Hellenic Journal of Cardiology最新文献

{"title":"Acute effectiveness and safety of the different mitral isthmus lines in the treatment of perimitral flutter with radiofrequency ablation.","authors":"Athanasios Ziakos, Julia Brilliant, Miltiadis Georgiadis, Kacem Zayakh, Angelis Sezenias, Harald Greiss, Armin Sause, Melchior Seyfarth","doi":"10.1016/j.hjc.2025.05.001","DOIUrl":"10.1016/j.hjc.2025.05.001","url":null,"abstract":"<p><strong>Objective: </strong>Ablating perimitral flutter (PMF) is challenging mainly because of epicardial structures such as the Bachmann bundle, the coronary sinus (CS) system, and the ligament of Marshall. There is still no consensus on which ablation strategy is the most effective. This study evaluates the acute effectiveness and safety of 3 different mitral isthmus (MI) ablation line types in treating PMF with radiofrequency ablation.</p><p><strong>Methods: </strong>This retrospective analysis reviewed 102 cases of definitively diagnosed PMF from 5131 electrophysiological procedures performed between January 2018 and April 2024 in our center. The 3 MI line types implemented were the anteroseptal line (ASML) from the mitral valve annulus to the right superior pulmonary vein, the anterior line (AML) from the mitral valve annulus to the left superior pulmonary vein, and the lateral (or posterior) line (LML) from the lateral mitral valve annulus to the left inferior pulmonary vein. In addition to endocardial ablation, when necessary, CS ablation and ethanol ablation of the vein of Marshall (VOM-ETOH) were used.</p><p><strong>Results: </strong>The LML had the highest block success rate (23/29 cases, 79.3%), followed by AML (41/64 cases, 64%) and ASML (19/33 cases, 57.6%). The overall acute block rate reached 81.4%, due to the combined use of multiple MI lines. In 16 cases (55.2% of LML), epicardial ablation in the CS system was performed. Use of VOM-ETOH with lateral lines increased success rates to 87.5%. Complications were rare, with one cardiac tamponade and one vascular complication.</p><p><strong>Conclusion: </strong>The LML demonstrated a trend toward superior acute effectiveness compared with AMLs and ASMLs for PMF, especially with adjunctive epicardial ablation techniques, without safety concerns. Accurate verification of bidirectional block and non-inducibility is critical.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular arrhythmias in patients with chronic total occlusion of coronary arteries: a review focused on interventional treatments.","authors":"Nikitas Katsillis, Ourania Kariki, Gerasimos Gavrielatos, Antonios Dimopoulos, Nikolaos Papakonstantinou, Elena Bousoula, Sarantos Linardakis, Athanasios Saplaouras, John Malakos, Stylianos Dragasis, Konstantinos P Letsas, Michael Efremidis, Nikolaos Patsourakos","doi":"10.1016/j.hjc.2025.04.006","DOIUrl":"10.1016/j.hjc.2025.04.006","url":null,"abstract":"<p><p>A chronic total occlusion (CTO) of a coronary artery is present in almost one-fifth of patients undergoing a scheduled coronary angiography. A CTO may be classified as infarct related when there is evidence of myocardial dysfunction in the territory of the obstructed vessel or as non-infarct related when the myocardial substrate has preserved its systolic function. The presence of a CTO has been associated with an increased risk of malignant ventricular arrhythmias (VAs), appropriate ICD shocks, and cardiac mortality, with infarct-related CTOs exhibiting a worse prognosis. During the last decade, technological advancements have improved the success rates of transcatheter revascularization, a treatment that has been proven valuable for persistently symptomatic patients. However, the role of revascularization in reducing the arrhythmic burden is unclear. On the contrary, catheter ablation of VAs has been suggested to be effective, despite the presence of a CTO. As for device therapies, an increased prevalence of appropriate ICD shocks should be expected in this population, bringing into consideration the implementation of the presence of CTO as a risk modifier in sudden cardiac death prevention algorithms. The aim of this review is to present the existing literature on the role of all kinds of interventions in the management of patients with CTOs and VAs.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humanistic values of the physician in the era of artificial intelligence.","authors":"Konstantinos Dean Boudoulas, Konstantinos Marmagkiolis, Filippos Triposkiadis, Harisios Boudoulas","doi":"10.1016/j.hjc.2025.04.005","DOIUrl":"10.1016/j.hjc.2025.04.005","url":null,"abstract":"<p><p>Artificial intelligence (AI) has recently been introduced into clinical practice with the potential to revolutionize medicine. AI will provide the physician with unlimited power, which is almost impossible to foresee at present. In addition, AI can be used for the development of pharmacologic agents and antibodies with unprecedented accuracy and speed. AI will assist the physician in defining individuals at high risk for developing a certain disease and, in turn, provide appropriate care to delay or prevent the disease. Using vast information related to a certain disease, the physician will be able to apply individualized care in contrast to the current approach based on guidelines where \"one size fits all.\" With prevention and individualized care, the cost of health care will decrease, human suffering will diminish, and overall mortality will decline. However, in this endless evolution of medicine, the role of the physician remains constant, which is to maintain the health of a human being. In addition to diagnosis and management, the physician should apply common sense, courage, and compassion when dealing with the difficulties of human life that may escape machines. Humanistic values, among others, are basic for the caring physician. Thus, the humanistic approach to the patient and the divine vocation of the physician should never be forgotten and should be based on a solid ethical foundation. The greatest challenge for physicians and medical leadership in the 21st century will not be living with and adapting to changing technology, but determining the proper balance between clinical wisdom and evolving technology.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In memoriam: George L. Bakris (1952–2024)","authors":"Konstantinos Tsioufis ,&nbsp;Pantelis Sarafidis ,&nbsp;Rigas Kalaitzidis ,&nbsp;George Stergiou ,&nbsp;Costas Thomopoulos ,&nbsp;Kyriakos Dimitriadis ,&nbsp;Athanasios Manolis ,&nbsp;John Boletis ,&nbsp;Fotis Tatakis ,&nbsp;Gerasimos Filippatos ,&nbsp;Vasilios Papademetriou ,&nbsp;Michalis Doumas ,&nbsp;Hellenic Cardiorenal and Hypertension Community","doi":"10.1016/j.hjc.2024.11.001","DOIUrl":"10.1016/j.hjc.2024.11.001","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 96-98"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind the gap: the silent divide of digital health (Il)literacy","authors":"Charalambos Vlachopoulos ,&nbsp;Constantinos Bakogiannis","doi":"10.1016/j.hjc.2025.05.002","DOIUrl":"10.1016/j.hjc.2025.05.002","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 1-2"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based differences in ischemic cardiovascular and bleeding outcomes following implantation of drug-eluting stent in patients at high bleeding risk","authors":"Chao-Feng Lin ,&nbsp;Chia-Ling Tsai ,&nbsp;Ya-Hui Chang ,&nbsp;Dai-Yi Lin ,&nbsp;Li-Nien Chien","doi":"10.1016/j.hjc.2024.01.001","DOIUrl":"10.1016/j.hjc.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Patients with high bleeding risk (HBR) may exhibit uncertain adherence to dual antiplatelet therapy (DAPT) following drug-eluting stent (DES) implantation. The current population-based cohort study aimed to investigate the sex-based differences in adverse outcomes among the HBR population by analyzing the National Health Insurance Research Database in Taiwan.</div></div><div><h3>Methods</h3><div>Patients who had HBR features defined by the Academic Research Consortium (ARC) and received DES implantation between January 1, 2007, and December 31, 2017, were enrolled. Propensity score matching was adopted to select 3,981 pairs with similar clinical cardiovascular risks but different sexes. A competing risk model was performed to evaluate the risk of adverse ischemic events (cardiac death, nonfatal myocardial infarction, and ischemic stroke) and any bleeding events in both sexes. Noncardiac death was considered a competing risk.</div></div><div><h3>Results</h3><div>Within a 5-year follow-up, the incidence rates (per 1,000 person-year (95% confidence interval (CI)) of composite ischemic events and any bleeding events in males were respectively 44.09 (40.25–48.30) and 42.55 (38.79–46.68), while those in females were respectively 40.18 (36.51–44.23) and 42.35 (38.57–46.51). After adjustment for clinical variables, male patients had a marginally increased risk in the composite ischemic events (adjusted subdistribution hazard ratio (SHR) = 1.15 (1.00–1.31), <em>p</em> = 0.045) and a similar risk of any bleeding events (adjusted SHR = 1.00 (0.88–1.15), <em>p</em> = 0.946) compared with female patients.</div></div><div><h3>Conclusions</h3><div>Of the HBR population, males had an increased risk of ischemic outcomes but a similar risk of bleeding compared with females following DES implantation.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 10-19"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139461611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of long-term prognoses of percutaneous coronary intervention via distal transradial and conventional transradial access for acute coronary syndrome","authors":"Lingxia Xu ,&nbsp;Wei Lu ,&nbsp;Ganwei Shi ,&nbsp;Wenhua Li ,&nbsp;Jianqiang Xiao ,&nbsp;Anni Yang ,&nbsp;Feng Li ,&nbsp;Gaojun Cai","doi":"10.1016/j.hjc.2024.03.001","DOIUrl":"10.1016/j.hjc.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Distal transradial access (dTRA) has recently emerged as a new vascular access alternative for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). However, published data on long-term mortality and major adverse cardiac events after PCI via dTRA are inconclusive. The aim of this study was to compare the long-term prognoses of PCI via dTRA and conventional transradial access (cTRA) for acute coronary syndrome (ACS) after 1–3 years of follow-up.</div></div><div><h3>Methods</h3><div>Patients who were diagnosed with ACS and underwent PCI between January 1, 2020 and December 31, 2021, were retrospectively enrolled. The patients were divided into two groups at a 1:1 ratio, subjected to propensity score matching (PSM), and then followed for 1–3 years after PCI. Cox proportional hazards regression was used to evaluate the relationship between the two access sites and clinical outcomes.</div></div><div><h3>Results</h3><div>Among the 550 patients in the dTRA and cTRA groups, 11 (4.0%) and 19 (6.9%) died during the observation period, respectively. dTRA and cTRA had similar risks of all-cause mortality [hazard ratio (HR) = 0.688; 95% CI = 0.323–1.463; <em>P</em> = 0.331] and major adverse cardiac events (MACEs, HR = 0.806, 95% CI = 0.515–1.263; <em>P</em> = 0.347) after PCI. The risk of cardiovascular mortality (HR = 0.330, 95% CI = 0.107–1.105; <em>P</em> = 0.053), TLR-MACEs (HR = 0.587, 95% CI = 0.339–1.109; <em>P</em> = 0.058), and unplanned revascularization (HR = 0.860, 95% CI = 0.483–1.529; <em>P</em> = 0.606) were not significantly different between the two groups.</div></div><div><h3>Conclusions</h3><div>PCI via dTRA has the same long-term prognoses as PCI via cTRA in ACS patients, and the compression time and bleeding rate are lower than those in patients undergoing PCI via cTRA.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 28-37"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifiers of the Association between E/e' Ratio and Survival among Patients with No Apparent Structural or Functional Cardiac Abnormality","authors":"Yishay Wasserstrum ,&nbsp;Rami Gilead ,&nbsp;Sagit Ben-Zekry ,&nbsp;Efrat Mazor-Dray ,&nbsp;Anan Younis ,&nbsp;Amit Segev ,&nbsp;Elad Maor ,&nbsp;Rafael Kuperstein","doi":"10.1016/j.hjc.2024.01.005","DOIUrl":"10.1016/j.hjc.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><div>The ratio between early mitral flow wave to early diastolic mitral annulus velocity (E/e’ ratio) varies according to age and sex and is associated with mortality in heart failure. We sought to describe the association between E/e’ and mortality in patients with no apparent structural or functional cardiac abnormality and explore possible modifiers of this association.</div></div><div><h3>Methods</h3><div>A retrospective study of 104,315 patients who underwent echocardiographic evaluation during 2009-2021 in the largest tertiary center in Israel. Patients with cancer, ventricular dysfunction, significant valvular or structural heart disease, or evidence of pulmonary hypertension were excluded.</div></div><div><h3>Results</h3><div>The final analysis included 32,836 patients with a median age of 56 (43-66) years, and 13,547 (41%) were female. The median E/e’ was 8.3 (6.8-10.3), and 9,306 (28%) had an E/e’ &gt;10. During a median follow-up of 5.7 (3.3-8.5) years, 2,396 (7.3%) individuals died. E/e’ &gt;10 was associated with mortality (adjusted hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.07-1.27, p&lt;0.001). The mortality risk associated with E/e’ &gt;10 was significantly higher in those aged ≤70 (HR 1.26, 95% CI 1.12-1.42, p&lt;0.001), males (HR 1.34, 95% CI 1.19-1.49, p&lt;0.001), a normal left ventricular mass (HR 1.13, 95% CI 1.02-1.24, p = 0.017), and pulmonary artery pressure &lt;30 mmHg (HR 1.18, 95% CI 1.06-1.30, p = 0.003).</div></div><div><h3>Conclusion</h3><div>An elevated E/e’ is associated with mortality, specifically in younger individuals, males, and those with a normal left ventricular mass and lower pulmonary artery pressure. This suggests that an elevated E/e’ might be a marker of subclinical risk in these subgroups. Further studies are needed to identify whether an elevated E/e' is useful in shared decision-making regarding the management of cardiovascular risk factors.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 20-27"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139551739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter closure of a postoperative iatrogenic pseudoaneurysm in a patient with congenital heart disease","authors":"Ioannis Kasouridis ,&nbsp;Oleksandr Danylenko ,&nbsp;Wei Li ,&nbsp;Aleksander Kempny","doi":"10.1016/j.hjc.2024.05.016","DOIUrl":"10.1016/j.hjc.2024.05.016","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 99-101"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Causality between Gut Microbiota and Hypertension and Hypertension-related Complications: A Bidirectional Two-Sample Mendelian Randomization Analysis","authors":"Changhong Miao ,&nbsp;Xinyi Xu ,&nbsp;Shuoxuan Huang ,&nbsp;Lingyi Kong ,&nbsp;Zhiwei He ,&nbsp;Yihan Wang ,&nbsp;Kuang Chen ,&nbsp;Lu Xiao","doi":"10.1016/j.hjc.2024.02.002","DOIUrl":"10.1016/j.hjc.2024.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies have highlighted a connection between gut microbiota and hypertension, yet the precise nature of this relationship remains unclear.</div></div><div><h3>Objective</h3><div>This research aims to analyze the causal link between gut microbiota and hypertension, along with associated complications, utilizing two-sample bidirectional Mendelian randomization (MR).</div></div><div><h3>Materials and Methods</h3><div>Summary data from genome-wide association studies (GWAS) meta-analyses, including gut microbiota GWAS data from 24 cohorts, and the latest GWAS data for hypertension-related conditions were acquired. Employing various MR methods, including Inverse-variance weighted (IVW), MR-Egger, Weighted Median, Simple Mode, and Weighted Mode, we investigated the association between gut microbiota and hypertension-related conditions. Sensitivity analyses were conducted for result stability, and reverse MR analysis assessed the potential for reverse causality.</div></div><div><h3>Results</h3><div>The Mendelian randomization analysis involving 199 microbial taxa and four phenotypes identified 46 microbial taxa with potential causal links to hypertension and its complications. Following Bonferroni correction, <em>genus.Victivallis</em> showed a robust causal relationship with hypertension (OR = 1.08, 95% CI = 1.04-1.12, P = 9.82e-5). This suggests an 8% increased risk of hypertension with each unit rise in <em>genus.Victivallis</em> abundance.</div></div><div><h3>Conclusion</h3><div>In conclusion, this study establishes a causal connection between gut microbiota and hypertension, along with common associated complications. The findings unveil potential targets and evidence for future hypertension and complication treatment through gut microbiota interventions, offering a novel avenue for therapeutic exploration.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 38-50"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}