IntroductionAcute-on-chronic liver failure (ACLF) is a severe complication of advanced liver disease. A significant number of ACLF patients have not clear precipitating factors.AimThe aim of the study was to investigate the role of alterations in porto-hepatic hemodynamics, especially non-forward portal flow (NFPF), in ACLF and liver-related mortality.Materials and Methods233 cirrhotic patients were included in the study with a median follow-up of 24 months. Color-Doppler ultrasound was used to assess portal vein patency, flow direction and significant porto-systemic collaterals (> 8 mm). Patients with active cancer, both at baseline and during follow-up, severe non liver-related comorbidities and liver-unrelated death were excluded. ACLF and liver-related mortality were recorded during follow-up.ResultsFifty-six patients (24%) developed ACLF; 24 (10,3%) had baseline NFPF. In survival analysis, NFPF, but not portal vein thrombosis, was independently associated with ACLF development (HR 2.85 95% C.I. [1.49-5.42], p=0.001) and liver-related mortality (HR 2.24 95% C.I. [1.16-4.28], p=0.015), even after adjustment for liver disease severity scores, baseline portal vein thrombosis, age and etiology of liver disease.ConclusionsNFPF was independently associated with ACLF development and liver-related mortality, regardless of etiology, severity disease scores and portal vein thrombosis. Although there is no specific measure to reverse NFPF, patients with NFPF should receive prompt intensive management and urgent prioritization for liver transplantation.

Background and purpose Bacterial infections represent a major cause of morbidity and mortality in cirrhotic patients. Our aim was to assess the incidence of bacterial infections, in particular due to multidrug-resistant organisms (MDROs) before and after the introduction of the antimicrobial stewardship program, "Stewardship Antimicrobial in VErona" (SAVE). In addition, we also analysed the liver complications and the crude mortality during the whole follow up. Methods We analysed 229 cirrhotic subjects without previous hospitalization for infections enrolled at the University Verona Hospital from 2017 to 2019 and followed up until December 2021 (mean follow-up 42.7 months). Results 101 infections were recorded and 31.7% were recurrent. The most frequent were sepsis (24.7%), pneumonia (19.8%), spontaneous bacterial peritonitis (17.8%). 14.9% of infections were sustained by MDROs. Liver complications occurred more frequently in infected patients, and in case of MDROs infections with a significantly higher MELD and Child-Pugh score. In Cox regression analysis, mortality was associated with age, diabetes and bacterial infections episodes (OR 3.30, CI 95%: (1.63-6.70). Despite an increase in total infections over the past three years, a decrease in the incidence rate in MDROs infections was documented concurrently with the introduction of SAVE (IRD 28.6; 95% CI: 4.6-52.5, p = 0.02). Conclusions Our study confirms the burden of bacterial infections in cirrhotic patients, especially MDROs, and the strong interconnection with liver complications. The introduction of SAVE decreased MDROs infections. Cirrhotic patients require a closer clinical surveillance to identify colonized patients and avoid the horizontal spread of MDROs in this setting.

Hepatocellular carcinoma (HCC) is the major cause of liver-related death worldwide. Interleukin 6 (IL-6) promotes the growth of the HCC microenvironment. The correlation between Child–Pugh (CP) and HCC stage and between HCC stage and sarcopenia is still not clear. Our aim was to investigate whether IL-6 is correlated with HCC stage and could represent a diagnostic marker for sarcopenia. Ninety-three HCC cirrhotic patients in different stages, according to BCLC-2022 (stages A, B, and C), were enrolled. Anthropometric and biochemical parameters, comprehensive of IL-6, were collected. The skeletal muscle index (SMI) was measured using dedicated software on computer tomography (CT) images. IL-6 level was higher in advanced (BCLC C) compared to the early-intermediate (BCLC A-B) stages (21.4 vs. 7.7 pg/mL, p < 0.005). On multivariate analysis, IL-6 levels were statistically dependent on the degree of liver disease severity (CP score) and HCC stages (p = 0.001 and p = 0.044, respectively). Sarcopenic patients presented lower BMI (24.7 ± 5.3 vs. 28.5 ± 7.0), higher PMN/lymphocyte ratio (2.9 ± 2.4 vs. 2.3 ± 1.2) and increased values of log (IL-6) (1.3 ± 0.6 vs. 1.1 ± 0.3). Univariate logistic regression between sarcopenia and log (IL-6) showed a significant odds ratio (OR 14.88, p = 0.044) with an AUC of 0.72. IL-6 appears to be an effective biomarker for the diagnosis of advanced cirrhotic HCC. In addition, IL-6 could be considered a marker of cirrhotic HCC-related sarcopenia, suggesting further investigation with BIA- or CT-dedicated software.

BACKGROUND:Portal vein thrombosis (PVT) and sepsis are common complications in patients with liver cirrhosis. Factors that lead to PVT are not completely understood. This study aimed to investigate the possible association between bacterial infections and the development of PVT in cirrhotic patients. PATIENTS AND METHODS:202 consecutive cirrhotic patients without previous infections, followed at the Liver Unit in Verona Hospital, were enrolled from 2017 to 2021 (median follow-up 3.3 years). During the follow-up period, PVT was diagnosed by ultrasound, CT and/or MRI, and episodes of bacterial infections requiring hospitalization were recorded. Malignant PVT was an exclusion criterion. RESULTS:Of the 202 patients enrolled (68.3 % males, mean age 63.8 ± 11 years), 22 (10.8 %) developed PVT during the follow up. In patients with PVT, the prevalence of previous bacterial infections was significantly higher compared to patients without PVT (63.6% vs 31.1 %; p = 0.02). Cox regression analysis revealed that a history of bacterial infection was the only variable that demonstrated a significant association with the risk of de novo PVT occurrence (HR 4.04, 95 % CI: 1.68-9.65). CONCLUSION:in patients with liver cirrhosis bacterial infections are a predisposing factor for the following development of PVT. Further studies are needed to confirm this evidence.

Chronic anaemia in advanced liver disease is a frequent finding. The aim was to explore the clinical impact of spur cell anaemia, a rare entity typically associated with end-stage of the disease. One-hundred and nineteen patients (73.9

Introduction: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death. Most cases (90%) of HCC arise in the setting of a chronic liver disease. The advanced stages of HCC are amendable only to systemic treatment. Systemic therapy has been revolutionized by immune-based therapies. However, a recent meta-analysis of three randomized phase III clinical trials that tested inhibitors of PD-L1 or PD1 in more than 1,600 patients with advanced HCC, revealed that immune therapy did not improve survival in patients with non-viral HCC.

Objectives Hepatitis C virus (HCV) infection is associated with an increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The impact of HCV eradication on the metabolic profile in diabetic patients treated with direct-acting antiviral agents (DAAs) is not well defined. The aim of our study was to evaluate the effects of DAAs on a lipid and glucose profile in a cohort of diabetic patients with different liver fibrotic stages. Methods T2DM patients with active HCV infection were consecutively enrolled in this prospective trial. Glycolipidic status was assessed, before starting DAA treatment (T0) and at 12 months after the beginning of treatment (T1). Liver fibrotic stage was assessed by FibroScan. Results In all, 131 patients were enrolled and all of them achieved a sustained virologic response. At baseline, no significant differences were found in lipid and glucose profiles in subgroup analysis by liver fibrosis, HCV genotype, and cardiovascular risk factors. At T1, total cholesterol and low-density lipoprotein cholesterol, but not triglycerides, significantly increased irrespective of liver fibrotic stage and baseline anthropometric and clinical profiles, while glycated hemoglobin significantly decreased only in F4 patients. Conclusions HCV eradication in diabetic patients is associated with a worsening lipid profile that could impact future cardiovascular risk. A careful global monitoring of cardiovascular risk factors in all diabetic patients after HCV eradication is needed.

Introduction and aims: Hepatocellular carcinoma (HCC) is a major cause of liver cancer-related death worldwide. It usually occurs in cirrhosis with different aetiopathogenesis. Serum IL-6 is a proinflammatory cytokine that increases considerably in pathological settings such as trauma, inflammation and neoplasia. Based on pre-clinical data in HCC, IL-6 signalling leads to tumour progression or local recurrence. Aim of our study is to clarify if the levels of IL-6 are associated with HCC progression and its different aetiopathogenesis in cirrhotic patients.

Background and Aims: Non-malignant portal vein thrombosis (PVT) is one of the complications of liver cirrhosis. The predisposing factors for PVT in cirrhotic patients are not entirely clear. The aim of this study was to identify possible clinical risk factors related to the development of PVT in patients with liver cirrhosis.

Background and aims: Non-alcoholic fatty liver disease (NAFLD) is associated with increased cardiovascular (CV) risk. However, it is unclear whether NAFLD contributes independently to the development of CV disease. Our study aimed at assessing the differences in several indices of atherosclerosis, arterial stiffness and cardiac morphology among patients with isolated NAFLD, isolated hypertension (HT) or a combination of the two conditions. Methods and results: A total of 169 participants (mean age = 50.4 + 10.2 yrs; males = 73.6%) were divided according to the presence of NAFLD and HT into three groups: only NAFLD (55 patients), only HT (49 patients), and NAFLD + HT (65 patients). Exclusion criteria were a BMI >= 35 kg/m2 and a diagnosis of diabetes mellitus. Carotid ultrasonography was performed to measure markers of atherosclerosis and arterial stiffness. Cardiac remodeling was analyzed using echocardiography. The prevalence of subclinical and overt atherosclerosis was significantly higher in the NAFLD + HT patients as compared to the other two groups (atherosclerotic plaques: 43.1%, 10.9%, and 22.4% (p < 0.001) in NAFLD + HT, NAFLD, and HT groups, respectively). No differences were found among indices of arterial stiffening and cardiac remodeling across the three groups. In multivariate regression analysis, the coexistence of NAFLD and HT was an independent risk factor for overt atherosclerosis (OR = 4.88, CI 95% 1.14-20.93), while no association was found when either NAFLD or HT was considered alone. Conclusion: Overt atherosclerosis was significantly present only in NAFLD + HT patients, but not in patients with isolated NAFLD. This implies that the impact of NAFLD on vascular structure and function could depend on the coexistence of other major CV risk factors, such as HT. (c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

A paucity of information currently exists on plasma bile acid (BA) profiles in patients with and without type 2 diabetes mellitus (T2DM). We assayed 14 plasma BA species in 224 patients with T2DM and in 102 nondiabetic individuals with metabolic syndrome. Plasma BA levels were measured with ultra-performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) technique. Multivariable linear regression analyses were undertaken to assess associations between measured plasma BA species and T2DM status after adjustment for confounding factors. The presence of T2DM was significantly associated with higher plasma concentrations of both primary BAs (adjusted-standardized β coefficient: 0.279, p = 0.005) and secondary BAs (standardized β coefficient: 0.508, p < 0.001) after adjustment for age, sex, adiposity measures, serum alanine aminotransferase and use of statins or metformin. More specifically, the presence of T2DM was significantly associated with higher levels of plasma taurochenodeoxycholic acid, taurodeoxycholic acid, glycochenodeoxycholic acid, hyodeoxycholic acid, glycodeoxycholic acid, glycolithocholic acid, deoxycholic acid, taurochenodeoxycholic acid, taurodeoxycholic acid, glycochenodeoxycholic acid and glycodeoxycholic acid (adjusted-standardized β coefficients ranging from 0.315 to 0.600; p < 0.01 or less), as well as with lower plasma levels of cholic acid (adjusted-standardized β coefficient: −0.250, p = 0.013) and taurocholic acid (adjusted-standardized β coefficient: −0.309, p = 0.001). This study shows that there are marked differences in plasma BA profiles between patients with and without T2DM. Further research will be needed to better understand how these differences in plasma BA profiles may interplay with the pathophysiology of T2DM.

Abstract Objective: Non-alcoholic fatty liver disease (NAFLD) is associated with an increased cardiovascular (CV) risk. However, it is still not clear whether NAFLD contributes independently to the development and progression of CV disease. This study aimed to assess the differences between NAFLD patients with or without hypertension (HT) and patients with HT but no NAFLD through markers of subclinical and clinical atherosclerosis, cardiac function and morphology and liver fibrosis. Design and method: Eighty-seven participants (51,9 ± 9y; males = 83,7%) were divided according to the presence of NAFLD and essential HT in three groups: only-NAFLD, only-HT and NAFLD + HT. Patients with BMI > 35 and type II diabetes were excluded. Blood pressure (BP) measurement, carotid ultrasonography, echocardiography and transient elastography were performed. Carotid intima–media thickness (cIMT), Carotid Distensibility (CD) and Carotid-femoral pulse wave velocity (cf-PWV) were measured as markers of subclinical atherosclerosis and arterial stiffness. Results: The prevalence of atherosclerotic plaques was significantly higher in NAFLD + HT group compared with only-NAFLD group (40% vs 5,7%; p < 0,001). Belonging to NAFLD + HT group, rather than other clinical variables, was independently associated with atherosclerotic plaques in stepwise multiple logistic regression analysis (beta ± SEM = 2.083 ± 0.958; p = 0,01). No differences in cIMT, CD, cf-PWV, echocardiographic parameters and liver stiffness were found among the three groups; nevertheless, a significant prevalence of concentric cardiac remodeling (RWT > 0,42) was detected in all groups (only-HT, NAFLD + HT and only-NAFLD group at 40,9%, 35,7% and 33,3%, respectively; p = not significant). Conclusions: Overt atherosclerosis, rather than subclinical atherosclerosis and arterial stiffness, was more evident in NAFLD + HT patients. A surprising finding was the high prevalence of concentric cardiac remodelling in all groups, including in the only-NAFLD one, suggesting a possible direct involvement of NAFLD in cardiac structural changes. Therefore, the impact of NAFLD on vascular and cardiac structure could be different and partially dependent on the presence of HT.

The Severe Acute Respiratory Syndrome (SARS) related to COVID-19 infection is a hard-to-treat disease with a poor prognosis. High casualty rate has been reported in the frail elderly where malnutrition and defective micronutrient state may both impair the immune response [1Calder P.C. Carr A.C. Gombart A.F. Eggersdorfer M. Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections.Nutrients. 2020; 12: 1181Crossref PubMed Scopus (538) Google Scholar]. Rodriguez et all showed that 2% of patients admitted to an Intensive Care Unit (ICU) were Vitamin B12 deficient [2Rodriguez R.M. Corwin H.L. Gettinger A. Corwin M.J. Gubler D. Pearl R.G. Nutritional deficiencies and blunted erythropoietin response as causes of the anemia of critical illness.J Crit Care. 2001; 16: 36-41Crossref PubMed Scopus (243) Google Scholar]. Low plasma vitamin B12 (B12) and folate levels may also be associated with high homocysteine concentration. Moreover, vitamin B12 supplementation has been showed to add favourably to chronic hepatitis C treatment [3Gupta S. Read S.A. Shackel N.A. Hebbard L. George J. Ahlenstiel G. The role of micronutrients in the infection and subsequent response to hepatitis C virus.Cells. 2019; 8: 603Crossref Scopus (41) Google Scholar]. Aim of our study was to study prospectively vitamin B12 and folate plasma level in patients admitted for COVID Pneumonia. 51 patients diagnosed with SARS-Cov2 pharyngeal nose swab hospitalized at our internal medicine unit from 30Th March to 30Th April 2020 were considered for the study. 2 patients were excluded for ongoing vitamin supplementation. 49 patients (males 64.5%; median age 72 years, IQR = 22 years) underwent extensive blood test, including B12, folates and blood gas analysis. Results were correlated with the outcome with a worse outcome intended as transfer to ICU or death. Continuous variables are expressed as mean ± standard deviation (SD) and as median with Inter-Quartile Range (IQR) depending on data distribution; discrete variables are expressed as number and percentage. Comparison between continuous variables is performed using the Student's T test for unpaired data and/or the Mann–Whitney U test, depending on the distribution of the data. A stepwise multivariate linear regression analysis was performed in order to determine any independent determinants of outcome. Nine out of 49 patients were transferred to the ICU or died. Patients with poor outcome were significantly older (p = 0.01), had lower P/F ratio (p = 0.01) and higher plasma level of B12 (p = 0.02) compared with those who recovered. In a multivariate regression analysis, only age was independently associated with a worse outcome (β±SEM 0.016 ± 0.005, p = 0.001). No significant differences were noticed as regards to folates, transaminases, D-dimer, homocysteine, and fibrinogen (Table 1) A shortage of B vitamins may weaken host immune response [1Calder P.C. Carr A.C. Gombart A.F. Eggersdorfer M. Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections.Nutrients. 2020; 12: 1181Crossref PubMed Scopus (538) Google Scholar]. One might postulate B12 as basic treatment option for COVID-19 illness. However, B12 status has not been previously assessed in this population. Unexpectedly, our data do not support a potential therapeutic role of B12 supplementation for a low 2% rate of B12 deficiency and normal homocysteine levels were not consistent with a significant B12 shortage [4Spence J.D. Yi Q. Hankey G.J. B vitamins in stroke prevention: time to reconsider.Lancet Neurol. 2017; 16: 750-760Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar]. Unfortunately, we did not perform plasma methylmalonic acid evaluation which is the most sensitive marker for B12 deficiency. However, a potential association between high plasma levels of vitamin B12 and increased risk of mortality is suggested. Moreover, it has been reported that the cyanocobalamin fraction of B12 may worsen prognosis of renal insufficiency patients [4Spence J.D. Yi Q. Hankey G.J. B vitamins in stroke prevention: time to reconsider.Lancet Neurol. 2017; 16: 750-760Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar]. However, no difference of B12 levels were found when the population was divided for glomerular filtration rate (GFR) by a post-hoc analysis with few patients showing altered GFR. Our study supports recent findings in both the general population and the ICU patients where excessive B12 has been reported to be associated with increased mortality rates [5Flores-Guerrero J.L. Minovic I. Groothof D. Gruppen E.G. Riphagen I.J. Kootstra-Ros J. et al.Association of plasma concentration of vitamin B12 with all-cause mortality in the general population in The Netherlands.JAMA Netw Open. 2020; 3e1919274https://doi.org/10.1001/jamanetworkopen.2019.19274Crossref PubMed Scopus (42) Google Scholar,6Sviri S. Khalaila R. Daher S. Bayya A. Linton D.M. Stav I. et al.Increased Vitamin B12 levels are associated with mortality in critically ill medical patients.Clin Nutr. 2012; 31: 53-59Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar]. A number of mechanisms can cause high Vitamin B12 levels in our study population: elevated levels of carrier proteins, decreased Vitamin B12 clearance by the liver and decreased uptake by peripheral tissues. However, it is tempting to speculate a correlation with the cytokine storm of the COVID-19 infection to consider a potential role of excessive vitamin B12 on predicting illness outcome.Table 1Population characteristics of the COVID-19 patients.No ICU/alive (#40)ICU or death (#9)p valueAge (years)70.2 ± 13.483.3 ± 10.5p = 0.01Sex (males, %)3637n.s.VitB12 (ng/mL)583 ± 2951315 ± 1087p = 0.02Folates (ng/mL)6.1 ± 7.75.7 ± 6.1n.s.Fibrinogen (g/L)6.0 ± 1.85.0 ± 2.0n.s.Homocysteine μmol/L9 ± 1.211 ± 1.4n.s.D-dimer (ng/L)2910 ± 23101350 ± 1130n.s.ALT (U/L)28 ± 1743 ± 34n.s.Lymphocytes (per mm3)1750 ± 2600810 ± 409n.s.Creatinine (mg/dL)1.1 ± 0.50.8 ± 0.6n.s.GFR mL/min/1,73 m64 ± 2061 ± 18n.s.P/F ratio (pO2/%Oxinhaled)280 ± 54202 ± 91p = 0.01Protrombin Time (INR)1.3 ± 0.31.1 ± 0.2n.s. Open table in a new tab The author declares that there is no conflict of interest.

Patients with rheumatoid arthritis (RA) have an increased incidence of cardiovascular events. Ultrasound examination of the carotid arteries can show the presence of plaques and detect the atherosclerotic subclinical process through the evaluation of intima-media thickness (cIMT) and carotid segmental distensibility (cCD). The aim of the present study was to identify which factors could independently influence the evolution of atherosclerosis (plaques, cIMT, and cCD) after 1 year of follow-up in a sample of patients with RA. A total of 137 patients with RA without previous cardiovascular (CV) events were enrolled at baseline, and 105 (M/F: 21/84, age 59.34 ± 11.65 years) were reassessed after one year using ultrasound of carotid arteries to detect atheromatous plaques and to measure cIMT and cCD. After one year, all the indices of subclinical atherosclerosis worsened with respect to baseline (Δ-cIMT = 0.030 ± 0.10 mm, p = 0.005; Δ-cCD = −1.64 ± 4.83, 10–3/KPa, p = 0.005; Δ-plaques = 8.6%, p = 0.035). Traditional CV risk factors (age, mean arterial pressure, and diabetes) and corticosteroid therapy were independently associated with the worsening of subclinical atherosclerosis. Interestingly, when considering RA patients divided according to the degree of disease activity score 28 with C-reactive protein (DAS28 [CRP] ≥2.6), the worsening of subclinical atherosclerosis indices was detectable exclusively in the group of patients with active disease. Our longitudinal study supports the hypothesis of a key role of both traditional CV risk factors and the inflammatory activity of arthritic disease in the progression of subclinical atherosclerosis in RA patients. In addition, corticosteroids might have a deleterious effect.

Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching for a relationship with possible causative factors in patients with metastatic renal cell carcinoma. We included 29 patients in a prospective, observational study; 22 were treated with a first-line drug (sunitinib), while seven participated in the second-line treatment (axitinib or cabozantinib). Patients were investigated at the beginning of antiangiogenic therapy (T0) and at one (T1), three (T2), and six months (T3) after treatment. Patients were evaluated by office blood pressure (BP) and ultrasonography to measure flow-mediated dilatation (FMD), and carotid artery distensibility (cDC) by echocardiography and nailfold capillaroscopy. Plasma endothelin-1 (p-ET-1), urine nitrates, and proteins were also measured. At T1, systolic BP, along with U proteins and p-ET-1, increased significantly. In patients with a clinically significant increase in BP (defined as either the need for an antihypertensive drug or systolic blood pressure (SBP) T1–T0 ≥10 and/or SBP ≥140 mmHg and/or diastolic blood pressure (DBP) T1–T0 ≥5 and/or DBP ≥90 mmHg), the urine nitrate concentration was lower at T0, whereas there were no differences in the p-ET-1 and U proteins. Seventeen participants showed changes in the capillaroscopic pattern at T1 with no association with BP increases. There were no differences in the FMD, cDC, and echocardiographic parameters. Our findings are consistent with those of previous studies about BP increases by TKI, and suggest a role of nitric oxide in BP maintenance in this population.

Introduction: Arterial stiffness is known to be associated with atherosclerosis, cardiac remodelling and cardiovascular diseases. In recent studies, common carotid artery rigidity was seen to better predict cardiac morphology and function if compared to aortic parameters. The aim of the study was to determine the relation between carotid/aortic stiffness indices and the main echocardiographic measures in patients with rheumatological disease. Methods: 208 participants were evaluated (57,4 ± 11,4 yr; males = 36,1%); 65,9% were previously diagnosed with rheumatoid arthritis, 20,2% with psoriatic arthritis and 13,9% with ankylosing spondylitis. In each subjects medical history, use of drugs and glico-metabolic status was assessed. Echocardiography, blood pressure (BP) measurement and carotid ultrasonography were performed. Carotid Distensibility (CD) and Aortic Stiffness (AoS) were measured as indices of arterial stiffness. Results: Mean Left Ventricular Mass indexed by body surface area (LVM/BSA) and Relative Wall Thickness (RWT) were 98,8 ± 20,7 g/m2 and 0,46 ± 0,06, respectively. In multiple regression analysis, DC was correlated with age (β = 0,325, p < 0,0001) and mean BP (β = 0,502, p < 0,0001) while AoS was not associated with any anthropometric, anamnestic and vascular parameters. DC has been seen to inversely correlate with LVM/BSA (r = −0,20, p = 0,005), Intraventricular Septum and Posterior Wall Thickenss; a direct correlation between AoS and left E/e’ (a diastolic function indicator) has emerged (r = 0,191, p = 0,007). Conclusion: Results are consistent with a possible predictive role of DC assessment in left cardiac hypertrophy and remodelling and a direct link between AoS and left ventricular diastolic function.

Tomato consumption has been recently associated with a reduced incidence of cardiovascular disease (CVD). The aim of this study was to test whether a seven-day period of tomato paste purèe (tomato paste, TP) supplementation could improve some haemodynamic parameters in healthy volunteers before and after a standardized fat meal (FM).METHODS AND RESULTS:Nineteen healthy male volunteers participated in a randomized, single-blind (operator) crossover study. Participants maintained low fiber diets (LFD) during the study periods. They were randomized either to a LFD and TP arm (80 g of TP/day) for seven-days, or to a control arm (LFD-only) with a two-week washout period. Flow Mediated Dilatation and other morpho-functional vascular indices were measured by ultrasound. Stiffness Index and Reflection Index were estimated by digital photo-plethysmography. All these parameters were measured one h before and two and 3.5 h after the FM. The difference in Stiffness Index was increased in the LFD and TP + FM-arm, as compared to the LFD-only + FM arm at both two and 3.5 h points. After the FM, in both arms, at two h, we observed a reduction in the Reflection Index and an increase in heart rate. Interestingly, only in the LFD and TP + FM-arm, some haemodynamic changes were detectable at two h; notably, there was an increase in brachial artery diameter and a reduction in diastolic blood pressure (BP).CONCLUSIONS:TP has no effect on Flow Mediated Dilatation but acutely modifies some haemodynamic parameters triggered by FM, suggesting possible haemodynamic beneficial effects in people consuming tomatoes.