Publications by authors named "Maria Virginia Manzi"

: Acute hypertensive disorders, including hypertensive emergencies (HEs) and urgencies (HUs), are a frequent cause of emergency department (ED) visits. Early differentiation between HEs and HUs is essential, as their clinical management and prognostic implications differ substantially. : We retrospectively analyzed patients admitted to an Italian second-level ED between January and June 2022 with systolic blood pressure (SBP) ≥ 180 mmHg and/or diastolic blood pressure(DBP) ≥ 110 mmHg.

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FOSTER is the first ever publicly available dataset of forcecardiography (FCG) signals with simultaneous recordings of conventional seismocardiography (SCG), phonocardiography (PCG), electrocardiography (ECG), and respiratory signals. The dataset contains recordings from 40 participants (20 males and 20 females) and aims to foster and facilitate research on non-invasive cardio-respiratory monitoring using mechanical sensors. All signals were acquired simultaneously to ensure precise temporal alignment for accurate analysis.

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This study aimed to determine whether daily low-dose aspirin reduces the risk of type 2 diabetes (T2D) associated with COVID-19. A longitudinal cohort of 200,000 adults followed from 2018 to 2022 was analyzed, comparing T2D incidence between aspirin users and non-users. Propensity score matching was used to balance the groups.

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Background: Prediabetes represents the final stage on the glycemic spectrum before the onset of type 2 diabetes mellitus (T2DM), and delaying its progression offers a unique opportunity to address the growing T2DM epidemic.

Methods: In this longitudinal cohort study, we investigated the effect of daily low-dose aspirin on the development of T2DM in individuals with prediabetes residing in Naples, Italy, who were followed by their primary care physicians between 2018 and 2022. Outcomes in the aspirin-treated group were compared with those in a control group not receiving aspirin, using data from the same database.

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Background: The long-term risk of cardiovascular (CV) events in individuals who develop new-onset type 2 diabetes (T2D) after having received statin therapy in primary prevention is mostly unknown.

Methods: We designed a population-based cohort study in individuals without T2D and atherosclerotic CV disease (ASCVD), divided in two groups according to the presence or not of statin therapy. We also balanced the study groups for demographic and clinical factors using propensity score matching.

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We aimed to investigate the link between LDL cholesterol (LDL-C) levels and hemorrhage risk over an extended period, both in subjects taking aspirin and in individuals not receiving any antiplatelet agent. We calculated the predicted adjusted relative hazard of bleeding by LDL-C concentration for the whole cohort and the aspirin-treated subgroup. The study included 39,784 individuals with a mean follow-up of 14.

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Article Synopsis
  • - AHA introduced the term cardiovascular-kidney-metabolic (CKM) syndrome to explain how heart, kidney, and metabolic health conditions interact.
  • - A study compared the prevalence of CKM syndrome components before (2017-2019) and during (2020-2022) the COVID-19 pandemic using data from over 81,000 primary care patients.
  • - Results showed a significant increase in type 2 diabetes, hypertension, dyslipidemia, obesity, and a 170% rise in prediabetes during the pandemic, with older age groups showing a higher prevalence of CKM conditions.
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Introduction: Delay in arterial hypertension (AH) diagnosis and late therapy initiation may affect progression towards hypertensive-mediated organ damage (HMOD) and blood pressure (BP) control.

Aim: We aimed to assess the impact of time-to-therapy on BP control and HMOD in patients receiving AH diagnosis.

Methods: We analysed data from the Campania Salute Network, a prospective registry of hypertensive patients (NCT02211365).

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Article Synopsis
  • Women generally have a lower risk of cardiovascular disease compared to men, but it's unclear how hypertension-related organ damage affects this difference.
  • A study assessed whether carotid plaque influences the risk of cardiovascular events in young patients with treated hypertension, finding that women without carotid plaque had a significantly lower risk than men.
  • However, when carotid plaque was present, the cardiovascular risk for women was similar to that of men, indicating that carotid plaque neutralizes the protective effect in women.
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Background: Sex-specific differences in left ventricular (LV) geometry might help in developing tailored strategies for hypertension management.

Objectives: The purpose of the study was to evaluate sex-related differences in LV geometry at baseline and over time in hypertension.

Methods: From a prospective registry, we included hypertensives without prevalent cardiovascular disease, incident myocardial infarction, chronic kidney disease > stage III, and with normal LV ejection fraction.

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  • A 6-year study in Naples, Italy, involving over 228,000 individuals, aimed to analyze the impact of COVID-19 on dyslipidemia incidence, using data from both before and during the pandemic.
  • Findings showed a 29% increased risk of dyslipidemia during the pandemic compared to pre-COVID-19, suggesting the need for targeted monitoring for those who've recovered from COVID-19.
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Introduction: No data are available on the diagnostic algorithms recommended by guidelines for the assessment of diastolic dysfunction (DD) in patients with arterial hypertension.

Aim: To fill this gap, we evaluated diastolic function in hypertensive patients with and without LVH matched with healthy subjects by applying 2016 American Society of Echocardiography-European Association of Cardiovascular Imaging Guidelines for the evaluation of LV diastolic function.

Methods: 717 healthy and hypertensives with normal LV ejection fraction and with and without LV hypertrophy (LVH), matched 1:1:1 from two prospective registries, represented the study population.

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Background: While the augmented incidence of diabetes after COVID-19 has been widely confirmed, controversial results are available on the risk of developing hypertension during the COVID-19 pandemic.

Methods: We designed a longitudinal cohort study to analyze a closed cohort followed up over a 7-year period, i.e.

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Emerging evidence indicates that the relationship between coronavirus disease 2019 (COVID-19) and diabetes is 2-fold: 1) it is known that the presence of diabetes and other metabolic alterations poses a considerably high risk to develop a severe COVID-19; 2) patients who survived a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have an increased risk of developing new-onset diabetes. However, the mechanisms underlying this association are mostly unknown, and there are no reliable biomarkers to predict the development of new-onset diabetes. In the present study, we demonstrate that a specific microRNA (miR-34a) contained in circulating extracellular vesicles released by endothelial cells reliably predicts the risk of developing new-onset diabetes in COVID-19.

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Background: The association of COVID-19 with the development of new-onset diabetes has been recently investigated by several groups, yielding controversial results. Population studies currently available in the literature are mostly focused on type 1 diabetes (T1D), comparing patients with a SARS-CoV-2 positive test to individuals without COVID-19, especially in paediatric populations. In this study, we sought to determine the incidence of type 2 diabetes (T2D) before and during the COVID-19 pandemic.

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Recent reports have evidenced an increased mortality rate in hypertensive patients with electrocardiographic left ventricular hypertrophy (ECG-LVH) achieving systolic blood pressure (SBP) <130 mmHg. However, to the best of our knowledge, the actual effects of blood pressure reduction to the ≤130/80 mmHg target on the incidence of cardiovascular (CV) events have never been determined in hypertensive patients with a diagnosis of left ventricular hypertrophy based on echocardiographic criteria (Echo-LVH). To fill this long-standing knowledge gap, we harnessed a population of 9511 hypertensive patients, followed-up for 33.

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Article Synopsis
  • The study looked at how high blood pressure (hypertension) can harm different organs in the body, leading to serious health issues.
  • It involved 7,237 patients and found that those with damage to more organs had a higher risk of heart problems.
  • The results showed that how well patients manage their blood pressure affects their risk, but having damage in multiple organs is a big risk factor on its own.
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  • Recent studies indicate conflicting outcomes regarding the long-term impact of statins on cardiovascular (CV) events, prompting a study on LDL cholesterol levels and CV events in hypertensive patients without prior CV issues in Southern Italy.
  • The study involved 725 patients over a mean follow-up of about 7 years, categorizing them into three groups based on LDL-C levels: those without statin treatment, statin-treated individuals, and those with high LDL-C levels.
  • Results revealed that maintaining LDL-C levels at or below 100 mg/dl significantly decreased the incidence of major CV events, showing a 40% reduction over the study period compared to higher LDL-C levels.
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Aims: In the present study, we assessed correlates and their consistency of ascending aorta (AscAo) measurement in treated hypertensive patients.

Methods And Results: A total of 1634 patients ≥ 18 years old with available AscAo ultrasound were included. Ascending aorta was measured at end-diastole with leading edge to leading edge method, perpendicular to the long axis of the aorta in parasternal long-axis view at its maximal identifiable dimension.

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Background: Adverse drug reactions (ADRs) remain among the leading causes of therapy-resistant hypertension (TRH) and uncontrolled blood pressure (BP). We have recently reported beneficial results in BP control in patients with TRH adopting an innovative approach, defined as therapeutic concordance, in which trained physicians and pharmacists reach a concordance with patients to make them more involved in the therapeutic decision-making process.

Methods: The main scope of this study was to investigate whether the therapeutic concordance approach could lead to a reduction in ADR occurrence in TRH patients.

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Background: Arterial hypertension causes cardiac functional and structural alterations. In hypertensive patients without flow-limiting epicardial coronary artery disease, we investigated possible relationships between positron emission tomography/computed tomography-derived myocardial blood flow (MBF) and echocardiographic parameters of left ventricular (LV) performance, including mechano-energetic efficiency indexed for myocardial mass (MEEi).

Methods: Seventy-eight hypertensive patients without flow-limiting epicardial coronary artery disease underwent echocardiography, including MEEi computation, and cardiac positron emission tomography/computed tomography with assessment of MBF/mass ratio at rest and after stress and myocardial flow reserve.

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Introduction: An empathetic approach may be particularly useful in patients with therapy-resistant hypertension (TRH), defined as the failure to achieve target blood pressure (BP) despite a maximal doses of 3 antihypertensive drugs including a diuretic. However, the effects of therapeutic concordance have not been determined in hypertensive patients.

Methods: We designed a study to explore the impact of therapeutic concordance in patients with TRH, who were included in an intervention arm based on a protocol in which trained personnel periodically verified the pharmacological regimen of these patients.

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Article Synopsis
  • Home blood pressure monitoring (HBPM) may be a reliable alternative to ambulatory blood pressure monitoring (ABPM) for hypertension management, but correct techniques are essential for accuracy.
  • A survey conducted over two years with 643 hypertensive patients revealed that although 71% of participants were informed about HBPM practices, many still made significant errors in measurement techniques.
  • Proper HBPM practices correlate with better health outcomes, indicating that enhancing patient education on accurate measurement could improve hypertension management.
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Background: Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated.

Objectives: The aim of this study was to assess the sex-related differences in TB and its clinical implications in patients with STEMI.

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