Università Magna Græcia di Catanzaro

1. Università Magna Græcia di Catanzaro Dipartimento di Medicina Sperimentale e Clinica Cattedra di Medicina Interna Scuola di Specializzazione in Geriatria U.O. Malattie Cardiovascolari Geriatriche Prof. Francesco Perticone Sindrome Infiammatoria Sistemica e Rischio CV

6. Association Between Airflow Obstruction, CRP and AMI Ukena C et al. Int J Cardiol 2010

8. Inflammatory Events in Complex Comorbidities Ukena C et al. Int J Cardiol 2010

9. Cardiopulmonary Continuum Concept of systemic inflammatory processes as underlying pathophysiological relationship between COPD and CAD Ukena C et al. Int J Cardiol 2010

12. Low-Dose Aspirin Reduces Thromboxane B2 but not CRP 140 100 60 20 140 100 60 20 28 Days 31 Days Serum CRP (% of Baseline) Serum Thromboxane (% of Baseline) * p<0.001 * * Placebo(n=11) ASA 81 mg qd(n=13) Placebo(n=11) ASA 81 mg qd(n=13) Feldman M et al. J Am Coll Cardiol 2001;37:2036-2041

13. CARE: La Pravastatina Riduce il Rischio Rappresentato dall’Infiammazione P trend=0.005 3 P=0.007 2 Rischio relativo di un evento 1 0 Pravastatina Placebo Pravastatina Placebo Infiammazione Presente( PCR e SAA) Infiammazione Assente Ridker et al: Circulation 1998;98:839–844

14. L-ascorbic Acid Depletion in Spiked Sera from Nonsmoking Men (10 control subjects, 15 PAD patients), Stratified for Serum CRP (5.0 mg/L) Serum L-ascorbic acid, % Controls PAD Correlation Between Serum L-ascorbic Acid and CRP Concentrations in PAD Patients Serum L-ascorbic acid, mmol/L r= -0.72P< .001 Serum CRP, mg/L Tzoulaky I et al., Circulation 2005

15. Oxidative Stress and Atorvastatin Cangemi R et al, Eur Heart J 2008;29:54–62

16. Vascular Function According to Median of Hb Perticone F et al, Clin J Am Soc Nephrol, accepted

17. 140 180 120 160 HR (b/m) and BP (mmHg) FBF (ml/min) 100 140 80 120 60 100 Hemodynamics and Flow Before and After Smoking FBF SBP DBP HR Baseline 0 30 60 90 120 min J Lekakis et al, Am J Cardiol 1998;81:1225-28

18. Flow-mediated Dilation of the Brachial Artery after Smoking, Sham Smoking and after Smoking a Second Cigarette 12 sham 10 1st cigarette 2nd cigarette 8 FMD (%) 6 4 2 0 0 30 60 90 120 Time, min J Lekakis et al, Am J Cardiol 1998

19. 10 5 0 FMD % Relationship Between Smoking and Flow Mediated Dilation P < .01 None 1 - 4 5 - 9 10 - 19 > 20 Celermajer et al, N Engl J Med 1996

20. Relationship Between Passive Smoking and Flow Mediated Dilation P < .001 20 P < .001 P = NS 15 FMD % 10 5 0 Controls Passive Active smokers smokers Celermajer et al, N Engl J Med 1996

21. NADH/NA DPH Oxidase O2 e- O-2 NO OONO- e-NOS L-arginina citrullina NO- production inactivation NO bioavailabilty

22. Endothelial Dysfunction and C-Reactive Protein Are Risk Factors for Diabetes in Essential Hypertension 80 Exponential fitting r=0.85 P<0.001 60 5.6-years estimated probability of diabetes (%) 40 20 0 0 200 400 600 800 1000 Maximal vasodilatory response to ACh (%) Perticone F et al, Diabetes 2008

23. Sindrome Metabolica e Livelli di PCR 8 6 C-reactive Protein (mg/L) 4 2 0 0 1 2 3 4 5 Number of Components of the Metabolic Syndrome Ridker PM, et al. Circulation. 2003;107:391-397.

24. Unadjusted Kaplan-Meier Curves Coronary Heart Disease Mortality All Cause Mortality Cardiovascular Disease Mortality 20 20 20 15 15 15 RR (95% CI), 2.43 (1.64-3.61) RR (95% CI), 3.55 (1.96-6.43) RR (95% CI), 3.77 (1.74-8.17) Cumulative Hazard (%) 10 10 10 5 5 5 0 0 0 8 10 12 2 6 8 10 12 0 4 8 10 12 2 6 2 6 0 4 0 4 Follow-up, Y Follow-up, Y Follow-up, Y No. at Risk Metabolic Syndrome 834 234 292 100 866 288 852 279 834 234 292 100 834 234 292 100 866 288 852 279 Yes No 866 288 852 279 Metabolic Syndrome: Yes No Lakka H-M, et al. JAMA. 2002;288:2709-2716.

25. Relationship between metabolic syndrome, lung dysfunction and CV disease

26. Creatinine Cl (ml/min/1.73m2) 100 95 90 IL-1β 4.4 1rst 2nd 3rd 4th CRP quartiles PREVEND study, Kidney Int 63:654, 2003 The 3 years risk for CV events in the women health study Ridker NEJM 2000; 342:836 8 6 4 2 0 IL-6 TNF-α CRP un solido indicatore di rischio CV

27. MBP (change) 5 0 -5 800 r = 0.587 P < 0.0001 SVR (change) 400 200 0 -200 400 -30 0 30 60 min 0 0,4 0,6 0,8 1 ADMA mmol/L ADMA and Endothelial Vasodilation in Hypertension Achan V & Vallance P. ATVB 2003 ADMA Perticone F et al, J Am Coll Cardiol, 2005;46:518-23 FBF, % increase Perticone F et al, Int J Cardiol 2009

28. Sciacqua A et al, NMCD 2010

29. r = 0.636 p< 0.0001 220 170 LVMI, g/m2 120 70 0 10 20 30 Insulin, mU/mL Fasting Insulin and Left Ventricular Mass F Perticone et al, J Clin Endocrinol Metab 2001 G Sesti, F Perticone et al, J Hypertens 2007

30. Signaling Determining Mesenchimal-Cell Differentiation toward Osteoblasts and Signals Acting on Mature Osteoblasts to Enhance Bone Formation Signaling Pathways Used by Bone Morphometric Proteins in Osteoblasts

31. Molecularsignalingpathwayslinking ROS tocardiachypertrophy and remodeling DeletionPolymorphismof ACE-Gene and LeftVentricularHypertrophy Takimoto E , Kass DA, Hypertension 2007 Perticone F et al, J Am CollCardiol 1997;29:365-9

32. Scieffer B et al, Circulation, 2000;101:1372-78

34. EffectofFructose on VariousOrganSystems Johnson RJ et al, Endocrine Reviews 2009;30:96–116

35. 0.001 Acido Urico, Funzione Endoteliale e Diabete 0.012 0.340 0.799 0.355 0.192 0.124 0.090 0.071 HR (plus uric acid 1 g/dL increase) ACh % of increase Perticone F et al, submitted

36. Endothelial Dysfunction and e-GFR Decline Perticone F et al, Circulation 2010

37. Effects of FFA on Various Organs Effects of LDL Particles on the Wessel Wall Rocha VZ and Libby P, Nat Rev Cardiol 2009;6:399-409

38. INFLAMMATION HYPERTENSION DIABETES INSULIN RESISTANCE ENDOTHELIAL DYSFUNCTION TARGET ORGAN DAMAGE AMI STROKE HEART FAILURE SUDDEN DEATH