartj/suab054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8263076PMC
May 2021

Glycoprotein IIb/IIIa Inhibitors May Modulate the Clinical Benefit of Radial Access as Compared to Femoral Access in Primary Percutaneous Coronary Intervention: A Meta-Regression and Meta-Analysis of Randomized Trials.

J Interv Cardiol 2021 15;2021:9917407. Epub 2021 Jun 15.

Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy.

Objectives: Several randomized controlled trials (RCTs) consistently reported better clinical outcomes with radial as compared to femoral access for primary percutaneous coronary intervention (PCI). Nevertheless, heterogeneous use of potent antiplatelet drugs, such as Gp IIb/IIIa inhibitors (GPI), across different studies could have biased the results in favor of radial access. We performed an updated meta-analysis and meta-regression of RCTs in order to appraise whether the use of GPI had an impact on pooled estimates of clinical outcomes according to vascular access.

Methods: We computed pooled estimates by the random-effects model for the following outcomes: mortality, major adverse cardiovascular events (death, myocardial infarction, stroke, and target vessel revascularization), and major bleedings. Additionally, we performed meta-regression analysis to investigate the impact of GPI use on pooled estimates of clinical outcomes.

Results: We analyzed 14 randomized controlled trials and 11090 patients who were treated by radial (5497) and femoral access (5593), respectively. Radial access was associated with better outcomes for mortality (risk difference 0.01 (0.00, 0.01), =0.03), MACE (risk difference 0.01 (0.00, 0.02), =0.003), and major bleedings (risk difference 0.01 (0.00, 0.02), =0.02). At meta-regression, we observed a significant correlation of mortality with both GPI use (=0.011) and year of publication (=0.0073), whereas no correlation was observed with major bleedings.

Conclusions: In this meta-analysis, the use of radial access for primary PCI was associated with better clinical outcomes as compared to femoral access. However, the effect size on mortality was modulated by GPI rate, with greater benefit of radial access in studies with larger use of these drugs.
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http://dx.doi.org/10.1155/2021/9917407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221896PMC
July 2021

A SPRINT towards tighter control of blood pressure in hypertension.

Eur Heart J 2021 Aug;42(32):3042-3043

Department of Pharmacology, Catholic University School of Medicine, Via di Grottarossa 1035-1039, 00189, Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab400DOI Listing
August 2021

The increased mortality of STEMI patients without risk factors supports the need for evidence-based pharmacotherapy irrespective of perceived low risk.

Eur Heart J 2021 06;42(24):2329-2330

Department of Pharmacology, Catholic University School of Medicine, Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab268DOI Listing
June 2021

Role of induced pluripotent stem cells in diagnostic cardiology.

World J Stem Cells 2021 May;13(5):331-341

Division of Cardiology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, St. Andrea Hospital, Via di Grottarossa, 1035, 00189 Rome, Italy.

Ethical concerns about stem cell-based research have delayed important advances in many areas of medicine, including cardiology. The introduction of induced pluripotent stem cells (iPSCs) has supplanted the need to use human stem cells for most purposes, thus eliminating all ethical controversies. Since then, many new avenues have been opened in cardiology research, not only in approaches to tissue replacement but also in the design and testing of antiarrhythmic drugs. This methodology has advanced to the point where induced human cardiomyocyte cell lines can now also be obtained from commercial sources or tissue banks. Initial studies with readily available iPSCs have generally confirmed that their behavioral characteristics accurately predict the behavior of beating cardiomyocytes . As a result, iPSCs can provide new ways to study arrhythmias and heart disease in general, accelerating the development of new, more effective antiarrhythmic drugs, clinical diagnoses, and personalized medical care. The focus on producing cardiomyocytes that can be used to replace damaged heart tissue has somewhat diverted interest in a host of other applications. This manuscript is intended to provide non-specialists with a brief introduction and overview of the research carried out in the field of heart rhythm disorders.
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http://dx.doi.org/10.4252/wjsc.v13.i5.331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176845PMC
May 2021

Glycaemicindex: an emergent global silent killer for the heart.

Eur Heart J 2021 07;42(28):2727-2728

Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab308DOI Listing
July 2021

Unhealthy lifestyles mediate only a small proportion of the socioeconomic inequalities' impact on cardiovascular outcomes in US and UK adults: a call for action for social cardiology.

Eur Heart J 2021 07;42(25):2420-2421

Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant 'Andrea Hospital, Via di Grottarossa, Rome 1035-1039, 00189, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab287DOI Listing
July 2021

Preexisting Oral Anticoagulant Therapy Ameliorates Prognosis in Hospitalized COVID-19 Patients.

Front Cardiovasc Med 2021 13;8:633878. Epub 2021 May 13.

Department of Clinical Medicine, Public Health, Life and Environment Sciences, University of L'Aquila, L'Aquila, Italy.

Altered coagulation parameters in COVID-19 patients is associated with a poor prognosis. We tested whether COVID-19 patients on chronic oral anticoagulants (cOACs) for thromboembolism prophylaxis could receive protection from developing more severe phenotypes of the disease. We searched the database of the SARS-RAS study (Clinicaltrials.gov: NCT04331574), a cross-sectional observational multicenter nationwide survey in Italy designed by the Italian Society of Hypertension. The database counts 2,377 charts of Italian COVID-19 patients in 26 hospitals. We calculated the Charlson comorbidity index (CCI), which is associated with death in COVID-19 patients. In our population ( = 2,377, age 68.2 ± 0.4 years, CCI: 3.04 ± 0.04), we confirm that CCI is associated with increased mortality [OR: 1.756 (1.628-1.894)], admission to intensive care units [ICU; OR: 1.074 (1.017-1.134)], and combined hard events [CHE; OR: 1.277 (1.215-1.342)]. One hundred twenty-five patients were on cOACs (age: 79.3 ± 0.9 years, CCI: 4.35 ± 0.13); despite the higher CCI, cOACs patients presented with a lower risk of admissions to the ICU [OR 0.469 (0.250-0.880)] but not of death [OR: 1.306 (0.78-2.188)] or CHE [OR: 0.843 (0.541-1.312)]. In multivariable logistic regression, cOACs confirmed their protective effect on ICU admission and CHE. The CCI remains the most important risk factor for ICU admission, death, and CHE. Our data support a mechanism for the continuation of cOAC therapy after hospital admission for those patients who are on chronic treatment. Our preliminary results suggest the prophylactic use of direct cOACs in patients with elevated CCI score at the time of the COVID-19 pandemic even in absence of other risks of thromboembolism.
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http://dx.doi.org/10.3389/fcvm.2021.633878DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155285PMC
May 2021

Vulnerable non-culprit coronary plaques: are they worth treating?

Eur Heart J 2021 06;42(23):2233-2234

Department of Pharmacology, Catholic University School of Medicine, Rome, Italy and Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.

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http://dx.doi.org/10.1093/eurheartj/ehab232DOI Listing
June 2021

A Plea for Smoking-Free Policies in COVID-19 Times: Cardiovascular Prevention as an Ally in Coronavirus Containment.

High Blood Press Cardiovasc Prev 2021 May 26;28(3):325-326. Epub 2021 Apr 26.

Cardiology, Clinical and Molecular Medicine Department, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035-1038, 00189, Rome, Italy.

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http://dx.doi.org/10.1007/s40292-021-00447-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072317PMC
May 2021

Cryoblation as first-line treatment of new-onset atrial fibrillation?

Eur Heart J 2021 04;42(16):1543-1544

Sapienza University of Rome, Sant, Andrea Hospital, Rome, Italy.

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http://dx.doi.org/10.1093/eurheartj/ehab161DOI Listing
April 2021

Hypertension, a Moving Target in COVID-19: Current Views and Perspectives.

Circ Res 2021 04 1;128(7):1062-1079. Epub 2021 Apr 1.

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie (R.K.).

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associates with a considerable high rate of mortality and represents currently the most important concern in global health. The risk of more severe clinical manifestation of COVID-19 is higher in males and steeply raised with age but also increased by the presence of chronic comorbidities. Among the latter, early reports suggested that arterial hypertension associates with higher susceptibility to SARS-CoV-2 infection, more severe course and increased COVID-19-related deaths. Furthermore, experimental studies suggested that key pathophysiological hypertension mechanisms, such as activation of the renin-angiotensin system (RAS), may play a role in COVID-19. In fact, ACE2 (angiotensin-converting-enzyme 2) is the pivotal receptor for SARS-CoV-2 to enter host cells and provides thus a link between COVID-19 and RAS. It was thus anticipated that drugs modulating the RAS including an upregulation of ACE2 may increase the risk for infection with SARS-CoV-2 and poorer outcomes in COVID-19. Since the use of RAS-blockers, ACE inhibitors or angiotensin receptor blockers, represents the backbone of recommended antihypertensive therapy and intense debate about their use in the COVID-19 pandemic has developed. Currently, a direct role of hypertension, independent of age and other comorbidities, as a risk factor for the SARS-COV-2 infection and COVID-19 outcome, particularly death, has not been established. Similarly, both current experimental and clinical studies do not support an unfavorable effect of RAS-blockers or other classes of first line blood pressure lowering drugs in COVID-19. Here, we review available data on the role of hypertension and its management on COVID-19. Conversely, some aspects as to how the COVID-19 affects hypertension management and impacts on future developments are also briefly discussed. COVID-19 has and continues to proof the critical importance of hypertension research to address questions that are important for global health.
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http://dx.doi.org/10.1161/CIRCRESAHA.121.318054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011346PMC
April 2021

Circulating NT-proANP level is a predictor of mortality for systemic sclerosis: a retrospective study of an Italian cohort.

Expert Rev Clin Immunol 2021 Jun 8;17(6):661-666. Epub 2021 Apr 8.

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

: The authors aimed to evaluate the role of N-terminal proANP (NT-proANP) and of NT-proBNP circulating levels as predictive markers of death due to systemic sclerosis (SSc).: The authors retrospectively enrolled 51 SSc patients. At baseline, NT-proBNP and NT-proANP circulating levels and clinical features were collected. Date and causes of death were extracted during a 6-year follow-up.: 13 SSc patients (23.2%) died for SSc complications (9 for interstitial lung disease and 4 for pulmonary arterial hypertension). The median NT-proBNP plasma level did not significantly differ (p > 0.05) in SSc patients died or alive [645 (448-1026) fmol/ml vs 592 (409-789) fmol/ml]. The median NT-proANP plasma level was significantly (p < 0.01) higher in SSc died than in SSc patients alive [4000 (2100-6722) fmol/ml vs 1640 (1381-2721) fmol/ml]. The Kaplan-Meier analysis revealed that SSc patients with increased NT-proANP level had increased mortality (p < 0.05). In the multivariate analysis, DLco [HR 0.966 (0.934-0.999), p < 0.05] and NT-proANP level [HR 1 (1-1), p < 0.05] were predictive markers of death due to SSc.: NT-proANP plasma level is a predictive marker of death due to SSc.
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http://dx.doi.org/10.1080/1744666X.2021.1908888DOI Listing
June 2021

Usefulness of the corporate wellness projects in primary prevention at the population level: a study on the prevalence, awareness, and control of hypertension in the Ferrari company.

J Hum Hypertens 2021 Mar 23. Epub 2021 Mar 23.

Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.

The aim of our study was to evaluate the prevalence, awareness, and control of hypertension in an apparently healthy company population. We conducted a cross-sectional study on a total sample of 2058 individuals with a mean age of 38 ± 9 years, enrolled for the first time to the Ferrari corporate wellness program "Formula Benessere". Hypertension was defined as systolic blood pressure (SBP) level ≥140 mmHg or diastolic BP (DBP) ≥90 mmHg or use of antihypertensive medication, whereas BP control was defined as BP level <130/80 mmHg. All 2058 participants were divided into three groups based on age: Group 1 aged <40 years (n = 1177, 57%), Group 2 aged 40-50 years (n = 627, 30%), and Group 3 aged >50 years (n = 254, 13%). Four-hundred and one subjects had BP levels ≥130/80 mmHg (19.5%). Two-hundred and sixty-one individuals (12.7%) had high-normal BP values and 140 subjects had rest SBP ≥140 mmHg and/or DBP ≥90 mmHg (6,8%), of which 41 (29.3%) with grade 2 hypertension. In the overall population, 259 individuals (12.5%) were affected by hypertension, the prevalence increasing with age. Only a minority (51%) was aware of being hypertensive and already treated with antihypertensive medications (45.9%). An adequate BP control was achieved in only 57% of subjects who received BP-lowering therapy. Corporate wellness programs may represent an essential tool in identifying apparently healthy subjects with an inadequate control of cardiovascular (CV) risk factors, such as hypertension. These preventive programs in the workplace may help to improve and spread primary CV prevention at the population level.
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http://dx.doi.org/10.1038/s41371-021-00528-1DOI Listing
March 2021

Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project.

J Nephrol 2021 Mar 23. Epub 2021 Mar 23.

Department of Medicine, University of Padua, Padua, Italy.

Background: Hyperuricemia is commonly observed in patients with chronic kidney disease (CKD). However, a better understanding of the relationship among uric acid (UA) values, glomerular filtration rate (GFR) and albuminuria may shed light on the mechanisms underlying the excess of cardiovascular mortality associated with both chronic kidney disease and hyperuricemia and lead to better risk stratification. Our main goal was to study the relationships between serum uric acid and kidney disease measures (namely estimated GFR [eGFR] and albuminuria) in a large cohort of individuals at cardiovascular risk from the URic acid Right for heArt Health (URRAH) Project database.

Methods: Clinical data of 26,971 individuals were analyzed. Factors associated with the presence of hyperuricemia defined on the basis of previously determined URRAH cutoffs for cardiovascular and all-cause mortality were evaluated through multivariate analysis. Chronic kidney disease was defined as eGFR < 60 ml/min per 1.73 m and/or abnormal urinary albumin excretion diagnosed as: (i) microalbuminuria if urinary albumin concentration was > 30 and ≤ 300 mg/L, or if urinary albumin-to-creatinine ratio (ACR) was > 3.4 mg/mmol and ≤ 34 mg/mmol; (ii) macroalbuminuria if urinary albumin concentration was > 300 mg/L, or if ACR was > 34 mg/mmol.

Results: Mean age was 58 ± 15 years (51% males, 62% with hypertension and 12% with diabetes), mean eGFR was 81 ml/min per 1.73m2with a prevalence of eGFR < 60 and micro- or macroalbuminuria of 16, 15 and 4%, respectively. Serum uric acid showed a trend towards higher values along with decreasing renal function. Both the prevalence of gout and the frequency of allopurinol use increased significantly with the reduction of eGFR and the increase in albuminuria. Hyperuricemia was independently related to male gender, eGFR strata, and signs of insulin resistance such as body mass index (BMI) and triglycerides.

Conclusions: The lower the eGFR the higher the prevalence of hyperuricemia and gout. In subjects with eGFR < 60 ml/min the occurrence of hyperuricemia is about 10 times higher than in those with eGFR > 90 ml/min. The percentage of individuals treated with allopurinol was below 2% when GFR was above 60 ml/min, it increased to 20% in the presence of CKD 3b and rose further to 35% in individuals with macroalbuminuria.
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http://dx.doi.org/10.1007/s40620-021-00985-4DOI Listing
March 2021
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