Roberto Zulli

Universidade Estadual de Campinas (UNICAMP)

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

María Lorenza Muiesan

University of Brescia

Enrico Agabiti‐Rosei

University of Brescia

Damiano Rizzoni

Institute of Biomedical Technologies

Maurizio Castellano

University of Brescia

Cármino Antônio De Souza

Universidade Estadual de Campinas (UNICAMP)

Massimo Salvetti

University of Brescia

Silvia Calebich

University of Brescia

Enzo Porteri

University of Brescia

Vittorio Grassi

University of Perugia

Franco Nicosia

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia

Cooperative Institutions

Universidade Estadual de Campinas (UNICAMP)

University of Brescia

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia

University of Milan

Hospital de Clínicas da Unicamp

Universidade de São Paulo

Brescia University

Istituti di Ricovero e Cura a Carattere Scientifico

Medica (Italy)

Sapienza University of Rome

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Persistence of left ventricular hypertrophy is a stronger indicator of cardiovascular events than baseline LV mass or performance A ten years follow-up

M.L. Muiesan Massimo Salvetti Roberto Zulli Maurizio Castellano Giorgio Rizzoni

Persistence (discontinuity)

Baseline (sea)

Source

Cite

Citations (0)

Power spectral analysis of the heart rate in hypertensive patients with and without left ventricular hypertrophy

Journal of Hypertension (1998)

María Lorenza Muiesan Damiano Rizzoni Roberto Zulli Maurizio Castellano Giorgio Bettoni

Objective The aim of this study was to evaluate the spectral analysis of the heart rate in normotensive subjects and in hypertensive patients with and without left ventricular hypertrophy (LVH), under basal conditions and after a reduction in left ventricular mass. Subjects and methods In 12 normotensive subjects and 22 hypertensive patients (14 with and eight without LVH), we performed 24 h electrocardiogram Holter monitoring, ambulatory blood pressure monitoring and an echocardiographic study. Sequences of 512 R-R intervals, during daytime, afternoon and night-time periods, were taken for an evaluation of spectral analysis (Box–sJenkins method). We then calculated the absolute and percentage power spectral density of the peak centred at 0.10 Hz (low-frequency peak) and at 0.25 Hz (high-frequency peak). Results At baseline, a daytime to night-time decrease in the low-frequency peak was detected in normotensives (P < 0.01) and in hypertensives without LVH (P < 0.01), while no change was observed in hypertensives with LVH. The power spectral density low-frequency peak during the daytime and night-time was significantly greater in hypertensives with LVH than in those without LVH (P < 0.001) and in normotensive subjects (P < 0.001). Fourteen of these patients with LVH were given effective long-term antihypertensive treatment and were studied again 20 days after the treatment had been withdrawn, when blood pressure had increased to pretreatment values. In eight patients showing a reduction in LVH, we found a significant decrease in the power spectral density low-frequency peak and an increase in the high-frequency peak during daytime and night-time in respect to basal conditions, and circadian variations in the spectral indices of heart rate variability were restored. In contrast, in six patients without reversal of LVH, the power spectral density low-frequency peak did not change in respect to basal conditions and remained significantly higher in comparison with the patients with LVH regression. Conclusion A reduction in LVH may be associated with restoration of daytime to night-time cardiac autonomic control, as evaluated by a power spectral analysis of the heart rate.

Spectral Analysis

10.1097/00004872-199816110-00011

Cite

Citations (14)

P. falciparum malaria recrudescence in a cancer patient.

PubMed (2009)

Emanuele Focà Roberto Zulli F. Buelli M. Vecchi Antonio Regazzoli

Persons living for long periods of time in malaria hyper-endemic areas may suffer from hyper-reactive malarial splenomegaly (HMS), a frequent cause of splenomegaly in such areas. Splenomegaly and sub-microscopic P. falciparum parasitaemia are hallmarks of HMS. Spleen has been suggested to play a protective antimalarial role and splenectomy may trigger symptomatic malaria attacks. Other causes of immune suppression may possibly reactivate latent malaria parasites. We report the case of an Italian 60-year-old male, who had spent 33 years in sub-Saharan Africa, who experienced a P. falciparum malaria attack 12 months after his return to Italy, concomitantly with a diagnosis of lung carcinoma possibly impairing his immune system.

Severe Malaria

Source

Cite

Citations (13)

Validation of the EBMT risk score in chronic myeloid leukemia in Brazil and allogeneic transplant outcome.

PubMed (2005)

Cármino Antônio De Souza Afonso Celso Vigorito Milton Artur Ruiz Márcio Nucci Frederico Luiz Dulley

The management of chronic myeloid leukemia (CML) has changed radically since the introduction of imatinib therapy. The decision of whether to offer a patient a hematopoietic stem cell transplant (HSCT) must be based on the probability of success of the procedure. The aim of this retrospective analysis of 1,084 CML patients who received an allogeneic HSCT in 10 Brazilian Centers between February 1983 and March 2003 was to validate the EBMT risk score.The study population comprised 647 (60%) males and 437 (40%) females, with a median age of 32 years old (range 1 - 59); 898 (83%) were in chronic phase, 146 (13%) were in accelerated phase and 40 (4%) were in blast crisis; 151 (14%) were younger than 20 years old, 620 (57%) were between 20 and 40 and 313 (29%) were older than 40; 1,025 (94%) received an HLA fully matched sibling transplant and only 59 (6%) received an unrelated transplant. In 283 cases (26%) a male recipient received a graft from a female donor. The interval from diagnosis to transplantation was less than 12 months in 223 (21%) cases and greater in 861 (79%). The overall survival, disease-free survival, transplant-related mortality and relapse incidence were 49%, 50%, 45% and 25%, respectively.Of the 1084 patients, 179 (17%) had a risk score of 0 or 1, 397 (37%) had a score of 2, 345 (32%) had a score of 3, 135 (12%) had a score of 4 and 28 (2%) a score of 5 or 6. The overall survival (OS) rate in patients with risk scores 0-1 and 2 was similar (58% and 55%, respectively) but significantly better than that in patients with scores 3 or more (score 3 - 44%, 4 - 36 % and 5-6 - 27%, respectively) pp<0.001). Disease-free survival (DFS) and transplant related mortality (TRM) in a patients with a score of 3 or more were 46% and 49%, respectively and the relapse rate beyond score 5-6 was 77%. Disease status had a negative impact on all outcomes (OS, DFS, TRM, and relapse). The OS rate for male recipients of a graft from a female donor was 40% compared to 52% among the other donor-recipient pairs (p=0.004). DFS and TRM were significant for disease phase and female donor-male recipient (p<0.001 and p<0.003, respectively). In our experience, age and interval between diagnosis and transplant did influence OS, DFS, TRM, and relapse rate.Our results validate the EBMT risk score in the context of a developing country and confirm its usefulness for making point decisions in the imatinib era.

Source

Cite

Citations (37)

Quality of life in patients randomized to receive a bone marrow or a peripheral blood allograft.

PubMed (2002)

Cármino Antônio De Souza Durães Mi Vigorito Ac Penteado Aranha Fj GB Oliveira

Quality of life (QOL) is an important clinical end-point to be considered in the late follow-up of patients treated with allogeneic bone marrow (BM) or peripheral blood progenitor cell (PBPC) transplantation.To assess the QOL in a group of survivors of hematologic malignancies who had been enrolled in a prospective randomized trial comparing allogeneic BM with PBPC. Sixty randomized patients had been enrolled in a study comparing BM with PBPC graft during 1995-99. At the time of this QOL study, 30 were alive and 26 (13 BM and 13 PBPC) were eligible. Clinical and demographic data were collected and psychometric instruments (WHOQOL-100 and the Hospital Anxiety and Depression Scale HAD) were used. Non-parametric and univariate analyses were performed.The PBPC recipients had more chronic graft-versus-host disease (p=0.03) and were on immunosuppressive treatment for a longer period (p=0.02). The WHOQOL-100 analysis demonstrated significant differences between groups with more favorable results in the BM group in the facets of Pain and Discomfort (p=0.03), Mobility (p=0.02) and Daily Living Activities (p=0.03). According to the patients' spontaneous responses, 8 individuals (6 in the PBPC group) believed that their QOL had worsened.With the limitations of a small randomized study, these findings suggest a lower QOL in recipients of allogeneic PBPC than in recipients of BM grafts, probably due to the frequency and severity of chronic graft-versus-host disease. This need to be confirmed in a large international trial.

Depression

Univariate analysis

Source

Cite

Citations (28)

Cardiovascular structural changes and calcium antagonist therapy in patients with hypertension.

PubMed (1994)

Enrico Agabiti‐Rosei Muiesan Ml Giorgio Rizzoni Roberto Zulli Silvia Calebich

Regression of cardiovascular structural changes is a main goal of antihypertensive treatment. Two recent meta-analyses of relatively small noncomparative studies have suggested that angiotensin-converting enzyme (ACE) inhibitors may be more effective than other classes of drugs in inducing regression of left ventricular hypertrophy (LVH). The effect of different antihypertensive drugs on arteriolar structural changes has not yet been properly investigated. The aim of this study was to evaluate the effect of 6 months of treatment with amlodipine (5-10 mg o.d.) or enalapril (10-20 mg o.d.) on blood pressure (BP) (ambulatory monitoring), heart rate (HR), LV mass and function (M-mode echo, two-dimensionally guided), forearm minimal vascular resistance (min VR = BP/max blood flow-venous occlusion plethysmography, taken as an index of vascular structural changes) in 24 hypertensive patients in a comparative single-blind, randomized study, with blind reading of echocardiograms and plethysmographic tracings. After 6 months of treatment with amlodipine 5-10 mg o.d., significant reductions in LV mass index (p = 0.004) and forearm min VR (p = 0.02) were observed. Before and during treatment, LV systolic function, both at rest and during stress (handgrip test), evaluated by fractional shortening as related to end-systolic stress, was in every case within 95% confidence limits calculated in normal subjects. Similar results were observed with enalapril. No significant differences were observed for Doppler indices of diastolic filling after 6 months of treatment with either drug. These results indicate that a significant regression of structural changes in the heart and in the small resistance vessels can be observed after long-term treatment with amlodipine in essential hypertensive patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Amlodipine

Essential hypertension

Plethysmograph

Lisinopril

Source

Cite

Citations (34)

QT Dispersion and Heart Rate Variability Abnormalities in Alzheimer's Disease and in Mild Cognitive Impairment

Journal of the American Geriatrics Society (2005)

Roberto Zulli Franco Nicosia Barbara Borroni Chiara Agosti Paola Prometti

Objectives: To investigate the effect of cardiovascular changes (i.e., QT interval, QT dispersion (QTD), heart rate variability (HRV), and other cardiovascular measures) in subjects with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Design: Each subject underwent clinical and cognitive examination, a structural brain imaging study, echocardioDoppler, electrocardiogram (ECG), HRV analysis using 24‐hour ECG monitoring, and 24‐hour blood pressure monitoring. Setting: Community population‐based sample of patients admitted to an AD center for investigation of cognitive disturbances. Participants: Thirty‐three subjects with AD, 39 subjects with MCI, and 29 cognitive healthy subjects (controls) matched for demographic characteristics, hypertensive condition, smoking habits, and laboratory parameters were enrolled consecutively. Measurements: Clinical and cognitive examination, structural brain imaging study, echocardioDoppler, ECG, HRV analysis using 24‐hour ECG monitoring, and 24‐hour blood pressure monitoring. Results: QTD and QT corrected dispersion mean values were significantly higher in patients with AD than in patients with MCI and controls and higher in patients with MCI than in controls. HRV time and domain parameters were lower in patients with AD than in patients with MCI and controls. No difference in other cardiovascular measures was found. QTD and HRV were found to be significantly correlated with the degree of cognitive impairment. Conclusion: These findings support the presence of a peculiar neuroanatomic dysfunction in patients with AD and MCI that parallels the disease progression. These noninvasive parameters might prove to be powerful predictive tools in the worsening of cognitive function and mortality risk.

10.1111/j.1532-5415.2005.00508.x

Cite

Citations (88)

Ventricular arrhythmias as related to adrenergic activity in untreated patients with cardiac hypertrophy

Enrico Agabiti Rosei Mario Malerba Giorgio Rizzoni Roberto Zulli María Lorenza Muiesan

Source

Cite

Citations (3)

Inspiratory capacity predicts mortality in patients with chronic obstructive pulmonary disease

Respiratory Medicine (2007)

Claudio Tantucci P. Donati Franco Nicosia E. Bertella Stefania Redolfi

10.1016/j.rmed.2007.11.004