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Vogiatzi G, Lazaros G, Oikonomou E, Kostakis M, Kypritidou Z, Christoforatou E, Theofilis P, Argyraki A, Thomaidis N, Tousoulis D. Impact of drinking water hardness on carotid atherosclerosis and arterial stiffness: Insights from the "Corinthia" study. Hellenic J Cardiol 2023; 74:32-38. [PMID: 37121519 DOI: 10.1016/j.hjc.2023.04.006] [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: 12/01/2022] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Several investigations have highlighted the role of water quality in cardiovascular health. In the present study, we have investigated the effects of drinking water hardness on atherosclerotic burden in carotid arteries and arterial stiffness. METHODS "Corinthia" study was conducted in the homonym region in Greece from 2015 to 2017. Carotid atherosclerosis was assessed by intima-media thickness (IMT). Pulse wave velocity (PWV) was used to evaluate arterial stiffness. Tap-water samples were collected from the study area and analyzed for a variety of elements, as well as pH and total hardness. RESULTS Individuals living in lower drinking water hardness areas (Area 1) versus individuals living in higher water hardness areas (Area 2) had lower max IMT (p = 0.004) and were less susceptible to carotid plaque formation (p = 0.004). Interestingly, individuals over 65 years from Area 1 had lower mean IMT, max IMT, and less plaque formation (p < 0.001 for all). The mean value of PWV in the overall study population was below the 10 m/s cutoff, which defines arterial stiffness (9.15 ± 2.79 m/s). Nevertheless, a marginally higher rate of vascular stiffening was noted in Area 2 vs. Area 1 (16.2% and 12.8%, respectively, p = 0.048). CONCLUSIONS According to this cross-sectional study's findings, a positive association between extra hard water and carotid atherosclerotic burden was found. However, the association with arterial stiffness is unclear and should be investigated further.
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Affiliation(s)
- Georgia Vogiatzi
- 1(st) Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
| | - George Lazaros
- 1(st) Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Evangelos Oikonomou
- 1(st) Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Marios Kostakis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Zacharenia Kypritidou
- Section of Economic Geology and Geochemistry, Department of Geology and Geoenvironment, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Christoforatou
- 1(st) Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Theofilis
- 1(st) Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Ariadne Argyraki
- Section of Economic Geology and Geochemistry, Department of Geology and Geoenvironment, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Tousoulis
- 1(st) Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Kalogeras K, Kyvelou SM, Vythoulkas-Biotis N, Pesiridis T, Vogiatzi G, Katsianos E, Vavuranakis MA, Oikonomou E, Siasos G, Vavuranakis M. Diffuse LAD and LV Thrombus as Possible Manifestation of Protein-S Deficiency in a Young Patient. JACC Case Rep 2023; 20:101939. [PMID: 37614329 PMCID: PMC10442610 DOI: 10.1016/j.jaccas.2023.101939] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 08/25/2023]
Abstract
Patients with inherited hypercoagulopathies such as protein-S deficiency commonly present with venous thrombosis. However, there are rare cases of arterial thrombosis. We describe a rare case of a diffuse left anterior descending and left ventricular thrombus in a young patient with protein-S deficiency complicated with mid cerebral artery occlusion. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Konstantinos Kalogeras
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | - Stella-Maria Kyvelou
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vythoulkas-Biotis
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Pesiridis
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Vogiatzi
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratios Katsianos
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | | | - Evangelos Oikonomou
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Siasos
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
| | - Manolis Vavuranakis
- Third Department of Cardiology, Thoracic Diseases Hospital of Athens “Sotiria,” National and Kapodistrian University of Athens, Athens, Greece
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Papadopoulou E, Bouzarelou D, Tsaousis G, Papathanasiou A, Vogiatzi G, Vlachopoulos C, Miliou A, Papachristou P, Prappa E, Servos G, Ritsatos K, Seretis A, Frogoudaki A, Nasioulas G. Application of next generation sequencing in cardiology: current and future precision medicine implications. Front Cardiovasc Med 2023; 10:1202381. [PMID: 37424920 PMCID: PMC10327645 DOI: 10.3389/fcvm.2023.1202381] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/12/2023] [Indexed: 07/11/2023] Open
Abstract
Inherited cardiovascular diseases are highly heterogeneous conditions with multiple genetic loci involved. The application of advanced molecular tools, such as Next Generation Sequencing, has facilitated the genetic analysis of these disorders. Accurate analysis and variant identification are required to maximize the quality of the sequencing data. Therefore, the application of NGS for clinical purposes should be limited to laboratories with a high level of technological expertise and resources. In addition, appropriate gene selection and variant interpretation can result in the highest possible diagnostic yield. Implementation of genetics in cardiology is imperative for the accurate diagnosis, prognosis and management of several inherited disorders and could eventually lead to the realization of precision medicine in this field. However, genetic testing should also be accompanied by an appropriate genetic counseling procedure that clarifies the significance of the genetic analysis results for the proband and his family. In this regard, a multidisciplinary collaboration among physicians, geneticists, and bioinformaticians is imperative. In the present review, we address the current state of knowledge regarding genetic analysis strategies employed in the field of cardiogenetics. Variant interpretation and reporting guidelines are explored. Additionally, gene selection procedures are accessed, with a particular emphasis on information concerning gene-disease associations collected from international alliances such as the Gene Curation Coalition (GenCC). In this context, a novel approach to gene categorization is proposed. Moreover, a sub-analysis is conducted on the 1,502,769 variation records with submitted interpretations in the Clinical Variation (ClinVar) database, focusing on cardiology-related genes. Finally, the most recent information on genetic analysis's clinical utility is reviewed.
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Affiliation(s)
| | | | | | | | - Georgia Vogiatzi
- Third Department of Cardiology, Sotiria Hospital, Athens, Greece
| | - Charalambos Vlachopoulos
- Unit of Inherited Cardiac Conditions and Sports Cardiology, First Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Antigoni Miliou
- Unit of Inherited Cardiac Conditions and Sports Cardiology, First Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Efstathia Prappa
- Second Department of Cardiology, Arrhythmia Unit, Evangelismos General Hospital of Athens, Athens, Greece
| | - Georgios Servos
- Pediatric Cardiology Unit, “P. & A. Kyriakou” Children’s Hospital, Athens, Greece
| | - Konstantinos Ritsatos
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Center, Athens, Greece
| | - Aristeidis Seretis
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Center, Athens, Greece
| | - Alexandra Frogoudaki
- Second Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Lytra T, Kalogeras K, Pesiridis T, Moldovan C, Vavuranakis MA, Vogiatzi G, Oikonomou E, Dardas P, Chrissoheris M, Ninios V, Vavuranakis M. Correlation of Clinical Outcomes with the Prominent Indication of Transcatheter Paravalvular Leak Closure: A Multicenter Experience. J Clin Med 2023; 12:4047. [PMID: 37373740 DOI: 10.3390/jcm12124047] [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: 03/22/2023] [Revised: 05/07/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND A paravalvular leak (PVL) is a complication following valve replacement, which may lead to heart failure and hemolysis. The aim of this study is to investigate whether the clinical outcome after transcatheter PVL closure differs according to the prominent indication of the procedure (symptoms of heart failure or hemolysis). METHODS The data of consecutive patients who had transcatheter treatment for PVL between July 2011 and September 2022 in five Greek centers were analyzed. The primary endpoint was the technical, and clinical success rates with regards to the prominent indication of paravalvular leak closure. The secondary endpoints included the evaluation and comparison of the clinical and technical success in relation to the type of valve that was treated (aortic or mitral) as well as the survival analysis in relation to the closure indication and type of valve that was treated. RESULTS In total, 60 patients were retrospectively studied (39% men, mean age 69.5 ± 11 years). Regarding the primary outcomes, the technical success in patients mainly suffering from hemolysis was 86.1%, while in those presenting heart failure it was 95.8%, p = 0.387. Furthermore, the clinical success was 72.2% and 87.5% among hemolysis and heart failure patients, respectively, p = 0.210. During the follow-up period, the two-year survival rates were significantly better for patients treated for the aortic valve (78.94%) compared to those in the mitral position (48.78%), p = 0.014. In total, 25 patients died (41.7%) during 24 months of follow-up. CONCLUSIONS Transcatheter paravalvular leak closure can be performed with high technical and clinical success rates without any difference according to the prominent indication of closure.
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Affiliation(s)
- Thekla Lytra
- 3rd Department of Cardiology, University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, University of Athens, Sotiria Hospital, 11527 Athens, Greece
- 1st Department of Cardiology, University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Theodoros Pesiridis
- 3rd Department of Cardiology, University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Carmen Moldovan
- 3rd Department of Cardiology, University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | | | - Georgia Vogiatzi
- 3rd Department of Cardiology, University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Evaggelos Oikonomou
- 3rd Department of Cardiology, University of Athens, Sotiria Hospital, 11527 Athens, Greece
| | - Petros Dardas
- Cardiology Department, Aghios Loukas Hospital, 55236 Thessaloniki, Greece
| | | | - Vlasis Ninios
- Cardiology Department, Interbalkan Medical Center, 55535 Thessaloniki, Greece
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, University of Athens, Sotiria Hospital, 11527 Athens, Greece
- 1st Department of Cardiology, University of Athens, Hippokration Hospital, 11527 Athens, Greece
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5
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Theofilis P, Oikonomou E, Lazaros G, Vogiatzi G, Niarchou P, Goliopoulou A, Anastasiou M, Mistakidi VC, Tsalamandris S, Fountoulakis P, Papamikroulis GA, Tousoulis D. The Association of Depression With QT Duration: A Comparison Between Individuals Younger or Older Than 65 Years. Psychosom Med 2023; 85:18-25. [PMID: 36516316 DOI: 10.1097/psy.0000000000001152] [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: 12/15/2022]
Abstract
OBJECTIVE The electrocardiogram-derived corrected QT (QTc) interval is an indicator of cardiac autonomic activity that has been proposed as a biological measure to investigate the interplay between depression and cardiovascular diseases. This study assesses whether depression is associated with a longer QTc interval across age groups. METHODS Assessment of depressive symptoms was performed in 1637 participants of the cross-sectional Corinthia study with the Zung Self-Rating Depression Scale in those younger than 65 years (group 1) and with the Geriatric Depression Scale in elderly individuals (≥65 years, group 2). The QT interval was obtained from electrocardiogram recordings and corrected for heart rate (QTc). RESULTS Individuals in group 1 with depression were predominantly women and had a higher prevalence of coronary artery disease and diabetes mellitus. Group 1 individuals with depression had longer QTc duration (no depression versus depression, 389.3 [27.0] versus 401.1 [32.9] milliseconds; p < .001) and percentage of abnormal QTc (no depression versus depression, 2.0% versus 10.8%; p = .001) compared with those without depression. Elderly individuals (group 2) had similar values of QTc and percentage of abnormal QTc irrespective of depression status. Even after adjustment for known QT-prolonging factors, the presence of depression in younger individuals was associated with an increased QTc by 11.1 milliseconds and with an approximately 10.6-fold higher prevalence of abnormal QTc duration. CONCLUSIONS Depression was associated with a longer QTc interval especially in individuals younger than 65 years. These findings may indicate an interrelationship between depression and autonomic dysregulation as potential risk factors for cardiovascular disease and sudden cardiac death.
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Affiliation(s)
- Panagiotis Theofilis
- From the 1st Cardiology Clinic, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
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Theofilis P, Oikonomou E, Vogiatzi G, Sagris M, Antonopoulos AS, Siasos G, Iliopoulos DC, Perrea D, Vavouranakis M, Tsioufis K, Tousoulis D. The Role of MicroRNA-126 in Atherosclerotic Cardiovascular Diseases. Curr Med Chem 2023; 30:1902-1921. [PMID: 36043750 DOI: 10.2174/0929867329666220830100530] [Citation(s) in RCA: 1] [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: 04/10/2022] [Revised: 05/02/2022] [Accepted: 05/31/2022] [Indexed: 11/22/2022]
Abstract
Atherosclerotic cardiovascular diseases remain the leading cause of morbidity and mortality worldwide despite all efforts made towards their management. Other than targeting the traditional risk factors for their development, scientific interest has been shifted towards epigenetic regulation, with microRNAs (miRs) being at the forefront. MiR-126, in particular, has been extensively studied in the context of cardiovascular diseases. Downregulated expression of this miR has been associated with highly prevalent cardiovascular risk factors such as arterial hypertension and diabetes mellitus. At the same time, its diagnostic and prognostic capability concerning coronary artery disease is still under investigation, with up-to-date data pointing towards a dysregulated expression in a stable disease state and acute myocardial infarction. Moreover, a lower expression of miR-126 may indicate a higher disease complexity, as well as an increased risk for future major adverse cardiac and cerebrovascular events. Ultimately, overexpression of miR-126 may emerge as a novel therapeutic target in atherosclerotic cardiovascular diseases due to its potential in promoting therapeutic angiogenesis and anti-inflammatory effects. However, the existing challenges in miR therapeutics need to be resolved before translation to clinical practice.
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Affiliation(s)
- Panagiotis Theofilis
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.,3rd Cardiology Department, "Sotiria" Chest Diseases Hospital, University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.,3rd Cardiology Department, "Sotiria" Chest Diseases Hospital, University of Athens Medical School, Athens, Greece
| | - Marios Sagris
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Alexios S Antonopoulos
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.,3rd Cardiology Department, "Sotiria" Chest Diseases Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitrios C Iliopoulos
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", University of Athens Medical School, Athens, Greece
| | - Despoina Perrea
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", University of Athens Medical School, Athens, Greece
| | - Manolis Vavouranakis
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.,3rd Cardiology Department, "Sotiria" Chest Diseases Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Tsioufis
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
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Stampouloglou PK, Siasos G, Bletsa E, Oikonomou E, Vogiatzi G, Kalogeras K, Katsianos E, Vavuranakis MA, Souvaliotis N, Vavuranakis M. The Role of Cell Derived Microparticles in Cardiovascular Diseases: Current Concepts. Curr Pharm Des 2022; 28:1745-1757. [DOI: 10.2174/1381612828666220429081555] [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: 01/31/2022] [Accepted: 03/15/2022] [Indexed: 12/07/2022]
Abstract
Abstract:
Cardiovascular disease remains the main cause of human morbidity and mortality in the developed countries. Microparticles (MPs) are small vesicles originating from the cell membrane as a result of various stimuli and particularly of biological processes that constitute the pathophysiology of atherosclerosis, such as endothelial damage. They form vesicles that can transfer various molecules and signals to remote target cells without direct cell to cell interaction. Circulating microparticles have been associated with cardiovascular diseases. Therefore, many studies have been designed to further investigate the role of microparticles as biomarkers for diagnosis, prognosis, and disease monitoring. To this concept the pro-thrombotic and atherogenic potential of platelets and endothelial derived MPs has gain research interest especially concerning accelerate atherosclerosis and acute coronary syndrome triggering and prognosis. MPs especially of endothelial origin have been investigated in different clinical scenarios of heart failure and in association of left ventricular loading conditions. Finally, most cardiovascular risk factors present unique patterns of circulating MPs population, highlighting their pathophysiologic link to cardiovascular disease progression. In this review article we present a synopsis of the biogenesis and characteristics of microparticles, as well as the most recent data concerning their implication in the cardiovascular settings.
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Affiliation(s)
- Panagiota K. Stampouloglou
- 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
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Evanthia Bletsa
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens. Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens. Greece
| | - Georgia Vogiatzi
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens. Greece
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens. Greece
| | - Efstratios Katsianos
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens. Greece
| | - Michael-Andrew Vavuranakis
- 3rd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Sotiria Chest Disease Hospital, Athens. Greece
| | - Nektarios Souvaliotis
- 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
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Theofilis P, Oikonomou E, Lazaros G, Vogiatzi G, Anastasiou M, Mystakidi VC, Goliopoulou A, Christoforatou E, Bourouki E, Vavouranaki G, Marinos G, Tousoulis D. The association of diabetes mellitus with carotid atherosclerosis and arterial stiffness in the Corinthia study. Nutr Metab Cardiovasc Dis 2022; 32:567-576. [PMID: 35110000 DOI: 10.1016/j.numecd.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/24/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS Evaluation of arterial stiffness and carotid atherosclerotic burden can provide important prognostic information regarding the risk of future cardiovascular events. The aim of this study was to assess these vascular properties in patients with diabetes mellitus (DM). METHODS AND RESULTS In the context of the observational "Corinthia" study, we analyzed 1757 participants with determined DM status. Carotid ultrasonography was performed to evaluate intima-media thickness (cIMT) and carotid plaque burden. Arterial stiffness was estimated via assessment of carotid-to-femoral pulse wave velocity (cfPWV). Individuals with DM had increased mean cIMT, maximum cIMT, carotid plaque burden, and cfPWV compared to those without DM. After multivariable regression analysis, the presence of DM was still associated with significantly increased mean cIMT (by 0.074 mm, p = .004), maximum cIMT (by 0.134 mm, p = .007), cfPWV (by 0.929 m/s, p < .001), and a higher prevalence of carotid plaques (odds ratio 1.52, 95% confidence intervals 1.11, 2.10, p = .01). In a propensity score-matched cohort, mean cIMT, maximum cIMT, and carotid plaque burden were significantly higher in individuals with DM. Analysis according to territory of cIMT measurement displayed substantial differences in left (DM: 1.32 ± 0.78 mm vs. no DM: 1.20 ± 0.66 mm, p = .04) and right carotid bulbs (DM: 1.33 ± 0.82 mm vs. no DM: 1.18 ± 0.69 mm, p = .02) with respect to DM status while non-significant variations were observed in left (DM: 0.98 ± 0.49 mm vs. no DM: 0.91 ± 0.35 mm, p = .06) and right common carotid artery (DM: 0.95 ± 0.50 mm vs. no DM: 0.92 ± 0.40 mm, p = .36). CONCLUSIONS Diabetes mellitus is associated with increased cfPWV and cIMT, with more pronounced lesions in the carotid bulb.
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Affiliation(s)
- Panagiotis Theofilis
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece.
| | - George Lazaros
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Maria Anastasiou
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Vasiliki Chara Mystakidi
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Athina Goliopoulou
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Evangelia Christoforatou
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Evgenia Bourouki
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Georgia Vavouranaki
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Georgios Marinos
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, General Hospital of Athens Hippokration, University of Athens Medical School, Athens, Greece
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9
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Theofilis P, Oikonomou E, Lazaros G, Vogiatzi G, Mystakidi VC, Goliopoulou A, Anastasiou M, Christoforatou E, Tousoulis D. The Association of Physical Activity with Arterial Stiffness and Inflammation: Insight from the "Corinthia" Study. Angiology 2022; 73:716-723. [PMID: 35138950 DOI: 10.1177/00033197211065795] [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] [Indexed: 01/21/2023]
Abstract
Diminished physical activity is a frequent phenomenon leading to a higher incidence of cardiovascular morbidity and mortality. Our study aimed to assess the impact of physical activity on arterial stiffness and inflammation. Classification of physical activity was performed in 1945 individuals of the cross-sectional "Corinthia" study using the International Physical Activity Questionnaire. Demographic and clinical characteristics were obtained via a standardized questionnaire. Arterial stiffness was estimated via carotid-femoral pulse wave velocity evaluation, and the inflammatory burden was assessed via high sensitivity C reactive protein (hsCRP) measurement. Participants with low physical activity had the most impaired carotid-femoral pulse wave velocity values while abnormally increased measurements-adjusted for age and blood pressure-were more frequently encountered in individuals with low physical activity. Participants characterized as having vigorous physical activity had the lowest inflammatory burden, as estimated by hsCRP levels. The results remained unaffected even after adjustment for confounders. In a subgroup analysis according to sex, increased arterial stiffness and inflammatory burden were noted similarly in female and male subjects within the lowest percentile of physical activity. In conclusion, a significant association between physical activity, arterial stiffness, and inflammation was observed, even after adjusting for known cardiovascular risk factors.
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Affiliation(s)
- Panagiotis Theofilis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - George Lazaros
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Vasiliki C Mystakidi
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Athina Goliopoulou
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Maria Anastasiou
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelia Christoforatou
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
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10
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Vogiatzi G, Lazaros G, Oikonomou E, Lazarou E, Vavuranakis E, Tousoulis D. Role of genetic testing in cardiomyopathies: Α primer for cardiologists. World J Cardiol 2022; 14:29-39. [PMID: 35126870 PMCID: PMC8788175 DOI: 10.4330/wjc.v14.i1.29] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/18/2021] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Recent advances in cardiovascular genetics have transformed genetic testing into a valuable part of management of families with inherited cardiomyopathies. As novel mutations have been identified, understanding when to consider genetic testing has emerged as an important consideration in the management of these cases. Specific genetic testing has a paramount importance in the risk stratification of family members, in the prognosis of probands at higher risk of a serious phenotype expression, and finally in the identification of new mutations, all of which are discussed in this review. The indications for each type of cardiomyopathy are described, along with the limitations of genetic testing. Finally, the importance of public sharing of variants in large data sets is emphasized. The ultimate aim of this review is to present key messages about the genetic testing process in order to minimize potential harms and provide suggestions to specialized clinicians who act as a part of a multidisciplinary team in order to offer the best care to families with inherited cardiomyopathies.
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Affiliation(s)
- Georgia Vogiatzi
- The Third Department of Cardiology, Sotiria Hospital, Athens 11527, Greece
| | - George Lazaros
- The First Department of Cardiology, Hippokration Hospital, Athens 11526, Greece
| | - Evangelos Oikonomou
- The First Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Emilia Lazarou
- The First Department of Cardiology, Hippokration Hospital, Athens 11526, Greece
| | | | - Dimitris Tousoulis
- The First Department of Cardiology, Hippokration Hospital, Athens 11526, Greece
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11
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Theofilis P, Oikonomou E, Lazaros G, Vogiatzi G, Goliopoulou A, Chasikidis C, Mystakidi VX, Fountoulakis P, Christoforatou E, Tsalamandris S, Anastasiou M, Papakonstantinou M, Vavouranaki G, Siasos G, Tousoulis D. The impact of diabetes mellitus on carotid atherosclerosis and arterial stiffness; results from the Corinthia study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2620] [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
Background
Evaluation of arterial stiffness and carotid atherosclerotic burden can provide important prognostic information regarding the risk for future cardiovascular events. In that context, we tried to determine those vascular properties of diabetic individuals compared to non-diabetics.
Methods
In this analysis of the observational “Corinthia” study, we included 1757 participants with determined diabetic status. Propensity scores were employed to match diabetics to non-diabetics with regards to known cardiovascular risk factors. Carotid ultrasonography was performed to evaluate intima-media thickness (cIMT) across the common carotid arteries and the carotid bulbs as well as carotid plaque burden. Arterial stiffness was estimated via assessment of carotid-to-femoral pulse wave velocity (cfPWV).
Results
Diabetic individuals had increased mean cIMT (diabetics: 1.12±0.50mm vs. 0.94±0.38mm, p<0.001) and maximum cIMT (diabetics: 1.50±0.93mm vs. 1.20±0.71mm, p<0.001) when compared to non-diabetics (Figure 1, Panel A and B). Carotid plaque burden was also increased in diabetics (34.4% vs. 19.4% in non-diabetics, p<0.001) while bilateral plaques were observed in 14.2% of diabetics opposed to 8.2% of non-diabetics (p<0.001). Concerning arterial stiffness, individuals with DM had significantly higher values of cfPWV (10.6±3.4m/s vs. 8.8±2.5m/s in non-diabetics, p<0.001) (Figure 1, Panel C). In the propensity-matched cohort, mean cIMT (diabetics: 1.13±0.51mm vs. 0.98±0.38mm, p<0.001) and maximum cIMT (diabetics: 1.53±0.95mm vs. 1.24±0.73mm, p<0.001) were significantly higher in diabetics (Figure 2, Panel A and B), as well as carotid plaque burden (36.6% vs. 21.9% in non-diabetics, p<0.001). Analysis according to territory of cIMT measurement displayed substantial differences in left (diabetics: 1.30±0.76mm vs. non-diabetics: 1.06±0.58mm, p<0.001) and right carotid bulbs (diabetics: 1.30±0.82mm vs. non-diabetics: 1.07±0.57mm, p<0.001) with respect to DM (Figure 2, Panel C) but, unexpectedly, non-significant variations were observed in left (diabetics: 0.97±0.48mm vs. non-diabetics: 0.90±0.42mm, p=0.06) and right common carotid artery (diabetics: 0.95±0.50mm vs. non-diabetics: 0.90±0.40mm, p=0.21) (Figure 2, Panel D).
Conclusion
We observed increased carotid artery intima-media thickness and cfPWV in individuals with diabetes mellitus. As opposed to non-diabetics, carotid lesions in diabetics were more pronounced in the carotid bulb and not in the common carotid artery. Our findings may raise awareness regarding the focus of atherosclerotic echocardiographic examination in subjects with diabetes mellitus while the impact of glucose-lowering therapies on these specific vascular lesions merits further assessment.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- P Theofilis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Oikonomou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Lazaros
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Vogiatzi
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - A Goliopoulou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - C Chasikidis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - V X Mystakidi
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - P Fountoulakis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Christoforatou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - S Tsalamandris
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Anastasiou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Papakonstantinou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Vavouranaki
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Siasos
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
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12
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Vogiatzi G, Oikonomou E, Lazaros G, Kostakis M, Kypritidou Z, Christoforatou E, Chasikidis CH, Mystakidi V, Theofilis P, Vavouranaki G, Goliopoulou A, Argyraki A, Thomaidis N, Tousoulis D. Water hardness and its impact on arterial stiffness and carotid atherosclerotic burdens; insights from the 'Corinthia study'. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3146] [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
It has been long investigated the potential role of water quality in cardiovascular health.
Purpose
The aim of this study was to examine the association between water hardness, arterial stiffness and atheromatic burden in carotid arteries.
Design and methods
Corinthia study is a cross-sectional epidemiological study conducted in subjects aged 40–99 years. Intima media thickness (IMT) was measured in the left and right common carotid artery, carotid bulb and internal carotid artery. The average of the measurements (mean IMT) and the maximum IMT were determined as the representative value of carotid atherosclerosis burden. Pulse wave velocity (PWV) was used to evaluate arterial stiffness. Tap-water samples were collected from the study area, and analyzed for major, minor and trace elements, as well as pH and total hardness.
Results
In this analysis we included data from 1.404 participants. In subjects consuming water with a hardness above 250mg/dL, especially in those above >65 years old maximum and mean IMT was significantly increased compared to those consuming water with a hardness above 250mg/dL (1.61mm vs. 1.34mm respectively, p<0.001 and 1.15mm vs. 1.05, p=0.005 for WH ≥250mg/dL and WH <250mg/dL, respectively). Similarly, the prevalence of atheromatic plaques was higher in subjects of the first category (15,2% vs. 7,6%, p=0.004). No differences emerged for the arterial stiffness in the individual subgroups. statistically significant correlation was revealed (p=0.004).
Conclusions
There seem to be a negative association between extra hard water and carotid atheromatic burden highlighting the possible impact of water quality in cardiovascular health.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- G Vogiatzi
- Athens Chest Hospital Sotiria, Athens, Greece
| | - E Oikonomou
- Athens Chest Hospital Sotiria, Athens, Greece
| | - G Lazaros
- Hippokration General Hospital, 1st Cardiology Unit, Athens University Medical School, Greece, Athens, Greece
| | | | | | - E Christoforatou
- Hippokration General Hospital, 1st Cardiology Unit, Athens University Medical School, Greece, Athens, Greece
| | - C H Chasikidis
- Hippokration General Hospital, 1st Cardiology Unit, Athens University Medical School, Greece, Athens, Greece
| | - V Mystakidi
- Athens Chest Hospital Sotiria, Athens, Greece
| | - P Theofilis
- Hippokration General Hospital, 1st Cardiology Unit, Athens University Medical School, Greece, Athens, Greece
| | - G Vavouranaki
- Hippokration General Hospital, 1st Cardiology Unit, Athens University Medical School, Greece, Athens, Greece
| | | | | | | | - D Tousoulis
- Hippokration General Hospital, 1st Cardiology Unit, Athens University Medical School, Greece, Athens, Greece
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13
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Theofilis P, Vogiatzi G, Oikonomou E, Gazouli M, Siasos G, Katifelis H, Perrea D, Vavouranakis M, Iliopoulos DC, Tsioufis C, Tousoulis D. MicroRNA-126 mimic administration accelerates vascular perfusion recovery and angiogenesis in a hind limb ischemia model. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3380] [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
Peripheral arterial disease caused mainly by atherosclerosis portent significant morbidity, adverse prognosis and mortality, with localized treatment approaches aiming at symptom alleviation and improvement of circulation. Recently, scientific interest has been shifted towards epigenomics, with microRNAs appearing as a future therapeutic target in ischemic cardiovascular diseases due to their potential in regulating angiogenesis.
Purpose
We investigated the pro-angiogenic effect of miRNA-126 mimic in an in vivo model of hind limb ischemia.
Methods
Ten-week-old male C57Bl/6 mice (n=20) were subjected to left femoral artery ligation and were treated with microRNA-126 mimic at a dose of 5mg/kg (Group A, n=10) or 0.2ml normal saline (Group B, n=10) on days 1, 3 and 7. Laser Doppler imaging was performed to verify successful ligation on day 0 and to evaluate differences in the ischemic-to-normal (I/N) hind limb perfusion ratio on day 7 and 28. Muscle tissue expression of microRNA-126 and vascular endothelial growth factor (VEGF) was determined via PCR.
Results
Following microRNA-126 mimic administration in Group A subjects, we noted a qualitative and quantitative stepwise increase in I/N hind limb perfusion ratio [Day 0: 0.354 (0.276, 0.455) vs. Day 8: 0.775 (0.700, 0.844) vs. Day 28: 0.681 (0.660, 0.896), p=0.001] (Figure 1, Panels A and B). In Group B a stepwise increase of lesser magnitude was observed in I/N hind limb perfusion ratio [Day 0: 0.267 (0.164, 0.383) vs. Day 8: 0.400 (0.338, 0.418) vs. Day 28: 0.539 (0.483, 0.603), p=0.074]. Importantly, over time changes of I/N hind limb perfusion ratio were significantly higher in group A compared to group B (p for interaction=0.005) (Figure 1, Panel B). Muscle tissue expression of microRNA-126 in the ischemic hind limb of Group A was 350-fold lower compared to the ischemic hind limb of Group B (p<0.001) (Figure 1, Panel C). A higher expression (14.2-fold) of VEGF in the ischemic hind limb of microRNA-126-treated mice compared to that of control group was detected (p<0.001) (Figure 1, Panel C). A statistically significant negative correlation was noted between microRNA-126 and VEGF tissue expression levels in the ischemic limbs of both Group A and B subjects whereas no correlation between microRNA-126 and VEGF was observed in the non-ischemic hind limbs of the entire study population (Figure 1, Panel D).
Conclusion
MicroRNA-126 mimic delivery in the ischemic hind limb of mice can accelerate vascular perfusion recovery via angiogenesis, which is mediated by VEGF expression.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- P Theofilis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Vogiatzi
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Oikonomou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Gazouli
- National & Kapodistrian University of Athens, Department of Basic Medical Sciences, Athens, Greece
| | - G Siasos
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - H Katifelis
- National & Kapodistrian University of Athens, Department of Basic Medical Sciences, Athens, Greece
| | - D Perrea
- National & Kapodistrian University of Athens, Laboratory of Experimental Surgery and Surgical Research “N.S. Christeas”, Athens, Greece
| | - M Vavouranakis
- Sotiria Regional Chest Diseases Hospital, 3rd Department of Cardiology, Athens, Greece
| | - D C Iliopoulos
- National & Kapodistrian University of Athens, Laboratory of Experimental Surgery and Surgical Research “N.S. Christeas”, Athens, Greece
| | - C Tsioufis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
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14
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Goliopoulou A, Oikonomou E, Gazouli M, Koumalos N, Lymperiadis D, Pantelidis P, Mistakidi VC, Theofilis P, Vogiatzi G, Antonopoulos A, Tsioufis C, Siasos G, Vavuranakis M, Tousoulis D. Tissue microRNA expression in aortic aneurysm dissection. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2013] [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
Dissection and other complications of ascending aortic aneurysms are potentially life-threatening. Several factors may be implicated in aneurysm progression and dissection. The role of tissue microRNAs may be of interest.
Purpose
To examine how serum biomarkers and tissue expression of microRNAs are associated with thoracic aortic aneurysms and dissection.
Methods
We compared three groups of patients; 21 patients with aneurysm of the aortic root, ascending aorta or aortic arch undergoing scheduled repair, 11 patients with acute Stanford type A aortic dissection who underwent emergency surgery and 18 patients with normal aortic diameter undergoing other cardiac surgery (control group). Prior to surgery, peripheral blood samples were obtained from patients, to assess osteoprotegerin and adiponectin levels with the ELISA method. Tissue samples from ascending aortic wall were obtained from patients during surgery. Following appropriate storage and homogenization, tissue Matrix Metalloproteinases (MMPs) 2 and 9 were measured with the ELISA method, while tissue microRNAs 29 and 195 were measured using qrtPCR, after RNA extraction.
Results
There was no significant difference among control, aneurysm and dissection groups in terms of age (62±10 years vs 66±12 years vs 59±12 years, p=0.052), gender distribution (77.8% male vs 81% male vs 90% male, p=0.28) or BMI (28.51±2.92 kg/m2 vs 25.72±3.09 kg/m2 vs 27.02±3.2 kg/m2, p=0.76). There was also no difference among control, aneurysm and dissection groups regarding hypertension (72% vs 62% vs 73%, p=0.73), diabetes mellitus (22% vs 19% vs 36%, p=0.54), smoking (44% vs 29% vs 46%, p=0.09) or dyslipidemia (78% vs 43% vs 55%, p=0.08). The groups of control subjects, aneurysms and dissections did not differ in osteoprotegerin [44 (28, 52) pmol/l vs 31 (28, 37) pmol/l vs 45 (24, 71) pmol/l, p=0.17], adiponectin [6,65 (2,39, 9,79) μg/ml vs 5,28 (2,34, 6,98) μg/ml vs 4,13 (2,49, 7,52) μg/ml, p=0.43], tissue MMP2 [0.97 (0.42, 27.66) ng/ml vs 9.12 (1.72, 61.49) ng/ml vs 2.51 (0.22, 235.72) ng/ml, p=0.34] and tissue MMP9 levels [0.96 (0.29, 8.56) ng/ml vs 10.31 (1.18, 25.58) ng/ml vs 2.76 (0.63, 54.83) ng/ml, p=0.09] (Figure 1). Importantly, tissue expression of mir29 was 2.11-fold higher in the dissection group (p=0.001) and 2.99-fold higher in the aneurysm group (p<0.001) compared to the control group. Tissue expression of mir195 was 2.72-fold higher in the dissection group (p<0.001) and 2.00-fold lower in the aneurysm group (p=0.08) compared to the control group (Figure 2).
Conclusions
These findings highlight the role of epigenetic modifications through altered microRNA tissue expression in aortic wall synthesis, extracellular matrix degradation and progress of aneurysm formation and dissection. The exact role of microRNA expression in aortic dilatation and dissection, as well as their role as potential biomarkers, merit further validation.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- A Goliopoulou
- Sotiria Regional Chest Diseases Hospital, Athens, Greece
| | - E Oikonomou
- Sotiria Regional Chest Diseases Hospital, Athens, Greece
| | - M Gazouli
- National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - N Koumalos
- Ippokrateio General Hospital of Athens, Athens, Greece
| | - D Lymperiadis
- Ippokrateio General Hospital of Athens, Athens, Greece
| | - P Pantelidis
- Sotiria Regional Chest Diseases Hospital, Athens, Greece
| | - V C Mistakidi
- Sotiria Regional Chest Diseases Hospital, Athens, Greece
| | - P Theofilis
- Ippokrateio General Hospital of Athens, Athens, Greece
| | - G Vogiatzi
- Sotiria Regional Chest Diseases Hospital, Athens, Greece
| | | | - C Tsioufis
- Ippokrateio General Hospital of Athens, Athens, Greece
| | - G Siasos
- Sotiria Regional Chest Diseases Hospital, Athens, Greece
| | - M Vavuranakis
- Sotiria Regional Chest Diseases Hospital, Athens, Greece
| | - D Tousoulis
- Ippokrateio General Hospital of Athens, Athens, Greece
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15
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Theofilis P, Oikonomou E, Vogiatzi G, Lazaros G, Mystakidi VX, Goliopoulou A, Anastasiou M, Tsalamandris S, Chasikidis C, Papakonstantinou M, Fountoulakis P, Christoforatou E, Siasos G, Tousoulis D. The impact of physical activity on arterial stiffness and inflammation; results from the “Corinthia” study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2440] [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
Background
Diminished physical activity (PA) is associated with cardiovascular morbidity and mortality. Arterial stiffness and inflammation are associated with atherosclerosis and are established risk factors for cardiovascular disease.
Purpose
We investigated the association of PA status on arterial stiffness and inflammation.
Methods
Classification of PA was performed in 2053 participants of the cross-sectional “Corinthia” study using the International Physical Activity Questionnaire (IPAQ). In accordance with the standard IPAQ scoring procedures, participants were classified into one of the following groups: upper tertile: “vigorous” PA-IPAQ 2, middle tertile: “moderate” PA-IPAQ 1 or lower tertile: “low” PA-IPAQ 0. Arterial stiffness was estimated via carotid-femoral pulse wave velocity (cfPWV) estimation and inflammatory burden was assessed via high sensitivity C reactive protein (hsCRP) measurement.
Results
Participants with low PA had impaired cfPWV values (IPAQ 0: 9.5±3.2 m/s vs. IPAQ 1: 8.7±2.4 m/s vs. IPAQ 2: 8.7±2.2 m/s, p<0.001) (Figure 1, Panel A) while abnormal cfPWV –adjusted for age and blood pressure- were more frequently encountered in low PA individuals (IPAQ 0: 14% vs. IPAQ 1: 7.8% vs. IPAQ 2: 7.3%, p=0.001) (Figure 1, Panel B). Participants characterized as having vigorous physical activity had the lowest inflammatory burden, as estimated by hsCRP (IPAQ 0: 4.8±6.4 g/l vs. IPAQ 1: 4.6±5.2 g/l vs. IPAQ 2: 3.6±4.2 g/l, p=0.001) (Figure 1, Panel C). Importantly, results remained unaffected even after adjustment for confounders (Figure 1, Panel D). A correlation analysis between the total weekly physical activity (expressed as MET minutes/week) and arterial stiffness was performed demonstrating a statistically significant negative correlation was noted (r=−0.120, p<0.001) (Figure 1, Panel E).
Conclusion
A significant association between physical activity, arterial stiffness and inflammation was observed, even after adjusting for known cardiovascular risk factors. Our findings should raise public awareness about the beneficial effects of exercise on cardiovascular health.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- P Theofilis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Oikonomou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Vogiatzi
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Lazaros
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - V X Mystakidi
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - A Goliopoulou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Anastasiou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - S Tsalamandris
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - C Chasikidis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Papakonstantinou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - P Fountoulakis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Christoforatou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Siasos
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
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16
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Theofilis P, Oikonomou E, Lazaros G, Vogiatzi G, Tsalamandris S, Chasikidis C, Fountoulakis P, Anastasiou M, Goliopoulou A, Mystakidi VX, Papakonstantinou M, Christoforatou E, Siasos G, Tousoulis D. Emotional and cardiovascular health: the impact of depression on cardiac autonomic activity. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2421] [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: 11/12/2022] Open
Abstract
Abstract
Background
The coexistence of depression and cardiovascular diseases is frequently accompanied by an increased risk of adverse outcomes. QTc, an indicator of ventricular depolarization and cardiac autonomic activity, has been proposed as a biomarker of this interplay.
Purpose
We aimed to investigate the possible association of depression with QTc interval.
Methods
Assessment of depressive symptoms was performed in 1637 participants of the cross-sectional Corinthia study with the Zung self-rating depression scale in those younger than 65 years of age (Group 1) and with the geriatric depression scale in elderly individuals (>65 years, Group 2). Moreover, electrocardiogram was performed and measurement of the QT interval was derived after correction for heart rate (QTc) using the Bazett's formula. Abnormal QTc was present when QTc duration exceeded 440 ms.
Results
Group 1 individuals classified as having depression had longer QTc duration (No depression: 389.3±27.0 ms vs. Depression: 401.1±32.9 ms, p<0.001) and percentage of abnormal QTc (No depression: 2.0% vs. Depression: 10.8%, p=0.001) (Figure 1, Panels A and B). Elderly individuals had similar values of QTc (No depression: 409.9±29.6 ms vs. Depression: 405.2±46.4 ms, p=0.37) and percentage of abnormal QTc (No depression: 13.2% vs. Depression: 12.3%, p=0.78) irrespective of depression status (Figure 1, Panels C and D). The presence of depression in Group 1 subjects was associated with an increased QTc- by 10.8 ms and with an approximately 7-fold higher prevalence of abnormal QTc duration, even after adjustment for confounders (). Such finding was not detected in elderly individuals (Figure 1, Panel F).
Conclusion
Depression might adversely affect ventricular repolarization especially in middle-aged subjects. These findings highlight the interrelationship between emotional and cardiovascular health and the role of depression as a cardiovascular risk factor.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- P Theofilis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Oikonomou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Lazaros
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Vogiatzi
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - S Tsalamandris
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - C Chasikidis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - P Fountoulakis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Anastasiou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - A Goliopoulou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - V X Mystakidi
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Papakonstantinou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Christoforatou
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Siasos
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, 1st Department of Cardiology, Athens, Greece
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Lampsas S, Oikonomou E, Siasos G, Souvaliotis N, Goliopoulou A, Mistakidi CV, Theofilis P, Vogiatzi G, Kalogeras K, Katsianos E, Tousoulis D, Vavuranakis M. Mid-term endothelial dysfunction post COVID-19. Eur Heart J 2021. [PMCID: PMC8767607 DOI: 10.1093/eurheartj/ehab724.3401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Cardiovascular complications of Coronavirus disease (COVID-19), resulting from the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), have been documented. Endothelium-induced “cytokine storm” in critically ill COVID-19 patients is one of the leading causes of morbidity and mortality. Vascular endothelial damage caused by COVID-19 emphasizes the crucial role of endothelium in COVID-19 clinical impact.
Purpose
To examine the mid-term (1-month) impact of COVID-19 in endothelial function.
Methods
In this case control study, 20 consecutive patients who were hospitalized for COVID-19 either on Intensive Care Unit (ICU) or non-ICU were examined one month following hospital discharge. In the control group we recruited 12 consecutive subjects from the outpatient cardiology clinic. Demographic and clinical data were collected, and endothelial function was evaluated by brachial artery flow-mediated dilation (FMD).
Results
There was no difference in age between COVID-19 patients and control subjects (66±12 years vs. 71±5 years, p<0.17), in male sex (63% vs. 54%, p=0.66) in history of diabetes mellitus (27% vs. 36%, p=0.64), hypertension (36% vs. 54%, p=0.39), cardiovascular disease (27% vs.18%, p=0.61). From the COVID-19 subjects 65% were overweight or obese. During their hospitalization [3 ICU (15%)/17 non-ICU (85%), mean days: 17±6.7], 4 (20%) of COVID-19 patients developed ARDS, while single cases of stress-induced cardiomyopathy, pulmonary embolism, and acute coronary syndrome were detected. One month post discharge D-dimers (0.71±0.55 μg/ml) levels were above upper reference limit. Importantly, FMD one month after hospital discharge date, was significantly impaired in the COVID-19 group (3.59±1.63% vs. 9.31±2.98%, p<0.001) compared to control group.
Conclusion
Post COVID-19 subjects one month post discharge have significant impaired endothelial function compared to control subjects. These findings highlight the significant interaction of COVID-19 with arterial endothelium and merit further research to conclude on the exact impact of vascular endothelium in physical history of SARS-CoV-2 infection.
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, Athens, Greece
| | - E Oikonomou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
| | - G Siasos
- Ippokrateio General Hospital of Athens, 1st Department of Cardiology, Athens, Greece
| | - N Souvaliotis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
| | - A Goliopoulou
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
| | - C V Mistakidi
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
| | - P Theofilis
- Ippokrateio General Hospital of Athens, 1st Department of Cardiology, Athens, Greece
| | - G Vogiatzi
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
| | - K Kalogeras
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
| | - E Katsianos
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Ippokrateio General Hospital of Athens, 1st Department of Cardiology, Athens, Greece
| | - M Vavuranakis
- National & Kapodistrian University of Athens Medical School, 3rd Department of Cardiology, Athens, Greece
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18
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Marinos G, Lamprinos D, Georgakopoulos P, Patoulis G, Vogiatzi G, Damaskos C, Papaioannou A, Sofroni A, Pouletidis T, Papagiannis D, Symvoulakis EK, Konstantopoulos K, Rachiotis G. Reported COVID-19 Vaccination Coverage and Associated Factors among Members of Athens Medical Association: Results from a Cross-Sectional Study. Vaccines (Basel) 2021; 9:vaccines9101134. [PMID: 34696242 PMCID: PMC8540685 DOI: 10.3390/vaccines9101134] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 12/17/2022] Open
Abstract
There are limited data on the prevalence and determinants of COVID-19 vaccination coverage among physicians. A cross-sectional, questionnaire-based, online study was conducted among the members of the Athens Medical Association (I.S.A.) over the period 25 February to 13 March 2021. All members of I.S.A. were invited to participate in the anonymous online survey. A structured, anonymous questionnaire was used. Overall, 1993 physicians participated in the survey. The reported vaccination coverage was 85.3%. The main reasons of no vaccination were pending vaccination appointment followed by safety concerns. Participants being informed about the COVID-19 vaccines by social media resulted in lower COVID-19 vaccination coverage than health workers being informed by other sources. Logistic regression analysis demonstrated that no fear over COVID-19 vaccination-related side effects, history of influenza vaccination for flu season 2020–2021, and the perception that the information on COVID-19 vaccination from the national public health authorities is reliable, were independent factors of reported COVID-19 vaccination coverage. Our results demonstrate a considerable improvement of the COVID-19 vaccination uptake among Greek physicians. The finding that participants reported high reliability of the information related to COVID-19 vaccination provided by the Greek public health authorities is an opportunity which should be broadly exploited by policymakers in order to combat vaccination hesitancy, and further improve COVID-19 vaccination uptake and coverage among physicians/HCWs, and the general population.
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Affiliation(s)
- Georgios Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
| | - Dimitris Lamprinos
- Emergency Department, Laiko General Hospital, 11527 Athens, Greece; (D.L.); (P.G.); (A.S.); (T.P.)
| | | | | | - Georgia Vogiatzi
- 1st Cardiology Department, Medical School, National & Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece;
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - Anastasia Sofroni
- Emergency Department, Laiko General Hospital, 11527 Athens, Greece; (D.L.); (P.G.); (A.S.); (T.P.)
| | - Theodoros Pouletidis
- Emergency Department, Laiko General Hospital, 11527 Athens, Greece; (D.L.); (P.G.); (A.S.); (T.P.)
| | - Dimitrios Papagiannis
- Public Health & Vaccines Laboratory, Department of Nursing, School of Health Science, University of Thessaly, 41110 Larissa, Greece;
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Kostas Konstantopoulos
- Department of Haematology and Bone Marrow Transplantation Unit, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, 11527 Athens, Greece;
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece;
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19
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Theofilis P, Vogiatzi G, Oikonomou E, Gazouli M, Siasos G, Katifelis H, Perrea D, Vavuranakis M, Iliopoulos DC, Tsioufis C, Tousoulis D. The Effect of MicroRNA-126 Mimic Administration on Vascular Perfusion Recovery in an Animal Model of Hind Limb Ischemia. Front Mol Biosci 2021; 8:724465. [PMID: 34513927 PMCID: PMC8423909 DOI: 10.3389/fmolb.2021.724465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/13/2021] [Accepted: 08/16/2021] [Indexed: 01/08/2023] Open
Abstract
Background: MicroRNAs have been linked to angiogenesis and could prove to be valuable future therapeutic targets in ischemic cardiovascular diseases. Methods: Ten-week-old male C57Bl/6 mice were subjected to left femoral artery ligation and were treated with microRNA-126 mimic at a dose of 5 mg/kg (Group A, n = 10) or 5 mg/kg microRNA mimic negative control (Group B, n = 10) on days 1, 3, and 7. Laser Doppler imaging was performed to verify successful ligation on day 0 and to evaluate differences in the ischemic-to-normal (I/N) hind limb perfusion ratio on day 28. Muscle tissue expression of microRNA-126 and vascular endothelial growth factor (VEGF) was determined via PCR. Results: Following microRNA-126 mimic administration in Group A subjects, we noted a stepwise increase in I/N hind limb perfusion ratio (Day 0: 0.364 ± 0.032 vs. Day 8: 0.788 ± 0.049 vs. Day 28: 0.750 ± 0.039, p = 0.001). In Group B a stepwise increase in I/N hind limb perfusion ratio was observed (Day 0: 0.272 ± 0.057 vs. Day 8: 0.382 ± 0.020 vs. Day 28: 0.542 ± 0.028, p = 0.074). Muscle tissue expression of microRNA-126 in the ischemic hind limb of Group A was 350-fold lower compared to the ischemic hind limb of Group B (p < 0.001). A higher expression (14.2-fold) of VEGF in the ischemic hind limb of microRNA-126-treated mice compared to that of control group was detected (p < 0.001). A statistically significant negative correlation was noted between microRNA-126 and VEGF tissue expression levels in the ischemic limbs of the entire study population. Conclusion: MicroRNA-126 delivery in the ischemic hind limb of mice improved vascular perfusion with VEGF upregulation.
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Affiliation(s)
- Panagiotis Theofilis
- First Department of Cardiology, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- First Department of Cardiology, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.,Third Department of Cardiology, Thoracic Diseases General Hospital "Sotiria", University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- First Department of Cardiology, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.,Third Department of Cardiology, Thoracic Diseases General Hospital "Sotiria", University of Athens Medical School, Athens, Greece
| | - Maria Gazouli
- Department of Basic Medical Sciences, Laboratory of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Siasos
- First Department of Cardiology, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece.,Third Department of Cardiology, Thoracic Diseases General Hospital "Sotiria", University of Athens Medical School, Athens, Greece
| | - Hector Katifelis
- Department of Basic Medical Sciences, Laboratory of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Despoina Perrea
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", University of Athens Medical School, Athens, Greece
| | - Manolis Vavuranakis
- Third Department of Cardiology, Thoracic Diseases General Hospital "Sotiria", University of Athens Medical School, Athens, Greece
| | - Dimitrios C Iliopoulos
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", University of Athens Medical School, Athens, Greece
| | - Costas Tsioufis
- First Department of Cardiology, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece
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20
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Theofilis P, Oikonomou E, Vogiatzi G, Antonopoulos AS, Siasos G, Iliopoulos DC, Perrea D, Tsioufis C, Tousoulis D. The impact of proangiogenic microRNA modulation on blood flow recovery following hind limb ischemia. A systematic review and meta-analysis of animal studies. Vascul Pharmacol 2021; 141:106906. [PMID: 34509635 DOI: 10.1016/j.vph.2021.106906] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/04/2021] [Revised: 08/05/2021] [Accepted: 09/08/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Pro-angiogenic microRNA modulation is a potentially attractive approach in the management of peripheral artery disease (PAD). The aim of this systematic review and meta-analysis was to examine the impact of microRNAs involved in the process of angiogenesis on blood flow recovery following hind limb ischemia induction in animal models. METHODS A literature search was performed to identify studies testing the efficacy of microRNA treatment on animal models of hind limb ischemia. Following that, a meta-analysis of the included studies was executed with the primary outcome being the change in ischemic-to-normal hind limb perfusion ratio assessed via laser Doppler imaging. Moreover, risk of bias, sensitivity analysis and publication bias were evaluated. RESULTS Studies evaluation led to the inclusion of 18 studies whose meta-analysis suggested that microRNA treatment resulted in improved ischemic hind limb perfusion 7 [standardized mean difference (SMD): 0.93, 95% CI 0.49-1.38], 14 (SMD: 1.31, 95% CI 0.78-1.84), and 21 days (SMD: 1.13, 95% CI 0.59-1.66) after hind limb ischemia induction. Moderate-to-substantial heterogeneity and possible publication bias were noted. Risk of bias was unclear despite the balanced baseline animal characteristics. CONCLUSION The present meta-analysis suggests that pro-angiogenic modulation of microRNAs accelerates vascular perfusion recovery in animal models of acute hind limb ischemia. Further studies on animal models with similar characteristics to that of PAD patients are warranted to translate those findings in human PAD setting.
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Affiliation(s)
- Panagiotis Theofilis
- 1st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece; 3rd Cardiology Department, Sotiria Regional Hospital for Chest Diseases, University of Athens Medical School, Athens, Greece.
| | - Georgia Vogiatzi
- 1st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece; 3rd Cardiology Department, Sotiria Regional Hospital for Chest Diseases, University of Athens Medical School, Athens, Greece
| | - Alexios S Antonopoulos
- 1st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece; 3rd Cardiology Department, Sotiria Regional Hospital for Chest Diseases, University of Athens Medical School, Athens, Greece
| | - Dimitrios C Iliopoulos
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", University of Athens Medical School, Athens, Greece
| | - Despoina Perrea
- Laboratory of Experimental Surgery and Surgical Research "N.S. Christeas", University of Athens Medical School, Athens, Greece
| | - Costas Tsioufis
- 1st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
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21
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Giotis I, Tribonias G, Zacharopoulou E, Palatianou M, Leontidis N, Pantoula P, Vogiatzi G, Bakasis AD, Papanikolaou A, Tzouvala M. A rare case of duodenal-type follicular lymphoma in rectum appearing as hyperplastic polyp with metachronous appearance in duodenum and stomach. Clin J Gastroenterol 2021; 14:1632-1636. [PMID: 34453280 DOI: 10.1007/s12328-021-01501-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 08/11/2021] [Indexed: 11/25/2022]
Abstract
Hyperplastic polyps consist a very frequent finding in colonoscopy having a very low potential to malignancy. According to the international guidelines, it is recommended that all polyps should be resected except for diminutive (≤ 5 mm) rectal and rectosigmoid polyps which are predicted with confidence to be hyperplastic. Therefore, in departments where optical diagnosis can be ensured, a "resect and discard" strategy may be implemented for diminutive polyps. In our case, a duodenal-type follicular lymphoma was detected in a 5 mm rectum polyp with hyperplastic appearance. After 4 months, the lymphoma was detected also in stomach and duodenum. Under therapy with Rituximab, she is in remission. To our knowledge, there has never been reported such a case in the literature. Furthermore, it alerts us that we should be very cautious with the optical diagnosis and the "resect and discard strategy".
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Affiliation(s)
- Ioannis Giotis
- Department of Gastroenterology, General Hospital of Nikea-Piraeus 'Agios Panteleimon', Athens, Greece.
| | - George Tribonias
- Department of Gastroenterology, General Hospital of Nikea-Piraeus 'Agios Panteleimon', Athens, Greece
| | - Eirini Zacharopoulou
- Department of Gastroenterology, General Hospital of Nikea-Piraeus 'Agios Panteleimon', Athens, Greece
| | - Maria Palatianou
- Department of Gastroenterology, General Hospital of Nikea-Piraeus 'Agios Panteleimon', Athens, Greece
| | - Nikolaos Leontidis
- Department of Gastroenterology, General Hospital of Nikea-Piraeus 'Agios Panteleimon', Athens, Greece
| | - Panagiota Pantoula
- Department of Pathology, General Hospital of Nikea-Piraeus 'Agios Panteleimon', Athens, Greece
| | - Georgia Vogiatzi
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Maria Tzouvala
- Department of Gastroenterology, General Hospital of Nikea-Piraeus 'Agios Panteleimon', Athens, Greece
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22
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Foscolou A, Chrysohoou C, Dimitriadis K, Masoura K, Gkotzamanis V, Vogiatzi G, Lazaros G, Tsioufis C, Stefanadis C. The association of multimorbidity with healthy aging: Ikaria study. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.461] [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: 10/20/2022]
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23
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Oikonomou E, Lazaros G, Mystakidi VC, Papaioannou N, Theofilis P, Vogiatzi G, Chasikidis C, Fountoulakis P, Papakostantinou MA, Assimakopoulos MN, Barmparesos N, Tasios P, Kaski JC, Tousoulis D. The association of air pollutants exposure with subclinical inflammation and carotid atherosclerosis. Int J Cardiol 2021; 342:108-114. [PMID: 34339768 DOI: 10.1016/j.ijcard.2021.07.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/22/2021] [Accepted: 07/26/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Air pollution is a well-described environmental factor with evidence suggesting a firm association with cardiovascular diseases. The purpose of this study was to determine the association of exposure to gaseous air pollutants on atherosclerosis burden. METHODS 1955 inhabitants of the Corinthia region, aged 40 years or older, underwent clinical and biochemical assessment as well as carotid ultrasonography to evaluate carotid intima-media thickness (cIMT) and plaque burden. Analyzers recording time series concentration of CO, NO2, and SO2 were located at 4 different open sites (Regions 1, 2, 3 and 4) based on their proximity to industries, highways or shipyards. RESULTS A higher concentration of CO, NO2, and SO2 was observed in Region 4 compared to the other regions. Mean cIMT (Region 1: 0.93 ± 0.24 mm; Region 2: 0.96 ± 0.40 mm; Region 3: 0.94 ± 0.39 mm; Region 4: 1.14 ± 0.55 mm, p < 0.001), maximum cIMT (p < 0.001) as well as carotid plaque burden (Region 1: 13.3%; Region 2: 18.8%; Region 3: 22.4%; Region 4: 38.6%, p < 0.001) were significantly higher in individuals of Region 4. Inhabitants of Region 4 had also higher levels of C reactive protein (Region 1: 4.56 ± 4.85 mg/l; Region 2: 3.49 ± 4.46 mg/l; Region 3: 4.03 ± 3.32 mg/l, Region 4: 5.16 ± 8.26 mg/l, p < 0.001). Propensity score analysis revealed higher inter-area differences in mean cIMT of individuals with coronary artery disease (CAD) (high vs low air pollution area: 1.56 ± 0.80 mm; vs. 1.18 ± 0.54 mm, p < 0.001) while there was no difference in cIMT of the matched population without CAD (p = 0.52). CONCLUSIONS An increased carotid atherosclerotic and inflammatory burden is observed in inhabitants of areas with the highest concentration of air pollutants.
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Affiliation(s)
- Evangelos Oikonomou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
| | - George Lazaros
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Vasiliki Chara Mystakidi
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Nikolaos Papaioannou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Theofilis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgia Vogiatzi
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Christos Chasikidis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Petros Fountoulakis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Maria-Argentina Papakostantinou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Nikolaos Barmparesos
- National and Kapodistrian University of Athens, Department of Applied Physics, Faculty of Physics, Athens, Greece
| | - Panagiotis Tasios
- National and Kapodistrian University of Athens, Department of Applied Physics, Faculty of Physics, Athens, Greece
| | - Juan C Kaski
- Molecular and Clinical Sciences Research Institute, St. George's University of London, London, United Kingdom
| | - Dimitris Tousoulis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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24
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Chasikidis C, Oikonomou E, Lazaros G, Christoforatou E, Vogiatzi G, Chrysohoou C, Mystakidi VC, Vavouranaki G, Tousoulis D. Association of arterial stiffness with functional parameters in patients with systolic heart failure: Data from the Corinthia study. Hellenic J Cardiol 2021; 63:86-88. [PMID: 33965631 DOI: 10.1016/j.hjc.2021.04.005] [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] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/22/2021] [Accepted: 04/20/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Christos Chasikidis
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - Evangelos Oikonomou
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece; Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - George Lazaros
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Evangelia Christoforatou
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Georgia Vogiatzi
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Christina Chrysohoou
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Vasiliki Chara Mystakidi
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Georgia Vavouranaki
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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25
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Foscolou A, Chrysohoou C, Dimitriadis K, Masoura K, Vogiatzi G, Gkotzamanis V, Lazaros G, Tsioufis C, Stefanadis C. The Association of Healthy Aging with Multimorbidity: IKARIA Study. Nutrients 2021; 13:nu13041386. [PMID: 33924100 PMCID: PMC8074281 DOI: 10.3390/nu13041386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/15/2021] [Revised: 04/11/2021] [Accepted: 04/18/2021] [Indexed: 01/02/2023] Open
Abstract
The aim of this study was to evaluate several sociodemographic, lifestyle, and clinical characteristics of the IKARIA study participants and to find healthy aging trajectories of multimorbidity of Ikarian islanders. During 2009, 1410 people (aged 30+) from Ikaria Island, Greece, were voluntarily enrolled in the IKARIA study. Multimorbidity was defined as the combination of at least two of the following chronic diseases: hypertension; hypercholesterolemia; diabetes; obesity; cancer; CVD; osteoporosis; thyroid, renal, and chronic obstructive pulmonary disease. A healthy aging index (HAI) ranging from 0 to 100 was constructed using 4 attributes, i.e., depression symptomatology, cognitive function, mobility, and socializing. The prevalence of multimorbidity was 51% among men and 65.5% among women, while the average number of comorbidities was 1.7 ± 1.4 for men and 2.2 ± 1.4 for women. The most prevalent chronic diseases among men with multimorbidity were hypertension, hypercholesterolemia, and obesity while among women they were hypertension, hypercholesterolemia, and thyroid disease. Multimorbidity was correlated with HAI (Spearman’s rho = −0.127, p < 0.001) and for every 10-unit increase in HAI, participants had 20% lower odds of being multimorbid. Multimorbidity in relation to HAI revealed a different trend across aging among men and women, coinciding only in the seventh decade of life. Aging is usually accompanied by chronic diseases, but multimorbidity seems to also be common among younger adults. However, healthy aging is a lifelong process that may lead to limited co-morbidities across the lifespan.
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Affiliation(s)
- Alexandra Foscolou
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece;
| | - Christina Chrysohoou
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
- Correspondence: ; Tel.: +30-213-208-8000
| | - Kyriakos Dimitriadis
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
| | - Konstantina Masoura
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
| | - Georgia Vogiatzi
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
| | - Viktor Gkotzamanis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece;
| | - George Lazaros
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
| | - Costas Tsioufis
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
| | - Christodoulos Stefanadis
- First Cardiology Clinic, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.F.); (K.D.); (K.M.); (G.V.); (G.L.); (C.T.); (C.S.)
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26
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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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27
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Angelopoulos A, Oikonomou E, Vogiatzi G, Antonopoulos A, Tsalamandris S, Georgakopoulos C, Papanikolaou P, Lazaros G, Charalambous G, Siasos G, Vlachopoulos C, Tousoulis D. MiRNAs as Biomarkers in Hypertrophic Cardiomyopathy: Current State of the Art. Curr Med Chem 2021; 28:7400-7412. [PMID: 33820510 DOI: 10.2174/0929867328666210405122703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/02/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hypertrophic Cardiomyopathy (HCM) is the most common inherited Cardiomyopathy. The hallmark of HCM is myocardial fibrosis that contributes to heart failure, arrhythmias and sudden cardiac death. OBJECTIVE Currently there are no reliable serum biomarkers for detection of myocardial fibrosis, while cardiac magnetic resonance (CMR) is an imaging technique to detect myocardial fibrosis. MicroRNAs (miRNAs) have been increasingly suggested as biomarkers in cardiovascular diseases. However, in HCM there is as yet no identified and verified specific circulating miRNA signature. METHODS We conducted a review of literature to identify the studies that indicate the possible roles of miRNAs in HCM. RESULTS From studies in transgenic mice with HCM, miR-1, -133 may identify HCM in the early asymptomatic phase. Human miR-29a could be used as a circulating biomarker for detection of both myocardial hypertrophy and fibrosis in HCM, while it could also have a possible additional role in discrimination of hypertrophic obstructive cardiomyopathy from non-obstructive HCM. Additionally, miR-29a-3p is associated with diffuse myocardial fibrosis in HCM while miR-1-3p could discriminate end-stage HCM from dilated cardiomyopathy and left ventricle dilation. Another role of miRNAs could also be the contribution in differential diagnosis between HCM and phenocopies. Moreover, miRNA-targeted therapy (miR-133 mimics) is promising in inhibiting cardiac hypertrophy but this is still in the early stages. CONCLUSION A more reliable and specific signature of miRNAs is expected with forthcoming studies in samples from HCM patients and correlation of miRNAs with CMR and serum markers of fibrosis may implicate novel diagnostic and therapeutic pathways.
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Affiliation(s)
- Andreas Angelopoulos
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Evangelos Oikonomou
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Georgia Vogiatzi
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Alexios Antonopoulos
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Sotirios Tsalamandris
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Christos Georgakopoulos
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Paraskevi Papanikolaou
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - George Lazaros
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Georgios Charalambous
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Gerasimos Siasos
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Charalambos Vlachopoulos
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
| | - Dimitris Tousoulis
- EKKAN (Unit for the athletes and for hereditary cardiovascular diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens. Greece
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28
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Terentes-Printzios D, Vlachopoulos C, Kardara D, Anastasakis A, Vogiatzi G, Xaplanteris P, Georgakopoulos C, Lazaros G, Tousoulis D. IMPACT OF MARATHON RUNNING ON ENDOTHELIAL FUNCTION AND SUBCLINICAL ATHEROSCLEROSIS. J Hypertens 2021. [DOI: 10.1097/01.hjh.0000748764.44893.90] [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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29
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Lazaros G, Antonopoulos AS, Lazarou E, Vlachopoulos C, Vogiatzi G, Vassilopoulos D, Tousoulis D. Age- and sex-based differences in patients with acute pericarditis. Eur J Clin Invest 2021; 51:e13392. [PMID: 32857868 DOI: 10.1111/eci.13392] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Acute pericarditis has a wide spectrum of clinical presentations largely depending on underlying aetiologies. We assessed the role of age and sex in the clinical features and outcome of acute pericarditis. MATERIALS AND METHODS A total of 240 consecutive patients hospitalized with a first episode of acute pericarditis were included. At baseline demographics, clinical features, laboratory and imaging findings and medical therapy were recorded. Patients were followed up for at least 18 months for complications. Data comparisons were performed according to sex and age (≤60 or >60 years). RESULTS The male/female ratio was 1.42, and 56% of patients were >60 years. Younger patients depicted more often chest pain (P = .001), fever and rubs (P < .001 for both), ST elevation and PR depression (P = .032 and .009, respectively), higher CRP values (P = .009) and less often dyspnoea (P = .046) and pericardial effusion (P = .036). Moreover, they received less often glucocorticoids (P < .001) and depicted less atrial fibrillation (P = .003) and a higher rate of recurrent pericarditis (P = .013). After multivariate adjustment for confounders, age >60 years remained an independent predictor for a lower risk of recurrent pericarditis (hazard ratio 0.60, 95% CI: 0.39-0.96, P = .033). Regarding sex, females were older (P = .007), showed less often ST elevation and PR depression (P < .001 and .002, respectively) and had a higher baseline heart rate (P = .02). Sex was not associated with recurrent pericarditis risk. CONCLUSIONS Patients with acute pericarditis have distinct presenting clinical, biochemical and prognostic features according to age and sex. Awareness of such differences is important for clinical decision-making.
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Affiliation(s)
- George Lazaros
- 1st Cardiology Clinic, School of Medicine, Hippokration General Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexios S Antonopoulos
- 1st Cardiology Clinic, School of Medicine, Hippokration General Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Emilia Lazarou
- 1st Cardiology Clinic, School of Medicine, Hippokration General Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalambos Vlachopoulos
- 1st Cardiology Clinic, School of Medicine, Hippokration General Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Vogiatzi
- 1st Cardiology Clinic, School of Medicine, Hippokration General Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vassilopoulos
- 2nd Department of Medicine and Laboratory, Clinhical Immunology-Rheumatology Unit, School of Medicine, Hippokration General Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Clinic, School of Medicine, Hippokration General Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
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Georgakopoulou VE, Garmpis N, Damaskos C, Valsami S, Dimitroulis D, Diamantis E, Farmaki P, Papageorgiou CV, Makrodimitri S, Gravvanis N, Velonias S, Sklapani P, Trakas N, Antoniou EA, Kontzoglou K, Nikolidakis L, Damaskou Z, Syllaios A, Marinos G, Vogiatzi G, Korrou GE, Kyriakos G, Quiles-Sanchez LV, Patsouras A, Lamprinos D, Stelianidi A, Savvanis S, Garmpi A. The Impact of Peripheral Eosinophil Counts and Eosinophil to Lymphocyte Ratio (ELR) in the Clinical Course of COVID-19 Patients: A Retrospective Study. In Vivo 2021; 35:641-648. [PMID: 33402521 DOI: 10.21873/invivo.12303] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIM Eosinophils are blood cells responsible for response against parasites and allergens. Eosinophil to lymphocyte ratio (ELR) is a biomarker for inflammatory conditions. Our aim was to evaluate the role of eosinophils and ELR in COVID-19 patients. PATIENTS AND METHODS The study included 96 patients hospitalized with COVID-19. They were classified into moderate to severe cases and critical cases. Eosinophils and ELR were determined in both groups, in patients that died or survived and were correlated to duration of hospitalization. RESULTS There was a statistically significant decrease in eosinophils and ELR between patients that died and patients that survived (p<0.05), and in mean values of the two biomarkers (p<0.05 for eosinophils and p<0.05 for ELR) between patients hospitalized for more or less than 15 days among those with moderate to severe disease. CONCLUSION Lower eosinophil counts and ERL could probably predict worse outcome in COVID-19 patients.
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Affiliation(s)
- Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece; .,Renal Transplantation Unit, Laiko General Hospital, Athens, Greece
| | - Serena Valsami
- Blood Transfusion Department, Aretaieion Hospital, Medical School, National and Kapodistrian Athens University, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | | | - Pagona Sklapani
- Department of Cytology, Mitera-Hygeia Hospital, Athens, Greece
| | - Nikolaos Trakas
- Biochemistry Department, Sismanogleio Hospital, Athens, Greece
| | - Efstathios A Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Zoi Damaskou
- Department of Internal Medicine, Ygeias Melathron Hospital, Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Georgios Kyriakos
- Seccion de Endocrinologia y Nutrition, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | | | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | | | - Athanasia Stelianidi
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Savvanis
- Department of Internal Medicine, Elpis General Hospital, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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31
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Oikonomou E, Theofilis P, Vogiatzi G, Lazaros G, Tsalamandris S, Mystakidi VC, Goliopoulou A, Anastasiou M, Fountoulakis P, Chasikidis C, Christoforatou E, Tousoulis D. The impact of sleeping duration on atherosclerosis in the community: insights from the Corinthia study. Sleep Breath 2021; 25:1813-1819. [PMID: 33411185 DOI: 10.1007/s11325-020-02267-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/30/2020] [Revised: 11/22/2020] [Accepted: 11/28/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE Sleep is an essential physiologic process whose disturbances have been regarded as a risk factor in various pathophysiologic processes, including atherosclerosis and cardiovascular disease. Although the negative influence of short sleep duration has been well-established, recent data suggest a possible harmful effect of prolonged sleeping pattern. METHODS In the setting of the Corinthia cross-sectional study, self-reported night sleep duration was recorded in 1752 apparently healthy individuals and was classified as normal sleep duration (NSD, 7-8 h), short sleep duration (SSD, 6-7 h), very short sleep duration (VSSD, < 6 h), and long sleep duration (LSD, > 8 h). Carotid duplex ultrasonography was performed in order to measure the mean and maximum carotid intima-media thickness (cIMT) as a non-invasive marker of atherosclerosis. RESULTS Subjects with LSD and VSSD had significantly higher mean cIMT (VSSD: 1.02 ± 0.45 mm, SSD: 0.95 ± 0.35, NSD: 0.96 ± 0.38 mm, LSD: 1.07 ± 0.52 mm; p < 0.001) and maximum cIMT (VSSD: 1.39 ± 0.9 mm, SSD: 1.25 ± 0.71 mm, NSD: 1.23 ± 0.76 mm, LSD: 1.41 ± 0.93 mm). Following a regression analysis adjusting for known cardiovascular risk factors, individuals with LSD and VSSD had higher mean cIMT by 0.054 mm and 0.067 mm respectively compared to those with NSD. CONCLUSION A balanced sleeping duration of 6-8 h is associated with decreased mean and maximum IMT while both very short sleep duration and long sleep duration are associated with increased carotid intima-media thickness, a marker of subclinical atherosclerosis.
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Affiliation(s)
- Evangelos Oikonomou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Panagiotis Theofilis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Georgia Vogiatzi
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece.
| | - George Lazaros
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Sotirios Tsalamandris
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Vasiliki Chara Mystakidi
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Athina Goliopoulou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Maria Anastasiou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Petros Fountoulakis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Christos Chasikidis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Evangelia Christoforatou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Vasilissis Sofias 114, 115 28, Athens, Greece
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Papaioannou TG, Oikonomou E, Lazaros G, Christoforatou E, Vogiatzi G, Tsalamandris S, Chasikidis C, Kalambogias A, Mystakidi VX, Galiatsatos N, Santouri M, Latsios G, Deftereos S, Tousoulis D. Aortic stiffening is associated with increased left ventricular mass in women but not in men. Eur J Prev Cardiol 2020; 27:2109-2112. [DOI: 10.1177/2047487319865054] [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]
Affiliation(s)
| | | | - George Lazaros
- First Department of Cardiology, Hippokration Hospital, Greece
| | | | | | | | | | | | | | | | - Mina Santouri
- First Department of Cardiology, Hippokration Hospital, Greece
| | - George Latsios
- First Department of Cardiology, Hippokration Hospital, Greece
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33
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Papaioannou TG, Oikonomou E, Lazaros G, Vogiatzi G, Theofilis P, Tsalamandris S, Chasikidis C, Mystakidi VX, Mazaris S, Anastasiou M, Bourouki E, Papakonstantinou M, Tousoulis D. Differential effect of heart rate on pulse wave velocity measurement between subjects with normal and abnormal arterial stiffness but with similar blood pressure levels. Hellenic J Cardiol 2020; 62:455-456. [PMID: 33166650 DOI: 10.1016/j.hjc.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/24/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Theodore G Papaioannou
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Evangelos Oikonomou
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Lazaros
- 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
| | - Panagiotis Theofilis
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotiris Tsalamandris
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Chasikidis
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki-Xara Mystakidi
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Savvas Mazaris
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anastasiou
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evgenia Bourouki
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Margenti Papakonstantinou
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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34
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Theofilis P, Oikonomou E, Vogiatzi G, Lazaros G, Tsalamandris S, Mystakidi V, Goliopoulou A, Chasikidis C, Miliou A, Fountoulakis P, Papaioannou N, Papakonstantinou M, Tousoulis D. Association of habitual alcohol consumption with carotid atherosclerotic lesions: results from the Corinthia study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Alcohol is implicated in the pathophysiology of cardiovascular diseases. However, it is also believed to play a cardioprotective role if consumed in appropriate amounts.
Purpose
To assess the association between alcohol consumption and carotid atherosclerosis.
Methods
In the setting of the cross-sectional Corinthia study, volunteers filled in questionnaires regarding drinking habits and were characterized as social drinkers (SD) or habitual alcohol consumers (HAC). Furthermore, they underwent carotid ultrasonography examination to evaluate the carotid intima-media thickness (cIMT). Thickness of cIMT>1.5 mm or protrusion >50% compared to adjacent segments was considered as atherosclerotic plaque.
Results
HAC consumers were usually male (HAC: 61.1%, SD: 24.9%, p<0.001), smokers (HAC: 33.3%, SD: 23.5%, p<0.001) and frequently had a history of hypertension (HAC: 72.8%, SD: 67.5%, p=0.02) when compared to SD (Table 1). However, no significant differences were noted regarding other risk factors of atherosclerosis (Table). Notably, HAC had a greater extent of carotid atherosclerosis as demonstrated by an increased cIMT (HAC: 1.03±0.45mm, SD: 0.96±0.39mm, p<0.001) and carotid plaque burden (HAC: 27.7%, SD: 21.3%, p=0.004). Importantly, when taking into account the number of alcoholic drinks (in wine glasses), alcohol consumption of more than 1 wine glass resulted in significantly higher values of cIMT (1 wine glass: 1.00±0.42mm, >1 wine glass: 1.06±0.45mm, p=0.04) (Figure 1A) and extensive amount of carotid plaques (1 wine glass: 22.7%, >1 wine glass: 30.4%, p=0.02) when compared to consumption of 1 wine glass (Figure 1B).
Conclusion
Habitual alcohol consumption of more than one wine glass is associated with a higher carotid atherosclerotic burden.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Theofilis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - E Oikonomou
- National & Kapodistrian University of Athens, Athens, Greece
| | - G Vogiatzi
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - G Lazaros
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - S Tsalamandris
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - V.C Mystakidi
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - A Goliopoulou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - C Chasikidis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - A Miliou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - P Fountoulakis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - N Papaioannou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - M Papakonstantinou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - D Tousoulis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
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Theofilis P, Oikonomou E, Vogiatzi G, Lazaros G, Mystakidi V, Barbaresos N, Tasios P, Tsalamandris S, Fountoulakis P, Miliou A, Papaioannou N, Asimakopoulos M, Tousoulis D. Increased exposure to air pollutants leads to greater atherosclerotic burden mediated by systemic inflammation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3075] [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
Air pollution has been a well-described environmental factor contributing significantly to the global disease burden.
Purpose
To examine the association of gaseous air pollutants with atherosclerosis, especially in subjects with coronary artery disease (CAD).
Methods
2053 individuals enrolled in the Corinthia study underwent clinical and biochemical assessment followed by carotid ultrasonography to evaluate carotid intima-media thickness (cIMT) and plaque burden. Inflammation was estimated via measurement of C-Reactive protein (CRP). Air pollutants concentration analysis was performed in prespecified regions with respect to their proximity to heavy industries, highways and shipyards.
Results
A higher concentration of gaseous air pollutants was observed in Region 4 when compared to other regions (Table). Mean cIMT, maximum cIMT and carotid plaque burden were significantly increased in individuals of Region 4 (Table, Figure A and B), a result which remained unaffected after adjustment for cardiovascular confounders (Figure C). In parallel, inhabitants of Region 4 had higher levels of CRP (Region 1: 4.60±5.01mg/l; Region 2: 3.08±3.26mg/l; Region 3: 4.37±4.70mg/l, Region 4: 6.78±9.77mg/l, p<0.001). To examine the effect of air pollution on atherosclerosis in CAD, propensity scores were applied to match healthy controls with CAD subjects in terms of atherosclerosis risk factors resulting in two matched groups; one in regions 1, 2 and 3 -low air pollution areas (LAPA)- and another in region 4 -high air pollution area (HAPA). Interestingly, we noted substantially higher inter-area differences in mean cIMT of CAD individuals (Figure D).
Conclusion
Air pollution may significantly contribute to atherosclerosis progression, potentially via the induction of inflammation. A more pronounced effect was noted in CAD individuals exposed to high air pollution.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Theofilis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - E Oikonomou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - G Vogiatzi
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - G Lazaros
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - V.C Mystakidi
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - N Barbaresos
- University of Athens, Department of Applied Physics, Faculty of Physics, Athens, Greece
| | - P Tasios
- University of Athens, Department of Applied Physics, Faculty of Physics, Athens, Greece
| | - S Tsalamandris
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - P Fountoulakis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - A Miliou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - N Papaioannou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - M.N Asimakopoulos
- University of Athens, Department of Applied Physics, Faculty of Physics, Athens, Greece
| | - D Tousoulis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
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Theofilis P, Oikonomou E, Vogiatzi G, Lazaros G, Tsalamandris S, Mystakidi V, Goliopoulou A, Fountoulakis P, Miliou A, Chasikidis C, Tousoulis D. Depression in young adults is associated with increased carotid atherosclerotic burden: insights from the Corinthia study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2853] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Depression appears to have a detrimental effect not only on mental health but also in the progression of various diseases.
Purpose
The examination of a potential association between depression and atherosclerosis progression in a rural population.
Methods
In the context of the cross-sectional Corinthia study, volunteers fulfilled a questionnaire concerning emotional health. The Geriatric Depression Scale was used for individuals aged 60 or more while the Zung self-rating depression score was preferred in younger adults. Carotid ultrasonography examination was performed to evaluate the mean carotid intima-media thickness (cIMT). Thickness of cIMT>1.5 mm or protrusion >50% compared to adjacent segments was considered as atherosclerotic plaque.
Results
Young adults with significant depression were usually female and did not differ significantly on other risk factors of atherosclerosis compared to those with mild or no depressive disorder. Importantly, those with moderate-severe depression appeared to have increased mean cIMT (Mild-No depression: 0.85±0.30mm, Moderate-severe depression: 0.91±0.42mm, p=0.04) and a higher carotid plaque burden (Mild-No depression: 12.8%, Moderate-severe depression: 20.3%, p=0.04). With regards to the elderly, those with moderate-severe depression were usually smokers (Mild-No depression: 13.9%, Moderate-severe depression: 24.2%, p=0.01). However, mean cIMT (Mild-No depression: 1.11±0.47mm, Moderate-severe depression: 1.09±0.39mm, p=0.69) and carotid plaques (Mild-No depression: 31.1%, Moderate-severe depression: 36.1%, p=0.36) did not differ according to depression status in this subgroup.
Conclusion
Significant depressive disorder is associated with accelerated carotid atherosclerosis in young individuals.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Theofilis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - E Oikonomou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - G Vogiatzi
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - G Lazaros
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - S Tsalamandris
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - V.C Mystakidi
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - A Goliopoulou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - P Fountoulakis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - A Miliou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - C Chasikidis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - D Tousoulis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
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Anastasiou M, Oikonomou E, Vogiatzi G, Siasos G, Flora Z, Antonopoulos A, Tsalamandris S, Bamias A, Dimopoulos M, Tousoulis D. Differential effect of anthracycline and trastuzumab cancer therapeutic related vascular toxicity in patients with breast cancer. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3287] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Both anthracyclines and trastuzumab are key regiments for the treatment of breast cancer, but their concurrent use is contraindicated because of their cardiotoxicity. Their effects on vascular function have been less well studied.
Purpose
We explored the effects of the anthracycline-based chemotherapy followed by trastuzumab-based treatment on endothelial function and arterial stiffness in patients with breast cancer.
Methods
46 female patients (54.56±11.5 years old) with breast cancer scheduled for anthracycline-based chemotherapy followed by the combination of trastuzumab and taxane were enrolled. Trastuzumab was continued until the completion of one-year treatment. All participants underwent assessment of the brachial flow mediated dilatation (FMD), endothelial independent dilatation (EID), carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) at baseline (BL), at the end of anthracycline treatment (FU1), 3 months following initiation of trastuzumab with taxane (FU2) and at the completion of treatment with trastuzumab (FU3).
Results
Over the follow-up period (15 months) there was significant deterioration in FMD (p=0.04) (Table 1, Figure 1). Importantly, while there was no significant difference in FMD between BL vs FU1 (p=0.6), FMD has been significantly deteriorated over the treatment with trastuzumab with taxane FU1 vs FU2 (p=0.01) and FU2 vs FU3 (p=0.01) (Table 1, Figure 1). EID did not change over the follow-up period (Figure 1). Similarly, PWV has been significantly increased over the follow up period (p=0.03). There was no significant difference in PWV BL vs FU1 (p=0.1), however PWV has been significantly increased over the treatment with trastuzumab with taxane FU1 vs FU 2 (p=0.02) and FU2 vs FU3 (p=0.01) (Table 1, Figure 1). A similar pattern of impairment was observed with AIx (Table 1, Figure 1).
Conclusion
We report a significant adverse effect of the anthracycline- and trastuzumab-based therapy on the arterial stiffness and endothelial function. This effect is more considerable after the exposure to trastuzumab.
Figure 1. Changes of FMD, PWV, Alx, EID during FU
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Anastasiou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - E Oikonomou
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - G Vogiatzi
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - G Siasos
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - Z Flora
- National & Kapodistrian University of Athens Medical School, Department of Clinical Therapeutics, Alexandra General Hospital, Athens, Greece
| | - A.S Antonopoulos
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - S Tsalamandris
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
| | - A Bamias
- National & Kapodistrian University of Athens Medical School, Department of Clinical Therapeutics, Alexandra General Hospital, Athens, Greece
| | - M.A Dimopoulos
- National & Kapodistrian University of Athens Medical School, Department of Clinical Therapeutics, Alexandra General Hospital, Athens, Greece
| | - D Tousoulis
- National & Kapodistrian University of Athens Medical School, 1st Cardiology Clinic, Hippokration Hospital, Athens, Greece
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Lazaros G, Oikonomou V, Oikonomou E, Aznaouridis K, Vlachopoulos C, Vogiatzi G, Lazarou E, Imazio M, Brucato A, Adler Y, Tousoulis D. Recurrence of Pericardial Effusion After Pericardiocentesis: Does Catheter-Induced Acute Pericardial Inflammation Play a Role? Am J Med Sci 2020; 361:676-678. [PMID: 33243434 DOI: 10.1016/j.amjms.2020.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/18/2020] [Accepted: 10/08/2020] [Indexed: 12/29/2022]
Affiliation(s)
- George Lazaros
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece.
| | - Vasiliki Oikonomou
- Department of Clinical Cytopathology, Hippokration General Hospital, Athens, Greece
| | - Evangelos Oikonomou
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
| | - Konstantinos Aznaouridis
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
| | - Charalambos Vlachopoulos
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
| | - Georgia Vogiatzi
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
| | - Emilia Lazarou
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
| | - Massimo Imazio
- University Cardiology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonio Brucato
- Dipartimento Scienze Biomediche e Cliniche Luigi Sacco, Università degli Studi di Milano, Ospedale Fatebenefratelli-Sacco, Milan, Italy
| | - Yehuda Adler
- Dean for Medical Professions, College of Law and Business, Ramat Gan, Israel. Sackler Faculty of Medicine, Tel Aviv University, Mayanei Hayeshua Medical Center, Bnei Brak, Israel
| | - Dimitris Tousoulis
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
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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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Affiliation(s)
- Dimitris Tousoulis
- First Cardiology Department, National and Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Evangelos Oikonomou
- First Cardiology Department, National and Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Georgia Vogiatzi
- First Cardiology Department, National and Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Panos Vardas
- Heart Sector, Hygeia Hospitals Group, Athens, Greece
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Oikonomou E, Vogiatzi G, Lazaros G, Tsalamandris S, Goliopoulou A, Mystakidou V, Theofilis P, Christoforatou E, Chasikidis C, Tousoulis D. Relationship of depressive symptoms with arterial stiffness and carotid atherosclerotic burden in the Corinthia study. QJM 2020; 113:633-642. [PMID: 32125429 DOI: 10.1093/qjmed/hcaa079] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/26/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND It has been long hypothesized that emotional factors and depression may play role in the development of cardiovascular diseases. AIM The aim of this study was to examine the association between depression, arterial stiffness and atheromatic burden in carotid arteries. DESIGN AND METHODS Corinthia study is a cross-sectional epidemiological study conducted in subjects aged 40-99 years, inhabitants of the homonym region of Greece. Intima media thickness (IMT) was measured in the left and right common carotid artery, carotid bulb and internal carotid artery. The average of the measurements (mean IMT) and the maximum IMT were determined as the representative value of carotid atherosclerosis burden. Pulse wave velocity was used to evaluate arterial stiffness. The Zung Self-Rating Depression Scale was used to evaluate depressive symptoms in subjects <65 years and the Geriatric Depression Scale in those >65 years. RESULTS In this analysis, we included data from 1510 participants. In older subjects (i.e. >65 years), maximum IMT was significantly increased in subjects with depression compared to those without (1.57 ± 0.97 mm vs. 1.74 ± 1.05 mm, P = 0.04). Similarly, the prevalence of atheromatic plaques was higher in subjects with depression (46% vs. 34%, P = 0.005). In the younger subgroup (<65years), there was no difference in mean and maximum IMT. Pulse wave velocity was found higher in the presence of depression (8.35 ± 2.36m/s vs. 7.88 ± 1.77m/s, P = 0.007). No differences emerged for the rest of the variables assessed in the individual subgroups. CONCLUSIONS There is an age-dependent association between depression, arterial stiffness and carotid atheromatic burden highlighting the interplay between cardiovascular diseases and emotional status.
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Affiliation(s)
- E Oikonomou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - G Vogiatzi
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - G Lazaros
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - S Tsalamandris
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - A Goliopoulou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - V Mystakidou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - P Theofilis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - E Christoforatou
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - C Chasikidis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - D Tousoulis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Oikonomou E, Aznaouridis K, Barbetseas J, Charalambous G, Gastouniotis I, Fotopoulos V, Gkini KP, Katsivas A, Koudounis G, Koudounis P, Koutouzis M, Lamprinos D, Lazaris E, Lazaris E, Lazaros G, Marinos G, Platogiannis N, Platogiannis D, Siasos G, Terentes-Printzios D, Theodoropoulou A, Theofilis P, Toutouzas K, Tsalamandris S, Tsiafoutis I, Vavouranakis M, Vogiatzi G, Zografos T, Baka E, Tousoulis D, Vlachopoulos C. Hospital attendance and admission trends for cardiac diseases during the COVID-19 outbreak and lockdown in Greece. Public Health 2020; 187:115-119. [PMID: 32949881 PMCID: PMC7434308 DOI: 10.1016/j.puhe.2020.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 05/06/2020] [Revised: 07/29/2020] [Accepted: 08/12/2020] [Indexed: 11/25/2022]
Abstract
Objectives The coronavirus disease 2019 (COVID-19) outbreak, along with implementation of lockdown and strict public movement restrictions, in Greece has affected hospital visits and admissions. We aimed to investigate trends of cardiac disease admissions during the outbreak of the pandemic and possible associations with the applied restrictive measures. Study design This is a retrospective observational study. Methods Data for 4970 patients admitted via the cardiology emergency department (ED) across 3 large-volume urban hospitals in Athens and 2 regional/rural hospitals from February 3, 2020, up to April 12 were recorded. Data from the equivalent (for the COVID-19 outbreak) time period of 2019 and from the postlockdown time period were also collected. Results A falling trend of cardiology ED visits and hospital admissions was observed starting from the week when the restrictive measures due to COVID-19 were implemented. Compared with the pre–COVID-19 outbreak time period, acute coronary syndrome (ACS) [145 (29/week) vs. 60 (12/week), −59%, P < 0.001], ST elevation myocardial infarction [46 (9.2/week) vs. 21 (4.2/week), −54%, P = 0.002], and non-ST elevation ACS [99 cases (19.8/week) vs. 39 (7.8/week), −60% P < 0.001] were reduced at the COVID-19 outbreak time period. Reductions were also noted for heart failure worsening and arrhythmias. The ED visits in the postlockdown period were significantly higher than in the COVID-19 outbreak time period (1511 vs 660; P < 0.05). Conclusion Our data show significant drops in cardiology visits and admissions during the COVID-19 outbreak time period. Whether this results from restrictive measures or depicts a true reduction of cardiac disease cases warrants further investigation. The coronavirus disease 2019 (COVID-19) outbreak has led to an unprecedented health system overload. The restrictive measures in Greece resulted in a low number of COVID-19 cases. Hospital visits and cardiovascular events have diminished after implementation of restrictive measures. Acute coronary syndromes reduced by approximately 55%, despite limited incidence of COVID-19. The multifactorial etiology of this finding should be thoroughly investigated.
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Affiliation(s)
- E 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.
| | - K Aznaouridis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - J Barbetseas
- Department of Cardiology, Laiko General Hospital, Athens, Greece
| | - G Charalambous
- Emergency Department, Hippokration' General Hospital, Athens, Greece
| | - I Gastouniotis
- Emergency Department, Hippokration' General Hospital, Athens, Greece
| | - V Fotopoulos
- Emergency Department, Laiko General Hospital, Athens, Greece
| | - K-P Gkini
- Athens Red Cross Hospital, 2nd Department of Cardiology, Athens, Greece
| | - A Katsivas
- Athens Red Cross Hospital, 1st Department of Cardiology, Athens, Greece
| | - G Koudounis
- General Hospital of Kalamata, Department of Cardiology, Kalamata, Greece
| | - P Koudounis
- General Hospital of Kalamata, Department of Cardiology, Kalamata, Greece
| | - M Koutouzis
- Athens Red Cross Hospital, 2nd Department of Cardiology, Athens, Greece
| | - D Lamprinos
- Emergency Department, Laiko General Hospital, Athens, Greece
| | - E Lazaris
- Athens Red Cross Hospital, 2nd Department of Cardiology, Athens, Greece
| | - E Lazaris
- Athens Red Cross Hospital, 2nd Department of Cardiology, Athens, Greece
| | - G Lazaros
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - G Marinos
- Emergency Department, Laiko General Hospital, Athens, Greece
| | - N Platogiannis
- General Hospital of Trikala, Department of Cardiology, Trikala, Greece
| | - D Platogiannis
- General Hospital of Trikala, Department of Cardiology, Trikala, Greece
| | - G 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
| | - D Terentes-Printzios
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - A Theodoropoulou
- Emergency Department, Hippokration' General Hospital, Athens, Greece
| | - P Theofilis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - K Toutouzas
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - S Tsalamandris
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - I Tsiafoutis
- Athens Red Cross Hospital, 1st Department of Cardiology, Athens, Greece
| | - M Vavouranakis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - G Vogiatzi
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece; Emergency Department, Laiko General Hospital, Athens, Greece
| | - T Zografos
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece; Athens Red Cross Hospital, 1st Department of Cardiology, Athens, Greece
| | - E Baka
- Emergency Department, Hippokration' General Hospital, Athens, Greece
| | - D Tousoulis
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - C Vlachopoulos
- 1st Cardiology Clinic, 'Hippokration' General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Abstract
:
Cardiomyopathies are a heterogeneous group of heart muscle diseases and important cause of heart
failure with reduced or preserved ejection fraction. Although there is an increasing body of evidence on the incidence,
pathophysiology, and natural history of heart failure (HF) in cardiomyopathies, certain aspects of the
therapeutic strategies remain unclear. More particularly, there is no consensus if to whether antithrombotic therapy
has a favorable risk: benefit ratio in reducing thromboembolic event rate in patients with cardiomyopathies
without suffering from primary valvular disease or atrial fibrillation. Although the observational data on increased
venous thromboembolic risk are supported by multiple pathophysiological mechanisms, the role of antithrombotic
therapy in these patients remains unclear. This review article provides an overview of epidemiologic, pathophysiologic,
clinical, and therapeutic data for the prevention of thromboembolism in heart failure due to cardiomyopathies.
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Affiliation(s)
- Georgia Vogiatzi
- First Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Antonios Pantazis
- Inherited Cardiovascular Conditions Unit, Royal Brompton and Harefield Hospitals, London SW3 5UE, United Kingdom
| | - Dimitris Tousoulis
- First Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Oikonomou E, Papanikolaou A, Anastasakis A, Bournousouzis E, Georgakopoulos C, Goudevenos J, Ioakeimidis N, Kanakakis J, Lazaros G, Papatheodorou S, Tsatsopoulou A, Tsonou P, Vogiatzi G, Panagiotakopoulos G, Tousoulis D, Vlachopoulos C. Proposed algorithm for return to sports in competitive athletes who have suffered COVID-19. Hellenic J Cardiol 2020; 62:175-177. [PMID: 32634475 PMCID: PMC7335237 DOI: 10.1016/j.hjc.2020.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 02/08/2023] Open
Affiliation(s)
- Evangelos Oikonomou
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Angelos Papanikolaou
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Aris Anastasakis
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre, Greece
| | | | - Christos Georgakopoulos
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | - John Goudevenos
- Department of Cardiology, University of Ioannina Medical School, Greece
| | - Nikolaos Ioakeimidis
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | - John Kanakakis
- Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
| | - George Lazaros
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Stathis Papatheodorou
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre, Greece
| | | | | | - Georgia Vogiatzi
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | | | - Dimitris Tousoulis
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Charalambos Vlachopoulos
- EKKAN (Unit for the Athletes and for Hereditary Cardiovascular Diseases), 1st Department of Cardiology, Hippokration Hospital, Medical School of National and Kapodistrian University of Athens, Athens 11527, Greece.
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Vavouranaki G, Oikonomou E, Vavuranakis MA, Vavuranakis E, Vogiatzi G, Lazaros G, Tsalamandris S, Galiatsatos N, Theofilis P, Santouri M, Tousoulis D. Relationship between whole grain consumption and arterial stiffness. Results of the Corinthia cross-sectional study. Hellenic J Cardiol 2020; 62:219-220. [PMID: 32534110 DOI: 10.1016/j.hjc.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Georgia Vavouranaki
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Michael Andrew Vavuranakis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Emmanuel Vavuranakis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Georgia Vogiatzi
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - George Lazaros
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Sotirios Tsalamandris
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Nikolaos Galiatsatos
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Panagiotis Theofilis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Mina Santouri
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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Tsalamandris S, Oikonomou E, Vogiatzi G, Miliou A, Lazaros G, Georgakopoulos C, Gialafos E, Sideris S, Vlachopoulos C, Tousoulis D. X-linked dilated cardiomyopathy: the important role of genetic tests and imaging in the early diagnosis and treatment. Future Cardiol 2020; 16:629-634. [PMID: 32508136 DOI: 10.2217/fca-2020-0030] [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] [Indexed: 11/21/2022] Open
Abstract
Familial dilated cardiomyopathy predominantly affects younger adults and may cause advanced heart failure and sudden cardiac death. Therefore, detailed family history, family members screening, appropriate genetic testing and counselling may allow correct identification of cardiac remodeling etiology, as well as earlier disease detection. Accordingly, we present a case with an early diagnosis of an X-linked dilated cardiomyopathy guided by clinical features, cardiac MRI and genetic testing. The diagnostic workup was guided by the positive family history of cardiomyopathy and sudden cardiac deaths. Clinical implications including early management, better arrythmia risk stratification and the revealing of a potential endemic entity clustering in several male subjects of a community on Crete island are further discussed.
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Affiliation(s)
- Sotirios Tsalamandris
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Evangelos Oikonomou
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Georgia Vogiatzi
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Antigoni Miliou
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - George Lazaros
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Christos Georgakopoulos
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Elias Gialafos
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Skevos Sideris
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Charalampos Vlachopoulos
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Dimitris Tousoulis
- Unit for Athletes & Hereditary Cardiovascular Diseases (EKKAN), 1st Cardiology Department, National & Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece
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Oikonomou E, Karlis D, Tsalamadris S, Siasos G, Chrysohoou C, Vogiatzi G, Dimitropoulos S, Charalambous G, Kouskouni E, Tousoulis D. Galectin-3 and Arterial Stiffness in Patients with Heart Failure: A Pilot Study. Curr Vasc Pharmacol 2020; 17:396-400. [PMID: 29968538 DOI: 10.2174/1570161116666180703094919] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 06/27/2018] [Accepted: 06/27/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiac performance depends on optimum ventriculoarterial coupling which is impaired in patients with heart failure (HF). Galectin-3 is a mediator of myocardial fibrosis and remodeling, and is associated with clinical status in patients with chronic HF. We examined the association of arterial stiffness with galectin-3 levels in patients with HF of ischemic etiology. METHODS We consecutively enrolled 40 patients with stable ischemic HF and reduced ejection fraction. Central aortic stiffness was evaluated non-invasively by measuring carotid femoral pulse wave velocity (PWV). Among other factors, serum levels of galectin-3 and b-type natriuretic peptide (BNP) were measured. RESULTS The median galectin-3 levels in our study population were 12.9 (10.8-18.7) ng/ml and the mean PWV was 9.31±2.79 m/sec. There was significant association of galectin-3 levels with age (r=0.48, p=0.003), creatinine clearance (r=-0.66, p<0.001) and BNP levels (r=0.36, p=0.05). There was a significant association of galectin-3 levels with PWV (r=0.37, p=0.03) and patients with PWV above median also had significantly increased levels of galectin-3 compared with patients with lower values of PWV [16.1(11.8-25.2) vs. 12.1(10.5-14) ng/ml, p=0.03]. CONCLUSION We found an association of arterial stiffness and PWV with galectin-3 levels in patients with chronic HF of ischemic etiology. These findings suggest a pathway driving arterial stiffening and myocardial remodelling in HF. This may provide insight into the mechanism determining prognosis and clinical status of patients with HF.
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Affiliation(s)
- Evangelos Oikonomou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Karlis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Sotiris Tsalamadris
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Christina Chrysohoou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Stathis Dimitropoulos
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgios Charalambous
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelia Kouskouni
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Mourouzis K, Oikonomou E, Siasos G, Tsalamadris S, Vogiatzi G, Antonopoulos A, Fountoulakis P, Goliopoulou A, Papaioannou S, Tousoulis D. Pro-inflammatory Cytokines in Acute Coronary Syndromes. Curr Pharm Des 2020; 26:4624-4647. [PMID: 32282296 DOI: 10.2174/1381612826666200413082353] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 12/05/2019] [Accepted: 04/01/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Over the last decades, the role of inflammation and immune system activation in the initiation and progression of coronary artery disease (CAD) has been established. OBJECTIVES The study aimed to present the interplay between cytokines and their actions preceding and shortly after ACS. METHODS We searched in a systemic manner the most relevant articles to the topic of inflammation, cytokines, vulnerable plaque and myocardial infarction in MEDLINE, COCHRANE and EMBASE databases. RESULTS Different classes of cytokines (intereleukin [IL]-1 family, Tumor necrosis factor-alpha (TNF-α) family, chemokines, adipokines, interferons) are implicated in the entire process leading to destabilization of the atherosclerotic plaque, and consequently, to the incidence of myocardial infarction. Especially IL-1 and TNF-α family are involved in inflammatory cell accumulation, vulnerable plaque formation, platelet aggregation, cardiomyocyte apoptosis and adverse remodeling following the myocardial infarction. Several cytokines such as IL-6, adiponectin, interferon-γ, appear with significant prognostic value in ACS patients. Thus, research interest focuses on the modulation of inflammation in ACS to improve clinical outcomes. CONCLUSION Understanding the unique characteristics that accompany each cytokine-cytokine receptor interaction could illuminate the signaling pathways involved in plaque destabilization and indicate future treatment strategies to improve cardiovascular prognosis in ACS patients.
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Affiliation(s)
- Konstantinos Mourouzis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Sotiris Tsalamadris
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Alexios Antonopoulos
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Petros Fountoulakis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athina Goliopoulou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Spyridon Papaioannou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Vogiatzi G, Aznaouridis K, Tolis P, Tsiamis E, Tousoulis D. Jailed in a Bony Prison: Post-tuberculotic Calcific Constrictive Pericarditis. Am J Med Sci 2020; 359:188-189. [PMID: 31787226 DOI: 10.1016/j.amjms.2019.10.013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/13/2019] [Accepted: 10/25/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Georgia Vogiatzi
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece.
| | - Konstantinos Aznaouridis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Panagiotis Tolis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Eleftherios Tsiamis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, Hippokration Hospital, University of Athens Medical School, Athens, Greece
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Oikonomou E, Mourouzis K, Vogiatzi G, Siasos G, Deftereos S, Papaioannou S, Latsios G, Tsalamandris S, Tousoulis D. Coronary Microcirculation and the No-reflow Phenomenon. Curr Pharm Des 2019; 24:2934-2942. [PMID: 30205793 DOI: 10.2174/1381612824666180911122230] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 05/04/2018] [Revised: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 11/22/2022]
Abstract
The no-reflow phenomenon refers to the post-percutaneous coronary intervention condition in which, despite re-establishing epicardial coronary vessel patency, the flow to the previously ischemic myocardium is markedly reduced. When it does occur, it attenuates the beneficial effect of reperfusion therapy and substantial regions of the myocardium fail to receive adequate perfusion. The pathophysiology of this phenomenon is not completely understood. The possible mechanisms could be related to alterations in the microvascular circulation. Various mechanisms such as activation of inflammatory pathways, vascular damage and hemorrhage, leukocyte infiltration, and cellular edema may be responsible. As the no-reflow phenomenon is associated with adverse clinical consequences, it is of great importance to identify exact responsible mechanisms and apply effective preventive and therapeutic strategies. In this review, we describe an updated overview of the pathophysiological mechanisms and the current preventive tools for no-reflow as well as therapeutic interventions in order to improve coronary blood flow and consequently the prognosis for these patients.
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Affiliation(s)
- Evangelos Oikonomou
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Mourouzis
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - Spyridon Deftereos
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - Spyridon Papaioannou
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - George Latsios
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - Sotiris Tsalamandris
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, Greece
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