Hellenic Journal of Cardiology最新文献

{"title":"A comprehensive exploration of novel biomarkers for the early diagnosis of aortic dissection","authors":"Aman Goyal ,&nbsp;Hritvik Jain ,&nbsp;Muhammad Usman ,&nbsp;Varisha Zuhair ,&nbsp;Samia Aziz Sulaiman ,&nbsp;Binish Javed ,&nbsp;Ayesha Mubbashir ,&nbsp;Ahmed Mohamed Abozaid ,&nbsp;Siddhant Passey ,&nbsp;Shreyas Yakkali","doi":"10.1016/j.hjc.2024.06.006","DOIUrl":"10.1016/j.hjc.2024.06.006","url":null,"abstract":"<div><div>Aortic dissection (AD) is a catastrophic life-threatening cardiovascular emergency with a 1–2% per hour mortality rate post-diagnosis, characterized physiologically by the separation of aortic wall layers. AD initially presents as intense pain that can then radiate to the back, arms, neck, or jaw along with neurological deficits like difficulty in speaking, and unilateral weakness in some patients. This spectrum of clinical features associated with AD is often confused with acute myocardial infarction, hence leading to a delay in AD diagnosis. Cardiac and vascular biomarkers are structural proteins and microRNAs circulating in the bloodstream that correlate to tissue damage and their levels become detectable even before symptom onset. Timely diagnosis of AD using biomarkers, in combination with advanced imaging diagnostics, will significantly improve prognosis by allowing earlier vascular interventions. This comprehensive review aims to investigate emerging biomarkers in the diagnosis of AD, as well as provide future directives for creating advanced diagnostic tools and imaging techniques.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"82 ","pages":"Pages 74-85"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic value of stress echocardiography with limited myocardial ischemia in high-risk patients","authors":"Nikolaos P.E. Kadoglou ,&nbsp;Constantinos Η. Papadopoulos ,&nbsp;Elina Khattab ,&nbsp;Nikolaos Velidakis ,&nbsp;Stylianos Lambropoulos","doi":"10.1016/j.hjc.2023.12.007","DOIUrl":"10.1016/j.hjc.2023.12.007","url":null,"abstract":"<div><h3>Background</h3><div>The diagnostic value of limited myocardial ischemia in DSE is not well known.</div></div><div><h3>Objectives</h3><div>We investigated whether myocardial ischemia during dobutamine stress echocardiography (DSE) in 1 apical segment of any of the ventricular walls of the left ventricle relates to the anatomical and functional stenosis of the suppling coronary artery.</div></div><div><h3>Methods</h3><div>Our observational, prospective study enrolled 212 patients, symptomatic or asymptomatic, with newly diagnosed limited myocardial ischemia on DSE. Almost 25% of them had already known CAD, while the rest were divided into low-risk and high-risk groups, integrating 1-2 and ≥3 classical cardiovascular risk factors, respectively. After DSE, all patients underwent invasive coronary angiography (ICA) and were followed up for one year. In coronary arteries distributing ischemic area, the calculated stenosis ≥50% and FFR&lt;0.8 were considered anatomically and functionally significant, respectively. In the latter cases, the patients underwent coronary revascularization.</div></div><div><h3>Results</h3><div>Significant anatomical and functional stenosis of the supplying coronary artery was common among patients with already known CAD (62.5% and 44.5%, respectively) or those without CAD but a high-risk profile (60.2% and 25.6%, respectively). In logistic regression analysis, CAD revascularization was independently determined by an already known CAD, diabetes mellitus, and high-risk profile. During follow-up, 24 patients experienced ACS or new angina episodes, which were associated with diabetes and smoking in univariate analysis.</div></div><div><h3>Conclusion</h3><div>Limited myocardial ischemia may implicate significant anatomical and functional coronary stenosis among individuals with a history of CAD or those without known CAD but a high-risk profile. The prognostic value of our findings requires further investigation.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"82 ","pages":"Pages 34-42"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139092161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive pericardial hemorrhage due to incidentally rupture of a saccular pulmonary aneurysm","authors":"Gang Cheng ,&nbsp;Ming-Bin Deng ,&nbsp;Xiao-Jun Xie","doi":"10.1016/j.hjc.2024.05.012","DOIUrl":"10.1016/j.hjc.2024.05.012","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"82 ","pages":"Pages 114-115"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Including hemoglobin levels and female sex provide the additional predictive value of the APPLE score for atrial fibrillation recurrence post-catheter ablation","authors":"Wenchao Huang ,&nbsp;Huaxin Sun ,&nbsp;Yan Luo ,&nbsp;Yan Tang,&nbsp;Shiqiang Xiong,&nbsp;Yu Long,&nbsp;Hanxiong Liu","doi":"10.1016/j.hjc.2023.12.003","DOIUrl":"10.1016/j.hjc.2023.12.003","url":null,"abstract":"<div><h3>Objective</h3><div>We probed whether the addition of hemoglobin (HGB) or the female sex (SEX) as variables would provide additional prognostic value to the APPLE score.</div></div><div><h3>Methods</h3><div>An optimized APPLE score was used to evaluate the AF recurrence risk in the consecutive populations with AF post-catheter ablation including the development (n = 562) and validation (n = 239) cohorts.</div></div><div><h3>Results</h3><div>In the populations of AF recurrence, most patients were female sex (103/164, 62.8%), and had the lower HGB levels. After adjusting for the APPLE score, HGB level (Odds Ratio [OR], 0.828; 95% Confidence Interval [CI], 0.749–0.915; P &lt; 0.001) and female sex (OR, 1.596; 95% CI, 1.140-2.235; P = 0.006) independently predicted AF recurrence. Adjusting the APPLE score by HGB variable improved its predictive ability for AF recurrence (C-statistic value from 0.675 to 0.711, P = 0.010), which also increased the C-indexes in the external validation (from 0.653 to 0.725, p = 0.023). The female sex variable also enhanced the C-statistic value of the APPLE score for AF recurrence at both development and external validation (C-indices from 0.675 to 0.691, P = 0.004; C-indices from 0.653 to 0.704, p = 0.037, respectively). Decision curve analysis showed that the HGB plus APPLE score was better than the SEX plus APPLE score in predicting AF recurrence in two following AF populations.</div></div><div><h3>Conclusion</h3><div>The inclusion of HGB level and female sex variables improved the predictability and clinical usefulness of adjusted APPLE score. Adjustment of the APPLE score by HGB levels may provide better predictive value than inclusion of the female sex variable.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"82 ","pages":"Pages 54-65"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138821236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Pathogenic NR2F2 (COUP-TFII) Variants as Potential Etiological Causes in Pediatric Patients with Congenital Heart Diseases (CHDs).","authors":"Wahidullah Mansoor, Mohammad Mehdi Heidari, Mehri Khatami, Mehdi Hadadzadeh, Fateme Tabrizi, Mohammad Hosein Darvand Araghi","doi":"10.1016/j.hjc.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.hjc.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart diseases (CHDs) are complex genetic disorders, and their genetic basis is not yet fully understood. Nuclear receptor subfamily 2 group F member 2 (NR2F2 or COUP-TFII) encodes a transcription factor which is expressed at high levels during mammalian development. Few studies have identified heterozygous and rare variants in the NR2F2 gene in individuals with congenital heart disease (CHD).</p><p><strong>Objectives: </strong>This study aimed to evaluate the association between pathogenic genetic alterations in NR2F2 with CHD risk.</p><p><strong>Methods: </strong>A case-control study was conducted on a group of 135 patients (83 boys and 52 girls) with non-hereditary various types of isolated congenital heart disease who were undergoing open-heart surgery. Additionally, 95 matched healthy children without syndromic or isolated heart abnormalities were selected.</p><p><strong>Results: </strong>Using the Sanger sequencing method, we identified five heterozygous single nucleotide variations in exons two and three of the NR2F2 gene. These variations were novel and not present in any genomic variation databases. Four of the variations were missense mutations (p.Pro159Arg, p.Ser329Phe, p.Qln338Pro, and p.Tyr348Ser) and one was a synonymous variant (p.G361=) in the coding region. Importantly, in-silico results indicated that the missense variants had pathogenic effects on protein function. Additionally, the missense variants substantially altered the predicted structure of COUP-TFII.</p><p><strong>Conclusion: </strong>The results we obtained not only validate the correlation between NR2F2 mutations and CHDs but also have significant potential for guiding new preventive and therapeutic strategies. This could contribute to the advancement of medical interventions in the fields of cardiology and genetics.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525274","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":"Key messages and critical approach of the 2024 guidelines of the European Society of Cardiology on chronic coronary syndromes.","authors":"Athanasios J Manolis, Peter Collins, Manolis S Kallistratos, Giuseppe Rosano","doi":"10.1016/j.hjc.2025.02.003","DOIUrl":"10.1016/j.hjc.2025.02.003","url":null,"abstract":"<p><p>The updated European Society of Cardiology (ESC) guidelines empower physicians to tailor treatment plans more effectively to individual patient characteristics, preferences, and responses. With a more flexible and individualized approach to angina management, it seems that the traditional stepwise approach may not be optimal for all patients. In addition, there is a significant shift in the diagnostic approach for chronic coronary syndromes (CCS). In this review, we mainly refer to key points and queries concerning the current ESC recommendations regarding the diagnostic approach and treatment of patients with stable angina, recommending practical directions to physicians managing patients with CCS.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484606","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":"Revisiting treatment of pulmonary arterial hypertension in the current era: a Greek scientific document.","authors":"Eftychia Demerouti, Frantzeska Frantzeskaki, Tonia Adamidi, Anastasia Anthi, Effrosyni Filiou, Panagiotis Karyofyllis, Athanasios Manginas, Ioanna Mitrouska, Stylianos E Orfanos, Georgia Pitsiou, Iraklis Tsangaris, George Giannakoulas","doi":"10.1016/j.hjc.2025.02.004","DOIUrl":"10.1016/j.hjc.2025.02.004","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is a life-threatening condition characterised by the excessive proliferation of pulmonary artery vessels. Despite significant advancements in treatment strategies over recent years, mortality rates remain high. The current treatment strategy focuses on risk assessment both at the time of diagnosis and during follow-up. It involves the initial use of combination therapies targeting PAH. These therapies regulate vascular tone through 3 main pathways: the endothelin pathway, the nitric oxide/cyclic guanosine monophosphate pathway, and the prostacyclin pathway. Sotatercept, a fusion protein that binds to ligands of the transforming growth factor-β superfamily, rebalances the pro- and anti-proliferative signalling of activin receptor type II (A/B), thus targeting a unique pathogenic pathway and promoting anti-proliferative effects on the pulmonary vasculature. Recently, it received approval from the European Medicines Agency for patients with PAH classified as World Health Organisation functional class II or III. Proceedings from the latest World Symposium on Pulmonary Hypertension stress the importance of adding sotatercept to the treatment regimen for the majority of patients during follow-up, including those at high risk. In anticipation of upcoming scientific guidelines and with the hope of improved outcomes for patients with PAH, an expert opinion for the treatment of Greek patients has been developed, focusing on the integration of this novel agent into the therapeutic algorithm.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472592","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":"Impact of renal function on treatment strategies and clinical outcomes in acute myocardial infarction patients with multivessel disease.","authors":"Seongho Park, Eun Ju Park, Seung Hun Lee, Joon Ho Ahn, Yong-Kyu Lee, Donghyeon Joo, Kyung Hoon Cho, Min Chul Kim, Doo Sun Sim, Joo Myung Lee, Young Bin Song, Joo-Yong Hahn, Shung Chull Chae, Chong Jin Kim, Young Joon Hong, Ju Han Kim, Hyeon-Cheol Gwon, Hyo-Soo Kim, Youngkeun Ahn, Myung Ho Jeong","doi":"10.1016/j.hjc.2025.02.001","DOIUrl":"10.1016/j.hjc.2025.02.001","url":null,"abstract":"<p><strong>Objective: </strong>The impact of renal function on revascularization outcomes in patients with acute myocardial infarction and multivessel disease remains unclear. This study compared long-term outcomes of complete (CR) and incomplete revascularization (IR) in patients with estimated glomerular filtration rate (eGFR) ≥60 or <60 mL/min/1.73 m² METHODS: Using data from the Korea Acute Myocardial Infarction Registry-National Institute of Health, 5962 patients (mean age: 65.4 ± 12.1 years; 4389 men) were categorized by renal function into Group I (eGFR ≥60, n = 4689) and Group II (eGFR <60, n = 1273). Each group was divided into CR (IA, IIA) and IR (IB, IIB) subgroups. The primary end point was the incidence of major adverse cardiac events (MACEs), a composite of all-cause death, myocardial infarction, and repeat revascularization, assessed over a 3-year follow-up.</p><p><strong>Results: </strong>MACEs were more frequent in Group II than Group I (41.5% vs. 19.4%, p < 0.001). In Group I, CR reduced MACEs compared with IR (16.7% vs. 22.6%, p < 0.001). However, no significant difference was found between CR and IR in Group II (p = 0.118). Key predictors of MACEs included advanced age, diabetes, prior myocardial infarction, ST-elevation myocardial infarction, and IR.</p><p><strong>Conclusion: </strong>CR improved outcomes in patients with eGFR ≥60, whereas no difference was observed between CR and IR in those with eGFR <60. Therefore, IR may be a viable option for patients with reduced renal function.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460770","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":"A scientific document for the remote monitoring of cardiac implantable electronic devices in Greece.","authors":"Polychronis Dilaveris, Christos-Konstantinos Antoniou, Sotirios Xydonas, Christina Chrysohoou, Theodoros Apostolopoulos, Panagiotis Stafylas, George Kochiadakis, Konstantinos A Gatzoulis","doi":"10.1016/j.hjc.2025.02.002","DOIUrl":"10.1016/j.hjc.2025.02.002","url":null,"abstract":"<p><p>It is estimated that the number of patients with a cardiac implantable electronic device (CIED) in Greece exceeds 120,000, and this population is expected to further rise by 5% annually. The importance of adequate monitoring and follow-up management of these devices is well-recognized. However, the increasing complexity and growing number of CIEDs makes their management a demanding medical service. Traditionally, interrogation and programming of CIEDS is performed using a portable programmer by qualified personnel, requiring patient physical presence. During the last decade, remote monitoring (RM) of CIEDs tends to become more and more popular given the advantages and improved outcomes in many groups of patients. Currently, RM represents the standard of care for CIED follow-up, and it is recommended by major cardiology societies worldwide, including the European Society of Cardiology. The objective of this statement is to summarize the current management of patients with CIED in Greece and the available evidence about clinical efficacy and safety of RM of CIEDs, present the most recent guideline recommendations, and, finally, propose actions to move toward the widespread adoption of RM of CIEDs in Greece.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434396","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":"30-day unplanned readmission rates and causes in patients hospitalised for acute coronary syndrome based on DANish CoMorbidity index for Acute Myocardial Infarction score.","authors":"Balamrit Singh Sokhal, Andrija Matetić, Michelle Marshall, Helen Twohig, Thomas Shepherd, Christian D Mallen, Mamas A Mamas","doi":"10.1016/j.hjc.2025.01.006","DOIUrl":"10.1016/j.hjc.2025.01.006","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association of the DANish CoMorbidity Index for Acute Myocardial Infarction (DANCAMI) score with 30-day unplanned readmission rates and causes in patients with acute coronary syndrome (ACS).</p><p><strong>Methods: </strong>Using the US National Readmission Database, all index hospitalisations with a principal diagnosis of ACS between October 2015 and December 2019 were stratified by their DANCAMI score using International Classification of Diseases-10th edition codes. Thirty-day unplanned readmission rates and causes were analysed, including the assessment of factors associated with readmission. Multivariable regression analyses were reported as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>Of 2,066,328 ACS admissions, 173,304 (8.4%) had a DANCAMI score of 0, 602,640 (29.2%) had a DANCAMI score of 1-3, 327,046 (15.8%) had a DANCAMI score of 4-5, and 963,338 (46.6%) had a DANCAMI score ≥6. 189,240 (9.2%) had an unplanned readmission within 30 days. Patients with a higher DANCAMI score were more likely to be older and have an index presentation of non-ST-elevation ACS. A DANCAMI score ≥6 (aOR 1.30 95% CI 1.27-1.34), age (aOR 1.01 95% CI 1.01-1.01), female sex (aOR 1.09 95% CI 1.08-1.10), index ST-elevation ACS (aOR 1.03 95% CI 1.01-1.04), and atrial fibrillation (aOR 1.35 95% CI 1.33-1.37) were independently associated with readmission (all p < 0.001). Higher scores were associated with an increasing likelihood of readmission for non-cardiovascular causes.</p><p><strong>Conclusion: </strong>Increased DANCAMI score was associated with higher readmissions in patients with ACS. The DANCAMI score could be a valuable tool to assess risk.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257259","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}