Wall-to-lumen ratio of retinal arterioles might serve as an in vivo parameter of vascular damage.... more Wall-to-lumen ratio of retinal arterioles might serve as an in vivo parameter of vascular damage. We analyzed the impact of brachial clinic blood pressure (BP), of central BP, and of 24-hour BP on wall-to-lumen ratio (WLR) of retinal arterioles. In 295 subjects (147 men; age range, 22–72 years; mean age, 54±7 years), WLR of retinal arterioles was assessed in vivo using scanning laser Doppler flowmetry. In addition, clinic and 24-hour BP values were measured. Central hemodynamics was assessed by pulse wave analysis. In treated patients with essential hypertension (n=100), a higher WLR (0.29±0.18 versus 0.23±0.13; P =0.009) was observed in comparison with normotensive individuals (n=119); no significant differences were observed between treated and untreated hypertensive patients (0.29±0.18 versus 0.28±0.18; P =0.7). WLR of retinal arterioles was significantly related to clinic systolic ( r =0.18; P =0.002) and pulse pressure ( r =0.20; P =0.001), to 24-hour systolic ( r =0.25; P =0.0...
Inappropriate left ventricular mass (LVM; ie, the value of LVM exceeding individual needs to comp... more Inappropriate left ventricular mass (LVM; ie, the value of LVM exceeding individual needs to compensate hemodynamic load) predicts the risk of cardiovascular (CV) events, independent of risk factors, either in the presence or in the absence of traditionally defined LV hypertrophy. The relation between changes in appropriateness of LVM during antihypertensive treatment and subsequent prognosis was evaluated in 436 prospectively identified uncomplicated hypertensive subjects, with a baseline and follow-up standard clinical evaluation, laboratory examinations, and echocardiogram (last examination: 6±3 years apart), followed for additional 4.5±2.5 years. The appropriateness of LVM to cardiac workload was calculated by the ratio of observed LVM to the value predicted for individual sex, height, and stroke work at rest. At baseline, low or appropriate LVM (≤128% of predicted) was found in 178 patients, and 258 had inappropriate LVM. A first CV event occurred in 82 patients. Event rate (×1...
Background —It is not presently known whether non–insulin-dependent diabetes mellitus (NIDDM) is ... more Background —It is not presently known whether non–insulin-dependent diabetes mellitus (NIDDM) is associated with the presence of structural alterations in small arteries or whether the combination of hypertension and NIDDM may have an additive effect on endothelial dysfunction. Therefore, we investigated subcutaneous small arteries in 12 normotensive subjects (NT group), 18 patients with essential hypertension (EH group), 13 patients with NIDDM, and 11 patients with NIDDM and EH (NIDDM+EH group). Methods and Results —Subcutaneous small arteries were evaluated by a micromyographic technique. The internal diameter, the media-to-lumen ratio, remodeling and growth indices, and the collagen-to-elastin ratio were calculated. Concentration-response curves to acetylcholine, bradykinin, the endothelium-independent vasodilator sodium nitroprusside, and endothelin-1 were performed. The media-to-lumen ratio was higher in the EH, NIDDM, and NIDDM+EH groups compared with the NT group. EH patients...
Objective: Current hypertension guidelines recommend evaluation of preclinical organ damage (OD) ... more Objective: Current hypertension guidelines recommend evaluation of preclinical organ damage (OD) for cardiovascular risk assessment. Prevention and/or regression of OD is one of the main goals of antihypertensive treatment. To assess the differences of vascular OD in a large group of hypertensive patients (HT) and normotensive subjects (N) patients according to antihypertensive treatment and blood pressure (BP) control (BP < 140/90 mmHg). Design and method: A total of 319 subjects (mean age 54 ± 7 yrs), 49 % males, 61 % hypertensives (55 % treated), underwent clinical examination with BP measurement (clinic and 24 hours) and standard laboratory examinations. We compared carotido-femoral pulse wave velocity (PWV), ultrasound carotid intima media thickness (IMT) and wall to lumen ratio of retinal arterioles (WLR) among normotensive subjects (N, n = 125), 87 untreated patients with essential hypertension (UHT), 66 treated patients with controlled essential hypertension (TC_HT) and 4...
Wall-to-lumen ratio of retinal arterioles might serve as an in vivo parameter of vascular damage.... more Wall-to-lumen ratio of retinal arterioles might serve as an in vivo parameter of vascular damage. We analyzed the impact of brachial clinic blood pressure (BP), of central BP, and of 24-hour BP on wall-to-lumen ratio (WLR) of retinal arterioles. In 295 subjects (147 men; age range, 22–72 years; mean age, 54±7 years), WLR of retinal arterioles was assessed in vivo using scanning laser Doppler flowmetry. In addition, clinic and 24-hour BP values were measured. Central hemodynamics was assessed by pulse wave analysis. In treated patients with essential hypertension (n=100), a higher WLR (0.29±0.18 versus 0.23±0.13; P =0.009) was observed in comparison with normotensive individuals (n=119); no significant differences were observed between treated and untreated hypertensive patients (0.29±0.18 versus 0.28±0.18; P =0.7). WLR of retinal arterioles was significantly related to clinic systolic ( r =0.18; P =0.002) and pulse pressure ( r =0.20; P =0.001), to 24-hour systolic ( r =0.25; P =0.0...
Inappropriate left ventricular mass (LVM; ie, the value of LVM exceeding individual needs to comp... more Inappropriate left ventricular mass (LVM; ie, the value of LVM exceeding individual needs to compensate hemodynamic load) predicts the risk of cardiovascular (CV) events, independent of risk factors, either in the presence or in the absence of traditionally defined LV hypertrophy. The relation between changes in appropriateness of LVM during antihypertensive treatment and subsequent prognosis was evaluated in 436 prospectively identified uncomplicated hypertensive subjects, with a baseline and follow-up standard clinical evaluation, laboratory examinations, and echocardiogram (last examination: 6±3 years apart), followed for additional 4.5±2.5 years. The appropriateness of LVM to cardiac workload was calculated by the ratio of observed LVM to the value predicted for individual sex, height, and stroke work at rest. At baseline, low or appropriate LVM (≤128% of predicted) was found in 178 patients, and 258 had inappropriate LVM. A first CV event occurred in 82 patients. Event rate (×1...
Background —It is not presently known whether non–insulin-dependent diabetes mellitus (NIDDM) is ... more Background —It is not presently known whether non–insulin-dependent diabetes mellitus (NIDDM) is associated with the presence of structural alterations in small arteries or whether the combination of hypertension and NIDDM may have an additive effect on endothelial dysfunction. Therefore, we investigated subcutaneous small arteries in 12 normotensive subjects (NT group), 18 patients with essential hypertension (EH group), 13 patients with NIDDM, and 11 patients with NIDDM and EH (NIDDM+EH group). Methods and Results —Subcutaneous small arteries were evaluated by a micromyographic technique. The internal diameter, the media-to-lumen ratio, remodeling and growth indices, and the collagen-to-elastin ratio were calculated. Concentration-response curves to acetylcholine, bradykinin, the endothelium-independent vasodilator sodium nitroprusside, and endothelin-1 were performed. The media-to-lumen ratio was higher in the EH, NIDDM, and NIDDM+EH groups compared with the NT group. EH patients...
Objective: Current hypertension guidelines recommend evaluation of preclinical organ damage (OD) ... more Objective: Current hypertension guidelines recommend evaluation of preclinical organ damage (OD) for cardiovascular risk assessment. Prevention and/or regression of OD is one of the main goals of antihypertensive treatment. To assess the differences of vascular OD in a large group of hypertensive patients (HT) and normotensive subjects (N) patients according to antihypertensive treatment and blood pressure (BP) control (BP < 140/90 mmHg). Design and method: A total of 319 subjects (mean age 54 ± 7 yrs), 49 % males, 61 % hypertensives (55 % treated), underwent clinical examination with BP measurement (clinic and 24 hours) and standard laboratory examinations. We compared carotido-femoral pulse wave velocity (PWV), ultrasound carotid intima media thickness (IMT) and wall to lumen ratio of retinal arterioles (WLR) among normotensive subjects (N, n = 125), 87 untreated patients with essential hypertension (UHT), 66 treated patients with controlled essential hypertension (TC_HT) and 4...
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Papers by M. Muiesan