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- Barbato, E, et al.
(författare)
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Renal denervation in the management of hypertension in adults. A clinical consensus statement of the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)
- 2023
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 44:15, s. 1313-1330
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Tidskriftsartikel (refereegranskat)abstract
- Since the publication of the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) Guidelines for the Management of Arterial Hypertension, several high-quality studies, including randomised, sham-controlled trials on catheter-based renal denervation (RDN) were published, confirming both the blood pressure (BP)-lowering efficacy and safety of radiofrequency and ultrasound RDN in a broad range of patients with hypertension, including resistant hypertension. A clinical consensus document by the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on RDN in the management of hypertension was considered necessary to inform clinical practice. This expert group proposes that RDN is an adjunct treatment option in uncontrolled resistant hypertension, confirmed by ambulatory BP measurements, despite best efforts at lifestyle and pharmacological interventions. RDN may also be used in patients who are unable to tolerate antihypertensive medications in the long term. A shared decision-making process is a key feature and preferably includes a patient who is well informed on the benefits and limitations of the procedure. The decision-making process should take (i) the patient’s global cardiovascular (CV) risk and/or (ii) the presence of hypertension-mediated organ damage or CV complications into account. Multidisciplinary hypertension teams involving hypertension experts and interventionalists evaluate the indication and facilitate the RDN procedure. Interventionalists require expertise in renal interventions and specific training in RDN procedures. Centres performing these procedures require the skills and resources to deal with potential complications. Future research is needed to address open questions and investigate the impact of BP-lowering with RDN on clinical outcomes and potential clinical indications beyond hypertension.
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- Costantino, S, et al.
(författare)
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Impact of Glycemic Variability on Chromatin Remodeling, Oxidative Stress, and Endothelial Dysfunction in Patients With Type 2 Diabetes and With Target HbA1c Levels
- 2017
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Ingår i: Diabetes. - : American Diabetes Association. - 1939-327X .- 0012-1797. ; 66:9, s. 2472-2482
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Tidskriftsartikel (refereegranskat)abstract
- Intensive glycemic control (IGC) targeting HbA1c fails to show an unequivocal reduction of macrovascular complications in type 2 diabetes (T2D); however, the underlying mechanisms remain elusive. Epigenetic changes are emerging as important mediators of cardiovascular damage and may play a role in this setting. This study investigated whether epigenetic regulation of the adaptor protein p66Shc, a key driver of mitochondrial oxidative stress, contributes to persistent vascular dysfunction in patients with T2D despite IGC. Thirty-nine patients with uncontrolled T2D (HbA1c >7.5%) and 24 age- and sex-matched healthy control subjects were consecutively enrolled. IGC was implemented for 6 months in patients with T2D to achieve a target HbA1c of ≤7.0%. Brachial artery flow-mediated dilation (FMD), urinary 8-isoprostaglandin F2α (8-isoPGF2α), and epigenetic regulation of p66Shc were assessed at baseline and follow-up. Continuous glucose monitoring was performed to determine the mean amplitude of glycemic excursion (MAGE) and postprandial incremental area under the curve (AUCpp). At baseline, patients with T2D showed impaired FMD, increased urinary 8-isoPGF2α, and p66Shc upregulation in circulating monocytes compared with control subjects. FMD, 8-isoPGF2α, and p66Shc expression were not affected by IGC. DNA hypomethylation and histone 3 acetylation were found on the p66Shc promoter of patients with T2D, and IGC did not change such adverse epigenetic remodeling. Persistent downregulation of methyltransferase DNMT3b and deacetylase SIRT1 may explain the observed p66Shc-related epigenetic changes. MAGE and AUCpp but not HbA1c were independently associated with the altered epigenetic profile on the p66Shc promoter. Hence, glucose fluctuations contribute to chromatin remodeling and may explain persistent vascular dysfunction in patients with T2D with target HbA1c levels.
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- Ghadri, JR, et al.
(författare)
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Pheochromocytoma triggers takotsubo syndrome
- 2019
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 40:24, s. 1990-1990
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Tidskriftsartikel (refereegranskat)
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| 20. |
- Hill, JA, et al.
(författare)
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Medical Misinformation
- 2019
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Ingår i: Circulation. Cardiovascular interventions. - 1941-7632. ; 12:2, s. e007796-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 21. |
- Hill, JA, et al.
(författare)
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Medical Misinformation
- 2019
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Ingår i: Hypertension (Dallas, Tex. : 1979). - 1524-4563. ; 73:3, s. 506-507
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 22. |
- Hill, JA, et al.
(författare)
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Medical Misinformation
- 2019
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Ingår i: Circulation. Heart failure. - 1941-3297. ; 12:2, s. e005869-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 23. |
- Hill, JA, et al.
(författare)
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Medical Misinformation
- 2019
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Ingår i: Circulation. Cardiovascular imaging. - 1942-0080. ; 12:2, s. e008809-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 24. |
- Hill, JA, et al.
(författare)
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Medical Misinformation
- 2019
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Ingår i: Circulation. Genomic and precision medicine. - 2574-8300. ; 12:2, s. e002439-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Hill, JA, et al.
(författare)
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Medical Misinformation
- 2019
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Ingår i: Circulation. - 1524-4539. ; 139:5, s. 571-572
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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