0000000000923676
AUTHOR
M. Mogavero
A GIANT ANEURYSM OF PROPER HEPATIC ARTERY IN A CRYOGLOBULINEMIC PATIENT ON HEMODIALYSIS: A CASE REPORT.
Introductrion. Hepatic artery aneurysms (HAAs) are unusual vascular lesions often associated with many different pathological conditions. Most of reported cases are described in association with connective tissue diseases, such as polyarteritis nodosa and systemic lupus erythematosus. Case report. We observed a 52-year-old man with hypertension and HCV-related cryoglobulinemia complicated by end stage renal disease on replacement therapy by hemodialysis. He was admitted to our hospital because of the worsening of blood pressure values (170/110 mmHg) associated to new onset abdominal pain. After an initial physical examination, that showed a periumbelical bruit associated to a pulsatile mass…
SYSTEMIC ARTERIAL CHANGES AND PULSE PRESSURE: DIFFERENT IMPACT ON RENAL HAEMODYNAMICS IN HYPERTENSIVE PATIENTS.
Objective: Renal resistance index (RRI) is used for kidney disease detection and prognosis, but it also appears a good indicator of systemic vascular changes in hypertensive subjects. Structural atherosclerotic damage, arterial stiffness and pulse pressure may interact each other, and the relationship between intrarenal haemodynamics and systemic vascular alterations has been widely investigated. However, the independent impact of all these parameters on renal haemodynamics and the mechanisms by which they affect renal vasculature remain to be clarified. Design and method: We enrolled 463 hypertensive patients (30–70 years) with normal renal function (group 0; n = 280) and with chronic kidn…
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…
Absence of an independent association between serum uric acid and left ventricular mass in Caucasian hypertensive women and men
Background and aim: Experimentally uric acid may induce cardiomyocyte growth and interstitial fibrosis of the heart. However, clinical studies exploring the relationship between serum uric acid (SUA) and left ventricular (LV) mass yielded conflicting results. The aim of our study was to evaluate the relationships between SUA and LV mass in a large group of Caucasian essential hypertensive subjects. Methods and results: We enrolled 534 hypertensive patients free of cardiovascular complications and without severe renal insufficiency. In all subjects routine blood chemistry, including SUA determination, echocardiographic examination and 24 h ambulatory blood pressure (BP) monitoring were obtai…
Relazione tra indice di resistenza renale e severità dell’aterosclerosi carotidea in soggetti con ipertensione arteriosa.
RAZIONALE. L’indice di resistenza intraparenchimale renale (IR), valutato mediante eco-color-Doppler, è stato classicamente considerato mera espressione di resistenza vascolare distrettuale renale. Studi più recenti, tuttavia, hanno mostrato come tale indice sia anche influenzato da fattori a tergo, compliance vasale in primis, a prova di un suo possibile ruolo quale marker di alterazioni vascolari sistemiche. Diversi studi hanno dimostrato, inoltre, come lo spessore intimale (IMTc) e la placca a livello carotideo, valutati mediante ultrasonografia, siano documentati marcatori di danno d'organo subclinico nonché espressioni progressive di malattia aterosclerotica. Scopo del nostro studio è …
Renal haemodynamics and severity of carotid atherosclerosis in hypertensive patients with and without impaired renal function.
Background and Aim. Renal resistance index (RRI), assessed by Duplex-Doppler sonography, has been classically considered as a mere expression of intrarenal vascular resistance. Recent studies, however, have showed that RRI is also influenced by upstream factors, especially arterial compliance, confirming its possible role as a marker of systemic vascular alterations. Several studies have shown that carotid intima-media thickness (cIMT) and carotid plaques (cP), assessed by ultrasonography, are documented markers of subclinical organ damage as well as expression of progressive atherosclerotic disease, and that they get worse with the progressive deterioration of renal function. The study was…
Association between uric acid and renal function in hypertensive patients: which role for systemic vascular involvement?
The role of systemic vascular involvement in mediating the association between serum uric acid (SUA) and renal function in hypertension has not been explored. Main purpose of our study was to investigate whether morphofunctional vascular changes, assessed as carotid intima-media thickness (cIMT) and aortic pulse wave velocity (aPWV), might mediate the association between SUA and renal damage. We enrolled 523 hypertensive subjects with or without chronic kidney disease and divided population into tertiles of SUA based on sex-specific cutoff values. cIMT and aPWV were higher in uppermost SUA-tertile patients when compared to those in the lowest ones (all P < .001). Uricemia strongly correlate…
Association Between Uric Acid and Renal Hemodynamics: Pathophysiological Implications for Renal Damage in Hypertensive Patients
The role of vascular renal changes in mediating the association between serum uric acid (SUA) and renal damage is unclear. The purposes of this study were to investigate the relationship between SUA and renal resistive index (RRI), assessed by duplex Doppler ultrasonography, and to assess whether hemodynamic renal changes may explain the association between SUA and renal damage in hypertensive patients. A total of 530 hypertensive patients with and without chronic kidney disease were enrolled and divided into SUA tertiles based on sex-specific cutoff values. RRI and albuminuria were greater and glomerular filtration rate (GFR) was lower in the uppermost SUA tertile patients when compared wi…
Association of renal resistive index with aortic pulse wave velocity in hypertensive patients
Background: Recent data suggest that renal haemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes. However, conflicting data exist about the independent relationship between aortic stiffness and RI. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), in hypertensive patients. Design: Cross-sectional study. Methods: We enrolled 264 hypertensive subjects aged between 30 and 70 years. They were divided into two groups, either with normal renal function (n=140) or with chronic kidney disease (CKD) (n=124). E…
Aberrant origin of the superior thyroid artery and ascending pharyngeal artery from a common trunk arising from the common carotid artery in a hypertensive patient with dizziness.
Relationship between aortic stifness and renal resistance index in hypertensive patients
UTILITÀ DI UN BASSO CUT-OFF DI INDICE DI RESISTENZA INTRARENALE NEL PREDIRE ALTERAZIONI VASCOLARI SISTEMICHE PRECOCI IN SOGGETTI CON IPERTENSIONE ARTERIOSA ESSENZIALE
Studi recenti mostrano come l’indice di resistenza intraparenchimale renale (IR), classicamente considerato espressione di resistenza vascolare renale, possa avere un importante ruolo quale marker di alterazioni vascolari sistemiche. Il valore soglia di IR il più spesso utilizzato per identificare pazienti con maggiore probabilità di danno d’organo e di mortalità è stato 0.70. Non è stato tuttavia verificato se un cut-off più basso abbia una maggiore capacità di identificare alterazioni vascolari sistemiche subcliniche. Scopo del nostro studio è pertanto quello di determinare, in soggetti con ipertensione arteriosa essenziale (EH), il valore di IR renale che meglio predica l’esistenza di un…
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…
Relationship Between Carotid Atherosclerosis and Pulse Pressure with Renal Hemodynamics in Hypertensive Patients.
BACKGROUND Structural atherosclerotic damage, arterial stiffness, pulse pressure (PP), and renal hemodynamics may interact and influence each other. Renal resistance index (RRI) appears as a good indicator of systemic vascular changes. The aim of our study was to assess the independent relationships of carotid intima-media thickness (cIMT), aortic pulse wave velocity (aPWV), and peripheral PP with RRI in hypertensives with various degrees of renal function. METHODS We enrolled 463 hypertensive patients (30-70 years) with normal renal function (group 0; n = 280) and with chronic kidney disease (groups I-V; n = 183). All subjects underwent ultrasonographic examination of intrarenal and caroti…