European journal of internal medicine
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Eur. J. Intern. Med. · Dec 2024
Impaired insulin sensitivity measured by estimated glucose disposal rate is associated with decreased myocardial mechano-energetic efficiency in non-diabetic individuals.
Impaired myocardial mechano-energetic efficiency (MEE) has been associated with cardiac insulin resistance measured by dynamic positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) combined with euglycemic-hyperinsulinemic clamp. Estimate glucose disposal rate (eGDR) index has a good correlation with whole-body insulin sensitivity. It remains unsettled whether eGDR index is a suitable proxy of cardiac insulin sensitivity as well as its association with myocardial MEE. The aims of this study were: 1) to compare eGDR index with HOMA-IR, QUICKI and FIRI indexes for association with myocardial glucose metabolic rate (MrGlu); and 2) to determine the association of eGDR index with myocardial MEE. ⋯ These data suggest that the eGDR index may be a useful marker to identifying individuals at high cardiovascular risk.
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Eur. J. Intern. Med. · Dec 2024
Observational StudyCarotid plaque offsets sex-related differences in cardiovascular risk of young hypertensive patients.
Women have a lower risk for cardiovascular (CV) disease compared to men. Whether this difference is influenced by the presence of hypertension-mediated organ damage is unknown. ⋯ Our findings suggest that the presence of CP in young patients with treated hypertension offsets the CV disease protection in women.
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Eur. J. Intern. Med. · Dec 2024
Multicenter StudyTreatment of systemic lupus erythematosus: Analysis of treatment patterns in adult and paediatric patients across four European countries.
Multiple treatment options are recommended for Systemic Lupus Erythematosus (SLE) by clinical guidelines. This study aimed to explore SLE treatment patterns as there is limited real-world data of SLE medication utilisation, especially in childhood-onset SLE (cSLE). ⋯ Treatment choices for adult SLE patients across four European countries were in line with recent therapeutic consensus guidelines. High glucocorticoid prescriptions in paediatric patients suggests the need for steroid-sparing treatment alternatives and paediatric specific guidelines.
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Eur. J. Intern. Med. · Dec 2024
ReviewThe assessment, interpretation and implementation of lung ultrasound examinations in Heart Failure: Current evidence and gaps in knowledge.
Lung ultrasound (LUS) is a simple, fast and non-invasive tool for pulmonary congestion assessment with higher accuracy for the detection of acute heart failure (HF) compared to clinical examination and chest radiography. The integrated assessment with other ultrasound and echocardiographic parameters can lead to a better systemic and pulmonary congestion characterization. Additionally, the combination of echocardiographic and pulmonary features can identify patients at higher risk for adverse outcomes, potentially facilitating both acute and chronic HF management and prognostic stratification. ⋯ Despite the extensive potential role of LUS in a wide range of HF scenarios, clinicians may be unaware of the correct technique and exam interpretation. Specifically, the interpretation of LUS findings is influenced by several factors, such as imaging protocol, type of ultrasound transducer, patient positioning, and presence of concomitant pulmonary diseases. The aim of this review is to provide a practical overview of LUS in patients with known or suspected HF with the goal of providing a practical guide for clinicians and nurses in various clinical settings.
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Eur. J. Intern. Med. · Dec 2024
Multicenter StudyTowards a comprehensive approach to the management and prognosis of systemic sclerosis's patients: The role of comorbidities in the SPRING-SIR registry.
The current knowledge about the role of comorbidities in systemic sclerosis (SSc) is limited. Therefore, the aim of this study was to evaluate the prevalence of comorbidities and their impact on disease activity and prognosis in the Systemic sclerosis PRogression INvestiGation (SPRING) registry. ⋯ Comorbidities and disease activity independently impact on the prognosis of SSc patients. This suggests that the management of comorbidities, together with the reduction of disease activity, is fundamental to improve patient survival.