Nikolaos Theodorakis, Christos Hitas, Dimitrios Anagnostou, Magdalini Kreouzi, Sofia Kalantzi, Aikaterini Spyridaki, Gesthimani Triantafylli, Zoi Kollia, Michalitsa Christodoulou, Ioanna Nella, Georgios Feretzakis, Vassilios S Verykios, Maria Nikolaou
{"title":"Burden of cardiovascular hospitalizations and in-hospital mortality in Greece: national trends over five years.","authors":"Nikolaos Theodorakis, Christos Hitas, Dimitrios Anagnostou, Magdalini Kreouzi, Sofia Kalantzi, Aikaterini Spyridaki, Gesthimani Triantafylli, Zoi Kollia, Michalitsa Christodoulou, Ioanna Nella, Georgios Feretzakis, Vassilios S Verykios, Maria Nikolaou","doi":"10.1016/j.hjc.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.hjc.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>Nationwide epidemiological studies provide crucial insights into the burden of prevalent and emerging diseases, guiding the development of targeted health policies. This study analyzes trends in cardiovascular disease (CVD) hospitalizations and in-hospital mortality in Greece.</p><p><strong>Methods: </strong>Anonymized data were retrieved from the Hellenic Statistical Authority to calculate hospitalization rates (HRs) per 100,000 population and in-hospital mortality for cardiovascular (CV) sub-causes from 2013 to 2017. The statistical significance of temporal trends was assessed using generalized linear models in Python.</p><p><strong>Results: </strong>From 2013 to 2017, HRs increased by 9.2% for myocardial infarctions (MIs), 34.5% for heart failure (HF), 12.3% for stroke, 62.7% for cardiac arrest, and 36.6% for pulmonary embolism. In 2017, CVDs were the leading cause of hospitalization (14%) with a HR of 1942.4 per 100,000 population, with HF being the leading CV sub-cause of hospitalization (12%). HF together with stroke, atrial fibrillation/flutter (AF/Af), and coronary artery disease represented over 60% of all CV hospitalizations. While coronary artery disease was more prevalent in the male population, HF, strokes, and AF/Af were the primary CV sub-causes in the female population. HRs were higher in the male population for most CV sub-causes. Higher in-hospital mortality was found in the female population across all major CV sub-causes.</p><p><strong>Conclusion: </strong>This study demonstrated significant shifts in the burden of CV sub-causes in Greece, with increasing HRs for MIs and HF. These findings highlight the need for optimization of guideline implementation, and development of specialized CV units and cardiogeriatric centers to address the challenges posed by the aging population.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027045","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 history of Naxos disease: pioneering innovation and collaboration with limited means.","authors":"Adalena Tsatsopoulou","doi":"10.1016/j.hjc.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.hjc.2025.04.001","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042973","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}
Lefteris Teperikidis, Georgios Zormpas, Paschalis Karakasis, Dimitrios Patoulias, Aristi Boulmpou, Dimitrios E Kouzoukas, Bernardo Cortese, Giuseppe Biondi-Zoccai, Christodoulos Papadopoulos
{"title":"Efficacy of drug-coated balloons versus drug-eluting stents in bifurcated lesions: a systematic review and meta-analysis.","authors":"Lefteris Teperikidis, Georgios Zormpas, Paschalis Karakasis, Dimitrios Patoulias, Aristi Boulmpou, Dimitrios E Kouzoukas, Bernardo Cortese, Giuseppe Biondi-Zoccai, Christodoulos Papadopoulos","doi":"10.1016/j.hjc.2025.03.009","DOIUrl":"10.1016/j.hjc.2025.03.009","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781915","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}
Aurore Ughetto, Miloud Cherbi, Nicolas Lamblin, Laurent Bonello, Guillaume Leurent, Bruno Levy, Meyer Elbaz, Stéphane Manzo-Silberman, Pascal Lim, Francis Schneider, Alain Cariou, Hadi Khachab, Jeremy Bourenne, Marie-France Seronde, Brahim Harbaoui, Gerald Vanzetto, Charlotte Quentin, Hamid Merdji, Nicolas Combaret, Benjamin Marchandot, Benoit Lattuca, Patrick Henry, Edouard Gerbaud, Danka Tomasevic, Etienne Puymirat, François Roubille, Clément Delmas
{"title":"Features and outcomes of hypertrophic cardiomyopathy complicated by cardiogenic shock: an analysis of the FRENSHOCK multicenter prospective registry.","authors":"Aurore Ughetto, Miloud Cherbi, Nicolas Lamblin, Laurent Bonello, Guillaume Leurent, Bruno Levy, Meyer Elbaz, Stéphane Manzo-Silberman, Pascal Lim, Francis Schneider, Alain Cariou, Hadi Khachab, Jeremy Bourenne, Marie-France Seronde, Brahim Harbaoui, Gerald Vanzetto, Charlotte Quentin, Hamid Merdji, Nicolas Combaret, Benjamin Marchandot, Benoit Lattuca, Patrick Henry, Edouard Gerbaud, Danka Tomasevic, Etienne Puymirat, François Roubille, Clément Delmas","doi":"10.1016/j.hjc.2025.03.005","DOIUrl":"10.1016/j.hjc.2025.03.005","url":null,"abstract":"<p><strong>Objective: </strong>Cardiogenic shock (CS) in patients with left ventricular hypertrophy (LVH) due to hypertrophic cardiomyopathy (HCM) or hypertensive heart disease, is underreported in the literature. This study aimed to delineate the characteristics, management strategies, and outcomes of patients experiencing CS with preexisting LVH and HCM.</p><p><strong>Methods: </strong>FRENSHOCK is a prospective multicenter registry including 772 unselected CS patients from 49 centers. Baseline characteristics, management, and 1-year outcomes were analyzed according to the occurrence on preexisting LVH.</p><p><strong>Results: </strong>Among the 772 included patients with CS, CS occurred in 34 patients with preexisting LVH (4.4%, 1.4% with HCM). Clinical characteristics, medical history, usual medications, and hemodynamic parameters upon inclusion did not differ between the patients with or without LVH. Left ventricular ejection fraction in patients with CS and LVH was 27.3 ± 14.5% indicating a non-obstructive cause of CS. In-hospital management according to the LVH and non-LVH groups indicated no differences between the groups. The 1-month and 1-year mortality did not differ between patients with CS with and without LVH (26.5% vs. 26%, adjusted HR [hazard ratio] [95% CI]: 0.87 [0.44-1.72]) and 55.9% vs. 44.7%, respectively (adjusted HR [95% CI]:0.88 [0.54-1.42]). Subgroup analyses comparing HCM (n = 11) and hypertensive LVH (n = 23) revealed similar clinical characteristics, in-hospital management, and one-year rehospitalization rates in these patients.</p><p><strong>Conclusion: </strong>In a large and unselected CS population, the prevalence of patients with LVH was low (4.4%) with less than half having HCM (1.4%). The presentation, management, and outcomes of CS were similar to the broader CS population in our series. However, HCM-CS represents a distinct clinical entity necessitating tailored management approaches.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694391","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}
Alica Cesnakova Konecna, Otakar Jiravsky, Jan Alexander Mohr, Miroslav Hudec, Jaroslav Januska, Ivan Ranic, Radim Spacek, Piotr Branny, David Vician, Bogna Jiravska Godula, Libor Sknouril, Leos Pleva, Matej Pekar
{"title":"Atrial fibrillation's role in MitraClip patient outcomes: a retrospective analysis of mortality and heart failure hospitalization in a single-centre cohort.","authors":"Alica Cesnakova Konecna, Otakar Jiravsky, Jan Alexander Mohr, Miroslav Hudec, Jaroslav Januska, Ivan Ranic, Radim Spacek, Piotr Branny, David Vician, Bogna Jiravska Godula, Libor Sknouril, Leos Pleva, Matej Pekar","doi":"10.1016/j.hjc.2025.03.004","DOIUrl":"10.1016/j.hjc.2025.03.004","url":null,"abstract":"<p><strong>Objective: </strong>Atrial fibrillation (AF) is common in patients with mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER) with MitraClip; however, its impact on procedural hemodynamics and clinical outcomes remains inadequately characterized.</p><p><strong>Methods: </strong>This retrospective single-center study analyzed 226 high-risk patients who underwent MitraClip implantation between 2010 and 2022. The primary endpoint was time to first heart failure hospitalization. Secondary endpoints included procedural hemodynamics and long-term mortality.</p><p><strong>Results: </strong>AF was observed in 46.9% of the patients and was associated with distinct hemodynamic features, including significantly elevated right (11 vs. 9 mmHg, P = 0.008) and left atrial pressures (17 vs. 15 mmHg, P = 0.023). Despite similar procedural success rates, patients with AF experienced markedly accelerated time to first HF hospitalization (median 48 vs. 106 weeks, P = 0.005). Tricuspid regurgitation at discharge emerged as the strongest predictor of early heart failure hospitalization (HR 1.393, 95% CI: 1.009-1.924, P = 0.044). One-year mortality (16.0% vs. 16.7%, P = 0.899) and long-term survival remained comparable between groups.</p><p><strong>Conclusion: </strong>AF in TEER patients is characterized by elevated atrial filling pressures and substantially accelerated time to heart failure hospitalization, with tricuspid regurgitation at discharge predicting early events. Although these findings indicate the need for more intensive monitoring of patients with AF during the first post-procedural year, comparable survival rates suggest that AF alone should not preclude TEER in otherwise suitable candidates.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671778","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}
Linqi Liu, Yilin Pan, Zhao Ma, Jinfan Tian, Haoran Xing, Min Zhang, Mingduo Zhang, Feng Xu, Yanlong Ren, Lijun Zhang, Lei Xu, Li Wang, Xun Wang, Hongjia Zhang, Xiantao Song, Chenchen Tu
{"title":"Improved evaluation of coronary artery diseases from patients with coronary calcification utilizing FFR<sub>CT</sub>: a comparative study against CCTA.","authors":"Linqi Liu, Yilin Pan, Zhao Ma, Jinfan Tian, Haoran Xing, Min Zhang, Mingduo Zhang, Feng Xu, Yanlong Ren, Lijun Zhang, Lei Xu, Li Wang, Xun Wang, Hongjia Zhang, Xiantao Song, Chenchen Tu","doi":"10.1016/j.hjc.2025.03.002","DOIUrl":"10.1016/j.hjc.2025.03.002","url":null,"abstract":"<p><strong>Objective: </strong>This multicenter study evaluated the diagnostic accuracy of coronary computed tomography angiography (CCTA) and computed tomography-derived fractional flow reserve (FFR<sub>CT</sub>) in diagnosing coronary artery disease (CAD), focusing on the impact of coronary calcification, using invasive coronary angiography (ICA) as the reference.</p><p><strong>Methods: </strong>The study analyzed 4172 patients from 3 centers who underwent CCTA and FFR<sub>CT</sub> between August 2021 and August 2022. Exclusion criteria included the absence of ICA within 90 days after CCTA, left main disease, previous coronary revascularization, or unmeasurable Agatston score (AS).</p><p><strong>Results: </strong>The study included 492 patients. In patients with less than mild calcification (AS < 100), the area under the receiver operating characteristic curve (AUC) for FFR<sub>CT</sub> was superior to CCTA (0.87 [95% confidence interval (CI): 0.82-0.92] vs. 0.78 [95% CI: 0.73-0.84], P = 0.009). As the severity of calcification increased, both CCTA and FFR<sub>CT</sub> showed reduced diagnostic efficacy, but FFR<sub>CT</sub> maintained higher accuracy. In patients with greater than moderate calcification (AS ≥ 100), FFR<sub>CT</sub> significantly outperformed CCTA (0.80 [95% CI: 0.74-0.85] vs. 0.62 [95% CI: 0.56-0.68], P < 0.001). Furthermore, integrating FFR<sub>CT</sub> with CCTA and baseline factors using least absolute shrinkage and selection operator (LASSO) improved diagnostic performance in patients with greater than moderate calcification (AS≥100) than FFR<sub>CT</sub> (0.85 [95% CI: 0.78-0.92] vs. 0.81 [95% CI: 0.72-0.90], P = 0.003).</p><p><strong>Conclusion: </strong>FFR<sub>CT</sub> offers superior diagnostic accuracy over CCTA, particularly in patients with moderate to severe calcification. Furthermore, the LASSO model enhances diagnostic performance in these cases, demonstrating potential for improving CAD diagnosis in patients with significant coronary calcification.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598483","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":"L1 cell adhesion molecule: a novel potential biomarker for infective endocarditis patients at high risk of embolism and adverse events.","authors":"Jian Hou, Dayu Wang, Tingfeng Chen, Zhen Liu, Ruibing Wei, Cuiping Wang, Suiqing Huang","doi":"10.1016/j.hjc.2025.03.001","DOIUrl":"10.1016/j.hjc.2025.03.001","url":null,"abstract":"<p><strong>Aims: </strong>Despite advancements in medical and surgical therapies, infective endocarditis (IE) remains life-threatening owing to its complications. This study aimed to evaluate the clinical value and function of L1 cell adhesion molecule (L1CAM) in IE.</p><p><strong>Methods: </strong>A prospective observational study including 94 IE patients (40 with embolic events [EEs], 54 without; 38 with adverse events, 56 without) and 25 healthy controls was conducted. Adverse events were defined as death or poorly controlled conditions requiring surgery. Plasma L1CAM levels were measured using enzyme-linked immunosorbent assays. Logistic regression and receiver operating characteristic curves were used to assess the predictive value of L1CAM levels for EEs and adverse events.</p><p><strong>Results: </strong>L1CAM levels were higher in IE patients than in healthy controls (47.60 ± 10.86 vs. 94.80 ± 68.84 pg/mL, P = 0.008). Among IE patients, those with EEs or adverse events had significantly elevated L1CAM levels (EEs: 127.70 ± 78.20 vs. 70.45 ± 48.96 pg/mL; adverse events: 129.00 ± 79.79 vs. 71.59 ± 48.73 pg/mL, both P < 0.001). Multivariate analysis showed L1CAM level was an independent predictor for EEs (OR = 1.02; 95% CI = 1.01-1.04; P = 0.001) and adverse events (OR = 1.01; 95% CI = 1.00-1.02; P = 0.003). Areas under the curve were 0.7273 and 0.7119 for EEs and adverse events, respectively. L1CAM correlated positively with white blood cell count (P = 0.028, r = 0.225) and C-reactive protein levels (P = 0.025, r = 0.231).</p><p><strong>Conclusions: </strong>L1CAM may serve as a biomarker for embolism and adverse events in IE patients.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588356","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}
Georgios E Papadopoulos, Ilias Ninios, Eleftherios Leptopoulos, Konstantinos Papazoglou, Konstantinos Konstantinidis, Sotirios Evangelou, Andreas Ioannides, Vlasis Ninios
{"title":"Comparative analysis of percutaneous vs. surgical access in transfemoral TAVR: a propensity-matched cohort study.","authors":"Georgios E Papadopoulos, Ilias Ninios, Eleftherios Leptopoulos, Konstantinos Papazoglou, Konstantinos Konstantinidis, Sotirios Evangelou, Andreas Ioannides, Vlasis Ninios","doi":"10.1016/j.hjc.2025.03.003","DOIUrl":"10.1016/j.hjc.2025.03.003","url":null,"abstract":"<p><strong>Objective: </strong>Transcatheter aortic valve replacement (TAVR) is a proven treatment for severe aortic stenosis. Transfemoral access is the most prevalent method, achieved either surgically or percutaneously. This study compared in-hospital outcomes and length of stay between surgical cut-down and fully percutaneous approaches.</p><p><strong>Methods: </strong>This retrospective, propensity-matched study analyzed medical records of all patients who underwent transfemoral TAVR at our center from January 2019 to December 2023. Outcomes were assessed based on Valve Academic Research Consortium-2 (VARC-2) consensus criteria.</p><p><strong>Results: </strong>A total of 251 TAVR patients (77 propensity score-matched pairs) were included (55% female) with a median (IQR) age of 80 (11) years. Surgical cut-down showed fewer vascular complications, bleeding, and transfusions. No death was reported in this group. Fewer mean hospitalization days were observed in the total cohort over the years (p < 0.001). This reduction was more pronounced after 2021 when the surgical approach was adopted. Mean hospitalization days were 6.40 ± 6.46 for percutaneous and 4.34 ± 1.61 for surgical groups (p < 0.001).</p><p><strong>Conclusion: </strong>Surgical cut-down for TAVR femoral access yields superior outcomes and shorter hospital stays compared to fully percutaneous methods.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588353","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}