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Theofilis P, Antonopoulos AS, Sagris M, Papanikolaou A, Oikonomou E, Tsioufis K, Tousoulis D. Silent Myocardial Ischemia: From Pathophysiology to Diagnosis and Treatment. Biomedicines 2024; 12:259. [PMID: 38397860 PMCID: PMC10886642 DOI: 10.3390/biomedicines12020259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Silent myocardial ischemia (SMI), characterized by a lack of overt symptoms despite an inadequate blood supply to the myocardium, remains a challenging entity in cardiovascular medicine. The pathogenesis involves intricate interactions of vascular, neurohormonal, and metabolic factors, contributing to perfusion deficits without the characteristic chest pain. Understanding these mechanisms is pivotal for recognizing diverse clinical presentations and designing targeted interventions. Diagnostic strategies for SMI have evolved from traditional electrocardiography to advanced imaging modalities, including stress echocardiography, single-photon emission computed tomography (SPECT), positron emission tomography (PET), and cardiac magnetic resonance imaging (MRI). Treating SMI is a matter of ongoing debate, as the available evidence on the role of invasive versus medical management is controversial. This comprehensive review synthesizes current knowledge of silent myocardial ischemia, addressing its pathophysiology, diagnostic modalities, and therapeutic interventions.
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Affiliation(s)
- Panagiotis Theofilis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (M.S.); (A.P.); (K.T.)
| | - Alexios S. Antonopoulos
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (M.S.); (A.P.); (K.T.)
| | - Marios Sagris
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (M.S.); (A.P.); (K.T.)
| | - Aggelos Papanikolaou
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (M.S.); (A.P.); (K.T.)
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Konstantinos Tsioufis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (M.S.); (A.P.); (K.T.)
| | - Dimitris Tousoulis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (A.S.A.); (M.S.); (A.P.); (K.T.)
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Dimitriadis K, Stathakopoulou C, Pyrpyris N, Beneki E, Adamopoulou E, Soulaidopoulos S, Leontsinis I, Kasiakogias A, Papanikolaou A, Tsioufis P, Aznaouridis K, Tsiachris D, Aggeli K, Tsioufis K. Interventional management of mitral regurgitation and sleep disordered breathing: "Catching two birds with one stone". Sleep Med 2024; 113:157-164. [PMID: 38029624 DOI: 10.1016/j.sleep.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 12/01/2023]
Abstract
Sleep disordered breathing (SDB), mostly constituting of obstructive and central sleep apnea (OSA and CSA, respectively), is highly prevalent in the general population, and even more among patients with cardiovascular disease, heart failure (HF) and valvular heart disease, such as mitral regurgitation (MR). The coexistence of HF, MR and SDB is associated with worse cardiovascular outcomes and increased morbidity and mortality. Pulmonary congestion, as a result of MR, can exaggerate and worsen the clinical status and symptoms of SDB, while OSA and CSA, through various mechanisms that impair left ventricular dynamics, can promote left ventricular remodelling, mitral annulus dilatation and consequently MR. Regarding treatment, positive airway pressure devices used to ameliorate symptoms in SDB also seem to result in a reduction of MR severity, MR jet fraction and an improvement of left ventricular ejection fraction. However, surgical and transcatheter interventions for MR, and especially transcatheter edge to edge mitral valve repair (TEER), seem to also have a positive effect on SDB, by reducing OSA and CSA-related severity indexes and improving symptom control. The purpose of this review is to provide a comprehensive analysis of the common pathophysiology between SDB and MR, as well as to discuss the available evidence regarding the effect of SDB treatment on MR and the effect of mitral valve surgery or transcatheter repair on both OSA and CSA.
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Affiliation(s)
- Kyriakos Dimitriadis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece.
| | - Christina Stathakopoulou
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Nikolaos Pyrpyris
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Eirini Beneki
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Elena Adamopoulou
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Ioannis Leontsinis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Alexandros Kasiakogias
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Aggelos Papanikolaou
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Panagiotis Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Konstantinos Aznaouridis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Dimitris Tsiachris
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Konstantina Aggeli
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
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Vatopoulou A, Margioula-Siarkou C, Papanikolaou A. 118 Contraception practice and knowledge of IUD among teenagers and young women. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2022.02.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Vatopoulou A, Daniilidis A, Dampali R, Fotas A, Papanikolaou A, Dinas K. 402 A case of acute renal failure from bilateral ureteral obstruction due to endometriosis. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Karanikas I, Karayiannis D, Kournidakis A, Papanikolaou A, Mastora Z, Almperti A, Katsagoni C, Chourdakis M, Kakavas S. Increased waist circumference as a predictor of outcome among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Synetos A, Bounas P, Karanasos A, Latsios G, Drakopoulou M, Papanikolaou A, Olympios C, Trantalis G, Tsioufis K, Toutouzas K. In vivo correlation between morphological characteristics of coronary plaques and functional characteristics of carotid arteries in acute coronary syndrome. Am J Cardiovasc Dis 2021; 11:360-367. [PMID: 34322305 PMCID: PMC8303046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Carotid artery temperature heterogeneity (ΔΤ) measured by microwave radiometry (MWR) has been associated with future cardiovascular events including acute coronary syndromes. The vulnerable plaques of the coronary arterial tree, that can be ideally depicted by intracoronary imaging such as optical coherence tomography (OCT) have anatomical characteristics such as the thin fibrous cap (TCFA), that make them vulnerable to rupture. The scope of the study was to assess the implication of the carotid artery temperature heterogeneity on the culprit coronary plaque morphology in patients presenting with acute myocardial infarction. METHODS 34 patients presented with an acute myocardial infarction were enrolled in the study. All patients underwent percutaneous coronary intervention (PCI) and OCT for the evaluation of the anatomical characteristics of the culprit lesion. After the completion of the PCI all patients underwent carotid ultrasound and MWR of both carotid arteries and thermal heterogeneity of the carotid arteries was assessed. Blood samples were collected for high sensitivity C-reactive protein (CRP) analysis. RESULTS Thirty four patients, 21 with STEMI (61.76%) and 13 (38.23%) with NSTEMI, were included in the study. Patients with ruptured plaques had significantly increased hsCRP compared to patients that did not have a ruptured plaque (14.41±4.02 vs 9.9±2.5, P<0.005). Thermal heterogeneity, was significantly increased in ruptured plaques compared to no ruptured ones (1.01±0.31 vs 0.51±0.14°C, P=0.001), and in plaques with TCFA compared to those without a TCFA (0.82±0.37 vs 0.60±0.05°C, P=0.001). Diabetes mellitus, ΔΤ and hsCRP, were entered in the multivariate analysis, from which DM (OR 4.12; 95% CI 0.77-22.07; P=0.07) and ΔΤ (OR for 0.1°C increase 1.43; 95% CI 1.03-1.98; P=0.03) remained in the final analysis, and only ΔΤ was independently associated with the presence of the TCFA. Regarding plaque rupture, STEMI, hsCRP, and ΔT were entered in the multivariate analysis from which hsCRP (OR 1.51; 95% CI 0.99-2.28; P=0.051) and ΔΤ (OR for 0.1°C increase 3.40; 95% CI 1.29-8.96; P=0.013) remained in the final analysis with the ΔT being the only variable.
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Affiliation(s)
- Andreas Synetos
- First Department of Cardiology, Hippokration Hospital, University of AthensGreece
| | | | - Antonis Karanasos
- First Department of Cardiology, Hippokration Hospital, University of AthensGreece
| | - George Latsios
- First Department of Cardiology, Hippokration Hospital, University of AthensGreece
| | - Maria Drakopoulou
- First Department of Cardiology, Hippokration Hospital, University of AthensGreece
| | - Aggelos Papanikolaou
- First Department of Cardiology, Hippokration Hospital, University of AthensGreece
| | | | - George Trantalis
- First Department of Cardiology, Hippokration Hospital, University of AthensGreece
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Latsios G, Synetos A, Leopoulou M, Stamatopoulou E, Vogiatzi G, Parisis C, Papanikolaou A, Kanakakis J, Toutouzas K, Tousoulis D, Tsioufis K. Retention of knowledge after basic training in cardiopulmonary resuscitation: a cumulative 3-year experience of certified ERC seminars of the Hellenic Society of Cardiology. Hellenic J Cardiol 2021; 63:82-85. [PMID: 33845202 DOI: 10.1016/j.hjc.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/01/2021] [Indexed: 12/19/2022] Open
Affiliation(s)
- George Latsios
- First Department of Cardiology, National and Kapodistrian University of Athens - Medical School, "Hippokration" General Hospital, Athens, Greece
| | - Andreas Synetos
- First Department of Cardiology, National and Kapodistrian University of Athens - Medical School, "Hippokration" General Hospital, Athens, Greece.
| | | | - Evangelia Stamatopoulou
- Catheterization Laboratory, National and Kapodistrian University of Athens - Medical School, "Attikon" University Hospital, Athens, Greece
| | - Georgia Vogiatzi
- Third Department of Cardiology, National and Kapodistrian University of Athens - Medical School, "Sotiria" Hospital for Respiratory Diseases, Athens, Greece
| | | | - Aggelos Papanikolaou
- First Department of Cardiology, National and Kapodistrian University of Athens - Medical School, "Hippokration" General Hospital, Athens, Greece
| | - John Kanakakis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens - Medical School, "Alexandra" General Hospital, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, National and Kapodistrian University of Athens - Medical School, "Hippokration" General Hospital, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, National and Kapodistrian University of Athens - Medical School, "Hippokration" General Hospital, Athens, Greece
| | - Kostas Tsioufis
- First Department of Cardiology, National and Kapodistrian University of Athens - Medical School, "Hippokration" General Hospital, Athens, Greece
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Drakopoulou M, Soulaidopoulos S, Stathogiannis K, Oikonomou G, Papanikolaou A, Toutouzas K, Tousoulis D. Antiplatelet and Antithrombotic Therapy After Patent Foramen Oval and Atrial Septal Defect Closure. Curr Pharm Des 2021; 26:2769-2779. [PMID: 32338207 DOI: 10.2174/1385272824999200427083838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/18/2020] [Indexed: 12/18/2022]
Abstract
Pathologies of the atrial septum include different interatrial communications varying from patent foramen ovale (PFO) to actual defects. Atrial septal defects (ASDs) may be localized within the fossa ovalis such as the secundum type ASD or outside the region of fossa ovalis, such as the ostium primum defect and sinus venosus defect. Over the last decades, the percutaneous closure of interatrial shunts has become a feasible and safe method. During these procedures, the delicate balance between thrombotic risk, device sealing process and bleeding risk is crucial. In this review, we sought to describe current available data on the antiplatelet and antithrombotic management of patients after percutaneous ASD or PFO closure.
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Affiliation(s)
- Maria Drakopoulou
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Konstantinos Stathogiannis
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Georgios Oikonomou
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Aggelos Papanikolaou
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
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Papanikolaou A, Barkas F, Liberopoulos E. Effect of estradiol E2 on serum PCSK9 levels and lipid profile in women undergoing in vitro fertilization. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Soulaidopoulos S, Drakopoulou M, Stathogiannis K, Xanthopoulou M, Oikonomou G, Toskas P, Kouroutzoglou A, Synetos A, Papanikolaou A, Latsios G, Sideris S, Tousoulis D, Toutouzas K. The effect of permanent pacemaker implantation following transcatheter aortic valve implantation upon survival. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
Transcatheter aortic valve implantation (TAVI) is often followed by conduction abnormalities, leading to a permanent pacemaker implantation (PPI). Data regarding the clinical impact of PPI following TAVI is yet to be established.
Methods
Patients with severe and symptomatic aortic stenosis [effective orifice area (EOA) ≤1cm2] referred for TAVI at our institution were consecutively enrolled. Prospectively collected demographic, laboratory and echocardiographic data were retrospectively analyzed. Patients were stratified into two groups according to the need for PPI after TAVI and were followed up postoperatively with clinical and echocardiographic assessment. Primary clinical endpoint was all-cause mortality, as defined by the criteria proposed by the Valve Academic Research Consortium 2.
Results
In total, 292 patients were included (male: 50.2%, mean age: 80±7.6 years) in our study. Of these, 109 (37.5%) underwent PPI simultaneously or shortly after TAVI. The median follow-up period was 27.3 In this period, all-cause mortality showed no significant difference between patients with and those without PPI after TAVI (log-rank p=0.756), even after excluding patients with a pre-existing pacemaker from the analysis. Subgroup analysis also showed no difference in survival between patients with low ejection fraction (<50%) and those with preserved (≥50%) receiving a permanent pacemaker after TAVR (log-rank p=0.269). Taking into consideration factors that were found to associate to PPI in univariate analysis (pre TAVI - ejection fraction, pulmonary artery systolic pressure and New York Heart Association functional class) in a multivariate model, pre TAVI pulmonary artery systolic pressure was found to be an independent predictor of peri-procedural PPI [Exp(B): 0.977, 95% Confidence Interval: 0.957–0.998, B=−0.023, p=0.029]. Pre-TAVI conduction abnormalities and the degree of aortic annulus calcification, as assessed by computed-tomography, were not found to predict PPI after TAVI.
Conclusion
PPI following TAVI was not associated with survival at 27 months of follow-up, independently from the pre TAVI ejection fraction.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Soulaidopoulos
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - M Drakopoulou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - K Stathogiannis
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - M Xanthopoulou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - G Oikonomou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - P Toskas
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - A Kouroutzoglou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - A Synetos
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - A Papanikolaou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - G Latsios
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - S Sideris
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - K Toutouzas
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
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Bounas P, Karanasos A, Synetos A, Papanikolaou A, Latsios G, Drakopoulou M, Trantalis G, Olympios C, Tousoulis D, Toutouzas K. Thin cap fibroatheroma and plaque rupture is associated with carotid thermal heterogeneity in patients presenting with acute myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Microwave radiometry (MWR) has been applied successfully in the evaluation of carotid atherosclerosis, measuring reliably temperature heterogeneity of atherosclerotic plaques. Recent studies have shown an association between increased carotid temperature heterogeneity (ΔT) detected by MWR and cardiovascular events. Vulnerable plaques of the coronary arteries, share common characteristics such as the thin cap fibrous cap, that make the prone to rupture in the presence of stimulus such as shear stress or inflammation. Optical coherence tomography (OCT) is an imaging method, by which the fibrous cap and the presence of plaque rupture can be accurately in vivo visualized.
Purpose
To evaluate the impact of carotid temperature heterogeneity on the culprit plaque morphology on patients presenting with acute myocardial infarction.
Method
A total of 37 patients undergoing percutaneous coronary intervention (PCI) for an acute myocardial infarction who had an identifiable de novo culprit lesion in a native coronary artery, were enrolled in this study. All patients underwent PCI and Optical Coherence Study (OCT) within 12 hours since symptom onset. The OCT study was performed according to the standard techniques and acquired images were analyzed by 2 independent investigators., After the completion of the PCI all patients underwent MWR of both carotid arteries and ΔT was defined as maximal temperature detected along each carotid artery minus minimum.
Results
Thirty four patients with acute myocardial infarction 21 with STEMI (61.76%) and 13 (38.23%) with NSTEMI were included in the study. Thin cap fibroatheroma (TCFA) was present in 31 patients (91.1%), while all ruptured plaques had a TCFA compared to 11 TCFA (78.57%) observed in plaques that had no rupture (p=0.03). HsCRP was significantly increased in ruptured plaques compared to non ruptured ones (14.41±4.02 versus 9.9±2.5, p<0.005). Mean ΔT was significantly increased in ruptured plaques compared to no ruptured ones (1.01±0.31 versus 0.51±0.14°C, p<0.005), as well as in plaques with TCFA compared to those without a TCFA (0.82±0.37 versus 0.60±0.05°C, p=0.001). In the multivariate analysis DM, hsCRP, and ΔT were entered from which DM (OR 4.12; 95% CI 0.77–22.07; P=0.07) and ΔTau ((OR for 0.1°C increase 1.43; 95% CI 1.03–1.98; P=0.03) remained in the final model, with ΔT being the only variable independently associated with the presence of TCFA. Similarly regarding plaque rupture, STEMI, hsCRP, and ΔT were entered in the multivariate analysis from which hsCRP (OR 1.51; 95% CI 0.99–2.28; P=0.051) and ΔTau ((OR for 0.1°C increase 3.40; 95% CI 1.29–8.96; P=0.013) remained in the final model, with ΔT being the only variable independently associated with the presence of rupture.
Conclusions
Carotid thermal heterogeneity is associated with TCFA and plaque rupture in patients with acute myocardial infarction.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Bounas
- Thriassio General Hospital, Athens, Greece
| | - A Karanasos
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - A Synetos
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - A Papanikolaou
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - G Latsios
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - M Drakopoulou
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - G Trantalis
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - C Olympios
- Thriassio General Hospital, Athens, Greece
| | - D Tousoulis
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - K Toutouzas
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
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12
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Bounas P, Synetos A, Karanasos A, Papanikolaou A, Drakopoulou M, Latsios G, Trantalis G, Olympios C, Tousoulis D, Toutouzas K. Coronary plaque rupture is associated with carotid thermal heterogeneity in patients presenting with acute myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Vulnerable plaques of the coronary arteries, share common characteristics such as the thin cap fibrous cap, that make the prone to rupture in the presence of stimulus such as shear stress or inflammation. Optical coherence tomography (OCT) is an imaging method, by which the fibrous cap and the presence of plaque rupture can be accurately in vivo visualized. Recent studies have shown an association between increased carotid temperature heterogeneity (ΔT) detected by microwave radiometry (MWR) and cardiovascular events.
Purpose
To evaluate the impact of carotid temperature heterogeneity on the culprit plaque morphology on patients presenting with acute myocardial infarction.
Method
A total of 37 patients undergoing percutaneous coronary intervention (PCI) for an acute myocardial infarction who had an identifiable de novo culprit lesion in a native coronary artery, were enrolled in this study. All patients underwent PCI and Optical Coherence Study (OCT) within 12 hours since symptom onset. The culprit lesion of the angiogram was clearly identified by a combination of ECG, wall motion abnormalities seen in cardiac ultrasound, and coronary angiogram. The OCT study was performed using the LightLab OCT wire, and acquired images were analyzed by 2 independent investigators using previously validated criteria for OCT plaque characterization. After the completion of the PCI all patients underwent MWR of both carotid arteries and ΔT was defined as maximal temperature detected along each carotid artery minus minimum.
Results
Thirty four patients with acute myocardial infarction 21 with STEMI (61.76%) and 13 (38.23%) with NSTEMI were included in the study. STEMI patients had more ruptured plaques compared to NSTEMI patients (71.41 versus 38.46%, p=0.053). Thin cap fibroatheroma (TCFA) was present in 31 patients (91.1%), while all ruptured plaques had a TCFA compared to 11 TCFA (78.57%) observed in plaques that had no rupture (p=0.03). HsCRP was significantly increased in ruptured plaques compared to non ruptured ones (14.41±4.02 versus 9.9±2,5, p<0.005). Mean ΔT was significantly increased in ruptured plaques compared to no ruptured ones (1.01±0.31 versus 0.51±0.14°C, p<0.005), as well as in plaques with TCFA compared to those without a TCFA (0.82±0.37 versus 0.60±0.05°C, p=0.001). In the multivariate analysis, STEMI, hsCRP, and ΔT were entered from which hsCRP (OR 1.51; 95% CI 0.99–2.28; P=0.051) and ΔT ((OR for 0.1°C increase 3.40; 95% CI 1.29–8.96; P=0.013) remained in the final model, with ΔT being the only variable independently associated with the presence of rupture.
Conclusions
Carotid thermal heterogeneity is associated with the presence of plaque rupture in patients with acute myocardial infarction. Further studies are needed in order to assess the possible prognostic impact of carotid ΔT on such population.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Bounas
- Thriassio General Hospital, Athens, Greece
| | - A Synetos
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - A Karanasos
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - A Papanikolaou
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - M Drakopoulou
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - G Latsios
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - G Trantalis
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - C Olympios
- Thriassio General Hospital, Athens, Greece
| | - D Tousoulis
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
| | - K Toutouzas
- University of Athens Medical School, 1st Department of Cardiology, Athens, Greece
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13
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Drakopoulou M, Soulaidopoulos S, Stathogiannis K, Oikonomou G, Toskas P, Kouroutzoglou A, Papanikolaou A, Synetos A, Latsios G, Sideris S, Tousoulis D, Toutouzas K. Prognostic implication of electrocardiographic left ventricular strain in patients undergoing Transcatheter Aortic Valve Implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Electrocardiographic (ECG) strain has been linked to excess cardiovascular morbidity and mortality in asymptomatic patients with aortic stenosis.
Purpose
We aim to determine the differential impact of baseline ECG-strain on long-term mortality after transcatheter aortic valve implantation (TAVI).
Methods
Patients with severe and symptomatic aortic stenosis (effective orifice area [EOA]≤1cm2), who were scheduled for TAVI with a self-expanding valve between May 2015 and May 2018 were consecutively enrolled. Left ventricular strain was defined as the presence of ≥1mm convex ST-segment depression with asymmetrical T-wave inversion in leads V5 to V6 on baseline ECG. Patients were excluded, if they had bundle branch block or a permanent pacemaker at baseline. Baseline parameters were compared, and multivariate Cox proportional hazard regression models were generated to assess outcome difference. The primary clinical endpoint was cumulative mortality defined according to the criteria proposed by the Valve Academic Research Consortium-2.
Results
Of the 171 patients screened, 56 patients were excluded due to left bundle branch block or paced rhythm. In the 115 included patients (mean age: 81.4±7), 36 patients (31.3%) had strain pattern on pre-TAVI ECG. There were no differences in baseline characteristics between the two groups. During a median follow-up of 2.32 years (IQR 1.62 to 3), 11 patients (9.6%) reached the primary clinical endpoint. Patients in the strain group had higher incidence of all-cause mortality compared to patients without left ventricular strain (25% vs 2.5%, χ2=14.4, p<0.001). Kaplan-Meier survival analysis showed a significantly decreased cumulative probability of survival at 3 years in patients with LV-strain compared with patients without LV-strain (log-rank p=0.002, Figure 1). In the multivariate analysis, left ventricular strain [Exp(B): 8.952, 95% Confidence Interval (CI): 1.215–65.938, B=2.192, p=0.031] and QRS duration [Exp(B): 1.058, 95% CI: 1.022–1.095, B=0.056, p<0.001] were found to be independent predictors of all-cause mortality after TAVI.
Conclusion
Baseline ECG left ventricular strain was an independent predictor of long-term mortality post TAVI. Systematic strain measurements might aid in risk-stratifying patients scheduled for TAVI.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Drakopoulou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - S Soulaidopoulos
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - K Stathogiannis
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - G Oikonomou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - P Toskas
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - A Kouroutzoglou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - A Papanikolaou
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - A Synetos
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - G Latsios
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - S Sideris
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
| | - K Toutouzas
- Hippokration General Hospital, First Department of Cardiology, Medical School of Athens, Athens, Greece
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14
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Chrysohoou C, Kouvari M, Lazaros G, Varlas J, Dimitriadis K, Zaromytidou M, Masoura C, Skoumas J, Kambaxis M, Galiatsatos N, Papanikolaou A, Xydis P, Konstantinou K, Pitsavos C, Tsioufis K, Stefanadis C. Predicted Skeletal Muscle Mass and 4-Year Cardiovascular Disease Incidence in Middle-Aged and Elderly Participants of IKARIA Prospective Epidemiological Study: The Mediating Effect of Sex and Cardiometabolic Factors. Nutrients 2020; 12:nu12113293. [PMID: 33121164 PMCID: PMC7693172 DOI: 10.3390/nu12113293] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022] Open
Abstract
The sex-specific effect of skeletal muscle mass (SMM) index (SMI) on 4-year first fatal/non-fatal cardiovascular disease (CVD) event in free-of-disease individuals was examined. In 2009, n = 1411 inhabitants (mean age = 64(12)) from Ikaria were selected. Follow-up was performed in 2013. SMI was created to reflect SMM through appendicular skeletal muscle mass (indirectly calculated through formulas) divided by body mass index (BMI). Fifteen and six tenths percent of participants exhibited CVD (19.8% in men/12% in women, p = 0.002). Significant U-shape trends were observed in participants >65 years old and women irrespective to age confirmed through multi-adjusted Cox regression analysis; in age >65 years, Hazard Ratio (HR)(2nd vs. 1st SMI tertile) = 0.80, 95% Confidence Interval (95%CI) (0.45, 0.96) and in women HR(2nd vs. 1st SMI tertile) = 0.71, 95% CI (0.33, 0.95), while, as for the 3rd SMI tertile, no significant trends were observed. Mediation analysis revealed that mediators of the aforementioned associations in men were the arterial distensibility and total testosterone, while, in women, inflammation, insulin resistance, and arterial distensibility. High SMM accompanied by obesity may not guarantee lower CVD risk. Specific cardiometabolic factors seem to explain this need for balance between lean and fat mass.
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Affiliation(s)
- Christina Chrysohoou
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
- Correspondence: ; Tel.: +3-0210-960-3116
| | - Matina Kouvari
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17676 Athens, Greece
| | - George Lazaros
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - John Varlas
- Immunology, Scientific Support Department, MEDICON Hellas S.A., Gerakas, 15344 Attica, Greece;
| | - Kyriakos Dimitriadis
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Marina Zaromytidou
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Constantina Masoura
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - John Skoumas
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Manolis Kambaxis
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Nikos Galiatsatos
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Aggelos Papanikolaou
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Panagiotis Xydis
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Konstantinos Konstantinou
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Christos Pitsavos
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Konstantinos Tsioufis
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
| | - Christodoulos Stefanadis
- Cardiology Clinic, Hippokration Hospital, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (G.L.); (K.D.); (M.Z.); (C.M.); (J.S.); (M.K.); (N.G.); (A.P.); (P.X.); (K.K.); (C.P.); (K.T.); (C.S.)
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15
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Paschali A, Panagiotidis E, Triantafyllou T, Palaska V, Tsirou K, Verrou E, Υiannaki E, Markala D, Papanikolaou A, Pouli A, Konstantinidou P, Chatzipavlidou V, Terpos E, Katodritou E. A proposed index of diffuse bone marrow [18F]-FDG uptake and PET skeletal patterns correlate with myeloma prognostic markers, plasma cell morphology, and response to therapy. Eur J Nucl Med Mol Imaging 2020; 48:1487-1497. [PMID: 33099659 DOI: 10.1007/s00259-020-05078-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The investigation of a semi-quantitative index in the pelvis to assess for diffuse bone marrow (BM) [18F]-FDG uptake and the investigation of PET skeletal patterns in multiple myeloma (MM) patients, in accordance with prognostic markers, clonal plasma cell (cPC) morphology, and response to therapy. METHODS We prospectively analyzed [18F]-FDG PET/CT in 90 MM patients (newly diagnosed, 60; relapsed/refractory, 30). Among other PET/CT parameters, we calculated the ratio SUVmax pelvis/liver and examined for correlations with known MM prognostic parameters, cPC morphology (good vs. low/intermediate differentiation), and response to therapy. RESULTS SUVmax pelvis/liver ratio was significantly lower for the group of good differentiation vs. intermediate/low differentiation cPCs (p < 0.001) and showed a positive correlation with BM infiltration rate, β2 microglobulin, serum ferritin, international staging system (ISS), and revised ISS; no significant correlation was found with hemoglobin. A cutoff value of 1.1 showed an excellent specificity (99%) and high sensitivity (76%) for diffuse BM involvement (AUC 0.94; p < 0.001). Mixed pattern and appendicular involvement correlated with poor prognostic features while normal pattern, found in 30% of patients, correlated with good prognostic features. Presence of ≥ 10 focal lesions negatively predicted for overall response (p < 0.05; OR 4.8). The CT component improved the diagnostic performance of PET. CONCLUSION This study showed, for the first time, that cPC morphology and markers related with MM biology, correlate with SUVmax pelvis/liver index, which could be used as a surrogate marker for BM assessment and disease prognosis; PET patterns correlate with MM prognostic features and response rates.
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Affiliation(s)
- A Paschali
- Department of Nuclear Medicine, Theagenion Cancer Hospital, Thessaloniki, Greece.
| | - E Panagiotidis
- Department of Nuclear Medicine, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - T Triantafyllou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - V Palaska
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - K Tsirou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - E Verrou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - E Υiannaki
- Hematology/Flow cytometry Lab, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - D Markala
- Hematology/Flow cytometry Lab, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - A Papanikolaou
- Hematopathology Department, Evangelismos General Hospital, Athens, Greece
| | - A Pouli
- Hematology Department, "St Savvas" Oncology Hospital, Athens, Greece
| | - P Konstantinidou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - V Chatzipavlidou
- Department of Nuclear Medicine, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - E Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - E Katodritou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
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16
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Latsios G, Synetos A, Mastrokostopoulos A, Vogiatzi G, Bounas P, Nikitas G, Papanikolaou A, Parisis C, Kanakakis I, Goudevenos J. CardioPulmonary Resuscitation in patients with suspected or confirmed Covid-19. A consensus of the Working group on CardioPulmonary Resuscitation of the Hellenic Society of Cardiology. Hellenic J Cardiol 2020; 62:24-28. [PMID: 32949726 PMCID: PMC7495187 DOI: 10.1016/j.hjc.2020.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022] Open
Abstract
The unprecedented for modern medicine pandemic caused by the SARS-COV-2 virus (“coronavirus”, Covid-19 disease) creates in turn new data on the management and survival of cardiac arrest victims, but mainly on the safety of CardioPulmonary Resuscitation (CPR) providers. The Covid-19 pandemic resulted in losses of thousands of lives, and many more people were hospitalized in simple or in intensive care unit beds, both globally and locally in Greece. More specifically, in victims of cardiac arrest, both in- and out- of hospital, the increased mortality and high contagiousness of the SARS-CoV-2 virus posed new questions, of both medical and moral nature/ to CPR providers. What we all know in resuscitation, that we cannot harm the victim and therefore do the most/best we can, is no longer the everyday reality. What we need to know and incorporate into decision-making in the resuscitation process is the distribution of limited human and material resources, the potentially very poor outcome of patients with Covid-19 and cardiac arrest, and especially that a potential infection of health professionals can lead in the lack of health professionals in the near future. This review tries to incorporate the added skills and precautions for CPR providers in terms of both in- and out- hospital CPR.
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Affiliation(s)
- George Latsios
- 1st University Department of Cardiology, National and Kapodistrian University of Athens, "Hippocratio" General Hospital, Athens, Greece.
| | - Andreas Synetos
- 1st University Department of Cardiology, National and Kapodistrian University of Athens, "Hippocratio" General Hospital, Athens, Greece
| | | | - Georgia Vogiatzi
- 3rd University Department of Cardiology, National and Kapodistrian University of Athens, "Sotiria" General Hospital, Athens, Greece
| | - Pavlos Bounas
- General Hospital of Elefsina "Thriasio", Elefsina, Greece
| | - Georgios Nikitas
- Department of Cardiology, Konstantopoulio General Hospital, Athens, Greece
| | - Aggelos Papanikolaou
- 1st University Department of Cardiology, National and Kapodistrian University of Athens, "Hippocratio" General Hospital, Athens, Greece
| | | | - Ioannis Kanakakis
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
| | - John Goudevenos
- Department of Cardiology, University of Ioannina Medical School, Greece
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17
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Lazaros G, Oikonomou E, Theofilis P, Theodoropoulou A, Triantafyllou K, Charitos C, Charalambous G, Papanikolaou A, Gastouniotis I, Siasos G, Vlachopoulos C, Tousoulis D. The impact of COVID-19 pandemic on adult cardiac surgery procedures. Hellenic J Cardiol 2020; 62:231-233. [PMID: 32679176 PMCID: PMC7362781 DOI: 10.1016/j.hjc.2020.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 06/27/2020] [Accepted: 07/03/2020] [Indexed: 01/29/2023] Open
Affiliation(s)
- George Lazaros
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
| | - Evangelos Oikonomou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece; Emergency Department, Hippokration' General Hospital, Athens, Greece
| | - Panagiotis Theofilis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | | | - Christos Charitos
- Department of Cardiothoracic Surgery, "Evangelismos" General Hospital of Athens, Athens, Greece
| | | | - Aggelos Papanikolaou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Gerasimos Siasos
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Charalambos Vlachopoulos
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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18
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Papaioannou TG, Georgiopoulos G, Stamatelopoulos KS, Protogerou AD, Alexandraki KI, Argyris A, Vrachatis DA, Soulis D, Papanikolaou A, Manolesou D, Daskalopoulou SS, Tousoulis D. Blood pressure variability within a single visit and all-cause mortality. Neth J Med 2020; 78:175-182. [PMID: 32641542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Within-visit variability of repeated sequential readings of blood pressure (BP) is an important phenomenon that may affect precision of BP measurement and thus decision making concerning BP-related risk and hypertension management. However, limited data exist concerning predictive ability of within-visit BP variability for clinical outcomes. Therefore, we aimed to investigate the association between the variability of three repeated office BP measurements and the risk of all-cause mortality, independent of BP levels. METHODS Data collected through the National Health and Nutrition Examination Survey (NHANES) were analysed. NHANES is a program of studies designed to assess health and nutritional status of adults and children in the United States. A complete set of three sequential BP measurements, together with survival status, were available for 24969 individuals (age 46.8±;19.3 years, 49% males). Multivariable logistic regression models were used to determine the prognostic ability of the examined demographic, clinical, and haemodynamic indices. RESULTS Among various examined indices of variability of systolic (SBP) and diastolic (DBP) blood pressure measurements, the standard deviation of DBP (DBPSD) was the stronger independent predictor of mortality (odds ratio 1.064, 95% Confidence Interval: 1.011-1.12) after adjustment for age, sex, body mass index, smoking, SBP, heart rate, history of hypertension, diabetes mellitus, hypercholesterolaemia, and cardiovascular events. CONCLUSION Within-visit variability of three sequential office DBP readings may allow for the identification of high-risk patients better than mean SBP and DBP levels. The predictive value of within-visit BP variability and methods to improve its clinical application are worthy of further research.
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Affiliation(s)
- T G Papaioannou
- First Department of Cardiology, Biomedical Engineering Unit, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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19
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Boklund A, Dhollander S, Chesnoiu Vasile T, Abrahantes JC, Bøtner A, Gogin A, Gonzalez Villeta LC, Gortázar C, More SJ, Papanikolaou A, Roberts H, Stegeman A, Ståhl K, Thulke HH, Viltrop A, Van der Stede Y, Mortensen S. Risk factors for African swine fever incursion in Romanian domestic farms during 2019. Sci Rep 2020; 10:10215. [PMID: 32576841 PMCID: PMC7311386 DOI: 10.1038/s41598-020-66381-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/18/2020] [Indexed: 01/06/2023] Open
Abstract
African swine fever (ASF) entered Georgia in 2007 and the EU in 2014. In the EU, the virus primarily spread in wild boar (Sus scrofa) in the period from 2014-2018. However, from the summer 2018, numerous domestic pig farms in Romania were affected by ASF. In contrast to the existing knowledge on ASF transmission routes, the understanding of risk factors and the importance of different transmission routes is still limited. In the period from May to September 2019, 655 Romanian pig farms were included in a matched case-control study investigating possible risk factors for ASF incursion in commercial and backyard pig farms. The results showed that close proximity to outbreaks in domestic farms was a risk factor in commercial as well as backyard farms. Furthermore, in backyard farms, herd size, wild boar abundance around the farm, number of domestic outbreaks within 2 km around farms, short distance to wild boar cases and visits of professionals working on farms were statistically significant risk factors. Additionally, growing crops around the farm, which could potentially attract wild boar, and feeding forage from ASF affected areas to the pigs were risk factors for ASF incursion in backyard farms.
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Affiliation(s)
- A Boklund
- University of Copenhagen, Faculty of Health and Medical Sciences, Section for Animal Welfare and Disease Control, Grønnegårdsvej 8, 1870, Frederiksberg C, Denmark.
| | - S Dhollander
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - T Chesnoiu Vasile
- The National Sanitary Veterinary and Food Safety Authority, Bucharest, Piata Free Press no. 1 Body D1, District 1, Post Code 013 701, Bucharest, Romania
| | - J C Abrahantes
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - A Bøtner
- University of Copenhagen, Faculty of Health and Medical Sciences, Section for Veterinary Clinical Microbiology, Stigbøjlen 4, 1870, Frederiksberg C, Denmark
- Statens Serum Institut, Department of Virus and Microbiological Special Diagnostics, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - A Gogin
- Federal Research Center for Virology and Microbiology, 601125, Volginsky, Russia
| | | | - C Gortázar
- SaBio research group at IREC (Universidad de Castilla-La Mancha & CSIC), Ronda de Toledo 12, 13003, Ciudad Real, Spain
| | - S J More
- Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 W6F6, Ireland
| | - A Papanikolaou
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - H Roberts
- Department for Environment Food and Rural Affairs (DEFRA), Exotic Disease Control team, Area 2D, Nobel House, 17 Smith Square, London, SW1P 3JR, England
| | - A Stegeman
- Utrecht University, Faculty of Veterinary Medicine, Yalelaan 7, Utrecht, The Netherlands
| | - K Ståhl
- National Veterinary Institute, 751 89, Uppsala, Sweden
| | - H H Thulke
- Helmholtz Centre for Environmental Research GmbH - UFZ, Department of Ecological Modelling, PG EcoEpi, Permoserstr. 15, Leipzig, Germany
| | - A Viltrop
- Estonian University of Life Sciences, Institute of Veterinary Medicine and Animal Sciences, Kreutzwaldi 62, Tartu, 51006, Estonia
| | - Y Van der Stede
- European Food Safety Authority, Via Carlo Magno 1A, 43126, Parma, Italy
| | - S Mortensen
- Danish Veterinary and Food Administration, Stationsparken 31-33, 2600, Glostrup, Denmark
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Toutouzas K, Drakopoulou M, Latsios G, Synetos A, Stathogiannis K, Soulaidopoulos S, Oikonomou G, Trantalis G, Papanikolaou A, Aggeli C, Vavuranakis M, Mastrokostopoulos A, Katsimaglis G, Voudris V, Dardas P, Tousoulis D. Transfemoral transcatheter aortic valve replacement in the presence of a mitral prosthesis. J Cardiovasc Med (Hagerstown) 2019; 20:825-830. [PMID: 31592849 DOI: 10.2459/jcm.0000000000000876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
PURPOSE In the current case series, we present our experience with the self-expanding CoreValve or Evolut R (Medtronic Inc.) in patients with severe symptomatic aortic valve stenosis and concomitant mitral valve prosthesis. METHODS Twelve patients with previous mitral valve prosthesis underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and/or aortic valve regurgitation. All patients underwent evaluation with an echocardiogram, computed tomography and coronary angiogram. After the index intervention and before discharge all patients underwent transthoracic echocardiography. All outcomes were defined according to the Valve Academic Research Consortium-2 criteria. RESULTS Eleven patients underwent transcatheter aortic valve replacement for severe symptomatic aortic valve stenosis and one patient for severe aortic valve regurgitation. There was immediate improvement of patients' hemodynamic status; no cases of procedural death, stroke, myocardial infarction, or urgent cardiac surgery occurred. There was no 30-day mortality and all patients improved, with 91.6% in functional New York Heart Association class I-II. CONCLUSION The current study demonstrates that in patients with severe aortic valve stenosis or regurgitation and mitral valve prosthesis, the implantation of a self-expanding aortic valve via the transfemoral route is safe and feasible, with maintained long-term results.
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Affiliation(s)
- Konstantinos Toutouzas
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | - Maria Drakopoulou
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | - George Latsios
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | - Andreas Synetos
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | | | | | - George Oikonomou
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | - George Trantalis
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | - Aggelos Papanikolaou
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | - Constantina Aggeli
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | - Manolis Vavuranakis
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
| | | | | | | | | | - Dimitris Tousoulis
- First Department of Cardiology, Medical School of Athens University, Hippokration Hospital
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Angelis A, Chrysohoou C, Laina A, Antoniou CK, Konstantinou K, Aznaourides K, Georgakopoulos C, Papanikolaou A, Dilaveris P, Vlachopoulos C, Tousoulis D. P4534The Mediterranean diet benefit in chronic heart failure by decoding central and peripheral vessel rheology, atheroma formation and serum prolactin levels. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Central hemodynamics and especially wave reflection amplification exhibit a vital parameter of chronic heart failure (CHF) physiology. Erectile dysfunction (ED) displays a poor peripheral vessel rheology and serum prolactin role is still debated in CHF mechanisms. The Mediterranean diet (Med-diet) is famous for its vasoprotective and wellbeing properties.
Purpose
To investigate the effect of the Med-diet in central hemodynamics, erectile status, atheroma formation and serum prolactin levels in male patients with chronic heart failure.
Methods
123 CHF male patients under optimal medical therapy enrolled the study (mean age: 65±8 yo, NYHA class II, ejection fraction <40%). All underwent evaluation of the carotid – femoral pulse wave velocity (PWV), estimation of central pressures and augmentation index (AIx) as parameter of wave reflection amplification (sphygmocor device). Ejection fraction (EF) of the left ventricle was estimated by using 2D echocardiography (Simpson method). ED severity and adherence to the Med-diet were assessed by the SHIM-5 (range: 0–25) and the Med-diet (range: 0–55) scores. Higher values point to better erectile function and a great Med-diet compliance respectively. Detection of atheroma was based on the intima- media thickness (IMT) of the common carotid artery. Prolactin levels were assessed in morning blood samples taken before 09:00 am.
Results
The SHIM −5 score (mean: 12±4) was associated to the AIx (p=0,03, r=0,75) and both positively and strongly related to the Med-diet score (p=0,01, r=0,8 and p=0,01, r=0,75 respectively). Med-diet compliance was negatively associated to IMT (p=0,02, r=−0,8) and serum prolactin levels (p=0,03, r=−0,6).Moreover, we notice a positive association between prolactin and the IMT (p=0,04, r=0,7). By multiple linear regression analysis the relation of SHIM-5 and Med-diet score remained significant (p=0,04) after adjustment for BMI, central pulse and mean arterial pressures. We further subdivide our population according to the mean Med-diet value (28) into high and low Med-diet adherence groups. Only in the group with the greater Med-diet adherence (n=73, 60%) AIx was strongly associated to the SHIM-5 score (p=0,02) even after adjustment for PWV, age and BMI. Prolactin levels there were still related to IMT (p=0,04) after adjustment for PWV, AIx, BMI and central pulse pressure. All statistics remained significant when adjusting for ejection fraction of the left ventricle.
Conclusion
High adherence to the Med-diet benefits CHF hemodynamics by enforcing wave reflection amplification, thus generating a stronger pulse signal to peripheral vasculature. Moreover suppresses serum prolactin levels that relates to atheroma formation. Both actions enhance erectile performance independently of the EF of the left ventricle. It is important to advise CHF patients to adopt this dietary pattern in order to improve hemodynamic status and the sense of wellbeing.
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Affiliation(s)
- A Angelis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - C Chrysohoou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Laina
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - C.-K Antoniou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - K Konstantinou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - K Aznaourides
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - C Georgakopoulos
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Papanikolaou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - P Dilaveris
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - C Vlachopoulos
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
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Foukas P, Koliou GA, Papoudou-Bai A, Charchanti A, Vrettou E, Poulios C, Chatzopoulos K, Kotoula V, Fountzilas E, Zakopoulou R, Visvikis A, Pentheroudakis G, Pectasides D, Aravantinos G, Oikonomopoulos G, Papanikolaou A, Haidopoulos D, Zagouri F, Fountzilas G, Goussia A. Prognostic significance of elements of the adaptive immunity in the microenvironment of epithelial ovarian cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kastritis E, Karatrasoglou E, Dialoupi I, Gavriatopoulou M, Roussou M, Fotiou D, Kanellias N, Ntanasis-Stathopoulos I, Eleutherakis-Papaiakovou E, Manios E, Migkou M, Papanota AM, Papadopoulou E, Stamatelopoulos K, Ntalianis A, Papanikolaou A, Psimenou E, Gakiopoulou C, Tsitsilonis O, Tselegkidi M, Trougakos I, Kostopoulos I, Terpos E, Dimopoulos M. PS1378 AN EARLY, WITHIN THE FIRST MONTH, AND DEEP RESPONSE, SHOULD BE THE GOAL OF THERAPY IN AL AMYLOIDOSIS. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000563788.88142.a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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24
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Kakavas S, Karayiannis D, Papanikolaou A, Karachaliou A, Mastora Z, Pavlara M, Boulbasakos G. Food group consumption and lung function parameters among hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Panahi M, Papanikolaou A, Khan H, Torabi A, Cleland JGF, Vadgama N, Rosenthal NA, Harding S, Sattler S. P2861A systematic review and meta-analysis of anti-cytokine therapies targeting IL-1 and TNF- A in myocardial infarction and heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Panahi
- Imperial College London, National Heart and Lung Instutute, Hammersmith Hospital, London, United Kingdom
| | - A Papanikolaou
- Imperial College London, National Heart and Lung Instutute, Hammersmith Hospital, London, United Kingdom
| | - H Khan
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - A Torabi
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - J G F Cleland
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - N Vadgama
- Imperial College London, National Heart and Lung Instutute, Hammersmith Hospital, London, United Kingdom
| | - N A Rosenthal
- The Jackson Laboratory, Bar Harbor, Maine, United States of America
| | - S Harding
- Imperial College London, National Heart and Lung Instutute, Hammersmith Hospital, London, United Kingdom
| | - S Sattler
- Imperial College London, National Heart and Lung Instutute, Hammersmith Hospital, London, United Kingdom
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Stathogiannis K, Toutouzas K, Drakopoulou M, Latsios G, Synetos A, Oikonomou G, Xanthopoulou M, Trantalis G, Papanikolaou A, Peskesis G, Tsiamis E, Tousoulis D. 5250Effect of aortic valve calcification as measured by computed tomography in patients undergoing transcatheter aortic valve implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- K Stathogiannis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - K Toutouzas
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - M Drakopoulou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Latsios
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Synetos
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Oikonomou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - M Xanthopoulou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Trantalis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Papanikolaou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Peskesis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - E Tsiamis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
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Drakopoulou M, Toutouzas K, Stathogiannis K, Latsios G, Synetos A, Sideris S, Trantalis G, Papanikolaou A, Oikonomou G, Xanthopoulou M, Karmpalioti M, Tsiamis E, Tousoulis D. P6306Impact of aorto-ventricular angulation on clinical outcomes following TAVR with a self-expanding valve. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Drakopoulou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - K Toutouzas
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - K Stathogiannis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Latsios
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Synetos
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - S Sideris
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Trantalis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Papanikolaou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Oikonomou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - M Xanthopoulou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - M Karmpalioti
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - E Tsiamis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
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Synetos A, Toutouzas K, Drakopoulou M, Koutagiar I, Benetos G, Kotronias R, Anousakis-Vlachochristou N, Latsios G, Karanasos A, Agrogiannis G, Metaxas M, Stathogiannis K, Papanikolaou A, Georgakopoulos A, Pianou N, Tsiamis E, Patsouris E, Papalois A, Cokkinos D, Anagnostopoulos C, Tousoulis D. Inhibition of Aortic Valve Calcification by Local Delivery of Zoledronic Acid—an Experimental Study. J Cardiovasc Transl Res 2018; 11:192-200. [DOI: 10.1007/s12265-018-9802-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 03/15/2018] [Indexed: 12/19/2022]
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Antonopoulos AS, Latsios G, Oikonomou E, Aznaouridis K, Papanikolaou A, Syrseloudis D, Siasos G, Vavuranakis M, Toutouzas K, Tousoulis D. Long-term endothelial dysfunction after trans-radial catheterization: A meta-analytic approach. J Card Surg 2018; 32:464-473. [PMID: 28833634 DOI: 10.1111/jocs.13181] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Following cardiac catheterization using radial artery (RA) access, persistent endothelial dysfunction may limit the use of RA as a conduit during coronary artery bypass graft (CABG) surgery. We reviewed published literature to investigate the effects of transradial coronary catheterization on RA endothelial function. METHODS We searched PubMed from inception to April 2017 for published studies assessing RA endothelial function late (≥1 month) after coronary catheterization. A total of 12 eligible published studies (n = 490 patients) were included in the final quantitative synthesis. Statistical heterogeneity among studies was assessed by the I2 . A random effects model was used to calculate the pooled estimate for standardized mean difference (SMD). Meta-regression analysis was used to explore predictors of change in RA endothelial function following catheterization. RESULTS In all studies, a significant reduction in endothelium dependent response was observed post-catheterization (SMD = -0.53, 95% confidence interval [CI]: -0.93 to -0.13, P = 0.01) and a marginal, non-significant, reduction in endothelium independent response (SMD = -0.38, 95%CI: -0.77, 0.01, P < 0.059). In controlled studies, using the contralateral RA as a control, a significant impairment in endothelial function was confirmed (SMD = -6.26, 95%CI: -9.71 to -2.81, P < 0.0001), while the change in endothelium-independent response was not significant (SMD = -4.46, 95%CI: -13.3 to 4.37, P = 0.32). In meta-regression analysis male gender (z = 2.36, P = 0.018) and increasing time following catheterization (z = 2.62, P = 0.009) were associated with less RA endothelial dysfunction. CONCLUSIONS Transradial catheterization impairs endothelium dependent vasodilatory properties of the cannulated RA, which do not recover even several months post-catheterization. Non-recovery of vasomotor function of cannulated RAs may limit their use as arterial grafts during CABG surgery.
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Affiliation(s)
- Alexios S Antonopoulos
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - George Latsios
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Aznaouridis
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Aggelos Papanikolaou
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Syrseloudis
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Manolis Vavuranakis
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Toutouzas
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, Hippokration Hospital, University of Athens Medical School, Athens, Greece
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Balfousias T, Apostolopoulos AP, Papanikolaou A, Karadimas E, Zouboulis G, Maris I. Scapulothoracic Dissociation and Clavicle Fracture with Associated Brachial Plexus Palsy. J Long Term Eff Med Implants 2018; 28:233-237. [DOI: 10.1615/jlongtermeffmedimplants.2018029212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Papakonstantinou N, Zisis C, Balis E, Papanikolaou A, Bouros D. P-186H-TYPE TRACHEO-OESOPHAGEAL FISTULA: A CONGENITAL DEFORMITY FIRST DIAGNOSED 59 YEARS POSTNATALLY. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kakavas S, Karayiannis D, Papanikolaou A, Baschali A, Sarantidou M, Karachaliou A, Karli A, Mastora Z, Palavra M, Boulbasakos G. SUN-P126: Bioelectrical Impedance Analysis Phase Angle as a Prognostic Marker for Outcome in Patients Admitted in Hospital with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30501-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Synetos A, Papanikolaou A, Georgiopoulos G, Peskesis G, Drakopoulou M, Galanakos S, Benetos G, Stathogiannis K, Karanasos A, Toutouzas K, Tousoulis D. P4402Metabolic syndrome predicts plaque rupture in patients with acute myocardial Infarction. An optical coherence study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Antonopoulos A, Oikonomou E, Tsalamandris S, Vogiatzi G, Tolis P, Papanikolaou A, Kalogeras K, Latsios G, Syrseloudis D, Aznaouridis K, Vaina S, Siasos G, Vavouranakis E, Toutouzas K, Tousoulis D. P4286Endothelial function post radial artery catheterization: a systematic review and meta-analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Synetos A, Georgiopoulos G, Pylarinou V, Peskesis G, Papanikolaou A, Karanasos A, Stathogiannis K, Galanakos S, Benetos G, Tsiamis E, Toutouzas K, Drakopoulou M, Tousoulis D. P2484EuroSCORE II has the best predictive ability after successful primary percutaneous coronary intervention for the treatment of acute myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Synetos A, Papanikolaou A, Georgiopoulos G, Peskesis G, Drakopoulou M, Galanakos S, Karanasos A, Stathogiannis K, Koutajiar I, Toutouzas K, Tousoulis D. P3662CRP predicts cap thickness in the culprit lesions of patients with metabolic syndrome and acute myocardial infarction. An Optical Coherence Study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Synetos A, Toutouzas K, Drakopoulou M, Koutajiar I, Stathogiannis K, Peskesis G, Papanikolaou A, Kotronias R, Agrogiannis G, Papalois A, Anagnostopoulos C, Cokkinos D, Patsouris E, Tousoulis D. P1565Attenuation of aortic valve calcification by local delivery of zoledronic acid. A PET/CT study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Oikonomou E, Psaltopoulou T, Georgiopoulos G, Siasos G, Kokkou E, Antonopoulos A, Vogiatzi G, Tsalamandris S, Gennimata V, Papanikolaou A, Tousoulis D. Western Dietary Pattern Is Associated With Severe Coronary Artery Disease. Angiology 2017; 69:339-346. [DOI: 10.1177/0003319717721603] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The independent predictive value of an unhealthy diet on the severity of coronary artery disease (CAD) requires further investigation. We assessed the impact of dietary pattern on CAD severity. In this cohort study, we included 188 symptomatic stable patients with CAD. Patients were categorized as having severe CAD or nonsevere CAD by coronary angiography. Among several demographics and clinical characteristics, all patients were tested using a semiquantitative food frequency questionnaire. Concerning baseline demographic characteristics, there was no difference between patients with severe CAD and nonsevere CAD. Principal component analysis revealed 8 distinct dietary patterns. The first component Western dietary pattern (increased intake of fat, red meat, and carbohydrates and minimal consumption of fruits and green leafy vegetables) was predictive of severe CAD (area under the curve: 0.73, 95% confidence intervals: 0.64-0.83, P < .001). In conclusion, an unhealthy Western type of diet is associated with the severity of coronary artery lesions in patients with stable CAD. These findings highlight the role of dietary patterns when estimating cardiovascular risk for the management of patients with CAD.
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Affiliation(s)
- Evangelos Oikonomou
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Georgiopoulos
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Siasos
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Eleni Kokkou
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexios Antonopoulos
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Vogiatzi
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Tsalamandris
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Gennimata
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aggelos Papanikolaou
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Synetos A, Georgiopoulos G, Pylarinou V, Toutouzas K, Maniou K, Drakopoulou M, Tolis P, Karanasos A, Papanikolaou A, Latsios G, Tsiamis E, Tousoulis D. Comparison of prognostic risk scores after successful primary percutaneous coronary intervention. Int J Cardiol 2017; 230:482-487. [PMID: 28041714 DOI: 10.1016/j.ijcard.2016.12.078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/11/2016] [Accepted: 12/16/2016] [Indexed: 11/25/2022]
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Klonos E, Zepiridis L, Theodoridis T, Tsolakidis D, Grimbizis G, Papanikolaou A, Tarlatzis B. Endometrial stromal nodule in a woman with abnormal uterine bleeding and abdominal pain: a case report. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kotoula V, Lakis S, Giannoulatou E, Kouvatseas G, Lazaridis G, Tikas I, Efstratiou I, Chrisafi S, Charalambous E, Papanikolaou A, Fostira F, Tarlatzis B, Fountzilas G. Impact of genomic heterogeneity and mutation patterns on the outcome of patients with epithelial ovarian cancer (EOC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chrysohoou C, Metallinos G, Georgiopoulos G, Mendrinos D, Papanikolaou A, Magkas N, Pitsavos C, Vyssoulis G, Stefanadis C, Tousoulis D. Short term omega-3 polyunsaturated fatty acid supplementation induces favorable changes in right ventricle function and diastolic filling pressure in patients with chronic heart failure; A randomized clinical trial. Vascul Pharmacol 2016; 79:43-50. [DOI: 10.1016/j.vph.2016.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/21/2015] [Accepted: 01/21/2016] [Indexed: 10/22/2022]
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Synetos A, Stathogiannis K, Papanikolaou A, Drakopoulou M, Trantalis G, Kaitozis O, Latsios G, Giannopoulos G, Deftereos S, Toutouzas K, Tousoulis D. Therapeutic Applications of Calcium Metabolism Modulation in Heart Disease. Med Chem 2016; 12:177-83. [DOI: 10.2174/157340641202160209103313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/20/2015] [Accepted: 03/01/2015] [Indexed: 11/22/2022]
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Latsios G, Toutouzas K, Synetos A, Mastrokostopoulos A, Stathogiannis K, Aggeli C, Papaioannou S, Papanikolaou A, Tsiamis E, Tousoulis D. Buddy wire pre-dilatation with peripheral balloon in an extremely calcified aortic valve. Implications for TAVI. Int J Cardiol 2015; 198:136-7. [PMID: 26163905 DOI: 10.1016/j.ijcard.2015.06.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Affiliation(s)
- George Latsios
- 1st Department of Cardiology, "Hippokration" Hospital, University of Athens, Greece.
| | | | - Andreas Synetos
- 1st Department of Cardiology, "Hippokration" Hospital, University of Athens, Greece
| | | | | | - Constantina Aggeli
- 1st Department of Cardiology, "Hippokration" Hospital, University of Athens, Greece
| | - Spyridon Papaioannou
- 1st Department of Cardiology, "Hippokration" Hospital, University of Athens, Greece
| | - Aggelos Papanikolaou
- 1st Department of Cardiology, "Hippokration" Hospital, University of Athens, Greece
| | - Eleftherios Tsiamis
- 1st Department of Cardiology, "Hippokration" Hospital, University of Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, "Hippokration" Hospital, University of Athens, Greece
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Synetos A, Stathogiannis K, Papanikolaou A, Drakopoulou M, Trantalis G, Kaitozis O, Latsios G, Giannopoulos G, Deftereos S, Toutouzas K, Tousoulis D. Therapeutic Applications of Calcium Metabolism Modulation in Heart Disease. Med Chem 2015. [DOI: 10.2174/1573406411666150928113918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Stratos K, Toutouzas K, Synetos A, Latsios G, Stathogiannis K, Kaitozis O, Drakopoulou M, Mastrokostopoulos A, Anousakis-Vlachochristou N, Tsiachris D, Papanikolaou A, Sideris S, Tsiamis E, Tousoulis D. Percutaneous mitral valvuloplasty refined: use of a novel modified antegrade approach. Hellenic J Cardiol 2015; 56:262-265. [PMID: 26021251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Mitral stenosis usually occurs many years after an episode of rheumatic fever and it has an indolent course until its later stages, when it acutely worsens. The rates of mitral stenosis keep declining; nonetheless, the need for advanced and sophisticated treatment modalities still remains. Our group has been applying a novel modified antegrade approach for treating mitral valve stenosis and, although we have limited experience, the results thus far are favorable. We present the preliminary data of three patients who suffered from symptomatic mitral valve stenosis and underwent successful percutaneous mitral valvuloplasty with this novel modified antegrade approach. This method increases the safety and the efficacy of the procedure and has the same clinical results as other available percutaneous techniques.
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Pestell RG, Casimiro MC, Crosariol M, Loro E, Dampier W, Di Sante G, Ertel A, Yu Z, Saria EA, Papanikolaou A, Li Z, Wang C, Addya S, Lisanti MP, Fortina P, Tozeren A, Knudsen ES, Arnold A. Abstract P5-07-06: Kinase-independent role of cyclin D1 in chromosomal instability and mammary tumorigenesis. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p5-07-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Cyclin D1 is an important molecular driver of human breast cancer but better understanding of its oncogenic mechanisms is needed, especially to enhance efforts in targeted therapeutics. Activation of the cyclin D1 oncogene, often by amplification or rearrangement, is a major driver of multiple types of human tumors including breast and squamous cell cancers, B-cell lymphoma, myeloma, and parathyroid adenoma. The cyclin D1 gene is amplified or overexpressed in up to half of human breast cancers and its mammary-targeted overexpression induces mammary tumorigenesis in mice. Cyclin D1 encodes the regulatory subunit of the cyclin-dependent kinase (CDK) holoenzyme that phosphorylates several substrates including the retinoblastoma protein (pRb) to advance the G1S cell cycle checkpoint, promote DNA synthesis and regulate NRF-1 to inhibit mitochondrial biogenesis thereby coordinating nuclear and mitochondrial functions.
In addition to cyclin D1's function as a regulatory subunit of a CDK holoenzyme, several CDK-independent functions have been identified. Tumors overexpressing cyclin D1 tend to display normal levels of proliferation and expression of E2F target genes, which contrasts with tumors overexpressing cyclin E or an activator for pRb. Breast cancers overexpressing cyclin D1 that are wild type for pRb have relatively normal proliferation rates, in contrast to those caused by genetic inactivation of pRb, which show significantly increased proliferation rates. Furthermore, the alternate splice form of cyclin D1, (cyclin D1b), has potent transforming ability, which does not correlate with the ability to phosphorylate the pRb protein. Several other properties of cyclin D1 have been identified including the induction of cellular migration and enhanced angiogenesis, inhibition of mitochondrial biogenesis, and mediating DNA-damage repair signaling. Cyclin D1 binding proteins participating in these putatively CDK-independent functions include PACSIN2, NRF1, and p27KIP1; binding to p27KIP1 and PACSIN2 contribute to the pro-migratory function of cyclin D1.
Currently, pharmaceutical initiatives to inhibit cyclin D1 are focused on the catalytic component since the transforming capacity is thought to reside in the cyclin D1/CDK activity. We initiated the following study to directly test the oncogenic potential of catalytically inactive cyclin D1 in an in vivo mouse model that is relevant to breast cancer. Herein, transduction of cyclin D1-/- mouse embryonic fibroblasts (MEFs) with the kinase dead KE mutant of cyclin D1 led to aneuploidy, abnormalities in mitotic spindle formation, autosome amplification, and chromosomal instability (CIN) by gene expression profiling. Acute transgenic expression of either cyclin D1WT or cyclin D1KE in the mammary gland was sufficient to induce the CIN signature within 7 days. Sustained expression of cyclin D1KE induced mammary adenocarcinoma with similar kinetics to that of the wild-type cyclin D1. ChIP-Seq studies demonstrated recruitment of cyclin D1WT and cyclin D1KE to the genes governing CIN. We conclude that the CDK-activating function of cyclin D1 is not necessary to induce either chromosomal instability or mammary tumorigenesis.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-07-06.
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Affiliation(s)
- RG Pestell
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - MC Casimiro
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - M Crosariol
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - E Loro
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - W Dampier
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - G Di Sante
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - A Ertel
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - Z Yu
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - EA Saria
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - A Papanikolaou
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - Z Li
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - C Wang
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - S Addya
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - MP Lisanti
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - P Fortina
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - A Tozeren
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - ES Knudsen
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
| | - A Arnold
- Thomas Jefferson University, Philadelphia, PA; Drexel University, Philadelphia, PA; University of Conneticut, Farmington, CT; University of Manchester, Manchester, England, United Kingdom; Southwestern Medical Center, Dallas, TX
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Gounitsioti I, Poulimeneas D, Grammatikopoulou M, Tsolakidis D, Papanikolaou A, Tsigga M, Tarlatzis B. PP105-MON A PILOT STUDY ASSESSING PARAMETERS AND COMORBIDITIES DETERIORATING NUTRITIONAL STATUS IN PATIENTS WITH GYNECOLOGICAL CANCER POST-OPERATIVELY. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Baliaka A, Balis G, Michalopoulou-Manoloutsiou E, Papanikolaou A, Nikolaidou A. Primary angiosarcoma of bone. A case report. Hippokratia 2013; 17:180-182. [PMID: 24376329 PMCID: PMC3743628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Primary malignant vascular tumors of bone are very rare accounting for less than 1% of primary bone malignancies. They are characterized by unknown etiology, variable biologic behavior and histological appearance. Angiosarcoma is an aggressive malignant vascular tumor derived from mesenchymal cells with endothelial differentiation. CASE REPORT We present a rare case of angiosarcoma of bone in a 47-year-old male operated for a lumbar disk herniation. During his transportation from the operation theater, a pathological intertrochanteric fracture of the right hip occured. The magnetic resonance imaging (MRI) revealed a bone lytic lesion located into the great trochanter of the right femur. Open surgical biopsy of the lesion was performed and the histological examination showed primary angiosarcoma of bone. The treatment included radiotherapy (300 cGy per fraction in 13 days) followed by excision of the proximal femur and custom made total hip arthroplasty. The diagnosis was confirmed on the surgical specimen.
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Affiliation(s)
- A Baliaka
- Department of Pathology, Cancer Hospital of Thessaloniki "Theagenio"
| | - Gc Balis
- Department of Pathology, Cancer Hospital of Thessaloniki "Theagenio"
| | | | - A Papanikolaou
- Department of Pathology, General Hospital of Thessaloniki "G.Gennimatas", Thessaloniki, Greece
| | - A Nikolaidou
- Department of Pathology, Cancer Hospital of Thessaloniki "Theagenio"
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50
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Smirnakis SM, Keliris GA, Shao Y, Papanikolaou A, Logothetis NK. Population receptive field measurements in macaque visual cortex. J Vis 2012. [DOI: 10.1167/12.9.1397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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