George Michas , Ioannis Alexanian , Georgia Ntali , Marinella Tzanela , Athanasios Trikas
{"title":"Establishing a cardiometabolic outpatient department in Greece: a roadmap for multidisciplinary care","authors":"George Michas , Ioannis Alexanian , Georgia Ntali , Marinella Tzanela , Athanasios Trikas","doi":"10.1016/j.hjc.2024.05.018","DOIUrl":"10.1016/j.hjc.2024.05.018","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 112-115"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293982","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}
Paris Dimitrios Kalogerakos , Athanasios Pirentis , Yiannis Papaharilaou , Christos Skiadas , Apostolos Karantanas , Hamid Mojibian , Maria Marketou , George Kochiadakis , John Alex Elefteriades , George Lazopoulos
{"title":"Significant unfavorable geometrical changes in ascending aorta despite stable diameter at follow-up","authors":"Paris Dimitrios Kalogerakos , Athanasios Pirentis , Yiannis Papaharilaou , Christos Skiadas , Apostolos Karantanas , Hamid Mojibian , Maria Marketou , George Kochiadakis , John Alex Elefteriades , George Lazopoulos","doi":"10.1016/j.hjc.2023.10.007","DOIUrl":"10.1016/j.hjc.2023.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>The clinical importance of following up on the ascending aortic diameter lies in the fundamental presumption that wall pathology eventually manifests as a change in shape. However, the diameter describes the vessel locally, and the 55 mm criterion fails to prevent most dissections. We hypothesized that geometric changes across the ascending aorta are not necessarily imprinted on its diameter; i.e. the maximum diameter correlates weakly and insignificantly with elongation, surface stretching, engorgement, and tortuosity.</div></div><div><h3>Methods</h3><div>Two databases were interrogated for patients who had undergone at least 2 ECG-gated CT scans. The absence of motion artifacts permitted the generation of exact copies of the ascending aorta which then underwent three-dimensional analysis producing objective and accurate measurements of the centreline length, surface, volume, and tortuosity. The correlations of these global variables with the diameter were explored.</div></div><div><h3>Results</h3><div>Twenty-two patients, 13 male and 9 female, were included. The mean age at the first and last scan was 63.7 and 67.1 y, respectively. The mean diameter increase was approximately 1 mm/y. There were no dissections, while 7 patients underwent preemptive surgery. The yearly change rate of the global variables, normalized to height if applicable, showed statistically insignificant, weak, or negligible correlation with diameter increments at follow-up. Most characteristically, a patient's aorta maintained its diameter, while undergoing 1 mm/y elongation, 151 mm<sup>2</sup>/(y·m) stretching, 2366 mm<sup>3</sup>/(y·m) engorgement, and 0.02/y tortuosity.</div></div><div><h3>Conclusion</h3><div>Maximum diameter provides a local description of the ascending aorta and cannot fully portray the pathological process across this vessel. Following up the diameter is not suggestive of length, surface, volume, and tortuosity changes.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 55-63"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489175","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}
Hugo Costa , Miguel Espírito-Santo , Raquel Fernandes , João Bispo , João Guedes , Pedro Azevedo , Daniela Carvalho , Hugo Vinhas , Rui Baptista Gonçalves , Jorge Mimoso , Portuguese Registry of Acute Coronary Syndromes (ProACS)
{"title":"Pretreatment antithrombotic strategies in non-ST elevation acute coronary syndromes in contemporaneous clinical practice","authors":"Hugo Costa , Miguel Espírito-Santo , Raquel Fernandes , João Bispo , João Guedes , Pedro Azevedo , Daniela Carvalho , Hugo Vinhas , Rui Baptista Gonçalves , Jorge Mimoso , Portuguese Registry of Acute Coronary Syndromes (ProACS)","doi":"10.1016/j.hjc.2023.11.003","DOIUrl":"10.1016/j.hjc.2023.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Pretreatment antithrombotic strategies in non-ST elevation acute coronary syndromes (NSTE-ACS) during hospitalization is still a matter of contention within the cardiology community. Our aim was to analyze in-hospital and one-year follow-up outcomes of patients with NSTE-ACS pretreated with dual antiplatelet therapy (DAPT) versus single antiplatelet therapy (SAPT).</div></div><div><h3>Methods</h3><div>A retrospective study was carried out with NSTE-ACS patients who planned to undergo an invasive strategy and were included in the Portuguese Registry of ACS between 2018 and 2021. A composite primary outcome (in-hospital re-infarction, stroke, heart failure, hemorrhage, death) was compared regarding antiplatelet strategy (DAPT versus SAPT). Secondary outcomes were defined as one-year all-cause mortality and one-year cardiovascular rehospitalization.</div></div><div><h3>Results</h3><div>A total of 1469 patients were included, with a mean age of 66 ± 12 years, and 73.9 % were male. The DAPT regime was used in 38.2 % of patients and SAPT in 61.8 % of patients. NSTE myocardial infarction was the most frequent presentation (88.5 %). Revascularization was performed within 24 h in 55.2% of patients. Time until revascularization >24 h occurred in 44.8% of patients, with 16.5% of these between [24 h–48 h], 10.6% in [48 h–72 h] and 17.6% > 72 h. The primary outcome was more frequently observed in the SAPT group (10.4 %, p = 0.033), mainly driven by more ischemic events. Time until revascularization >72 h and the SAPT regime were independent predictors of the primary outcome (OR 3.09, p = 0.005, and OR 2.03, p = 0.008, respectively).</div></div><div><h3>Conclusion</h3><div>NSTE-ACS patients pretreated with SAPT had worse in-hospital outcomes. This difference can probably be explained by time until revascularization delay.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 12-20"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92157389","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}
Shuang Peng , Lei Yu , Yuhua Gao , Shan Dong , Yuhui Bai , Guojun Li , Changxue Liang , Zhuoyao Tian , Changsheng Lv , Fu Zhou , Yuan Wei , Ge Wang , Liangming Li , Guang Hao
{"title":"Association of objectively measured walking speed with incident cardiovascular diseases in middle-aged and older Chinese adults","authors":"Shuang Peng , Lei Yu , Yuhua Gao , Shan Dong , Yuhui Bai , Guojun Li , Changxue Liang , Zhuoyao Tian , Changsheng Lv , Fu Zhou , Yuan Wei , Ge Wang , Liangming Li , Guang Hao","doi":"10.1016/j.hjc.2023.10.006","DOIUrl":"10.1016/j.hjc.2023.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between objectively measured walking speed and cardiovascular disease (CVD) risk in middle-aged and elderly Chinese adults.</div></div><div><h3>Methods</h3><div>A total of 3969 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included in this study. Multilevel logistic and linear regression models (community-household-individual) were used to estimate the association between walking speed and the risk of CVD.</div></div><div><h3>Results</h3><div>A total of 1037 participants had a CVD event during the follow-up period, including 776 (19.6%) cases of cardiac disease and 353 (8.9%) cases of stroke. Participants who walked faster had a lower risk of CVD (tertile 2: OR = 0.80, 95% CI: 0.67-0.97, <em>P</em> = 0.022; tertile 3: OR = 0.73, 95% CI: 0.60–0.89, <em>P</em> = 0.002). Further analysis showed that participants who walked faster also had a lower risk of cardiac disease and stroke (cardiac disease: tertile 2: OR = 0.91, 95% CI: 0.74–1.12, <em>P</em> = 0.368; tertile 3: OR = 0.85, 95% CI: 0.68–1.07, <em>P</em> = 0.161; stroke: tertile 2: OR = 0.33, 95% CI: 0.14–0.78, <em>P</em> = 0.012; tertile 3: OR = 0.30, 95% CI: 0.11–0.82, <em>P</em> = 0.019). The results were consistent in pre-specified subgroups by sex, age, and body mass index.</div></div><div><h3>Conclusion</h3><div>We found that faster, objectively measured walking speed was significantly associated with a lower risk of CVD, especially stroke, in middle-aged and elderly Chinese people.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 47-54"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127479","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":"Transoesophageal echocardiography beyond the echo-laboratory. An expert consensus paper of the working group of echocardiography of the hellenic society of cardiology","authors":"Constantinos H. Papadopoulos , Nikolaos P.E. Kadoglou , Anastasios Theodosis-Georgilas , Ilias Karabinos , Savvas Loizos , Konstantinos G. Papadopoulos , Michail Chrysocheris , Vlasis Ninios , Alexandra Frogoudaki , Maria Drakopoulou , Maria Angelaki , Loukianos Rallidis , Nearchos Kassinos , Vasilios Sahpekidis , George Makavos , Kiriakos Yiangou , Stefanos Karagiannis , Nikolaos Zois , Alexandros Patrianakos , Ignatios Ikonomidis , Alexandros Stefanidis","doi":"10.1016/j.hjc.2024.06.004","DOIUrl":"10.1016/j.hjc.2024.06.004","url":null,"abstract":"<div><div>Transoesophageal echocardiography (TOE) is a well-established and valid imaging modality, providing more accurate and of higher quality information than transthoracic echocardiography (TTE) for several specific diagnoses and recently a useful guide of an increasing number of catheter-based and surgical interventions. The present paper represents an effort by the Echocardiography Working Group (WG) of the Hellenic Society of Cardiology to state the essential steps of the TOE exam performed beyond the echo lab: a) in the operating rooms intraoperatively during either transcatheter interventions, or cardiothoracic surgery and b) in the intensive care unit for critically ill patients’ monitoring. This paper includes information and tips and tricks about the pre-procedural evaluation, the procedural echocardiographic guidance, and post-procedural evaluation of the result and potential complications.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 64-82"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433427","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}
Dan Ni , Xiaofang Lin , Chuanhuan Deng , Ludong Yuan , Jing Li , Yuxuan Liu , Pengfei Liang , Bimei Jiang
{"title":"Energy metabolism: from physiological changes to targets in sepsis-induced cardiomyopathy","authors":"Dan Ni , Xiaofang Lin , Chuanhuan Deng , Ludong Yuan , Jing Li , Yuxuan Liu , Pengfei Liang , Bimei Jiang","doi":"10.1016/j.hjc.2024.05.010","DOIUrl":"10.1016/j.hjc.2024.05.010","url":null,"abstract":"<div><div>Sepsis is a systemic inflammatory response syndrome caused by a variety of dysregulated responses to host infection with life-threatening multi-organ dysfunction. Among the injuries or dysfunctions involved in the course of sepsis, cardiac injury and dysfunction often occur and are associated with the pathogenesis of hemodynamic disturbances, also defined as sepsis-induced cardiomyopathy (SIC). The process of myocardial metabolism is tightly regulated and adapts to various cardiac output demands. The heart is a metabolically flexible organ capable of utilizing all classes of energy substrates, including carbohydrates, lipids, amino acids, and ketone bodies, to produce ATP. The demand of cardiac cells for energy metabolism changes substantially in septic cardiomyopathy, with distinct etiological causes and different times. This review describes changes in cardiomyocyte energy metabolism under normal physiological conditions and some features of myocardial energy metabolism in septic cardiomyopathy and briefly outlines the role of the mitochondria as a center of energy metabolism in the septic myocardium, revealing that changes in energy metabolism can serve as a potential future therapy for infectious cardiomyopathy.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 96-106"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909341","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}
Lara-Marie Yamagata , Kentaro Yamagata , Alexander Borg , Mark Abela
{"title":"Shifting paradigms in hypertrophic cardiomyopathy: the role of exercise in disease management","authors":"Lara-Marie Yamagata , Kentaro Yamagata , Alexander Borg , Mark Abela","doi":"10.1016/j.hjc.2024.07.001","DOIUrl":"10.1016/j.hjc.2024.07.001","url":null,"abstract":"<div><div>Hypertrophic cardiomyopathy (HCM) is traditionally associated with exercise restriction due to potential risks, yet recent evidence and guidelines suggest a more permissive stance for low-risk individuals. The aim of this comprehensive review was to examine existing research on the impact of exercise on cardiovascular outcomes, safety, and quality of life in this population and to consider implications for clinical practice. Recent studies suggest that regular exercise and physical activity in low-risk individuals with HCM are associated with positive outcomes in functional capacity, haemodynamic response, and quality of life, with consistent safety. Various studies highlight the safety of moderate-intensity exercise, showing improvements in exercise capacity without adverse cardiac remodelling or significant arrhythmias. Psychological benefits, including reductions in anxiety and depression, have been also reported following structured exercise programmes. These findings support the potential benefits of integrating individualised exercise regimens in the management of low-risk individuals with HCM, with the aim of improving their overall well-being and cardiovascular health. Adoption of the FITT (frequency, intensity, time, and type of exercise) principle, consideration of individual risk profiles, and shared decision-making are recommended. Future research is warranted to clarify the definition of ‘low risk’ for exercise participation and investigate the influence of physical activity on disease progression in HCM. Innovation in therapeutic strategies and lifestyle interventions, alongside improved patient and provider education, will help advance the care and safety of individuals with HCM engaging in exercise.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 83-95"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560410","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 emerging importance of assessing recovery period gas exchange variables during cardiopulmonary exercise testing","authors":"Stavros Dimopoulos , Serafim Nanas","doi":"10.1016/j.hjc.2024.04.001","DOIUrl":"10.1016/j.hjc.2024.04.001","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 116-117"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140583955","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}