Roberto Zulli

Universidade Estadual de Campinas (UNICAMP)

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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

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Relationship Between Initial Cardiovascular Structural Changes and Daytime and Nighttime Blood Pressure Monitoring

American Journal of Hypertension (1992)

Damiano Rizzoni M.L. Muiesan Giovanni Montani Roberto Zulli Silvia Calebich

It has been shown that in hypertensive patients the degree of target organ damage correlates more closely with average blood pressure as recorded by ambulatory monitoring (ABPM) throughout 24 h than with clinic blood pressure. We examined a group of 91 clinically healthy subjects, 23 normotensives and 68 hypertensives according to clinic blood pressure. Cardiac anatomy was investigated by echocardiography. As an index of arterial structural changes forearm minimal vascular resistance was calculated from mean arterial pressure and maximal postischemic blood flow, as assessed by venous occlusion plethysmography. The results were correlated to clinic blood pressure or ABPM values (measured by noninvasive ABPM ICR 5200, Spacelabs, Bellevue, CA). Left ventricular mass was correlated more closely with the average blood pressure recorded during 24 h, or during daytime or nighttime periods, than with clinic blood pressure. Minimal vascular resistance was also significantly correlated to ABPM values, but the correlation was similar to that observed with clinic blood pressure. Minimal vascular resistance was significantly correlated to blood pressure variability, as evaluated by the standard deviation of the mean. Minimal vascular resistance and left ventricular mass were higher in a subgroup of patients in whom blood pressure was not significantly reduced during the night. The results of this study confirm that elevated average ABPM values are associated to higher left ventricular mass; in addition, they suggest that increased blood pressure variability may be associated with vascular structural changes, as evaluated by minimal vascular resistance. It remains to be clarified whether cardiac hypertrophy and/or vascular structural changes are a cause or consequence of increased blood pressure values and variability.

Mean blood pressure

Plethysmograph

10.1093/ajh/5.3.180

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Cystic fibrosis transmembrane conductance regulator gene mutations and glutathione S-transferase null genotypes in cystic fibrosis patients in Brazil* , ** Mutações do gene cystic fibrosis transmembrane conductance regulator e deleções dos genes glutationa S-transferase em pacientes com fibrose cística no Brasil

Carmen Sílvia Passos Lima Manoela Marques Ortega Fernando Augusto Fernando Augusto Lima Marson

Objective: To determine the effects that mutation of the cystic fibrosis transmembrane conductance regulator (CFTR) gene and deletion of the glutathione S-transferase (GST) genes mu-1 (GSTM1) and theta-1 (GSTT1) have on the clinical course of cystic fibrosis (CF) in patients residing in the southeastern region of Brazil. Methods: The study sample consisted of all consecutive CF patients treated at the Hospital de Clinicas School of Medical Sciences of the State University at Campinas between March of 2002 and March of 2005. We included 66 CF patients. Genomic DNA was analyzed by polymerase chain reaction and restriction endonuclease digestion for the identification of the genotypes. Results: The ΔF508 mutation of the CFTR gene was found in 44 patients (66.7%). The null genotypes GSTM1, GSTT1 and GSTM1/GSTT1 were found in 40.9%, 15.2%, and 3.0% of the patients, respectively. The ΔF508 CFTR mutation was more common in patients diagnosed with CF before 2.5 years of age than in those diagnosed later (75.5% vs. 41.2%; p = 0.008). The frequency of the ΔF508 CFTR mutation, as well as of the GSTM1 and GSTT1 genotypes, was not found to be associated with gender, ethnicity, pulmonary disease status, or pancreatic disease status. Conclusions: When the patients were stratified by clinical and epidemiological features, the frequencies of the GSTM1 and GSTT1 null genotypes were similar, suggesting that the inherited absence of these enzymatic pathways does not alter the course of CF. However, the high frequency of the ΔF508 CFTR mutation found in younger children suggests that it influences the age at diagnosis of CF in this region of Brazil.

ΔF508

Pancreatic Disease

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Mutações do gene cystic fibrosis transmembrane conductance regulator e deleções dos genes glutationa S-transferase em pacientes com fibrose cística no Brasil

Jornal Brasileiro de Pneumologia (2012)

Carmen Sílvia Passos Lima Manoela Marques Ortega Fernando Augusto Lima Marson Roberto Zulli Antônio Fernando Ribeiro

OBJETIVO: Determinar os efeitos que a mutação do gene cystic fibrosis transmembrane conductance regulator (CFTR) e da deleção dos genes glutationa S-transferase (GST) mu-1 (GSTM1) e teta-1 (GSTT1) têm na evolução clínica da fibrose cística (FC) em pacientes da região sudeste do Brasil. MÉTODOS: Entre março de 2002 e março de 2005, incluímos no estudo todos os pacientes com FC atendidos consecutivamente no Departamento de Pediatria do Hospital de Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas. O DNA genômico de 66 pacientes com FC foi analisado por PCR e digestão com endonuclease de restrição para a identificação dos genótipos. RESULTADOS: A mutação ΔF508 do gene CFTR foi identificada em 44 (66,7%) pacientes. As deleções dos genes GSTM1, GSTT1 e da combinação nula GSTM1/GSTT1 foram identificadas em 40,9%, 15,2% e 3,0% dos pacientes, respectivamente. A mutação ΔF508 do gene CFTR foi mais comum em pacientes diagnosticados com FC antes dos 2,5 anos de idade que naqueles diagnosticados mais tarde (75,5% vs. 41,2%; p = 0,008). CONCLUSÕES: Foram observadas frequências similares da mutação ΔF508 do gene CFTR e dos genótipos GSTM1 e GSTT1 nos pacientes, independentemente do sexo, etnia ou status da doença pulmonar ou pancreática. Quando os pacientes foram estratificados por aspectos clínicos e epidemiológicos, as frequências dos genótipos GSTM1 e GSTT1 nulos foram semelhantes, sugerindo que a ausência herdada dessas vias enzimáticas não altera o curso da FC. Em contraste, a alta frequência da mutação ΔF508 no gene CFTR encontrada em pacientes mais jovens sugere que essa mutação influencia a idade no momento do diagnóstico de FC nessa região do país.

10.1590/s1806-37132012000100008

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Media

Journal of Hypertension (1995)

Enrico Agabiti Rosei Damiano Rizzoni Maurizio Castellano Enzo Porteri Roberto Zulli

Background For the evaluation in humans of structural alterations in resistance arteries, most studies have used an indirect index, the measurement of minimal vascular resistance (mean blood pressure divided by maximal postischaemic blood flow) in suitable vascular beds. A sensitive and specific micromyographic technique was recently made available for the study of human small resistance arteries. Whether a correlation really exists between results obtained with the two techniques has not yet been investigated. Objective To evaluate both forearm minimal vascular resistance and media: lumen ratio of omental or subcutaneous small arteries in normotensive subjects and hypertensive patients. Design and methods Thirty-four individuals were included in the study (age range 35–74 years; 24 hypertensive, 10 normotensive). Twenty-five had elective abdominal surgery and nine hypertensive patients had a gluteal biopsy. Omental and subcutaneous small arteries were dissected and mounted on a wire micromyograph (Mulvany's technique), and media: lumen ratio and media thickness were measured. The dose-response curve to noradrenaline was constructed at cumulative concentrations from 3 ± 10–9 to 3 ± 10–5 mol/l. Venous occlusion plethysmography was used to measure blood flow in the forearm, and minimal vascular resistance was calculated from mean blood pressure and postischaemic maximal blood flow (13 min ischaemia plus exercise). Results A statistically significant correlation was found between media: lumen ratio and minimal vascular resistance (r = 0.74, P < 0.001) as well as between media: lumen ratio and systolic (r = 0.44, P < 0.01) and diastolic (r = 0.38, P < 0.05) blood pressures. Similar correlations were observed between media thickness and systolic and diastolic blood pressures. Small arteries from hypertensive patients had a significantly increased reactivity to noradrenaline (by analysis of variance) compared with those from normotensive subjects, in terms of wall tension but not of active media stress. Conclusions The present study demonstrated that the media: lumen ratio of small resistance vessels is significantly related to forearm minimal vascular resistance, suggesting that direct and indirect evaluations of vascular morphology will give similar results.

Lumen (anatomy)

Plethysmograph

10.1097/00004872-199503000-00010

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Effect of Antihypertensive Treatment on Daytime and Nighttime Power Spectral Analysis of Heart Rate

American Journal of Hypertension (1993)

Damiano Rizzoni María Lorenza Muiesan Roberto Zulli Maurizio Castellano Giorgio Bettoni

Power spectral analysis of heart rate may provide useful information about cardiac neural activity. The aim of this study was to evaluate cardiac sympathetic and parasympathetic activity, as assessed by power spectral analysis of heart rate, in hypertensive patients before and after antihypertensive treatment. In 14 hypertensive patients and in 7 normotensive subjects 24 h Holter electrocardiogram monitoring was performed under basal conditions and after 6 months of treatment with nifedipine (n = 7) or enalapril (n = 7). Sequences of 512 RR intervals were taken for the evaluation of power spectral analysis (autoregressive method); absolute and normalized power spectral density of the peak at 0.10 Hz (low frequency peak: LF) and at 0.25 Hz (high frequency peak: HF), as well as their ratio (index of sympatovagal interaction: SVI) were calculated. Under basal conditions SVI was significantly decreased from daytime to nighttime in normotensives, while no change was observed in hypertensive patients. In all hypertensive patients a reduction of SVI during nighttime in respect to basal values was observed after treatment. SVI during nighttime was significantly reduced with both nifedipine and enalapril, while SVI during daytime was slightly increased during nifedipine treatment, and significantly reduced during enalapril treatment. Systolic and diastolic arterial pressure as well as left ventricular mass index were significantly reduced with both treatments. In conclusion, long term treatment with nifedipine or enalapril seems to be able to restore an impaired daytime to nighttime SVI modulation in hypertensive patients, even considering the potential limitations of power spectral analysis of heart rate. Am J Hypertens 1993;6:204-208

Basal (medicine)

10.1093/ajh/6.3.204

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Management of VEGF-Targeted Therapy-Induced Hypertension

Current Hypertension Reports (2018)

Stefano Caletti Anna Paini Maria Antonietta Coschignano Carolina De Ciuceis Matteo Nardin

10.1007/s11906-018-0871-1

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Citations (33)

Ventricular arrhythmias in hypertensive patients with mild left ventricular hypertrophy. A possible relationship with autonomic nervous system activity.

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

Sympathetic nervous system

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Regression of cardiac hypertrophy and night-time blood pressure reduction

Journal of Hypertension (1993)

María Lorenza Muiesan Damiano Rizzoni Roberto Zulli Silvia Calebich Enzo Porteri

Muiesan, Maria L.; Rizzoni, Damiano; Zulli, Roberto; Calebich, Silvia; Porteri, Enzo; Agabiti-Rosei, Enrico Author Information

10.1097/00004872-199312050-00129

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The influence of the graft monocytes in the outcome of allogeneic bone marrow transplantation.

PubMed (2002)

F. J. P. Aranha AC Vigorito CA De Sousa G. H. M Oliveira Roberto Zulli

The influence of graft monocytes on graft-versus-host disease (GVHD) has not yet been established in clinical trials. To understand this association better, we evaluated the influence of bone marrow graft monocytes aiming to analyze, primarily, the correlation with acute GVHD and chronic GVHD and, secondarily, the correlation with engraftment and survival.

Graft rejection

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Cardiovascular Characteristics in Normotensive Subjects with or without Family History of Hypertension

Clinical and Experimental Hypertension (1996)

María Lorenza Muiesan Damiano Rizzoni Roberto Zulli Silvia Calebich Gian Franco Pasini

The aim of our study was to evaluate whether initial changes of cardiovascular structure and/or function can be detected in young normotensive subjects with (F+) and without (F-) family history of hypertension. Thirty-two subjects (19 F+, 10 males and 9 females, age range 17-32 years; 13 F-, 6 males and 7 females, age range 19-33 years) were studied. In each subject 24 hours ambulatory blood pressure monitoring, a M-mode, 2d guided and pulsed doppler echocardiogram and postischemic forearm strain gauge plethysmography were performed. The two groups of subjects did not differ for causal systolic and diastolic BP and 24 hours systolic and diastolic ambulatory monitored blood pressure. No differences in LV end-diastolic and end-systolic diameters, as well as in LV wall thickness, and in LV mass index were observed. Systolic functional parameters were also similar in the two groups. In F+ subjects peak early filling velocity was reduced in respect to F- (p < 0.01), peak late filling velocity integral was increased (p < 0.05) and the ratio of peak E/peak A integrals was decreased (p < 0.05). No difference was observed for postischemic forearm blood flow and minimal vascular resistance, taken as an index of arteriolar structural changes as well as intima-media thickness of carotid arteries. In conclusion in this study F+ and F- had similar BP values, LV mass and min VR; differences previously observed in LV mass between F+ and F- may have been due to the presence of different basal levels of BP; in F+ LV diastolic filling, although still in the normal range, shifted early toward the pattern of LV filling usually observed in hypertensive patients.

10.3109/10641969609097907

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Citations (10)