Hellenic Journal of Cardiology最新文献

{"title":"New guidelines of EACTS/STS on aortic disease: a useful tool for the management of “aortic organ” disease","authors":"Nikolaos Schizas , Panagiotis Dedeilias","doi":"10.1016/j.hjc.2024.10.001","DOIUrl":"10.1016/j.hjc.2024.10.001","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 110-113"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407217","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":"Combining catheter ablation and left atrial appendage occlusion in high-risk patients with atrial fibrillation: a propensity score-matched analysis","authors":"Ziyong Hao ,&nbsp;Bin Liu ,&nbsp;Xiaoyi Xie ,&nbsp;Yiting Fan ,&nbsp;Jian Wang ,&nbsp;Qin Shao ,&nbsp;Lisheng Jiang ,&nbsp;Ben He","doi":"10.1016/j.hjc.2024.03.002","DOIUrl":"10.1016/j.hjc.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><div>The safety and efficacy of a combined approach of catheter ablation (CA) and left atrial appendage occlusion (LAAO) compared to LAAO alone remain unknown.</div></div><div><h3>Methods</h3><div>Patients with atrial fibrillation (AF) at increased stroke risk who underwent LAAO were divided into either combined (CA and LAAO) procedures or LAAO alone group. Propensity score matching was utilized to balance baseline characteristics. The primary endpoint of the study was a composite of death, thromboembolic events, major bleeding, heart failure (HF) rehospitalization, and major periprocedural complications.</div></div><div><h3>Results</h3><div>A total of 707 AF patients who underwent LAAO were included. After 1:1 propensity score matching, 166 patients who underwent LAAO alone (n = 83) or the combined procedure (n = 83) were analyzed. Successful LAAO was achieved in all (100%) patients, with a low incidence of periprocedural complications in both groups (2.4% vs. 4.8%, LAAO vs. combined, p = 0.68). The incidence of peri-device leak post-LAAO was significantly higher in the combined group (25.3% vs. 43.4%, p = 0.01). After a median follow-up of 2 years, there were no significant differences in the rates of the primary composite endpoint between the two strategies (22.2% vs. 14.3%, HR: 1.24 [95% CI: 0.51–2.97], p = 0.63). However, the rate of HF rehospitalization was significantly lower in the combined group (19.6% vs. 3.6%, HR: 4.89 [95% CI: 1.50–15.97], p = 0.024).</div></div><div><h3>Conclusions</h3><div>Combining CA and LAAO in a “one-stop” approach is safe and brings additional benefits in relieving symptoms of heart failure, although peri-device leak was more common compared to LAAO alone.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 4-12"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068909","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":"Endomyocardial biopsy in clinical practice: the diagnostic yield and insights from a 5-year single-center experience","authors":"Mutaz Karameh ,&nbsp;Karen Meir ,&nbsp;Abed Qadan ,&nbsp;Orit Pappo ,&nbsp;Dotan Cohen ,&nbsp;Ronen Durst ,&nbsp;Offer Amir ,&nbsp;Rabea Asleh","doi":"10.1016/j.hjc.2024.03.004","DOIUrl":"10.1016/j.hjc.2024.03.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Endomyocardial biopsy (EMB) is a diagnostic tool for evaluating various cardiac conditions, such as myocarditis and myocardial infiltrative diseases. It is also the gold standard screening technique for detecting allograft rejection after heart transplantation. Despite advances in noninvasive imaging modalities for myocardial tissue characterization, EMB is still necessary for making a definitive diagnosis and determining treatment for certain conditions. Herein, we report our recent experience using EMB and its diagnostic yield.</div></div><div><h3>Methods and Results</h3><div>We retrospectively reviewed EMBs performed at our institution from March 2018 through March 2023. Clinical data, including patient characteristics, indication and diagnostic yield of EMB, and procedure-related complications, were collected. Histopathological findings of the biopsies were recorded and classified based on the degree to which they matched the clinical diagnosis and cardiac magnetic resonance imaging (CMR) findings. A total of 212 EMBs obtained in 178 consecutive patients were retrospectively analyzed, with 42 biopsies performed for allograft rejection surveillance (10 patients) and the remaining performed for presumptive diagnosis of acute myocarditis or unexplained cardiomyopathy. Among the non-heart transplant cases, 54.7% of EMBs provided a clear diagnosis. The most common diagnosis was myocarditis (69%), followed by cardiac amyloidosis (CA) (26%). EMB was also helpful in detecting several rare cardiac conditions, such as eosinophilic granulomatosis with polyangiitis (EGPA), Fabry disease, and cardiac sarcoidosis. In a cohort of 101 patients who underwent both CMR and EMB, the results were concordant in 66% of cases. However, in 24.7% of patients, EMB was able to identify pathological conditions where CMR results were inconclusive, highlighting its complementary role in determining an accurate diagnosis. No complications were reported in any of the 212 EMBs performed.</div></div><div><h3>Conclusions</h3><div>With advances in cardiac imaging modalities, EMB is not routinely indicated for the diagnosis of cardiomyopathy. However, EMB is still an important tool for diagnosing specific cardiac diseases and could be crucial for confirming the diagnosis. EMB is generally safe if performed at experienced centers.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 22-31"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121344","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":"INFLA-score: A new diagnostic paradigm to identify pericarditis","authors":"Alessandro Andreis ,&nbsp;Andrea Solano ,&nbsp;Marco Balducci ,&nbsp;Cristina Picollo ,&nbsp;Margherita Ghigliotti ,&nbsp;Mario Giordano ,&nbsp;Alessandra Agosti ,&nbsp;Valentino Collini ,&nbsp;Matteo Anselmino ,&nbsp;Gaetano Maria De Ferrari ,&nbsp;Mauro Rinaldi ,&nbsp;Gianluca Alunni ,&nbsp;Massimo Imazio","doi":"10.1016/j.hjc.2024.03.010","DOIUrl":"10.1016/j.hjc.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosis of pericarditis may be challenging because not all patients meet the conventional criteria. An overlooked diagnosis implies a longer course of symptoms and an increased risk of recurrences. C-reactive protein (CRP), widely used as an inflammation marker, has some limitations. This study aimed to assess the usefulness and prognostic value of INFLA-score, a validated index assessing low-grade inflammation, in the definite diagnosis of pericarditis.</div></div><div><h3>Methods</h3><div>Patients with suspected pericarditis were included. The INFLA-score was computed based on white blood cells and platelet count, neutrophil-to-lymphocyte ratio, and CRP, ranging from −16 to +16. An INFLA-score &gt; 0 was considered positive for the presence of pericardial inflammation. The primary end point was the association of INFLA-score with diagnosis of pericarditis according to conventional criteria. The recurrence of pericarditis at 6 months was the secondary end point.</div></div><div><h3>Results</h3><div>A total of 202 patients were included, aged 47 ± 17 years, and 57% were females. Among 72 (36%) patients with a diagnosis of pericarditis, an INFLA-score &gt; 0 was observed in 86% (vs. 36%, p &lt; 0.001), abnormal CRP in 42% (vs. 10%, p &lt; 0.001), pericardial effusion in 44% (vs. 19%, p &lt; 0.001), abnormal electrocardiogram in 56% (vs. 24%, p &lt; 0.001), and rubs in 5% (vs. 0.1%, p = 0.072). INFLA-score &gt; 0 had the strongest predictive value for the diagnosis of pericarditis (hazard ratio 8.48, 95% confidence interval [CI] 3.39–21.21), with 86% sensitivity and 64% specificity, as opposed to CRP (hazard ratio 1.72, non-significant 95% CI 0.69–4.29). Recurrent pericarditis at 6 months was more frequent in patients with a positive INFLA-score (37% vs. 8%, p &lt; 0.001, rate ratio 4.15, 95% CI 2.81–6.12). In patients with normal CRP, INFLA-score–confirmed ongoing inflammation in 78% of the cases. Compared with the conventional criteria, the INFLA-score had the highest accuracy (area under the curve = 0.82). Different cutoffs were valuable to rule out (INFLA-score &gt; 0, sensitivity 86%, and negative likelihood ratio 0.22) or rule in (INFLA-score ≥ 10, specificity 97%, and positive likelihood ratio 13) the diagnosis.</div></div><div><h3>Conclusions</h3><div>The INFLA-score is a useful diagnostic tool to assess the probability of pericarditis, with a strong prognostic value for further recurrences, outperforming CRP.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 43-50"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195067","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":"Ageism in medicine: procrustean logic in healthcare","authors":"Charalambos Vlachopoulos ,&nbsp;Demosthenes Panagiotakos","doi":"10.1016/j.hjc.2025.07.001","DOIUrl":"10.1016/j.hjc.2025.07.001","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 1-3"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602791","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":"Comparing the predictive ability of GRACE 2.0 and GRACE 3.0 scores in a Greek cohort of patients hospitalized with acute coronary syndrome","authors":"Christos Kofos ,&nbsp;Andreas S. Papazoglou ,&nbsp;Stavroula Rousopoulou ,&nbsp;Paraskevi Douki ,&nbsp;Andreas Takas ,&nbsp;Athanasios Samaras ,&nbsp;Panagiotis Stachteas ,&nbsp;Athina Nasoufidou ,&nbsp;Efstratios Karagiannidis ,&nbsp;Barbara Fyntanidou ,&nbsp;Nikolaos Fragakis ,&nbsp;George Kassimis","doi":"10.1016/j.hjc.2024.10.002","DOIUrl":"10.1016/j.hjc.2024.10.002","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 108-109"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481330","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":"Atrial fibrillation post CABG and the risk of arrhythmia recurrence: the AFRODITE study","authors":"Maria Nikolaou ,&nbsp;Gregory Pattakos ,&nbsp;Christos Hitas ,&nbsp;Katerina Koniari ,&nbsp;Antoniοs Pitsis ,&nbsp;Dimitrios Iliopoulos ,&nbsp;Αnastasia Xintarakou ,&nbsp;Emmanouil P. Vardas ,&nbsp;Stratis Pattakos ,&nbsp;Stylianos Tzeis ,&nbsp;Panagiotis Vardas","doi":"10.1016/j.hjc.2024.03.003","DOIUrl":"10.1016/j.hjc.2024.03.003","url":null,"abstract":"<div><h3>Background</h3><div>New-onset postoperative atrial fibrillation (POAF) after coronary artery bypass surgery (CABG) occurs with an incidence of 20–40%. The clinical relevance of POAF remains a concern, and the need for further studies regarding the clinical management of POAF is necessary.</div></div><div><h3>Aim</h3><div>The AFRODITE study, a prospective multicenter cohort study, had as its primary endpoint the evaluation of AF recurrence in patients post CABG over a one-year period.</div></div><div><h3>Methods</h3><div>Two hundred twenty-eight patients aged &gt;50 years who underwent isolated CABG were included in the study. Patients were stratified into two groups, POAF and non-POAF, and followed for 12 months for AF recurrence, hospitalizations, and death.</div></div><div><h3>Results</h3><div>Two hundred twenty-eight patients (mean age 67 years, 88.6% male) were included in the study. 28.5% of patients experienced at least one episode of POAF during index hospitalization (POAF group) and were compared with the non-POAF group (n = 163). Multivariate stepwise logistic regression analysis showed that the strongest prognostic parameter for POAF was the CHA₂DS_2-VASc score (odds ratio = 1.61, p &lt; 0.001). POAF patients had a worse in-hospital outcome, but the incidence of long-term AF recurrence was not statistically different (3.6% vs. 4.8%, p = 0.9).</div></div><div><h3>Conclusion</h3><div>Interestingly, a one-year prospective follow-up of patients in the study did not reveal significant differences between POAF and non-POAF patients. A notable finding was that patients with a higher CHA₂DS_2-VASc score were more likely to develop POAF.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 13-21"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061378","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":"Prognostic value of mitral valve regurgitation in patients with heart failure with mildly reduced ejection fraction","authors":"Noah Abel ,&nbsp;Michael Behnes ,&nbsp;Alexander Schmitt ,&nbsp;Marielen Reinhardt ,&nbsp;Felix Lau ,&nbsp;Mohammad Abumayyaleh ,&nbsp;Tina Sieburg ,&nbsp;Kathrin Weidner ,&nbsp;Mohamed Ayoub ,&nbsp;Kambis Mashayekhi ,&nbsp;Ibrahim Akin ,&nbsp;Tobias Schupp","doi":"10.1016/j.hjc.2024.03.013","DOIUrl":"10.1016/j.hjc.2024.03.013","url":null,"abstract":"<div><h3>Background</h3><div>Although mitral valve regurgitation (MR) is a common valvular heart disease in patients with heart failure (HF), there is a paucity of data on the characterization and outcomes of patients with HF with mildly reduced ejection fraction (HFmrEF) and concomitant MR.</div></div><div><h3>Methods</h3><div>From 2016 to 2022, consecutive patients hospitalized with HFmrEF (i.e., left ventricular ejection fraction from 41% to 49% and signs and/or symptoms of HF) were retrospectively included at one institution. Patients with MR were compared with patients without MR. Further risk stratification was performed according to MR severity and etiology (i.e., primary vs. secondary MR). The primary end point was all-cause mortality at 30 months (median follow-up), and the key secondary end point was hospitalization for worsening HF.</div></div><div><h3>Results</h3><div>Of 2181 patients hospitalized with HFmrEF, 59% presented with mild, 10% with moderate, and 2% with severe MR. MR was associated with increased all-cause mortality at 30 months (HR = 1.756; 95% CI 1.458–2.114; p = 0.001), with higher risk in more advanced stages. Furthermore, MR patients had higher risk of HF-related re-hospitalization at 30 months (HR = 1.560; 95% CI 1.172–2.076; p = 0.002). Even after multivariable adjustment, mild, moderate, and severe MR were still associated with all-cause mortality. Finally, the risk of all-cause mortality was lower in patients with secondary MR compared with patients with primary MR (HR = 0.592; 95% CI 0.366–0.956; p = 0.032).</div></div><div><h3>Conclusion</h3><div>MR is common in HFmrEF and independently associated with higher risk of all-cause mortality and HF hospitalization.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 61-74"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332332","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":"Efficacy and safety of polymer-free biolimus-eluting stents versus durable polymer novolimus-eluting stents in a real-world clinical practice (FREEDOM-DES trial)","authors":"Soohyung Park ,&nbsp;Seung-Woon Rha ,&nbsp;Byoung Geol Choi ,&nbsp;Sang Ho Park ,&nbsp;Jae-Bin Seo ,&nbsp;Ju Yeol Baek ,&nbsp;Jae Woong Choi ,&nbsp;Yong Hoon Kim ,&nbsp;Ji-Hun Ahn ,&nbsp;Gi Chang Kim ,&nbsp;Weon Kim ,&nbsp;Soo-Han Kim ,&nbsp;Markz RMP. Sinurat ,&nbsp;Se Yeon Choi ,&nbsp;Jin Ah Cha ,&nbsp;Su Jin Hyun ,&nbsp;Cheol Ung Choi ,&nbsp;Chang Gyu Park","doi":"10.1016/j.hjc.2024.09.005","DOIUrl":"10.1016/j.hjc.2024.09.005","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 104-107"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332734","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":"Massive right coronary aneurysm-left ventricle fistula","authors":"Xiangfeng Gong ,&nbsp;Chunyan Jiang ,&nbsp;Chaoyi Qin ,&nbsp;Xiaoqin Chen ,&nbsp;Zhenghua Xiao","doi":"10.1016/j.hjc.2025.03.006","DOIUrl":"10.1016/j.hjc.2025.03.006","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 114-115"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712201","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}