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Stougiannou TM, Christodoulou KC, Koufakis T, Mitropoulos F, Mikroulis D, Mazer CD, Karangelis D. Progenitor Cell Function and Cardiovascular Remodelling Induced by SGLT2 Inhibitors. FRONT BIOSCI-LANDMRK 2024; 29:145. [PMID: 38682194 DOI: 10.31083/j.fbl2904145] [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: 12/10/2023] [Revised: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 05/01/2024]
Abstract
Sodium-glucose cotransporters 2 (SGLT2) are high-capacity, low-affinity transporters, expressed mainly in the early portion of the proximal renal tube, mediating up to 90% of renal glucose uptake, while SGLT1 receptors are found mainly in the small intestine, facilitating glucose absorption. SGLT2 inhibitors (SGLT2i) originally emerged as agents for the treatment of type 2 diabetes mellitus; however, they soon demonstrated remarkable cardio- and renoprotective actions that led to their licensed use for the treatment of heart failure and chronic kidney disease, regardless of the diabetic status. Cardiovascular remodelling represents an umbrella term that encompasses changes that occur in the cardiovascular system, from the molecular and cellular level, to tissue and organs after local injury, chronic stress, or pressure. SGLT modulation has been shown to positively affect many of these molecular and cellular changes observed during pathological remodelling. Among the different pathophysiological mechanisms that contribute to adverse remodelling, various stem and progenitor cells have been shown to be involved, through alterations in their number or function. Recent studies have examined the effects of SGLT2i on stem and progenitor cell populations and more specifically on endothelial progenitor cells (EPCs). Although some found no significant effect, others showed that SGLT2i can modulate the morphology and function of EPCs. These preliminary observations of the effect of SGLT2i on EPCs may be responsible for some of the beneficial effects of gliflozins on pathological remodelling and, by extension, on cardiovascular disease. The purpose of this narrative review is to critically discuss recent evidence on the cardioprotective effects of SGLT2is, in the context of cardiac remodelling.
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Affiliation(s)
- Theodora M Stougiannou
- Department of Cardiothoracic Surgery, Democritus University of Thrace - University General Hospital, 68100 Alexeandroupolis, Greece
| | - Konstantinos C Christodoulou
- Department of Cardiothoracic Surgery, Democritus University of Thrace - University General Hospital, 68100 Alexeandroupolis, Greece
| | - Theocharis Koufakis
- Second Propaedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Fotios Mitropoulos
- Department of Adult and Congenital Cardiac Surgery, Mitera Hospital, 15123 Marousi, Greece
| | - Dimitrios Mikroulis
- Department of Cardiothoracic Surgery, Democritus University of Thrace - University General Hospital, 68100 Alexeandroupolis, Greece
| | - Cyril David Mazer
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, ON M5B 1W8, Canada
| | - Dimos Karangelis
- Department of Cardiothoracic Surgery, Democritus University of Thrace - University General Hospital, 68100 Alexeandroupolis, Greece
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Stougiannou TM, Christodoulou KC, Dimarakis I, Mikroulis D, Karangelis D. To Repair a Broken Heart: Stem Cells in Ischemic Heart Disease. Curr Issues Mol Biol 2024; 46:2181-2208. [PMID: 38534757 DOI: 10.3390/cimb46030141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
Despite improvements in contemporary medical and surgical therapies, cardiovascular disease (CVD) remains a significant cause of worldwide morbidity and mortality; more specifically, ischemic heart disease (IHD) may affect individuals as young as 20 years old. Typically managed with guideline-directed medical therapy, interventional or surgical methods, the incurred cardiomyocyte loss is not always completely reversible; however, recent research into various stem cell (SC) populations has highlighted their potential for the treatment and perhaps regeneration of injured cardiac tissue, either directly through cellular replacement or indirectly through local paracrine effects. Different stem cell (SC) types have been employed in studies of infarcted myocardium, both in animal models of myocardial infarction (MI) as well as in clinical studies of MI patients, including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), Muse cells, multipotent stem cells such as bone marrow-derived cells, mesenchymal stem cells (MSCs) and cardiac stem and progenitor cells (CSC/CPCs). These have been delivered as is, in the form of cell therapies, or have been used to generate tissue-engineered (TE) constructs with variable results. In this text, we sought to perform a narrative review of experimental and clinical studies employing various stem cells (SC) for the treatment of infarcted myocardium within the last two decades, with an emphasis on therapies administered through thoracic incision or through percutaneous coronary interventions (PCI), to elucidate possible mechanisms of action and therapeutic effects of such cell therapies when employed in a surgical or interventional manner.
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Affiliation(s)
- Theodora M Stougiannou
- Department of Cardiothoracic Surgery, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece
| | - Konstantinos C Christodoulou
- Department of Cardiothoracic Surgery, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece
| | - Ioannis Dimarakis
- Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, WA 98195, USA
| | - Dimitrios Mikroulis
- Department of Cardiothoracic Surgery, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece
| | - Dimos Karangelis
- Department of Cardiothoracic Surgery, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece
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Farmakis IT, Valerio L, Barco S, Christodoulou KC, Ewert R, Giannakoulas G, Held M, Hobohm L, Keller K, Wilkens H, Rosenkranz S, Konstantinides SV. Functional capacity and dyspnea during follow-up after acute pulmonary embolism. J Thromb Haemost 2024; 22:163-171. [PMID: 37652350 DOI: 10.1016/j.jtha.2023.08.024] [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: 04/27/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Dissecting the determinants of functional capacity during long-term follow-up after acute pulmonary embolism (PE) can help to better characterize a patient population with persisting limitation. METHODS In a prospective cohort study, consecutive unselected survivors of acute PE underwent 3- and 12-month follow-up, including six-minute walking distance (6MWD) and dyspnea assessment with the modified Medical Research Council (mMRC) scale. We used reference equations adjusting for age, sex, and anthropometric measurements to define abnormal 6MWD. RESULTS Overall, 323 of 363 (89.0%) patients had at least one recorded 6MWD value at one year. At 3 months, the prevalence of abnormal 6MWD was 21.9% and at 12 months it was 18.3%. At 3 and 12 months, 58.8% and 52.1% with abnormal 6MWD did not report dyspnea, respectively. On average and during follow-up, 6MWD significantly improved with time, while the mMRC dyspnea scale did not. Abnormal 6MWD was associated with younger age (odds ratio per decade, 0.91; 95% CI, 0.88-0.94), higher body mass index (1.10; 1.03-1.17), smoking (3.53; 1.34-9.31), intermediate- or high-risk PE (3.21; 1.21-8.56), and higher mMRC grading (2.28; 1.59-3.27). Abnormal 6MWD at 3 months was associated with the prospectively defined endpoint of post-PE impairment (3.72; 1.50-9.28) and with poor disease-specific and generic health-related quality of life. CONCLUSION Three months after PE, 37% of patients reported dyspnea and 22% had abnormal 6MWD. After a year, 20% still had abnormal 6MWD. Dyspnea correlated with abnormal 6MWD, but over 50% of patients with abnormal 6MWD did not report dyspnea. Abnormal 6MWD predicted subsequent post-pulmonary embolism impairment and worse long-term quality of life. CLINICAL TRIAL REGISTRATION German Clinical Trials Register Identifier DRKS00005939.
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Affiliation(s)
- Ioannis T Farmakis
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. https://twitter.com/itfarmakis
| | - Luca Valerio
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany; Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stefano Barco
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany; Department of Angiology, University Hospital Zurich, Zurich, Switzerland
| | - Konstantinos C Christodoulou
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Ralf Ewert
- Clinic for Internal Medicine, Greifswald University Hospital, Greifswald, Germany
| | - George Giannakoulas
- Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Matthias Held
- Department of Pulmonary Medicine, KWM Missio Clinic, Würzburg, Germany
| | - Lukas Hobohm
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany; Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Karsten Keller
- Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany; Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Heinrike Wilkens
- Department of Pneumology, Allergology and Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | - Stephan Rosenkranz
- Department of Cardiology, Heart Center at the University Hospital Cologne, and Cologne Cardiovascular Research Center, Cologne, Germany
| | - Stavros V Konstantinides
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany; Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece.
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Rigatou A, Christodoulou KC, Zlatidou X, Nikolakakis I. Dextrocardia With Situs Inversus in a COVID-19 Patient. Cureus 2024; 16:e52219. [PMID: 38347982 PMCID: PMC10861161 DOI: 10.7759/cureus.52219] [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] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
With an estimated incidence of one in 10,000 to one in 50,000 patients, Situs inversus totalis (SIT) is a rare innate anomaly, portraying a mirror image of the normal anatomy, as the cardiac position and abdominal viscera are completely inverted. Despite the fact that physicians and researchers have been dealing with the SARS-CoV-2 pandemic for three years, there is a lack of published data examining the potential effects of anatomic variations on coronavirus disease 2019 (COVID-19) infection. This study aimed to contribute to this domain by presenting a rare case of a COVID-19 infection coexisting with SIT as one of the very few cases reporting the simultaneous presence of the two pathologies. We sought to present this case of COVID-19 in a quinquagenarian female, in whom SIT was an incidental radiological finding. The reversed anatomy did not seem to affect the clinical progression of the virus. However, due to the lack of scientific evidence, the potential long-term effects, if any, of COVID-19 on SIT cannot be predicted. The recognition of the mirror pattern will offer a personalized treatment plan, reducing the risk of severe complications and management mishaps.
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Affiliation(s)
- Anastasia Rigatou
- Computed Tomography and MRI Department, Sismanogleio General Hospital, Athens, GRC
| | | | - Xafnoula Zlatidou
- Computed Tomography and MRI Department, Sismanogleio General Hospital, Athens, GRC
| | - Ioannis Nikolakakis
- Emergency Medicine, Tzaneio Prefecture General Hospital of Piraeus, Athens, GRC
- History of Medicine and Medical Ethics Department, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
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Vlahodimitris I, Karangelis D, Moschaki M, Moyssakis I, Christodoulou KC, Perrea DN, Mourouzis I, Papadogiannis D. Cardiotrophin-1 in Asymptomatic Hypertensive Patients With Mild Diastolic Dysfunction: Potential Prognostic Value in Early Stages of Hypertensive Heart Disease. Cureus 2023; 15:e46516. [PMID: 37927758 PMCID: PMC10625173 DOI: 10.7759/cureus.46516] [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] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Regardless of the advancements in modern technology and treatment options, heart failure (HF) exhibits impervious mortality and morbidity rates. Arterial hypertension poses one of the greatest risks for developing HF, yet the exact pathophysiological path and changes that lead from isolated hypertension to HF are still unclear. Cardiotrophin-1 (CT-1) serves as a promising prognostic biomarker for the onset of HF in hypertensive patients. The aim of this study was to investigate whether CT-1 levels are elevated in a selected group of asymptomatic hypertensive patients. METHODS In a selected cohort of 40 asymptomatic patients with early diastolic dysfunction (grade I), without any signs of increased filling pressures in the left ventricle, as well as 20 healthy individuals, the levels of CT-1 brain natriuretic peptide (BNP) along with various echocardiographic parameters were evaluated. RESULTS The mean age of the hypertensive patients was 56 ± 5 years and 52± 3.5 years for the normotensive controls. The hypertensive group exhibited higher levels of CT-1, which was not affected by left ventricular hypertrophy. Notably, in patients with normal E/E' < 8 (n = 30), CT-1 levels were 1165 ± 471 pg/ml compared to 2069 ± 576 pg/ml in patients with marginal E/E' > 8 and <14 (n = 10), p = 0.001. CONCLUSIONS Our study demonstrated elevated CT-1 levels in a cohort of asymptomatic hypertensive patients, exhibiting mild diastolic dysfunction. These findings are suggestive of the potentially prognostic value of this particular biomarker in the early stages of hypertensive heart disease.
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Affiliation(s)
| | - Dimos Karangelis
- Cardiothoracic Surgery, Democritus University of Thrace, Alexandroupolis, GRC
| | - Maria Moschaki
- Anesthesia, Evangelismos Hospital of Athens, Athens, GRC
| | | | | | - Despoina N Perrea
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Iordanis Mourouzis
- Pharmacology, National and Kapodistrian University of Athens, Athens, GRC
| | - Dimitrios Papadogiannis
- First Department of Propaedeutic Medicine, Laiko General Hospital of Athens, National and Kapodistrian University of Athens, Athens, GRC
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Stougiannou TM, Christodoulou KC, Georgakarakos E, Mikroulis D, Karangelis D. Promising Novel Therapies in the Treatment of Aortic and Visceral Aneurysms. J Clin Med 2023; 12:5878. [PMID: 37762818 PMCID: PMC10531975 DOI: 10.3390/jcm12185878] [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: 07/19/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Aortic and visceral aneurysms affect large arterial vessels, including the thoracic and abdominal aorta, as well as visceral arterial branches, such as the splenic, hepatic, and mesenteric arteries, respectively. Although these clinical entities have not been equally researched, it seems that they might share certain common pathophysiological changes and molecular mechanisms. The yet limited published data, with regard to newly designed, novel therapies, could serve as a nidus for the evaluation and potential implementation of such treatments in large artery aneurysms. In both animal models and clinical trials, various novel treatments have been employed in an attempt to not only reduce the complications of the already implemented modalities, through manufacturing of more durable materials, but also to regenerate or replace affected tissues themselves. Cellular populations like stem and differentiated vascular cell types, large diameter tissue-engineered vascular grafts (TEVGs), and various molecules and biological factors that might target aspects of the pathophysiological process, including cell-adhesion stabilizers, metalloproteinase inhibitors, and miRNAs, could potentially contribute significantly to the treatment of these types of aneurysms. In this narrative review, we sought to collect and present relevant evidence in the literature, in an effort to unveil promising biological therapies, possibly applicable to the treatment of aortic aneurysms, both thoracic and abdominal, as well as visceral aneurysms.
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Affiliation(s)
- Theodora M. Stougiannou
- Department of Cardiothoracic Surgery, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece; (K.C.C.); (E.G.); (D.M.); (D.K.)
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Christodoulou KC, Tsoucalas G. Artificial Intelligence-Oriented Heart Surgery: A Complex Bioethical Concept. Cureus 2023; 15:e41911. [PMID: 37588312 PMCID: PMC10425603 DOI: 10.7759/cureus.41911] [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] [Accepted: 07/13/2023] [Indexed: 08/18/2023] Open
Abstract
Artificial intelligence (AI) has come to the frontline, paving the way toward a future of operational efficiency. Following the current, cardiac surgery has evolved as well. We live in a world where AI has brought immense progress in almost every aspect of the field, but still, the question remains; will there be a time when robots will replace cardiac surgeons? The currently used operating systems necessitate constant supervision. Upgrading the algorithms from visual augmentation and post-operative prognosis to completely operating software is not something to be taken lightly. However, if we manage to succeed, would you be receptive to a fully autonomous robot as your surgeon? Significant barriers concerning bioethics emerge; the potential for misuse, risk assessment, supervision, referrals, the need to respect and protect patient autonomy and transparency while using the algorithms, and above all the understanding of the dynamics of illness and the human condition. So, can we provide a simple response to such a prime issue? The truth is, we cannot provide an answer for the future where an answer cannot be delivered effortlessly.
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Affiliation(s)
- Konstantinos C Christodoulou
- Department of Cardiac Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, GRC
| | - Gregory Tsoucalas
- Department of History of Medicine and Medical Deontology, School of Medicine, University of Crete, Heraklion, GRC
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Christodoulou KC, Stakos D, Androutsopoulou V, Chourmouzi-Papadopoulou M, Tsoucalas G, Karangelis D, Fiska A. Vieussens' Arterial Ring: Historical Background, Medical Review and Novel Anatomical Classification. Cureus 2023; 15:e40960. [PMID: 37378305 PMCID: PMC10291275 DOI: 10.7759/cureus.40960] [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] [Accepted: 06/25/2023] [Indexed: 06/29/2023] Open
Abstract
In coronary artery disease, the presence of Vieussens' arterial ring (VAR), a ring-shaped anastomosis between the conus branch of the right coronary artery with the left anterior descending artery (LAD), will allow blood flow to return to the obstructed coronary system. We have conducted a literature review, aiming to collect all the existing information about the documented VAR cases and any related pathological conditions. A total of 54 studies entered the review, including 56 patients. The mean age of the patients was 56.12 ± 16.2 years. Angina was present in 53.6% of the patients, with 7.2% of the cases being asymptomatic. Coronary artery disease outweighed (58.9%) as the patients' most frequent diagnosis. We propose a novel VAR anatomical classification, based on the sites of origin and termination of its course, with six distinct types, for a better understanding and surgical management of VAR. Type IA, originating from the conus branch and terminating in the proximal segment of the LAD was most frequently reported (51.8%). The recognition and the subsequent evaluation of the ring's anatomy and course are crucial for a customized clinical intervention. When right and left coronary angiographies fail to reveal any collateral circulation, selective conus artery catheterization should be in order. The proposed classification offers a manageable and comprehensive context for the assessment, evaluation and planning of therapeutic strategies of VAR and sets a new terminology frame for treatment guidelines.
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Affiliation(s)
- Konstantinos C Christodoulou
- Laboratory of Anatomy, School of Medicine, Democritus University of Thrace, Alexandroupolis, GRC
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Dimitrios Stakos
- Department of Cardiology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Vassiliki Androutsopoulou
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | | | - Gregory Tsoucalas
- Department of History of Medicine and Medical Deontology, School of Medicine, University of Crete, Heraklion, GRC
| | - Dimos Karangelis
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | - Aliki Fiska
- Laboratory of Anatomy, School of Medicine, Democritus University of Thrace, Alexandroupolis, GRC
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Christodoulou KC, Karangelis D, Efenti GM, Sdrevanos P, Browning JR, Konstantinou F, Georgakarakos E, Mitropoulos FA, Mikroulis D. Current knowledge and contemporary management of non-A non-B aortic dissections. World J Cardiol 2023; 15:244-252. [PMID: 37274377 PMCID: PMC10237007 DOI: 10.4330/wjc.v15.i5.244] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/10/2023] [Accepted: 04/25/2023] [Indexed: 05/19/2023] Open
Abstract
Non-A non-B aortic dissection (AAD) is an infrequently documented condition, comprising of only a small proportion of all AADs. The unique anatomy of the aortic arch and the failure of the existing classifications to adequately define individuals with non-A non-B AAD, have led to an ongoing controversy around the topic. It seems that the clinical progression of acute non-A non-B AAD diverges from the typical type A and B dissections, frequently leading to serious complications and thus mandating early intervention. Currently, the available treatment methods in the surgical armamentarium are conventional open, endovascular techniques and combined hybrid methods. The optimum approach is tailored in every individual case and may be determined by the dissection’s location, extent, the aortic diameter, the associated complications and the patient’s status. The management of non-A non-B dissections still remains challenging and a unanimous consensus defining the gold standard treatment has yet to be reached. In an attempt to provide further insight into this perplexing entity, we performed a minireview of the literature, aiming to elucidate the epidemiology, clinical course and the optimal treatment modality.
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Affiliation(s)
- Konstantinos C Christodoulou
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
| | - Dimos Karangelis
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
| | | | | | - Jennifer R Browning
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
| | - Fotis Konstantinou
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
| | - Efstratios Georgakarakos
- Department of Vascular Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | | | - Dimitrios Mikroulis
- Department of Cardiac Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis 68100, Greece
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Kakagia DD, Christodoulou KC, Noulas CN, Stouras I, Fiska A. A Linear Waxy Verrucous Plaque of the Scalp. Cureus 2023; 15:e37881. [PMID: 37223135 PMCID: PMC10202673 DOI: 10.7759/cureus.37881] [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] [Accepted: 04/20/2023] [Indexed: 05/25/2023] Open
Abstract
Nevus sebaceous of Jadassohn (NSJ) is an inborn, cutaneous hamartoma that is presented as a round-oval, or linear, yellowish-orange hairless plaque with an excess of sebaceous glands, typically localized to the head or neck. NSJ disease progresses slowly in three general stages. Due to its embryological origin, it yields an already documented potential for a variety of epidermal and adnexal tumors. The incidence of secondary neoplasms within NSJ is 10-30%, and the risk of neoplastic transformation increases with age. The majority of neoplasms are benign. Regarding malignant tumors, NSJ is usually associated with basal cell carcinoma. All neoplasms are typically encountered in long-standing lesions. Owing to NSJ's ample variety of associations with neoplasms, its management demands a case-driven tailored treatment. We present the case of a 34-year-old female with NSJ.
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Affiliation(s)
- Despoina D Kakagia
- Department of Plastic Surgery, Democritus University of Thrace, Alexandroupolis, GRC
| | | | - Christos N Noulas
- First Department of Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, GRC
| | - Ioannis Stouras
- Medical School, National and Kapodistrian University of Athens, Athens, GRC
| | - Aliki Fiska
- Laboratory of Anatomy, School of Medicine, Democritus University of Thrace, Alexandroupolis, GRC
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11
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Karangelis D, Alexiou C, Christodoulou KC, Gerontitis Z, Mikroulis D. Giant aneurysm of the circumflex artery. Clin Case Rep 2022; 10:e6521. [PMID: 36408086 PMCID: PMC9669490 DOI: 10.1002/ccr3.6521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/18/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022] Open
Abstract
In this paper, we describe a rare case of a giant aneurysm of the circumflex artery that we managed. A 59‐year‐old female patient presented in cardiogenic shock after partial aneurysm rupture. Giant aneurysms of the circumflex artery are extremely rare entities. The optimal surgical management dictates meticulous preoperative planning and the operation should be carried out on an elective basis. Surgery for giant coronary aneurysms is a challenge. It should be carried out electively to allow detailed imaging and meticulous preoperative planning. Acute cardiac tamponade caused by spontaneous aneurysm rupture carries significant mortality.
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Affiliation(s)
- Dimos Karangelis
- Department of Cardiac Surgery Democritus University of Thrace, University Hospital of Alexandroupolis Alexandroupolis Greece
| | - Christos Alexiou
- Department of Cardiac Surgery Mediterraneo Hospital Glyfada Greece
| | - Konstantinos C. Christodoulou
- Department of Cardiac Surgery Democritus University of Thrace, University Hospital of Alexandroupolis Alexandroupolis Greece
| | - Zisis Gerontitis
- Department of Cardiac Surgery Democritus University of Thrace, University Hospital of Alexandroupolis Alexandroupolis Greece
| | - Dimitrios Mikroulis
- Department of Cardiac Surgery Democritus University of Thrace, University Hospital of Alexandroupolis Alexandroupolis Greece
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