ASSOCIAZIONE TRA INDICE DI RESISTENZA INTRARENALE E STIFFNESS AORTICA IN SOGGETTI CON MALATTIA RENALE CRONICA

RAZIONALE. L’indice di resistenza intraparenchimale renale (IR), valutato mediante eco-color-Doppler, è stato classicamente utilizzato quale valido strumento di valutazione diagnostica e prognostica delle patologie renali. Studi recenti suggeriscono che i parametri emodinamici intrarenali, e l’IR in particolare, possano essere anche associati ad alterazioni vascolari sistemiche, nonché ad un incremento del rischio cardiovascolare. Tuttavia, dati contrastanti esistono in letteratura circa l'associazione indipendente tra IR e pulse wave velocity aortica (PWVa), indice di stiffness arteriosa, nonché espressione di danno d'organo subclinico. Scopo di questo studio è stato dunque quello di valut…

RELATIONSHIPS BETWEEN SHORT-TERM BLOOD PRESSURE VARIABILITY AND EARLY RENAL DYSFUNCTION IN ESSENTIAL HYPERTENSIVE PATIENTS

PREVALENZA DI IPERTROFIA VENTRICOLARE SINISTRA NELL’IPERTENSIONE ARTERIOSA: RIVALUTAZIONE CON I NUOVI CUT-OFF

Nelle linee guida 2013 ESH/ESC per il trattamento dell’ipertensione arteriosa si consiglia di utilizzare come cut-off per l’ipertrofia ventricolare sinistra (LVH) valutata con ecocardiografia, 95 g/m2 per il sesso femminile e 110 g/m2 per il sesso maschile e spessore parietale relativo (RWT) 0,42 per differenziare la forma concentrica dalla forma eccentrica. Tali cut-off sono diversi da quelli suggeriti nella versione precedente delle linee guida (110 g/m2 per il sesso femminile, 125 g/m2 per il sesso maschile e 0.45 per RWT). Scopo del presente studio è di valutare se tale variazione abbia determinato variazioni di rilievo nella valutazione della prevalenza di LVH nei pazienti ipertesi. A …

Correlations between non ivasive renal index and markers of atherosclerosis in lupus patients

Recent data suggest that renal hemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes in some groups of patients. However, conflicting data exist about the relationship between aortic stiffness and RI in autoimmune disease, like systemic lupus erythematosus, characterized by high and early incidence of atherosclerotic disease. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), and carotid atherosclerosis, evaluated by intimal medial thickness measurement (IMT) in patients with SLE. DESIGN: Cross-sectiona…

SHORT-TERM VARIABILITY OF 24-H SYSTOLIC BLOOD PRESSURE IS ASSOCIATED WITH MICROALBUMINURIA IN PATIENTS WITH PRIMARY HYPERTENSION

Introduction: Limited and conflicting data are available about the association between short-term blood pressure (BP) variability and urinary albumin excretion rate (uAER). Aim: To analyse the relationships between microalbuminuria, defined as an uAER between 20 and 200 lg/min, and short-term BP variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24-h BP, and as SD of daytime and nighttime BP. Methods: The study population consisted of 316 untreated essential hypertensive patients with normal estimated glomerular filtration rate ([60 ml/min/1.73m2), which underwent 24-h ambulatory BP monitoring and 24-h uAER determination. Results: Microalbuminuria w…

EARLY VASCULAR AGEING IN NORMOTENSIVE SUBJECTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. COMPARISON WITH YOUNG HYPERTENSIVE PATIENTS

Objective: Aortic pulse wave velocity (aPWV), is one of the most important markers of vascular aging. It is well known that connective tissue diseases are associated with accelerated atherosclerosis, but only a few data are available about aPWV in patients with systemic lupus erythematosus (SLE). The aim of this study was to evaluate early vascular aging, assessed by measuring aPWV, in a group of normotensive patients with SLE and to compare these subjects with a group of young essential hypertensive (EH) individuals Design and method: Crosssectional study. We have enrolled 39 normotensive SLE subjects (mean age: 38.7±8.3 years) matched for age with a group of essential hypertensive patient…

FATTORI ASSOCIATI ALLA DISCORDANZA TRA ALTERAZIONI DELLA PULSE WAVE VELOCITY AORTICA E AUMENTO DELLO SPESSORE MIO-INTIMALE CAROTIDEO IN SOGGETTI IPERTESI: DATI PRELIMINARI

Numerosi studi hanno dimostrato come lo spessore mio-intimale carotideo (IMTc), valutato mediante eco-color-Doppler, sia un importante marcatore di danno d’organo subclinico nonché espressione di alterazione vascolare sistemica. Recenti dati, d’altro canto, hanno evidenziato come anche la pulse wave velocity aortica (PWVa), nota misura di stiffness arteriosa, sia indice di precoce danno vasale. Pur dipendendo parzialmente da comuni fattori patogenetici, IMTc e PWVa non hanno un significato clinico del tutto sovrapponibile e risultano non raramente discordanti tra loro. Appare pertanto interessante identificare quali siano i fattori associati al divergente comportamento di tali parametri. So…

SHORT-TERM VARIABILITY OF 24H SYSTOLIC BLOOD PRESSURE IS ASSOCIATED WITH MICROALBUMINURIA IN PATIENTS WITH PRIMARY HYPERTENSION

Objective: Limited and conflicting data are available about the association between shortterm blood pressure (BP) variability and urinary albumin excretion rate (uAER). The objective of our study was to analyze the relationships between microalbuminuria, defined as an uAER between 20 and 200mg/ min, and shortterm BP variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24h BP, and as SD of daytime and nighttime BP. Design and method: The study population consisted of 315 untreated essential hypertensives with normal estimated glomerular filtration rate (> 60ml/min/1.73 m2), which underwent 24h ambulatory BP monitoring and 24h uAER determination. Result…

INVERSE RELATIONSHIPS BETWEEN CHOROIDAL THICKNESS AND RENAL RESISTANCE INDEX IN HYPERTENSIVE PATIENTS

Introduction: Alterations of the renal microcirculation have been documented in animal models of hypertensive renal damage. Traditionally, the retina has been considered the easiest accessible window to study the systemic microcirculation, even though the choroid is the most important vascular layer of the eye. The introduction in the past few years of advanced optical coherence tomography (OCT) techniques has greatly increased our understanding of the choroid. Although the renal resistive index (RRI) was initially considered to reflect intrarenal vascular pathological processes, this index is actually regarded as the result of complex interaction between renal and systemic vascular wall pr…

Early vascular aging in normotensive subjects with systemic lupus erythematous. Comparison with young hypertensive patients

early vascular aging