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Sokou R, Georgiadou P, Tsantes AG, Parastatidou S, Konstantinidi A, Ioakeimidis G, Makrogianni A, Theodoraki M, Kokoris S, Iacovidou N, Kriebardis AG, Piovani D, Bonovas S, Tsantes AE. The Utility of NATEM Assay in Predicting Bleeding Risk in Critically Ill Neonates. Semin Thromb Hemost 2023; 49:182-191. [PMID: 36055275 DOI: 10.1055/s-0042-1753513] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We aimed to investigate the hemostatic status of diseased neonates using nonactivated rotational thromboelastometry (ROTEM) assay (NATEM) assay and, in addition, to evaluate the discriminative power of NATEM parameters in predicting the risk of bleeding in critically ill neonates and compare it to that of EXTEM (extrinsically activated ROTEM) parameters. This cohort study included 158 consecutive, critically ill neonates with presumed sepsis, perinatal hypoxia, or respiratory distress syndrome. The EXTEM and NATEM assays were performed on the first day of disease onset. The neonatal bleeding assessment tool was used to record and assess clinical bleeding events on the day of ROTEM analysis. Several EXTEM and NATEM ROTEM parameters differed between neonates with and without clinical bleeding events, indicating a hypo-coagulable state in neonates with clinical bleeding. NATEM parameters had comparable predictive performance for clinical bleeding events with EXTEM parameters for clotting time, clot formation time (CFT), A10 (clot amplitude at 10minutes), maximum clot firmness, lysis index at 60minutes, and maximum clot elasticity (p>0.05). However, NATEM A20, A30, and α angle demonstrated better predictive ability than EXTEM A20, A30, and α angle, respectively (p<0.05). A NATEM CFT value ≥147seconds presented 95.2% sensitivity (95% confidence interval [CI]: 76.1-99.8%) and 65.6% specificity (95% CI: 57.1-73.5%) to detect neonates with clinical bleeding, while a NATEM A10 value ≤42mm had 80.8% sensitivity (95% CI: 71.8-85.9%) and 76.0% specificity (95% CI: 52.8-91.7%) to detect neonates with clinical bleeding events. The NATEM assay has shown remarkable sensitivity in predicting bleeding in critically ill neonates, exceeding EXTEM performance in some selected parameters. The incorporation of NATEM test parameters in predictive models for neonatal hemorrhage seems promising.
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Affiliation(s)
- Rozeta Sokou
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece
| | - Petroula Georgiadou
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece
| | - Andreas G Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula Parastatidou
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece
| | | | - Georgios Ioakeimidis
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece
| | - Athanasia Makrogianni
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece
| | - Martha Theodoraki
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece
| | - Styliani Kokoris
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nicoletta Iacovidou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios G Kriebardis
- Laboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Egaleo, Athens, Greece
| | - Daniele Piovani
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IRCCS Humanitas Research Hospital, Milan, Italy
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IRCCS Humanitas Research Hospital, Milan, Italy
| | - Argirios E Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Bonios M, Armenis I, Kogerakis N, Thodou A, Fragkoulis S, Gkouziouta A, Leontiadis E, Vartela V, Georgiadou P, Zarkalis D, Tsiapras D, Koliopoulou A, Chamogeorgakis T, Drakos S, Adamopoulos S. The effect of prolonged Intraaortic ballon pump (IABP) support on right ventricular function in end-stage heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0943] [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
Right Ventricular (RV) function has prognostic implications in end-stage heart failure (ESHF) patients. RV failure following Left Ventricular Assist Device (LVAD) implantation increases morbidity and mortality. Achieving optimal RV function before LVAD implantation is of paramount importance.
Purpose
Purpose was to investigate the effect of Intra-aortic Balloon Pump (IABP) on RV function optimization in patients with bi-ventricular ESHF.
Methods
ESHF patients with poor RV function, presenting with acutely decompensated heart failure resistant to inotropes/vasopressors, thus requiring IABP for stabilization, were prospectively enrolled. Serum biochemistry, echocardiography and invasive hemodynamics were applied and eligibility for LVAD according to RV function was determined on the basis of pre-specified criteria (Right atrium Pressure (RAP) <12mmHg, Pulmonary Artery Pulsatility index (PAPi) >1.85, RAP/Pulmonary Capillary Wedge Pressure (PCWP) <0.67, RV strain <−14%). LV and RV tissue was harvested during LVAD or bi-ventricular mechanical circulatory implantation or at the time of heart transplantation. Fibrosis of the myocardial tissue was quantified.
Results
Sixteen patients aged 38±14 years were enrolled. Duration of IABP support was 62±50 (3–180) days. Three patients deteriorated requiring additional mechanical circulatory support. Two patients were stabilized without RV function improvement. In the remaining 11 patients, RV improved and fulfilled LVAD eligibility criteria (IABP responders); RA and RA/PCWP decreased from 18±6 to 10±4mmHg (p=0.0001) and from 0.60±0.19 to 0.42±0.11 (p=0.011) respectively. PAPi and RV strain improved from 1.46±0.65 to 3.20±0.58 (p=0.0001) and from −12.9±3.4% to −18.7±1.7% (p=0.0001) respectively. Significantly lower baseline NTproBNP and total bilirubin values were observed in the responders group. Six patients finally received LVAD and none suffered RV failure post-operatively (the remaining 5 were successfully transplanted). RV fibrosis correlated with post-IABP NTproBNP (r=0.91, p=0.001), total bilirubin (r=0.79, p=0.011), RAP (r=0.78, p=0.014), PAPi (r=−0.69, p=0.040), RAP/PCWP (r=0.74, p=0.022) and LV fibrosis (r=0.77, p=0.016), but not with baseline (pre-IABP) parameters.
Conclusions
Prolonged IABP support contributes to partial RV function recovery in patients with ESHF and bi-ventricular failure, thus leading to eligibility for LVAD implantation. RV fibrosis may predict RV response to IABP and post-IABP eligibility for LVAD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M.J Bonios
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - I Armenis
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - N Kogerakis
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - A Thodou
- University of Utah Health Care, Division of Cardiovascular Medicine, Salt Lake City, United States of America
| | - S Fragkoulis
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - A Gkouziouta
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - E Leontiadis
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - V Vartela
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - P Georgiadou
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - D Zarkalis
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - D Tsiapras
- Onassis Cardiac Surgery Center, Department of Noninvasive Diagnostics, Athens, Greece
| | - A Koliopoulou
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - T Chamogeorgakis
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
| | - S.G Drakos
- University of Utah Health Care, Division of Cardiovascular Medicine, Salt Lake City, United States of America
| | - S Adamopoulos
- Onassis Cardiac Surgery Center, Department of Heart Failure and Transplantation, Athens, Greece
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Gkantseva-Patsoura S, Katsaras G, Georgiadou P, Lainakis N, Liovarou E, Theofanopoulos R, Theodoraki M. Idiopathic scrotal hematoma in a neonate. Ger Med Sci 2021; 19:Doc01. [PMID: 33642965 PMCID: PMC7894276 DOI: 10.3205/000288] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Neonatal scrotal hematoma is considered a surgical emergency in the neonatal period. Up to recently, immediate surgical exploration was considered the gold standard for the diagnosis and treatment in the underlying causes. Objective: In this article, we present a case of idiopathic scrotal hematoma in a neonate. Method: It was managed conservatively with clinical and ultrasonographic follow-up. Result: The hematoma had gradually subsided, and any surgical intervention was avoided to the neonate. Conclusion: With good clinical and imaging follow-up, some cases could be managed nonoperatively.
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Affiliation(s)
| | - George Katsaras
- Paediatric Department, General Hospital of Pella - Hospital Unit of Edessa, Greece
| | - Petroula Georgiadou
- Neonatal Intensive Care Unit, General State Hospital of Nikaia "Agios Panteleimon", Piraeus, Greece
| | - Nikolaos Lainakis
- Paediatric Surgery Department, General State Hospital of Nikaia "Agios Panteleimon", Piraeus, Greece
| | - Eirini Liovarou
- Radiology Department, General State Hospital of Nikaia "Agios Panteleimon", Piraeus, Greece
| | - Rita Theofanopoulos
- Neonatal Intensive Care Unit, General State Hospital of Nikaia "Agios Panteleimon", Piraeus, Greece
| | - Martha Theodoraki
- Neonatal Intensive Care Unit, General State Hospital of Nikaia "Agios Panteleimon", Piraeus, Greece
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Theodoraki M, Sokou R, Valsami S, Iliodromiti Z, Pouliakis A, Parastatidou S, Karavana G, Ioakeimidis G, Georgiadou P, Iacovidou N, Boutsikou T. Reference Values of Thrombolastometry Parameters in Healthy Term Neonates. Children (Basel) 2020; 7:children7120259. [PMID: 33256197 PMCID: PMC7759895 DOI: 10.3390/children7120259] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/22/2020] [Accepted: 11/24/2020] [Indexed: 12/02/2022]
Abstract
Background: Thromboelastometry (ROTEM), as a point of care test, is an attractive tool for rapid evaluation of hemostasis. Currently, no reference ranges exist for all ROTEM assays in neonates, limiting its use in this vulnerable population. The aim of the present study was: (1) to establish reference ranges for standard extrinsically activated (EXTEM), intrinsically activated (INTEM), and fibrinogen polymerization (FIBTEM) ROTEM assays in whole blood samples of healthy term neonates; (2) to determine the impact of gender, delivery mode, and hematocrit on ROTEM parameters. Methods: EXTEM, INTEM, and FIBTEM ROTEM assays were performed simultaneously with complete blood count in 215 healthy term neonates. Results: Reference ranges (2.5th and 97.5th percentiles) were obtained for clotting time (CT), clot formation time (CFT), α-angle, clot firmness at 10 min (A10), maximum clot firmness (MCF), and lysis index at 60 min (LI60, %). Reference ranges for EXTEM were CT 38–78 s, CFT 49–148 s, A10 40–65 mm, and MCF 47–69 mm, LI60 83–98%. For INTEM, CT 134–270 s, CFT 50–142 s, A10 41–63 mm, and MCF 48–67 mm, LI60 85–97%, and finally, for FIBTEM: CT 36–85 s, A10 9–25 mm and MCF 10–26 mm, LI60 92–100%. Hematocrit values were positively correlated with CT, CFT and negatively with A10, MCF values. Conclusion: This study provides, for the first time, reference ranges for ROTEM EXTEM/INTEM/FIBTEM values simultaneously in healthy term neonates. The combined evaluation of ROTEM tests increases its diagnostic accuracy, contributing to the expansion of ROTEM use in the neonatal population.
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Affiliation(s)
- Martha Theodoraki
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikaia, 184 54 Piraeus, Greece; (M.T.); (S.P.); (G.K.); (G.I.); (P.G.)
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikaia, 184 54 Piraeus, Greece; (M.T.); (S.P.); (G.K.); (G.I.); (P.G.)
- Correspondence:
| | - Serena Valsami
- Hematology Laboratory-Blood Bank, Aretaieio Hospital, National and Kapodistrian University of Athens, 157 72 Athens, Greece;
| | - Zoi Iliodromiti
- Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, 157 72 Athens, Greece; (Z.I.); (N.I.); (T.B.)
| | - Abraham Pouliakis
- 2nd Department of Pathology, National and Kapodistrian University of Athens Medical School, University General Hospital Attikon, 124 62 Haidari, Greece;
| | - Stavroula Parastatidou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikaia, 184 54 Piraeus, Greece; (M.T.); (S.P.); (G.K.); (G.I.); (P.G.)
| | - Georgia Karavana
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikaia, 184 54 Piraeus, Greece; (M.T.); (S.P.); (G.K.); (G.I.); (P.G.)
| | - Georgios Ioakeimidis
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikaia, 184 54 Piraeus, Greece; (M.T.); (S.P.); (G.K.); (G.I.); (P.G.)
| | - Petroula Georgiadou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikaia, 184 54 Piraeus, Greece; (M.T.); (S.P.); (G.K.); (G.I.); (P.G.)
| | - Nicoletta Iacovidou
- Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, 157 72 Athens, Greece; (Z.I.); (N.I.); (T.B.)
| | - Theodora Boutsikou
- Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, 157 72 Athens, Greece; (Z.I.); (N.I.); (T.B.)
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Sbarouni E, Georgiadou P, Manavi M, Analitis A, Beletsioti C, Niakas D, Iliodromitis E, Voudris V. P5598Long term outcome and quality of life following acute type A aortic dissection. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0542] [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
Introduction
Acute aortic dissection (AAD) represents surgical emergency and current literature mainly consists of postoperative outcome reports. Long term outcome and quality of life have not extensively been investigated.
Purpose
This is a single center study to assess long term outcome and quality of life of patients who underwent emergency surgery for AAD.
Methods
From January 2007 until December 2009, 74 consecutive patients were operated for AAD type A in our hospital. Seventeen died during hospital stay and 12 died during follow-up. Mean follow up was 108±10 months. Seventeen patients refused to answer the SF-36 questionnaire; therefore our study group consists of 28 patients. The SF-36 Questionnaire was retrospectively obtained by phone calls, the first, fifth and tenth postoperative year and 2 summary scores are reported, physical (PCS) and mental (MCS).
Results
Our in-hospital mortality was 23%, late mortality 21.1% and the overall mortality was 39.2%. Significant differences in both physical and mental score over time were found among the 28 long-term survivors (Table). Both PCS and MCS at 1st, 5th and 10th year did not differ compared to age-matched general population but compared to subjects with one or more chronic diseases both PCS and MCS were both significantly better at 5yrs in our patients vs controls (p=0.0028 and p=0.0259, respectively). Likewise, at 5 years PCS but not MCS was better in comparison to subjects with a history of one hospitalization the preceding year (p=0.035 and p=0.1, respectively).
Descriptive statistics of physical and mental component summary score over time Score 1 year (FU1) 5 years (FU2) 10 years (FU3) p-value Mean (SD) Mean (SD) Mean (SD) PCS 45.4 (7.7) 50.3 (7.0) 46.8 (9.2) 0.008* MCS 42.8 (15.1) 49.7 (12.7) 49.1 (12.3) 0.001** PCS, Physical component summary; *1 vs 5: p=0.003, 1 vs 10: p=0.469, 5 vs 10: p=0.027. MCS, Mental component summary; **1 vs 5: p=0.001, 1 vs 10: p=0.001, 5 vs 10: p=0.939. SD, standard deviation.
Conclusion
Quality of life improves after the 1st post-operative year and is comparable to healthy subjects. Although acute dissection is a catastrophic event with high mortality despite successful and timely repair, long term survival and quality of life on the long term are favorable.
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Affiliation(s)
- E Sbarouni
- Onassis Cardiac Surgery Center, 2nd Division of Interventional Cardiology, Athens, Greece
| | - P Georgiadou
- Onassis Cardiac Surgery Center, 2nd Division of Interventional Cardiology, Athens, Greece
| | - M Manavi
- Onassis Cardiac Surgery Center, 2nd Division of Interventional Cardiology, Athens, Greece
| | - A Analitis
- University of Athens, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, Athens, Greece
| | - C Beletsioti
- National & Kapodistrian University of Athens, Medical School, Athens, Greece
| | - D Niakas
- National & Kapodistrian University of Athens, Medical School, Athens, Greece
| | - E Iliodromitis
- Attikon University Hospital, Cardiology Department, Athens, Greece
| | - V Voudris
- Onassis Cardiac Surgery Center, 2nd Division of Interventional Cardiology, Athens, Greece
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Kosmas I, Iakovou I, Leontiadis E, Sbarouni E, Georgiadou P, Bousoula E, Aravanis N, Stratinaki M, Voudris V, Mpalanika M. The first transcatheter valve-in-valve implantation of a self-expandable valve for the treatment of a degenerated sutureless aortic bioprosthesis. Hellenic J Cardiol 2019; 61:49-50. [PMID: 31039413 DOI: 10.1016/j.hjc.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/05/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- I Kosmas
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece.
| | - I Iakovou
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Leontiadis
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Sbarouni
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - P Georgiadou
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - E Bousoula
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - N Aravanis
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - M Stratinaki
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - V Voudris
- Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Greece
| | - M Mpalanika
- Department of Anaesthesiology, Onassis Cardiac Surgery Center, Greece
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Chatzikyriakou S, Georgiadou P, Malakos J, Doulas N, Kousi T, Voudris V. A successful percutaneous removal of a ruptured and detached intra-aortic balloon pump with vascular entrapment. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht312.1704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pavlidis AN, Malakos JS, Karavolias GK, Sbarouni E, Georgiadou P, Mastorakou I, Voudris VV. Left main coronary artery aneurysm. Herz 2012; 37:565-6. [PMID: 22407421 DOI: 10.1007/s00059-011-3570-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 11/20/2011] [Indexed: 11/29/2022]
Abstract
Left main coronary artery aneurysms (LMCA) are usually asymptomatic and are rarely encountered during coronary angiography. The most serious complications include coronary thrombosis, acute myocardial infarction and sudden death. Atherosclerosis is the most common cause, although several autoimmune diseases and congenital abnormalities have been associated with the presence of coronary aneurysms. The case of a symptom-free 63-year-old man with a giant LMCA and severely ectatic coronary arteries is presented.
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Affiliation(s)
- A N Pavlidis
- 2nd Department of Cardiology, Onassis Cardiac Surgery Centre, Sygrou Avenue, 17674, Athens, Greece.
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Georgiadou P, Sbarouni E, Malakos J, Theodorakis GN. Angiographicde novoappearance of a myocardial bridge after successful percutaneous transluminal coronary angioplasty. ACTA ACUST UNITED AC 2009; 10:236-7. [DOI: 10.1080/17482940801975135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Georgiadou P, Iliodromitis EK, Kolokathis F, Mavroidis M, Andreadou I, Demopoulou M, Varounis C, Capetanaki Y, Boudoulas H, Kremastinos DT. Plasma levels of osteopontin before and 24 h after percutaneous coronary intervention. Expert Opin Ther Targets 2008; 12:1477-80. [DOI: 10.1517/14728220802510740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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11
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Georgiadou P, Iliodromitis EK, Varounis C, Mavroidis M, Kolokathis F, Andreadou I, Psarras S, Capetanaki Y, Boudoulas H, Kremastinos DT. Relationship between plasma osteopontin and oxidative stress in patients with coronary artery disease. Expert Opin Ther Targets 2008; 12:917-20. [PMID: 18620515 DOI: 10.1517/14728222.12.8.917] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND It is known that oxidative stress plays an important role in the pathogenesis of atherosclerosis and that an association exists between osteopontin (OPN) and atherosclerosis. OBJECTIVES It was proposed that malondialdehyde (MDA), a biomarker of lipid peroxidation and oxidative stress, would be related to plasma OPN levels in patients with coronary artery disease (CAD). METHODS/RESULTS Plasma OPN and MDA levels were measured in 71 patients (60 males and 11 females; mean age 61.7 +/- 10 years). Fifty-eight patients had significant CAD (group I) and 13 patients were free of CAD as defined angiographically (group II). Plasma OPN was measured by enzyme-linked immunosorbent assay (ELISA), while MDA was determined spectrophotometrically. Multivariate regression analysis revealed that ln-transformed OPN levels were independently associated with MDA after adjustment for age, hypertension and diabetes mellitus (R(2) = 0.278, p = 0.0004 and beta regression coefficient = 0.252 [standard error = 0.0958], p = 0.011). OPN and MDA levels were higher in patients with diabetes (73.6 +/- 36.2 ng/ml versus 56.1 +/- 30.9 ng/ml, p = 0.02 and 2.5 +/- 0.5 microM versus 2.0 +/- 0.5 microM, p = 0.002, respectively). CONCLUSIONS The association between OPN and MDA levels in patients with CAD suggests an interaction between OPN and oxidative stress. This interaction may play a role in the pathogenesis of atherosclerosis.
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Affiliation(s)
- P Georgiadou
- University of Athens, Second University Department of Cardiology, Medical School, Attikon General Hospital, 1 Rimini Street 124 62, Athens, Greece.
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12
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Sbarouni E, Georgiadou P, Theodorakis G, Kremastinos D. PO19-585 THE ISCHEMIA MODIFIED ALBUMIN IN RELATION TO EXERCISE STRESS TESTING. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Georgiadou P, Iliodromitis EK, Theodorakis GN, Kremastinos DT. Quinidine ceases electrical storm in an ablated patient with an implantable cardioverter–defibrillator: An old lady in the modern era. Int J Cardiol 2006; 113:129-31. [PMID: 16318889 DOI: 10.1016/j.ijcard.2005.08.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2005] [Revised: 08/26/2005] [Accepted: 08/29/2005] [Indexed: 11/30/2022]
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14
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Georgiadou P, Sbarouni E, Kremastinos DT. Midventricular hypertrophic cardiomyopathy coexistent with anomalous origin of circumflex artery. Int J Cardiol 2006; 110:102-3. [PMID: 15993500 DOI: 10.1016/j.ijcard.2005.05.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 05/21/2005] [Indexed: 10/25/2022]
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Mundy HR, Georgiadou P, Davies LC, Cousins A, Leonard JV, Lee PJ. Exercise capacity and biochemical profile during exercise in patients with glycogen storage disease type I. J Clin Endocrinol Metab 2005; 90:2675-80. [PMID: 15671110 DOI: 10.1210/jc.2004-0890] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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] [Indexed: 02/12/2023]
Abstract
Glycogen storage disease type I (GSD-I) is an inherited disorder of carbohydrate metabolism. Hepatic glucose-6-phosphatase is deficient, leading to impaired gluconeogenesis and glycogenolysis. Patients prevent fasting hypoglycemia by frequent feeds of low glycemic index foods. Normal muscle does not contain glucose-6-phosphatase, and GSD-I is usually classified as a hepatic glycogenosis. However, clinical experience has suggested that patients have decreased cardiovascular fitness, but this had not been formally investigated. This paper reports the results of maximal treadmill cardiopulmonary exercise testing in adult patients with GSD-I. It documents a major reduction in exercise capacity in these patients and demonstrates biochemical aspects of exercise that are different from those of normal controls. All patients showed a reduction in exercise capacity, but there was a wide range of exercise tolerance. Additional work needs to address whether improved adherence to or intensification of therapy in adulthood will ameliorate exercise intolerance.
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Affiliation(s)
- H R Mundy
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom
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Georgiadou P, Babu-Narayan SV, Francis DP, Kremastinos DT, Gatzoulis MA. Periodic breathing as a feature of right heart failure in congenital heart disease. Heart 2004; 90:1075-6. [PMID: 15310713 PMCID: PMC1768429 DOI: 10.1136/hrt.2003.025221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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