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Stampouloglou PK, Anastasiou A, Bletsa E, Lygkoni S, Chouzouri F, Xenou M, Katsarou O, Theofilis P, Zisimos K, Tousoulis D, Vavuranakis M, Siasos G, Oikonomou E. Diabetes Mellitus in Acute Coronary Syndrome. Life (Basel) 2023; 13:2226. [PMID: 38004366 PMCID: PMC10671950 DOI: 10.3390/life13112226] [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: 10/14/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
The global prevalence of diabetes mellitus (DM) has led to a pandemic, with significant microvascular and macrovascular complications including coronary artery disease (CAD), which worsen clinical outcomes and cardiovascular prognosis. Patients with both acute coronary syndrome (ACS) and DM have worse prognosis and several pathophysiologic mechanisms have been implicated including, insulin resistance, hyperglycemia, endothelial dysfunction, platelet activation and aggregations as well as plaque characteristics and extent of coronary lesions. Therefore, regarding reperfusion strategies in the more complex anatomies coronary artery bypass surgery may be the preferred therapeutic strategy over percutaneous coronary intervention while both hyperglycemia and hypoglycemia should be avoided with closed monitoring of glycemic status during the acute phase of myocardial infraction. However, the best treatment strategy remains undefined. Non-insulin therapies, due to the low risk of hypoglycemia concurrently with the multifactorial CV protective effects, may be proved to be the best treatment option in the future. Nevertheless, evidence for the beneficial effects of glucagon like peptide-1 receptor agonists, dipeptidyl-peptidase 4 inhibitors and sodium glycose cotransporter 2 inhibitors, despite accumulating, is not robust and future randomized control trials may provide more definitive data.
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Affiliation(s)
- Panagiota K. Stampouloglou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Evanthia Bletsa
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Stavroula Lygkoni
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Flora Chouzouri
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Maria Xenou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Ourania Katsarou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Panagiotis Theofilis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
| | - Konstantinos Zisimos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Dimitris Tousoulis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.K.S.); (A.A.); (E.B.); (S.L.); (F.C.); (M.X.); (K.Z.); (M.V.); (G.S.)
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Katsioupa M, Kourampi I, Oikonomou E, Tsigkou V, Theofilis P, Charalambous G, Marinos G, Gialamas I, Zisimos K, Anastasiou A, Katsianos E, Kalogeras K, Katsarou O, Vavuranakis M, Siasos G, Tousoulis D. Novel Biomarkers and Their Role in the Diagnosis and Prognosis of Acute Coronary Syndrome. Life (Basel) 2023; 13:1992. [PMID: 37895374 PMCID: PMC10608753 DOI: 10.3390/life13101992] [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: 09/04/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
The burden of cardiovascular diseases and the critical role of acute coronary syndrome (ACS) in their progression underscore the need for effective diagnostic and prognostic tools. Biomarkers have emerged as crucial instruments for ACS diagnosis, risk stratification, and prognosis assessment. Among these, high-sensitivity troponin (hs-cTn) has revolutionized ACS diagnosis due to its superior sensitivity and negative predictive value. However, challenges regarding specificity, standardization, and interpretation persist. Beyond troponins, various biomarkers reflecting myocardial injury, neurohormonal activation, inflammation, thrombosis, and other pathways are being explored to refine ACS management. This review article comprehensively explores the landscape of clinically used biomarkers intricately involved in the pathophysiology, diagnosis, and prognosis of ACS (i.e., troponins, creatine kinase MB (CK-MB), B-type natriuretic peptides (BNP), copeptin, C-reactive protein (CRP), interleukin-6 (IL-6), d-dimers, fibrinogen), especially focusing on the prognostic role of natriuretic peptides and of inflammatory indices. Research data on novel biomarkers (i.e., endocan, galectin, soluble suppression of tumorigenicity (sST2), microRNAs (miRNAs), soluble oxidized low-density lipoprotein receptor-1 (sLOX-1), F2 isoprostanes, and growth differentiation factor 15 (GDF-15)) are further analyzed, aiming to shed light on the multiplicity of pathophysiologic mechanisms implicated in the evolution of ACS. By elucidating the complex interplay of these biomarkers in ACS pathophysiology, diagnosis, and outcomes, this review aims to enhance our understanding of the evolving trajectory and advancements in ACS management. However, further research is necessary to establish the clinical utility and integration of these biomarkers into routine practice to improve patient outcomes.
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Affiliation(s)
- Maria Katsioupa
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Islam Kourampi
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Vasiliki Tsigkou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Panagiotis Theofilis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
| | - Georgios Charalambous
- Department of Emergency Medicine, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - George Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Gialamas
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Konstantinos Zisimos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Efstratios Katsianos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Ourania Katsarou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Dimitris Tousoulis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
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Goliopoulou A, Theofilis P, Oikonomou E, Anastasiou A, Pantelidis P, Gounaridi MI, Zakynthinos GE, Katsarou O, Kassi E, Lambadiari V, Tousoulis D, Vavuranakis M, Siasos G. Non-Alcoholic Fatty Liver Disease and Echocardiographic Parameters of Left Ventricular Diastolic Function: A Systematic Review and Meta-Analysis. Int J Mol Sci 2023; 24:14292. [PMID: 37762592 PMCID: PMC10532416 DOI: 10.3390/ijms241814292] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
The cardiovascular implications of non-alcoholic fatty liver disease (NAFLD) have been associated with heart failure with preserved ejection fraction (HFpEF). The purpose of this review was to conduct a bibliographic search regarding the correlation between NAFLD and the echocardiographic parameters of left ventricular diastolic function. A systematic literature search was conducted in PubMed and Embase for original research data reporting on the association of NAFLD with diastolic function markers [E/e', left atrial volume index (LAVi), left ventricular mass index (LVMi)]. Meta-analysis was performed using the meta and dmetar packages in R studio v.1.4.1106, with p < 0.05 values being considered significant. Results are expressed as the standardized mean difference (SMD) for continuous variables and as the odds ratio (OR) for categorical variables, with respective 95% confidence intervals (CI). Heterogeneity between studies was expressed with index Ι2. From the preliminary search, 2619 articles were found from which 31 studies were included in the final statistical analysis. The meta-analysis of 8 studies which reported on the prevalence of diastolic dysfunction showed that it was increased in patients with NAFLD (OR: 2.07, 95% CI 1.24-3.44 with p = 0.01, I2: 80% with p < 0.01). The meta-analysis of 21 studies showed significantly higher E/e' in NAFLD patients (SMD 1.02, 95% CI 0.43-1.61 with p < 0.001, I2: 97% with p < 0.001). Individuals with NAFLD had increased LAVi (SMD: 0.87, 95% CI 0.38-1.37 with p < 0.001, I2: 96% with p < 0.001) and LVMi (SMD: 0.89, 95% CI 0.31-1.48 with p = 0.003, I2: 100% with p < 0.001). To conclude, in the meta-analysis of 31 observational studies, NAFLD patients were found to have affected left ventricular diastolic function, supporting the hypothesis of NAFLD being associated with HFpEF.
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Affiliation(s)
- Athina Goliopoulou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Panagiotis Theofilis
- 1st Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Panteleimon Pantelidis
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Maria Ioanna Gounaridi
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Georgios E. Zakynthinos
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Ourania Katsarou
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Eva Kassi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Vaia Lambadiari
- 2nd Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, 12462 Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (P.P.)
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Tsigkou V, Oikonomou E, Anastasiou A, Lampsas S, Zakynthinos GE, Kalogeras K, Katsioupa M, Kapsali M, Kourampi I, Pesiridis T, Marinos G, Vavuranakis MA, Tousoulis D, Vavuranakis M, Siasos G. Molecular Mechanisms and Therapeutic Implications of Endothelial Dysfunction in Patients with Heart Failure. Int J Mol Sci 2023; 24:ijms24054321. [PMID: 36901752 PMCID: PMC10001590 DOI: 10.3390/ijms24054321] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
Heart failure is a complex medical syndrome that is attributed to a number of risk factors; nevertheless, its clinical presentation is quite similar among the different etiologies. Heart failure displays a rapidly increasing prevalence due to the aging of the population and the success of medical treatment and devices. The pathophysiology of heart failure comprises several mechanisms, such as activation of neurohormonal systems, oxidative stress, dysfunctional calcium handling, impaired energy utilization, mitochondrial dysfunction, and inflammation, which are also implicated in the development of endothelial dysfunction. Heart failure with reduced ejection fraction is usually the result of myocardial loss, which progressively ends in myocardial remodeling. On the other hand, heart failure with preserved ejection fraction is common in patients with comorbidities such as diabetes mellitus, obesity, and hypertension, which trigger the creation of a micro-environment of chronic, ongoing inflammation. Interestingly, endothelial dysfunction of both peripheral vessels and coronary epicardial vessels and microcirculation is a common characteristic of both categories of heart failure and has been associated with worse cardiovascular outcomes. Indeed, exercise training and several heart failure drug categories display favorable effects against endothelial dysfunction apart from their established direct myocardial benefit.
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Affiliation(s)
- Vasiliki Tsigkou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-69-4770-1299
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Stamatios Lampsas
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - George E. Zakynthinos
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Maria Katsioupa
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Maria Kapsali
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Islam Kourampi
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Theodoros Pesiridis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Georgios Marinos
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Michael-Andrew Vavuranakis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Oikonomou E, Tsaplaris P, Anastasiou A, Xenou M, Lampsas S, Siasos G, Pantelidis P, Theofilis P, Tsatsaragkou A, Katsarou O, Sagris M, Vavuranakis MA, Vavuranakis M, Tousoulis D. Interleukin-1 in Coronary Artery Disease. Curr Top Med Chem 2022:CTMC-EPUB-127032. [PMID: 36263481 DOI: 10.2174/1568026623666221017144734] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 11/22/2022]
Abstract
Cardiovascular disease is the leading cause of mortality worldwide. Inflammation has long been established as a key component in the pathophysiology of coronary artery disease. The interleukin-1 family consists of 11 members that regulate the inflammatory response through both pro- and anti-inflammatory properties with the Nod-like receptor (NLR) family pyrin domain containing 3 inflammasome having a pivotal role in the process of converting interleukin-1 beta and interleukin-18, two key inflammatory mediators, into their mature forms. Interleukin-1 affects various cell types that participate in the pathogenesis of atherosclerosis as it enhances the expression of leukocyte adhesion molecules on the surface of endothelial cells augment the permeability of the endothelial cell barrier, attracting monocytes and macrophages into the vessel wall and aids the migration of smooth muscle cells toward atheroma. It also enhances the aggregation of low-density lipoprotein particles in endothelium and smooth muscle cells and exhibits procoagulant activity by inducing synthesis, cell-surface expression and release of tissue factor in endothelial cells, promoting platelet adhesion. The value of interleukin-1 as a diagnostic biomarker is currently limited but interleukin-1 beta, interleukin-18 and interleukin-37 have shown promising data regarding their prognostic value in coronary artery disease. Importantly, target anti-inflammatory treatments have shown promising results regarding atherosclerosis progression and cardiovascular events. In this review article we focus on the immense role of interleukin-1 in atherosclerosis progression, inflammation cascade and in the clinical application of target anti-inflammatory treatments.
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Affiliation(s)
- Evangelos Oikonomou
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Paraskevas Tsaplaris
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Artemis Anastasiou
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Maria Xenou
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Stamatios Lampsas
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece.,1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration General Hospital, Athens, Greece.,Cardiovascular Division, Brigham and Women\'s Hospital, Harvard Medical School, Boston, MA, USA
| | - Panteleimon Pantelidis
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Panagiotis Theofilis
- 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration General Hospital, Athens, Greece
| | - Aikaterini Tsatsaragkou
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Ourania Katsarou
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Marios Sagris
- 1st Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Hippokration General Hospital, Athens, Greece
| | - Michael-Andrew Vavuranakis
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
| | - Dimitris Tousoulis
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens, Greece
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6
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Lampsas S, Oikonomou E, Souvaliotis N, Goliopoulou A, Papamikroulis GA, Anastasiou A, Theofilis P, Zakynthinos G, Gialamas I, Pantelidis P, Gounaridi MA, Tsatsaragkou A, Siasos G, Tousoulis D, Vavuranakis M. Impaired heart rate variability one and six months post acute COVID-19. Eur Heart J 2022. [PMCID: PMC9619568 DOI: 10.1093/eurheartj/ehac544.402] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Long COVID-19 syndrome is an increasingly recognized problem. Post-infectious cardiac autonomic dysfunction is commonly reported. This study aims to evaluate autonomic dysfunction by means of Heart rate variability (HRV) on post-COVID-19 patients. Methods Hospitalized patients for COVID-19 (either at the medical ward or Intensive Care Unit (ICU)) were followed up at 1 and 6 months after hospital discharge. Medical history and clinical information were collected. HRV was assessed by 24-hour ambulatory electrocardiography Holter, with the measure of the standard deviation of normal RR intervals in 24 h, ms (SDNN). The comparison was conducted with age and sex-matched non-COVID-19 controls. Results Thirty-four patients hospitalized with COVID-19 (20.6% admitted in ICU) were examined 1-month and 6-months post-hospital discharge. SDNN was significantly (p<0.001) reduced in the COVID-19 group (111±23 ms) compared to the control subjects (152±24 ms) 1-month after discharge. Subgroup analysis between COVID-19 group revealed that ICU subjects presented significantly (p<0.001) reduced SDNN compared to the medical ward, respectively (83±20 ms vs. 118±17 ms). At 6-months, an improvement was noted at SDNN 24h (6-month: 133±24 vs. control: 151±24 ms, p=0.004; 1-month: 111±23 ms vs. 6-month: 133±24 ms, p<0.001). Also at 6-months, ICU subjects noted significantly (p=0.003) reduced SDNN 24h compared to medical ward subjects (107±17 ms vs. 140±20 ms). On the 6-months follow-up, 32% of the subjects had “long-COVID-19” symptoms. Subjects with long COVID-19 symptoms had low SDNN values (“long-COVID-19”: 112±17 ms vs. non-“long-COVID-19”: 142±20 ms, p=0.001) Conclusion Patients hospitalized for COVID-19 have reduced SDNN, at one month post-hospital discharge which is improved at the six months follow-up. These findings emphasize the increased sympathetic drive activity in the post-acute COVID-19 phase and imply a link between autonomic dysfunction and long COVID-19. Funding Acknowledgement Type of funding sources: None.
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Affiliation(s)
- S Lampsas
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - E Oikonomou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - N Souvaliotis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - A Goliopoulou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - G A Papamikroulis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - A Anastasiou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - P Theofilis
- National & Kapodistrian University of Athens Medical School, 1st Department of Cardiology, Hippokration General Hospital , Athens , Greece
| | - G Zakynthinos
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - I Gialamas
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - P Pantelidis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - M A Gounaridi
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - A Tsatsaragkou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - G Siasos
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - D Tousoulis
- National & Kapodistrian University of Athens Medical School, 1st Department of Cardiology, Hippokration General Hospital , Athens , Greece
| | - M Vavuranakis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
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7
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Lampsas S, Oikonomou E, Souvaliotis N, Anastasiou A, Katsarou O, Marathonitis A, Lysandrou A, Tzima I, Sarantos S, Kalogeras K, Tsatsaragkou A, Mystakidi VC, Siasos G, Tousoulis D, Vavuranakis M. Ventricular-arterial coupling impairment in patients recovered from COVID-19. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.113] [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
Myocardial and vascular alterations among post-COVID-19 patients are observed. The coupling between arterial stiffness with left ventricular (LV) myocardial function (ventricular-arterial coupling, VAC) is an important determinant of cardiovascular performance and cardiac energetics. The aim of the study was to investigate the spectrum of cardiac and vascular abnormalities at mid-term follow-up in post-COVID-19 patients.
Methods
We enrolled 25 hospitalized patients for COVID-19, at one and six months after hospital discharge. The ratio (PWV/GLS) of carotid-femoral pulse wave velocity (cf-PWV), as a marker of arterial stiffness, to global longitudinal strain (LV-GLS), as a marker of left ventricular performance, was estimated as a marker of arterial elastance/left ventricular elastance index the long-term. The comparison was conducted with age and sex-matched non-COVID-19 controls.
Results
There was no difference in age (56.8±11.6 y vs. 57.4±9.5 y; p=0.85) and male sex (64% vs. 68%; P=0.76) between post-COVID-19 and control subjects respectively. At one-month follow-up, significant impairment was noted between post-COVID-19 and control subjects regarding: VAC (−0.71±0.24 m/s% vs. −0.44±0.11 m/sec%; p<0.001), LV-GLS (−17.9±3.1% vs. −21.9±2.7%; p<0.001), cf-PWV (12.3±3.5 m/s vs. 9.6±1.9; p<0.001). At six-month follow-up, an improvement was observed but there still was significant difference between post-COVID-19 and control subjects in: VAC (−0.62±0.19 m/sec% vs. −0.44±0.11 m/sec%; p<0.001), LV-GLS (−19.3±2.9% vs. −21.9±2.7%; p=0.001), cf-PWV (11.7±2.7 m/s vs. 9.6±1.9 m/s; p=0.001). Moreover, it was observed at 1-month: VAC adverse correlation with the levels of IL-6 (r=−0.54; p<0.001), CRP (−0.71; p=0.011) and at 6-months: IL-6 (r=−0.47; p=0.003), CRP (−0.56; p=0.007).
Conclusion
Ventricular-arterial coupling is impaired 6 months following COVID-19 highlighting the possible effects of SARS-CoV-2 infection in left ventricular mechanics and performance.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Lampsas
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - E Oikonomou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - N Souvaliotis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - A Anastasiou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - O Katsarou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - A Marathonitis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - A Lysandrou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - I Tzima
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - S Sarantos
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - K Kalogeras
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - A Tsatsaragkou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - V C Mystakidi
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - G Siasos
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
| | - D Tousoulis
- National & Kapodistrian University of Athens Medical School, 1st Department of Cardiology, Hippokration General Hospital , Athens , Greece
| | - M Vavuranakis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Sotiria Chest Disease Hospital , Athens , Greece
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8
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Pantelidis P, Spartalis M, Zakynthinos G, Anastasiou A, Goliopoulou A, Oikonomou E, Iliopoulos DC, Siasos G. Artificial Intelligence: The new "fuel" to accelerate pharmaceutical development. Curr Pharm Des 2022; 28:2127-2128. [PMID: 35909280 DOI: 10.2174/1381612828666220729101103] [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: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 12/07/2022]
Affiliation(s)
- Panteleimon Pantelidis
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Spartalis
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Zakynthinos
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athina Goliopoulou
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios C Iliopoulos
- Laboratory of Experimental Surgery and Surgical Research 'N. S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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9
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Spartalis M, Tzima I, Anastasiou A, Spartalis E, Iliopoulos DC, Siasos G. Controversy regarding the disease taxonomy of Takotsubo syndrome: pathophysiological, morphological and anatomical considerations. Eur Rev Med Pharmacol Sci 2022; 26:4161-4162. [PMID: 35776015 DOI: 10.26355/eurrev_202206_29052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- M Spartalis
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, Laboratory of Experimental Surgery and Surgical Research 'N. S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens, Greece.
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10
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Spartalis M, Tzima I, Anastasiou A, Spartalis E, Iliopoulos DC, Siasos G. Anti-inflammatory drug combination therapy for atherosclerosis: colchicine and fenofibrate. Curr Med Chem 2022; 29:4477-4480. [PMID: 35392778 DOI: 10.2174/0929867329666220407095216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 12/07/2022]
Affiliation(s)
- Michael Spartalis
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Tzima
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Spartalis
- Laboratory of Experimental Surgery and Surgical Research 'N. S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitrios C Iliopoulos
- Laboratory of Experimental Surgery and Surgical Research 'N. S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Sotiria Thoracic Diseases General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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11
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Andrikou E, Dimitriadis K, Andrikou I, Kasiakogias A, Tatakis F, Dimitriadi M, Anastasiou A, Kintis K, Kalos T, Iliakis P, Tousoulis D, Tsioufis C. Blood pressure response in exercise is associated with future cardiac structural alterations in hypertensive patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2708] [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/Introduction
Exaggerated blood pressure response (EBPR) during the exercise treadmill test (ETT) is often observed in individuals without known cardiovascular disease. Although it is generally considered as an abnormal response and a risk factor for hypertension development, its clinical significance remains controversial. On the other hand, regression of left ventricular hypertrophy (LVH) is independently associated with improved cardiovascular outcome.
Purpose
In this study we aimed to investigate the role of EBPR during exercise in LVH regression in hypertensive subjects over time.
Methods
1413 hypertensive subjects, (mean age 57±11 years), 51% males, with baseline office blood pressure (BP) 144/89mmHg were followed for a mean period of 6.4±3.0 years. At baseline and last follow-up visit all patients underwent office BP, laboratory tests and echocardiographical determination of left ventricular mass index (LVMI). At baseline, all subjects underwent treadmill exercise testing (Bruce protocol) in order to identify the presence of EBPR based on the systolic BP elevation at peak exercise (> or =210 mmHg for men and > or =190 mmHg for women). Main outcome variable was LVH Regression/prevention (LVH Regr/prev), defined as: LVH at baseline visit with normal LVMI values at last visit or absence of LVH at baseline and last visit. BP control was considered optimal when the mean of office BP measurements during follow-up was <140/90mmHg.
Results
46% of study population presented LVH Regr/prev during follow-up period. Cox-regression analysis, after adjustment for clinical and biochemical variables, revealed that low levels of baseline LVMI (HR=0.98, 95% CI 0.97–0.99, p<0.0001), absence of EBPR (HR=0.81, 95% CI 0.67–0.98, p=0.02) and optimal BP control during follow-up (HR=1.19, 95% CI 1.01–1.56, p=0.03) were independent predictors of LVH Regr/prev during follow-up.
Conclusions
Beyond optimal BP control, EBPR is a significant predictor of left ventricular mass changes overtime. Hence, ETT can provide clinical relevant information, including EBPR, which may help in the improvement of risk stratification of hypertensive subjects.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- E Andrikou
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - K Dimitriadis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - I Andrikou
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Kasiakogias
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - F Tatakis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - M Dimitriadi
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Anastasiou
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - K Kintis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - T Kalos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - P Iliakis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Tousoulis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - C Tsioufis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
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12
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Sideris K, Kasiakogias A, Konstantinidis D, Papakonstantinou P, Tatakis F, Kouremeti M, Tsioufis P, Anastasiou A, Leontsinis I, Manta E, Tousoulis D, Tsioufis C. Time in blood pressure range for different blood pressure targets and risk of cardiovascular disease: an analysis of a 7-year follow-up registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2745] [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
Objective
Recent guideline recommendations have revisited the optimal target blood pressure (BP) for hypertensive patients. The Time in BP Range (TBPR) is an alternative metric for evaluation of long-term achieved BP. We investigated the association of TBPR for different levels of BP control with cardiovascular outcome among treated hypertensives.
Design and method
This is a retrospective analysis of 1202 treated hypertensive patients (age 59±11 years) without a history of cardiovascular disease followed for a mean period of 7±3 years. We calculated the TBPR [(No of Visits in BP range/ Total No of Visits) x 100%] for office systolic BP targets of 130–139mmHg, 120–129mmHg and <120mmHg and examined the associated cardiovascular risk. The outcome studied was the composite of stroke and coronary artery disease. Time spent in systolic BP≥140mmHg served as the reference.
Results
In the entire population, mean TBPR for systolic BP 130–139mmHg, 120–129mmH, and <120mmHg were 26%, 19% and 11% respectively. A TBPR of ≥50% for systolic BP 130–139mmHg, 120–129mmHg and <120mmHg was observed in 332 (28%), 226 (19%) and 107 (9%) patients respectively. The composite endpoint occurred in 54 patients (4.5%). Patients with a TBPR for 120–140mmHg of ≥50% presented with a HR: 0.6 (95% CI: 0.34–1.06) for cardiovascular events. The TBPR of ≥50% for systolic BP 130–139mmHg, 120–129mmHg and <120mmHg was associated with HR of 0.48 (95% CI: 0.23–1.01, p=0.05), 0.64 (95% CI: 0.29–1.39, p=0.26) and 0.72 (95% CI: 0.26–2.05) respectively. This pattern was sustained but further attenuated after controlling for standard risk factors. In comparison, a mean BP across visits of 130–139mmHg, 120–129mmHg and <120mmHg was associated with a HR of 0.54 (5% CI: 0.28–1.03), 0.61 (95% CI: 0.29–1.26) and 0.80 (95% CI: 0.24–2.65).
Conclusions
Among treated hypertensives, a time in BP of 130–140mmHg of more than 50% is associated with the greatest reduction in cardiovascular risk. The TBPR is a potentially useful measure of BP control for evaluation of risk reduction in hypertensive patients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Sideris
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Kasiakogias
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Konstantinidis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - P Papakonstantinou
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - F Tatakis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - M Kouremeti
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - P Tsioufis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Anastasiou
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - I Leontsinis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - E Manta
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Tousoulis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - C Tsioufis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
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13
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Gkoura L, Diamantopoulos G, Fardis M, Homouz D, Alhassan S, Beazi-Katsioti M, Karagianni M, Anastasiou A, Romanos G, Hassan J, Papavassiliou G. The peculiar size and temperature dependence of water diffusion in carbon nanotubes studied with 2D NMR diffusion-relaxation D - T 2eff spectroscopy. Biomicrofluidics 2020; 14:034114. [PMID: 32595817 PMCID: PMC7305942 DOI: 10.1063/5.0005398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Abstract
It is well known that water inside hydrophobic nano-channels diffuses faster than bulk water. Recent theoretical studies have shown that this enhancement depends on the size of the hydrophobic nanochannels. However, experimental evidence of this dependence is lacking. Here, by combining two-dimensional nuclear magnetic resonance diffusion-relaxation ( D - T 2 e f f ) spectroscopy in the stray field of a superconducting magnet and molecular dynamics simulations, we analyze the size dependence of water dynamics inside Carbon Nanotubes (CNTs) of different diameters ( 1.1 - 6.0 nm), in the temperature range of 265 - 305 K. Depending on the CNT diameter, the nanotube water is shown to resolve in two or more tubular components acquiring different self-diffusion coefficients. Most notably, a favorable CNT diameter range ( 3.0 - 4.5 nm) is experimentally verified for the first time, in which water molecule dynamics at the center of the CNTs exhibits distinctly non-Arrhenius behavior, characterized by ultrafast diffusion and extraordinary fragility, a result of significant importance in the efforts to understand water behavior in hydrophobic nanochannels.
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Affiliation(s)
- L. Gkoura
- Institute of Nanoscience and Nanotechnology, NCSR Demokritos, 15310 Aghia Paraskevi, Attiki, Greece
| | | | - M. Fardis
- Institute of Nanoscience and Nanotechnology, NCSR Demokritos, 15310 Aghia Paraskevi, Attiki, Greece
| | | | - S. Alhassan
- Department of Chemical Engineering, Khalifa University of Science and Technology, 127788 Abu Dhabi, UAE
| | - M. Beazi-Katsioti
- School of Chemical Engineering, National Technical University of Athens, 15780 Zografou, Athens, Greece
| | - M. Karagianni
- Institute of Nanoscience and Nanotechnology, NCSR Demokritos, 15310 Aghia Paraskevi, Attiki, Greece
| | - A. Anastasiou
- Institute of Nanoscience and Nanotechnology, NCSR Demokritos, 15310 Aghia Paraskevi, Attiki, Greece
| | - G. Romanos
- Institute of Nanoscience and Nanotechnology, NCSR Demokritos, 15310 Aghia Paraskevi, Attiki, Greece
| | - J. Hassan
- Department of Physics, Khalifa University of Science and Technology, 127788 Abu Dhabi, UAE
| | - G. Papavassiliou
- Institute of Nanoscience and Nanotechnology, NCSR Demokritos, 15310 Aghia Paraskevi, Attiki, Greece
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14
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Christofidis C, Anastasiou A, Krasnikova E, Mandros C, Potolidis E. Posterior reversible encephalopathy syndrome as a complication of bacterial meningitis. Hippokratia 2019; 23:131-134. [PMID: 32581499 PMCID: PMC7307506] [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: 06/11/2023]
Abstract
BACKGROUND Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, which is presented with headache, seizures, altered mental consciousness, and visual disturbances, and is characterized by white matter vasogenic edema, predominantly affecting the posterior occipital and parietal lobes of the brain. This clinical syndrome is increasingly recognized due to the improvement and availability of brain imaging and, more specifically, magnetic resonance imaging. CASE REPORT We report the case of an otherwise healthy 20-year-old female who presented with fever, headache, and generalized arthralgia, raising the suspicion of Neisseria meningitidis serotype B meningitis, which was later complicated by PRES. The patient was treated with the antiepileptic drug levetiracetam, mannitol, and dexamethasone. Her mental status was completely restored in 3-4 days after the initiation of the treatment for PRES and was characterized by rapid clinical recovery. CONCLUSION PRES is a neurotoxic state characterized by a unique brain imaging pattern typically associated with a number of complex clinical conditions including infection, sepsis, and shock. The syndrome should be promptly recognized since it is reversible and treatable. HIPPOKRATIA 2019, 23(2): 131-134.
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Affiliation(s)
- Ch Christofidis
- Second Internal Medicine Department, Volos General Hospital, Volos, Greece
| | - A Anastasiou
- Second Internal Medicine Department, Volos General Hospital, Volos, Greece
| | - E Krasnikova
- Neurology Department, Volos General Hospital, Volos, Greece
| | - Ch Mandros
- Second Internal Medicine Department, Volos General Hospital, Volos, Greece
| | - E Potolidis
- Second Internal Medicine Department, Volos General Hospital, Volos, Greece
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Kasimatis E, Fylaktou A, Karampatakis T, Schoina M, Zarras C, Anastasiou A, Papachristou M, Boukla A, Daoudaki M, Fouzas I, Papagianni A. Human Leukocyte Antigen Compatibility and De Novo Donor-Specific Antibodies in Long-term Renal Transplant Patients With Stable Graft Function. Transplant Proc 2019; 51:413-415. [PMID: 30879554 DOI: 10.1016/j.transproceed.2019.01.013] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE De novo donor-specific antibodies (DSA) are associated with antibody-mediated rejection leading to late renal transplant failure. The aim of this study was to evaluate whether HLA compatibility is associated with sensitization along with other risk factors. METHODS Eighty-nine stable renal transplant recipients (47 men) were studied. Patients were classified into 2 groups according to HLA compatibility between donor and recipient, group A (1-4/8 matches) and group B (5-8/8 matches). Cold ischemia time (CIT) and delayed graft function (DGF) were recorded along with time with a functional graft. Anti-HLA antibodies were detected using a Luminex single-antigen bead assay and were further classified into DSA and non-DSA. RESULTS HLA group A consisted of 49 (56%) transplant recipients while 38 (44%) were classified to group B, with functional grafts for 10.9 ± 6.7 and 14.8 ± 8.5 years, respectively (P = .019). Group A patients had more anti-HLA antibodies than group Β (P = .001) and this correlation was retained for DSA patients. De novo anti-HLA were detected in 40 patients; DSA were detected in 19 (21.8%). DSA (+) patients had recorded with functional renal grafts for 11 ± 5 years, compared to 14.4 ± 8.6 years (P = .048) for anti-HLA negative patients. Increased CIT and DGF were associated with anti-HLA antibodies detection but no with DSA. CONCLUSION HLA compatibility is probably correlated with DSA in a context of a more general anti-HLA sensitization, and both have a negative effect on long-term renal graft outcome.
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Affiliation(s)
- E Kasimatis
- Department of Nephrology, Aristotle University Medical School, Hippokration General Hospital, Thessaloniki, Greece.
| | - A Fylaktou
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - T Karampatakis
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - M Schoina
- Department of Nephrology, Aristotle University Medical School, Hippokration General Hospital, Thessaloniki, Greece
| | - C Zarras
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - A Anastasiou
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - M Papachristou
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - A Boukla
- National Peripheral Histocompatibility Center, Immunology Department, Hippokration General Hospital, Thessaloniki, Greece
| | - M Daoudaki
- Division of Organ Transplantation, Department of Surgery, Aristotle University Medical School, Hippokration General Hospital, Thessaloniki, Greece
| | - I Fouzas
- Division of Organ Transplantation, Department of Surgery, Aristotle University Medical School, Hippokration General Hospital, Thessaloniki, Greece
| | - A Papagianni
- Department of Nephrology, Aristotle University Medical School, Hippokration General Hospital, Thessaloniki, Greece
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Abstract
The Becchi-Rouet-Stora-Tyutin (BRST) transformations and equations of motion of a gravity-two-form-dilaton system are derived from the product of two Yang-Mills theories in a BRST covariant form, to linear approximation. The inclusion of ghost fields facilitates the separation of the graviton and dilaton. The gravitational gauge fixing term is uniquely determined by those of the Yang-Mills factors which can be freely chosen. Moreover, the resulting gravity-two-form-dilaton Lagrangian is anti-BRST invariant and the BRST and anti-BRST charges anticommute as a direct consequence of the formalism.
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Affiliation(s)
- A Anastasiou
- Nordita, KTH Royal Institute of Technology and Stockholm University, Roslagstullsbacken 23, 10691 Stockholm, Sweden
| | - L Borsten
- School of Theoretical Physics, Dublin Institute for Advanced Studies, 10 Burlington Road, Dublin 4, Ireland
| | - M J Duff
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
- Mathematical Institute, University of Oxford, Andrew Wiles Building, Woodstock Road, Radcliffe Observatory Quarter, Oxford OX2 6GG, United Kingdom
- Institute for Quantum Science and Engineering and Hagler Institute for Advanced Study, Texas A&M University, College Station, Texas 77840, USA
| | - S Nagy
- Centre for Astronomy & Particle Theory, University Park, Nottingham NG7 2RD, United Kingdom
| | - M Zoccali
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
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Vargiami E, Papathanasiou E, Batzios S, Kyriazi M, Dimitriou E, Anastasiou A, Michelakakis H, Giese AK, Zafeiriou DI. Neuroradiological, neurophysiological and molecular findings in infantile Krabbe disease: two case reports. Balkan J Med Genet 2016; 19:85-90. [PMID: 27785412 PMCID: PMC5026284 DOI: 10.1515/bjmg-2016-0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 11/15/2022] Open
Abstract
Krabbe disease is an autosomal recessive neurodegenerative disorder due to a defect of the lysosomal enzyme β-galactocerebrosidase (β-GALC). Depending on the age of onset, the disease is classified into infantile and later-onset forms. We report neuroradiological, neurophysiological and molecular findings in two Greek patients with the infantile form of Krabbe disease. The index patients presented at the age of 3.5 and 6 months, respectively, due to developmental delay. Magnetic resonance imaging (MRI) of the first patient’s brain demonstrated signs of leukodystrophy, while nerve conduction velocities (NCVs) were significantly decreased. The second patient’s MRI at the age of 4 months was initially normal, but at 18 months demonstrated leukodystrophic alterations as well, whereas NCVs were also significantly delayed. In both patients, a severe decrease in β-GALC, activity supported the diagnosis of Krabbe disease, while the final diagnosis was confirmed by molecular genetic testing. Two homozygous mutations of the GALC gene, the c.411_413delTAA [p.K139del] mutation in the first patient, and the c.749T>C [p.I250T] mutation in the second patient, were identified. At their last follow-up visit at the age of 4 and 6 years, respectively, both patients were bedridden and quadri-plegic, suffering from frequent respiratory tract infections and fed through a gastrostomy. Both mutations found in homozygosity in these two unrelated patients of Greek ancestry, could pinpoint a common origin. Genotyping of patients with Krabbe disease is important, in order to contribute to the creation of a European mutation database and to further study possible genotype-phenotype correlations of the disease.
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Affiliation(s)
- E Vargiami
- 1 Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Papathanasiou
- 1 Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Batzios
- 1 Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Kyriazi
- 1 Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Dimitriou
- Department of Enzymology and Cellular Function, Institute of Child Health, Athens, Greece
| | - A Anastasiou
- Department of Radiology, Hippokratio General Hospital, Thessaloniki, Greece
| | - H Michelakakis
- Department of Enzymology and Cellular Function, Institute of Child Health, Athens, Greece
| | - A-K Giese
- Neurogenetics and Metabolic Disorders Unit, University of Rostock, Rostock, Germany
| | - D I Zafeiriou
- 1 Pediatric Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Anastasiou A, Giokas K, Koutsouris D. Monitoring of compliance on an individual treatment through mobile innovations. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:7320-7323. [PMID: 26737982 DOI: 10.1109/embc.2015.7320082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The present work examines the potential of smartphone usage for offering health services to elderly patients. The purpose of this work is the design, development, and implementation of a telemedicine application. This application aims to improve the monitoring mode and increase patient adherence to the instructions assigned by the medical staff. It consists of three parts: the doctor's application (Web Application), the patient's application (Android Application) and the Web Server of the platform, where the database is stored necessary for the smooth operation of the platform. Also the Web Server hosts the doctor's Web Application. The Web Application is based on web front-end technologies, providing the medical personnel with a variety of features and useful actions. These actions and capabilities are mainly relevant to the assignment of instructions to patients and the monitoring of their health progress. The Android Application has been implemented and validated for the Android-based mobile devices operating system and consists of a handy and user-friendly environment, equipped with the right tools so that the patient has the ability to update the system on the progress of his/her health by storing the appropriate measurements. Both applications also provide customization capabilities in regards to the patients' and doctors' profile.
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Abstract
By regarding gravity as the convolution of left and right Yang-Mills theories together with a spectator scalar field in the biadjoint representation, we derive in linearized approximation, the gravitational symmetries of general covariance, p-form gauge invariance, local Lorentz invariance, and local supersymmetry from the flat space Yang-Mills symmetries of local gauge invariance and global super-Poincaré symmetry. As a concrete example, we focus on the new minimal (12+12) off shell version of simple four-dimensional supergravity obtained by tensoring the off shell Yang-Mills multiplets (4+4, N_{L}=1) and (3+0, N_{R}=0).
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Affiliation(s)
- A Anastasiou
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - L Borsten
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - M J Duff
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - L J Hughes
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
| | - S Nagy
- Theoretical Physics, Blackett Laboratory, Imperial College London, London SW7 2AZ, United Kingdom
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Chrisoulidou A, Alexandraki KI, Kita M, Tsolakidou K, Papanastasiou L, Samara C, Anastasiou A, Piaditis G, Kaltsas G. Incidence of pituitary incidentalomas in patients with adrenal adenomas. Exp Clin Endocrinol Diabetes 2014; 122:15-9. [PMID: 24464594 DOI: 10.1055/s-0033-1358761] [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: 10/25/2022]
Abstract
With the advent of modern imaging modalities, endocrine incidentalomas are increasingly being discovered. We aimed to investigate the presence of pituitary incidentalomas (PI) in patients with adrenal incidentalomas (AI), and identify potential metabolic correlates in this cohort. 26 patients (18 females) with AI discovered on abdominal computerized tomography were studied. All patients underwent pituitary magnetic resonance imaging (MRI) and endocrine investigations to evaluate functional adrenal pathology, anterior pituitary hormonal status, insulin-resistance indices and presence of metabolic syndrome. Pituitary MRI revealed a microadenoma and a 4×5 mm cyst in 1 patient respectively, and an empty sella in 4 (2 partial) patients. Overall, 6/26 (23%) patients with an AI had evidence of pituitary imaging pathology but only 8% had a PI; none had any evidence of abnormalities in pituitary function. Subclinical hypercortisolism was the only hyperfunctional status detected in 4 patients with AI but was unrelated to the pituitary findings. No abnormality of insulin secretion and action was found between patients with or without pituitary pathology. In the present study 23% of patients with AI had some alteration in pituitary morphology, and 2 a PI without accompanying pituitary hormonal deficit or metabolic derangement. Further studies are required to address this issue and identify a potential pathogenetic mechanism.
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Affiliation(s)
- A Chrisoulidou
- Unit of Endocrinology, Theagenio Hospital, Thessaloniki, Greece
| | | | - M Kita
- Unit of Endocrinology, Ippokratio Hospital, Thessaloniki, Greece
| | - K Tsolakidou
- Unit of Endocrinology, Ippokratio Hospital, Thessaloniki, Greece
| | - L Papanastasiou
- Unit of Endocrinology and Diabetes, "G. Genimatas" Hospital, Athens, Greece
| | - C Samara
- Unit of Radiology, "G. Genimatas" Hospital, Athens, Greece
| | - A Anastasiou
- Unit of Endocrinology, Ippokratio Hospital, Thessaloniki, Greece
| | - G Piaditis
- Unit of Endocrinology and Diabetes, "G. Genimatas" Hospital, Athens, Greece
| | - G Kaltsas
- Unit of Pathophysiology, Laiko Hospital, Athens, Greece
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21
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Tzimou M, Anastasiou A, Katsarou Z, Pyrpasopoulou A, Douma S. Cerebral amyloid angiopathy. Neuroradiol J 2013; 25:525-7. [PMID: 24029086 DOI: 10.1177/197140091202500504] [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] [Received: 07/06/2012] [Accepted: 08/16/2012] [Indexed: 11/15/2022] Open
Abstract
The aim of this report was to describe the case of an elderly patient with cerebral amyloid angiopathy and associated dementia who presented with new onset symptomatology compatible with an acute cerebrovascular event. Computed tomography scanning was suggestive of an incipient ischemic cerebrovascular event. Magnetic resonance imaging was requested due to the presence of small hyperdense lesions on CT, and revealed multiple diffuse hypodense parenchymal lesions with hemosiderin deposits, indicative of cerebral amyloid angiopathy. Diagnosis of the underlying pathology is of importance, as aspirin use, and antiplatelet use in general, may in these patients be associated with microbleed burden.
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Affiliation(s)
- M Tzimou
- 2nd Propedeutic Department of Internal Medicine, Hippokration General Hospital; Thessaloniki, Greece -
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22
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Kanavidis P, Kousoulis AA, Michelakos T, Katsiardanis K, Anastasiou A, Katsiardani KP, Stefanadis C, Petridou ET. Life-course experience of hospitalised injuries in a rural Greek town during the last century: the Velestino study. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040590k.7] [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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Haritou M, Glickman Y, Androulidakis A, Xefteris S, Anastasiou A, Baboshin A, Cuno S, Koutsouris D. A Technology Platform for a Novel Home Care Delivery Service to Patients with Dementia. j med imaging hlth inform 2012. [DOI: 10.1166/jmihi.2012.1060] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
Lemierre syndrome, also known as postanginal sepsis, is a severe complication of an acute oropharyngeal infection that results in septic thrombophlebitis of the ipsilateral internal jugular vein with subsequent septicemia, often complicated by metastatic infections (Syed et al., Laryngoscope 117:1605-1610, 2007). We present the case of a previously healthy 12-year-old boy with Lemierre syndrome, caused by streptococci (Abiotrophia defectiva), complicating a subcutaneous neck abscess. The patient had metastatic sequelae, was treated with antibiotics (clindamycin and vancomycin) and low molecular weight heparin, and had an uneventful outcome.
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Affiliation(s)
- Efthimia G Vargiami
- 1st Pediatric Clinic, Aristotle University of Thessaloniki, Dorilaiou 3, Kalamaria, Thessaloniki, 55133, Greece.
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26
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Kandarakis I, Cavouras D, Nikolopoulos D, Anastasiou A, Dimitropoulos N, Kalivas N, Ventouras E, Kalatzis I, Nomicos C, Panayiotakis G. Evaluation of ZnS:Cu phosphor as X-ray to light converter under mammographic conditions. RADIAT MEAS 2005. [DOI: 10.1016/j.radmeas.2004.02.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Papadopoulos FC, Petridou E, Argyropoulou S, Kontaxakis V, Dessypris N, Anastasiou A, Katsiardani KP, Trichopoulos D, Lyketsos C. Prevalence and correlates of depression in late life: a population based study from a rural Greek town. Int J Geriatr Psychiatry 2005; 20:350-7. [PMID: 15799076 DOI: 10.1002/gps.1288] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Depression in late life is common and has serious consequences on function, medical co-morbidity, quality of life, and use of medical services. OBJECTIVE To estimate the age- and gender-specific prevalence of depression among people over 60 years of age, and to examine correlates of depression, in particular the relationship between depression and cognitive impairment. METHOD From a total of 965 inhabitants, aged over 60 years, in Velestino, a rural town in central Greece, 608 were accessible and constituted the target population. During a five-month period in 2000, a trained health visitor interviewed all study participants. The interview covered socio-demographic characteristics, medical history, and administration of the 15-question Geriatric Depression Scale (GDS-15) and the Mini Mental Scale Examination instrument (MMSE). RESULTS The prevalence of mild or more severe depression (GDS> or =7) was 27%, while the prevalence of moderate to severe depression (GDS> or =11) was 12%. Increasing age, female gender, lower education, and being currently unmarried were associated with higher risk of depression in univariate regression models, but these associations disappeared after controlling for cognitive function, except for the association with marital status. Cognitive impairment was strongly associated with increased risk for depression. The co-morbid presence of digestive, neurological and heart conditions was also associated with increased risk for depression, while cancer was not. CONCLUSION In a rural Greek area, the prevalence of depression in late life is high. Depression was more common among unmarried individuals, those with significant cognitive impairment, and in association with specific medical conditions.
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Affiliation(s)
- F C Papadopoulos
- Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece
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28
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Anastasiou A, Skioldebrand E, Ekman S, Hall LD. EX VIVO MAGNETIC RESONANCE IMAGING OF THE DISTAL ROW OF EQUINE CARPAL BONES: ASSESSMENT OF BONE SCLEROSIS AND CARTILAGE DAMAGE. Vet Radiol Ultrasound 2003; 44:501-12. [PMID: 14599160 DOI: 10.1111/j.1740-8261.2003.tb00498.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The distal row of carpal bones (C2, C3, and C4) from eight left intercarpal joints--four from Standardbred Trotters and four from Swedish Warmblood horses--were used to assess the potential of magnetic resonance (MR) imaging to detect cartilage and bone lesions. The joints used in the study were classified by macroscopic and radiographic examinations as having normal, mild, moderate, or severe articular cartilage lesions and bone sclerosis. Those classifications correlated well with the appearance of the MR images. Bone sclerosis in the MR images was observed as regions of decreased signal intensity. Upon quantitative analysis of the MR images there was a significant difference (p < 0.0001) in the MR signal intensity from areas where radiographic bone sclerosis was observed compared to areas of radiographic nonsclerotic bone. In addition, the MR images were used to pilot the location of histology slices through areas of interest that were then examined microscopically; hence, the lesions found from the MR imaging examination were verified microscopically. It was concluded that cartilage lesions and cartilage loss are related to the sclerotic state of the underlying bone. The MR protocols developed in this study were applied on five intact cadaveric carpal joints, and it was concluded that MR imaging could successfully be used in the intact joint to detect minor cartilage and bone lesions not visualized by either radiography or macroscopic examination. Hence, MR imaging can be used to delineate interactions between articular cartilage and subchondral bone over time and in vivo.
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Affiliation(s)
- A Anastasiou
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical and Veterinary Medicine, Robinson Way, Cambridge, CB2 2PZ, UK
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Allen DN, Anastasiou A, Goldstein G, Gilbertson M, van Kammen DP. Influence of haloperidol on the relationship of frontal lobe function to psychomotor poverty and disorganization syndromes. Psychiatry Res 2000; 93:33-9. [PMID: 10699226 DOI: 10.1016/s0165-1781(00)00112-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the study was to examine effects of haloperidol on the relationships between neuropsychological measures of frontal lobe functioning and the schizophrenia syndromes of psychomotor poverty and disorganization. Twenty-one participants with schizophrenia were initially evaluated when clinically stable and chronically treated with haloperidol, and 19 were evaluated again after a 3-week haloperidol-free period. Participants were evaluated with the Trail Making Test, the Wisconsin Card Sorting Test, the Purdue Pegboard, and psychiatric rating scales at each evaluation. There were significant correlations between schizophrenia syndromes and the tests sensitive to frontal lobe function when participants were medicated but not when drug-free. No significant changes in symptom severity or motor function occurred from the medication to the medication-free evaluation. The results indicate that haloperidol mediates the relationship between tests sensitive to frontal lobe function and the schizophrenia syndromes of psychomotor poverty and disorganization. This mediation effect was not attributable to changes in overall symptom severity or motor function.
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Affiliation(s)
- D N Allen
- Department of Psychology, University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 455030, Las Vegas, NV 859154-5030, USA.
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Hatzis T, Anastasiou A, Cardamakis E, Pantos A, Pistofidis G, Panagogiannopoulou E, Efthimiadi E, Anastasiou V, Stathopoulos A, Linardos N, Koumantaki Y, Creatas G. Homeostatic abnormalities in primary unexplained abortions: A significant role for coagulation factor XII. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)83114-8] [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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Moschovi M, Tsangaris G, Vamvoukakis J, Anastasiou A, Van Vliet-Konstantinidou C, Tzortzatou-Stathopoulou F. Angiogenesis of tumors in childhood. Preliminary study. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)80814-4] [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: 11/24/2022]
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Affiliation(s)
- M Arvanitakis
- Department of Radiology, First General Hospital St. Paul, Thessaloniki, Greece
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33
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Pavlopoulou J, Leotsacos P, Sereti E, Anastasiou A, Syriopoulou V. Randomized controlled study of clarithromycin versus cefaclor suspensions in the treatment of acute otitis media in children. J Chemother 1995; 7 Suppl 4:150-3. [PMID: 8904139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- J Pavlopoulou
- First Department of Pediatrics, Aghia Sophia Children's Hospital, Athens, Greece
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Mourelatos D, Mylonaki E, Papageorgiou A, Boutis L, Paradelis A, Anastasiou A, Catsoulacos P. Comparative study of SCE induction and cytostatic effects by homo-azasteroidal esters of N,N-bis(2-chloroethyl)aminobenzoic acid in human lymphocytes. Mutat Res 1995; 346:129-33. [PMID: 7700276 DOI: 10.1016/0165-7992(95)90044-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The effect of homo-azasteroidal esters of benzoic acid mustard isomers and the 4-methyl derivatives, which have steroidal lactams as a biological basis, on cytogenetic damage was studied. Twenty compounds were comparatively studied, on a molar basis, as regards their ability to induce sister-chromatid exchanges (SCEs) and cell division delays. A correlation between potency for SCE induction, effectiveness in cell division delay and previously established antitumor activity of these compounds was observed.
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Affiliation(s)
- D Mourelatos
- Department of General Biology and Genetics, Medical School, Aristotle University, Thessaloniki, Greece
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35
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Anastasiou A, Catsoulacos P, Papageorgiou A, Margariti E. On the formation of homo-azasteroidal esters ofN,N-bis(2-chloroethyl)aminobenzoic acid isomers and their antitumor activity. J Heterocycl Chem 1994. [DOI: 10.1002/jhet.5570310219] [Citation(s) in RCA: 12] [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] [Indexed: 11/10/2022]
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