Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study.

Purpose: Obesity is associated with increased cardiovascular risk. Bariatric surgery (BS) improves the clinical and metabolic profile. Retinal caliber changes could precede cardiovascular events.

Predictive risk factors for death in elderly patients after hospitalization for acute heart failure in an internal medicine unit.

To determine the predictive factors of mortality after hospitalization for acute heart failure (AHF) in an internal medicine department. Retrospective observational analysis conducted on 164 patients hospitalized for AHF in 2016-2017. Demographic, clinical and biological characteristics were assessed during hospitalization.

Relevance and feasibility of a systematic screening of multimorbidities in patients with chronic inflammatory rheumatic diseases.

Objectives: EULAR recently proposed to screen multimorbidities in chronic inflammatory rheumatic diseases. The aims of the study were to define the most common multimorbidities in chronic inflammatory rheumatic diseases, compare the screening approach performed in the clinic with the recent EULAR recommendations, validate the points to consider for the systematic standardized multimorbidity screening proposed by EULAR and assess feasibility of such a screening in a daily clinic.

Methods: Data were collected prospectively during a 1-day multimorbidity clinic.

Sodium excretion is higher in patients with rheumatoid arthritis than in matched controls.

Objective: It was shown that sodium can promote auto-immunity through the activation of the Th17 pathway. We aimed to compare sodium intake in patients with rheumatoid arthritis (RA) vs. matched controls.

Noninvasive evaluation of left ventricular elastance according to pressure-volume curves modeling in arterial hypertension.

End-systolic left ventricular (LV) elastance () has been previously calculated and validated invasively using LV pressure-volume (P-V) loops. Noninvasive methods have been proposed, but clinical application remains complex. The aims of the present study were to ) estimate according to modeling of the LV P-V curve during ejection ("ejection P-V curve" method) and validate our method with existing published LV P-V loop data and ) test the clinical applicability of noninvasively detecting a difference in between normotensive and hypertensive subjects.

Retinal vascular caliber associated with cardiac and renal target organ damage in never-treated hypertensive patients.

Objective: The aim of this study was to assess the relationship between retinal vascular caliber and target organ damage in HT patients.

Methods: Data were collected on cardiac, renal, vascular, and retinal variables in 88 consecutive never-treated HT subjects. Retinal vascular calibers were measured from fundus photographs by using a semi-automated computer-assisted program and summarized as CRAE and CRVE.

Arterial stiffness: an independent determinant of adaptive glomerular hyperfiltration after kidney donation.

After kidney donation, the remaining kidney tends to hyperfiltrate, thus limiting the initial loss of renal function. The potential determinants of this adaptive glomerular hyperfiltration (GHF) and specifically the influence of arterial function are poorly known. In 45 normotensive healthy kidney donors [51 ± 10 yr (mean ± SD), 39 females], glomerular filtration rate (GFR) was measured as the clearance of continuously infused (99m)Tc-DTPA and timed urine collections at baseline, i.

Left ventricular mass changes after renal transplantation: influence of dietary sodium and change in serum uric acid.

Background: We hypothesized that dietary sodium may modulate the effect of systolic blood pressure and other nonhemodynamic factors, such as high uric acid and renal dysfunction, on changes in the left ventricular mass after renal transplantation. The objective of the present 3-year follow-up longitudinal study was to assess the concomitant influence of these factors on changes in the left ventricular mass after renal transplantation.

Methods: Twenty-four-hour urinary sodium excretion, glomerular filtration rate (isotopic clearance), and left ventricular mass (echocardiography) assessment were done in 165 renal transplant patients during the first year and after a follow-up of 3 years after renal transplantation.

Effect of early stage kidney disease on cardiac mass: comparison to post-donation renal function.

Background/aim: In chronic renal failure the increase in cardiovascular risk is in part related to the high prevalence of left ventricular hypertrophy. The aim of the present monocentric retrospective study was to evaluate the influence of the presence of parenchymal kidney disease on left ventricular geometry in normotensive (arterial pressure <140/90 mm Hg) patients (KD+, n = 50, mean age 39 ± 19 years) with mild to moderate renal failure (stage 2-3 chronic kidney disease).

Methods: Left ventricular geometry was estimated by echocardiography and compared to a group of healthy subjects with similarly reduced renal function as a consequence of renal donation (KD-, n = 63, mean age 52 ± 12 years).

Retinal vascular caliber is associated with renal function in apparently healthy subjects.

Purpose: To assess the relation between retinal vascular caliber and renal function.

Patients And Methods: Eighty apparently healthy subjects screened for cardiovascular risk factors (mean age 47 years, 51% female, 36% hypertensive, without diabetes or renal dysfunction) were recruited. Retinal vascular calibers were measured from fundus photographs and expressed as central retinal artery and venular equivalent.

Etanercept normalises left ventricular mass in patients with rheumatoid arthritis.

Background: Cardiovascular mortality is increased in patients with rheumatoid arthritis (RA). RA is associated with an increased left ventricular mass index (LVMI), a strong marker of cardiovascular mortality, and vessel abnormalities. Experimental studies have suggested that tumour necrosis factor α (TNFα) may induce LV hypertrophy.

Treatment of hypertension with renin-angiotensin system inhibitors and renal dysfunction: a systematic review and meta-analysis.

Background: To determine whether inhibitors of the renin-angiotensin system (RAS) reduce the incidence of renal dysfunction when compared to other antihypertensive treatments in patients with essential hypertension and no pre-existent renal disease.

Methods: The search strategy used the Cochrane Library, Medline, previous meta-analyses, and journal reviews. The selection criteria included randomized, controlled trials of antihypertensive drugs that compared a RAS inhibitor with another treatment in essential hypertension.

Early detection of isolated left ventricular diastolic dysfunction in high-risk differentiated thyroid carcinoma patients on TSH-suppressive therapy.

Objective: L-Thyroxine-suppressive therapy benefits high-risk differentiated thyroid cancer patients by decreasing recurrence rates and cancer-related mortality. However, fully suppressed serum thyroid-stimulating hormone (TSH) implies a state of subclinical hyperthyroidism (SCH) with associated adverse cardiac effects. Because left ventricular (LV) diastolic dysfunction may be the first manifestation of more severe LV failure, and to balance the risks from thyroid cancer recurrence with risks of cardiac failure, the purpose of this study was to analyse new parameters of LV function in asymptomatic patients with exogenous SCH.

Dietary sodium, aldosterone, and left ventricular mass changes during long-term inhibition of the renin-angiotensin system.

In essential hypertension, the regression of left ventricular hypertrophy is an important goal of treatment. In addition to treatment-associated changes in blood pressure (BP), the roles of other determinants of left ventricular hypertrophy regression, including dietary sodium intake, deserve investigation. In the present study, the change in echographic left ventricular mass index (LVMI) was assessed in 182 patients with never-treated essential hypertension at baseline and after 3 years of treatment by angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists given at recommended doses and associated with other antihypertensive agents.

Glomerular hemodynamics and arterial function in normal individuals.

Objective: To determine the relationship between arterial function (stiffness and wave reflection) and glomerular hemodynamics.

Methods: In 49 healthy normotensive individuals, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured by urinary clearances of 99mTC-DTPA and 131I-hippuran, respectively. Filtration fraction was computed as GFR/ERPF.

Non-pressure-related effects of dietary sodium.

After the demonstration of a positive correlation between sodium intake and arterial pressure in large population studies, the effect of short-term reduction in sodium intake demonstrated the efficacy of this nonpharmacologic therapy. In addition, a positive relation between urinary sodium (the most reliable estimate of salt intake) and left ventricular hypertrophy was found; and in recent years it was shown that cardiovascular morbidity clearly progressed with increasing sodium intake, despite one contradictory study. The role of non-pressure-related effects of dietary sodium is discussed in order to bring more arguments for a large-scale attempt to reduce sodium intake by 30% to 50%.

Pulse pressure is an independent determinant of renal function decline during treatment of essential hypertension.

Background: In large epidemiological studies and using serum creatinine or estimates of glomerular filtration rate (GFR), blood pressure has emerged as a predominant determinant of the age-associated decline in renal function.

Methods: The present longitudinal study (median follow-up period of 5.8 years) was conducted in 132 never-treated patients with essential hypertension at baseline.

Non-pressure-related effects of dietary sodium.

After the demonstration of a positive correlation between sodium intake and arterial pressure in large population studies, the effect of short-term reduction in sodium intake demonstrated the efficacy of this nonpharmacological therapy. In addition, a positive relation between urinary sodium (the most reliable estimate of salt intake) and left ventricular hypertrophy was found; and in recent years it was shown that cardiovascular morbidity clearly progressed with increasing sodium intake, despite one contradictory study. The role of non-pressure-related effects of dietary sodium is discussed in order to bring more arguments for a large-scale attempt to reduce sodium intake by 30% to 50%.

Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index.

Background: The Cockcroft-Gault (CG) and simplified Modification of Diet in Renal Disease (MDRD) formulas are the most widely used estimates of renal function. The influence of age and body mass index (BMI) on the performance of these equations was analyzed in 850 subjects with serum creatinine levels less than 1.5 mg/dL (<133 micromol/L).

Determinants of cardiorenal damage progression in normotensive and never-treated hypertensive subjects.

Background: In the present longitudinal study, we attempted to identify the determinants of cardiorenal damage progression in normotensive subjects (<140/90 mm Hg) and patients with never-treated essential hypertension.

Methods: Renal hemodynamics and function and cardiac morphology were evaluated by isotopic techniques and echocardiography at baseline and after a median follow-up period of 5.2 years (range 3 to 13) in 30 normotensive and 33 hypertensive subjects.

Relative glomerular hyperfiltration in primary aldosteronism.

Experimental and clinical data suggest that primary aldosteronism (PA) may be associated with cardiovascular hypertrophy and fibrosis, in part independent of the BP level. Whether PA may also result in specific deleterious effects on the kidneys was less studied. In 25 patients with tumoral PA, renal studies (urinary excretion of proteins, GFR, and effective renal plasma flow [ERPF], as clearances of technetium-labeled diethylene triaminopentaacetic acid and 131I-ortho iodohippurate, respectively) were performed both before and 6 mo after surgical cure.

Elevated pulse pressure is associated with low renal function in elderly patients with isolated systolic hypertension.

In the past decade, pulse pressure has emerged as a strong predictor of cardiovascular morbidity and mortality. During aging, elevation of pulse pressure is a consequence of stiffening of the arterial wall. The relationship between pulse pressure and the renal aging process was studied in a cohort of 212 patients with never-treated isolated systolic hypertension.

Dietary sodium and pulse pressure in normotensive and essential hypertensive subjects.

Objectives: To assess the influence of sodium intake on the two components of arterial blood pressure [mean blood pressure (MBP) and pulse pressure] and left ventricular mass (LVM) in normotensive subjects and never-treated hypertensive patients.

Methods: Blood pressure, LVM (M-mode echocardiography) and sodium excretion as an index of dietary sodium were measured in 459 males and 396 females, aged 14-93 years, with elevated (63% of population) or normal blood pressure.

Results: Because pulse pressure decreased with age up to approximately 40 years of age, and increased thereafter, analysis was undertaken separately in 438 young (age < or = 40 years) and 417 middle-aged to elderly subjects.