Hellenic Journal of Cardiology最新文献

{"title":"Myocardial work in patients with heart failure and ischemic cardiomyopathy according to the mode of coronary revascularization","authors":"","doi":"10.1016/j.hjc.2023.08.005","DOIUrl":"10.1016/j.hjc.2023.08.005","url":null,"abstract":"<div><h3>Background</h3><p>The association of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) on myocardial function, as reflected in myocardial work (MyW) parameters, in patients with ischemic cardiomyopathy and heart failure (HF) is unknown.</p></div><div><h3>Methods</h3><p>We analyzed data from 68 patients who were hospitalized with chronic HF due to ischemic cardiomyopathy and stratified them according to the mode of revascularization. All patients underwent a 2D speckle tracking echocardiography exam performed by the same expert sonographer and had complete MyW data including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE).</p></div><div><h3>Results</h3><p>The mean age of patients was 70 ± 10 years and 86.8% were men. The mean left ventricular ejection fraction (LVEF) in overall cohort was 31.6 ± 9.5%. Both subgroups did not significantly differ in terms of baseline LVEF, comorbidities, and pharmacotherapy. Compared with those who received PCI, patients revascularized with CABG had significantly greater GWI (821 <em>vs.</em> 555 mmHg%, p = 0.002), GCW (1101 <em>vs.</em> 794 mmHg%, p = 0.001), GWE (78 <em>vs.</em> 72.6%, p = 0.025), and global longitudinal strain (−8.7 <em>vs.</em> −6.7%, p = 0.004). Both patient subgroups did not significantly differ with respect to GWW (273 <em>vs.</em> 245 mmHg%, p = 0.410 for CABG and PCI, respectively) and survival during the median follow-up of 18 months (log-rank p = 0.813).</p></div><div><h3>Conclusion</h3><p>Patients with HF and ischemic cardiomyopathy revascularized with CABG had greater myocardial work performance when compared with those revascularized with PCI. This might suggest a higher degree of functional myocardial revascularization associated with the CABG procedure.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 16-24"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001422/pdfft?md5=1892041827f918e4fe06e4b0d53e20c9&pid=1-s2.0-S1109966623001422-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10133568","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":"Atrial fibrillation impact on hospitalization costs for the management of acute ischemic stroke. Results from the athens stroke registry","authors":"","doi":"10.1016/j.hjc.2024.02.008","DOIUrl":"10.1016/j.hjc.2024.02.008","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 87-89"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966624000332/pdfft?md5=ce57aeadbf5a23790fe7043ad0830941&pid=1-s2.0-S1109966624000332-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139927447","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":"Association of serum cytokines with coronary chronic total occlusion and their role in predicting procedural outcomes","authors":"","doi":"10.1016/j.hjc.2023.08.013","DOIUrl":"10.1016/j.hjc.2023.08.013","url":null,"abstract":"<div><h3>Background</h3><p>Cytokines are strongly associated with coronary artery disease (CAD); however, few studies have explored the relevance of cytokines in coronary chronic total occlusion (CTO). This study aimed to clarify the association of cytokines with CTO and its procedural outcomes.</p></div><div><h3>Methods</h3><p>A total of 526 patients with suspected CAD but not acute myocardial infarction were enrolled and divided into CTO (n = 122) and non–CTO (n = 404) groups based on coronary angiography. Furthermore, serum levels of 12 cytokines [Interleukin–1β (IL–1β), IL–2, IL–4, IL–5, IL–6, IL–8, IL–10, IL–12p70, IL–17, tumor necrosis factor–α (TNF–α), interferon–α (IFN–α), and IFN–γ] were measured for each patient.</p></div><div><h3>Results</h3><p>Patients with CTO had higher rates of male (<em>P</em> = 0.001), smoking (<em>P</em> = 0.014), and diabetes (<em>P</em> = 0.008); higher levels of IL–6 (<em>P</em> &lt; 0.001), total triglycerides (<em>P</em> = 0.020), serum creatine (<em>P</em> = 0.001), and high–sensitivity troponin I (<em>P</em> = 0.001); and lower IL–4 (<em>P</em> &lt; 0.001), total cholesterol (<em>P</em> = 0.027), and high–density lipoprotein cholesterol (HDL–C) (<em>P</em> &lt; 0.001) levels compared to those without CTO. IL–4 (OR = 0.216, 95%CI:0.135–0.345, <em>P</em> &lt; 0.001), IL–6 (OR = 1.248, 95%CI:1.165–1.337, <em>P</em> &lt; 0.001), and HDL–C (OR = 0.047, 95%CI:0.010–0.221, <em>P</em> &lt; 0.001) were identified as independent predictors of CTO. And good predictive performance (AUC = 0.876) for CTO, with a sensitivity of 81.96% and specificity of 81.19%, could be achieved by combining these three predictors. Furthermore, patients with procedural success had younger age (<em>P</em> = 0.004) and lower serum IL-6 levels (<em>P</em> = 0.039) compared to those with procedural failure, and IL-6 levels (OR = 0.962, 95%CI: 0.931-0.995, <em>P</em> = 0.023) were associated with procedural success.</p></div><div><h3>Conclusion</h3><p>IL–4, IL–6, and HDL–C levels were strongly associated with CTO, and IL–6 also linked to procedural outcomes of CTO.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 25-35"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001501/pdfft?md5=e09febe6a07fc42b386ff985f760bb94&pid=1-s2.0-S1109966623001501-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126088","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":"Mitral Valve Repair of the Anterior Leaflet: Are We There Yet?","authors":"","doi":"10.1016/j.hjc.2024.02.001","DOIUrl":"10.1016/j.hjc.2024.02.001","url":null,"abstract":"<div><p>Mitral regurgitation is one of the most prevalent valvulopathies with a disease burden that incurs significant healthcare costs globally. Surgical repair of the posterior mitral valve leaflet is a standard treatment, but approaches for repairing the anterior mitral valve leaflet are not widely established. Since anterior leaflet involvement is less common and more difficult to repair, fewer studies have investigated its natural history and treatment options. In this review, we discuss surgical techniques for repairing the anterior leaflet and their outcomes, including survival, reoperation, and recurrence of regurgitation. We show that most patients with mitral regurgitation from the anterior leaflet can be repaired with good outcomes if performed at centers with expertise. Additionally, equal consideration for early repair should be given to patients with mitral regurgitation from both anterior and posterior pathology. However, more studies to better evaluate the efficacy and safety of anterior mitral valve leaflet repair are needed.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 72-83"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966624000253/pdfft?md5=faf53c33c69135d0b7dbca5393c5fff3&pid=1-s2.0-S1109966624000253-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736821","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":"Efficiency of optimal fluoroscopic projection angle defined by computed tomography angiography for left atrial appendage closure","authors":"","doi":"10.1016/j.hjc.2023.09.009","DOIUrl":"10.1016/j.hjc.2023.09.009","url":null,"abstract":"<div><h3>Background</h3><p>Left atrial appendage (LAA) closure (LAAC) procedures are conventionally performed using empirical fluoroscopic viewing angles. However, because the LAA is a highly variable anatomical structure, these angles cannot depict the LAA in the optimal position. The present study aimed to assess the efficiency of using a novel optimal fluoroscopic projection angle (OPA) for LAAC and to validate its feasibility.</p></div><div><h3>Methods</h3><p>The OPAs of the derivation cohort were acquired using cardiac computed tomography angiography (CCTA) to assess its superiority for depicting LAA depth versus traditional working angles (TAs) of RAO 30°, CAU 20°. The practicability of OPA-guided LAAC was demonstrated by comparison between clinical data from the validation cohort and those from a propensity-score matched (PSM) control group, as well as randomized controlled studies investigating LAAC.</p></div><div><h3>Results</h3><p>Of 705 patients in the derivation cohort, the median OPA was RAO 46°, CAU 31°. Compared with TA, the OPA depicted a longer mean (±SD) LAA depth (5.1 ± 4.4) mm and a larger orifice diameter (1.1 ± 1.1 mm), (P &lt; 0.0001 for both). All 38 OPA-guided LAACs were successful, with a shorter mean procedure duration (42.9 ± 12.3 min versus [vs.] 107.2 ± 41.5 min; P &lt; 0.0001) and reduced device consumption (1.08 vs. 1.5 per case), compared with the PSM control group. At the 3-month follow-up, the incidence of peri-device leak was 52.6% (20/38) detected by CCTA, with a mean leakage of 1.6 ± 0.8 mm.</p></div><div><h3>Conclusion</h3><p>By unfolding the LAA depth and orifice diameter for a better view, OPA demonstrated the potential to optimize LAAC procedural efficiency, although further larger-scale studies are required to confirm this.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 50-59"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001793/pdfft?md5=86a89c29f25632e2842899cd3a3c3626&pid=1-s2.0-S1109966623001793-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10634080","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":"Is it a steal or a squeeze?","authors":"","doi":"10.1016/j.hjc.2024.03.007","DOIUrl":"10.1016/j.hjc.2024.03.007","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 93-94"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966624000629/pdfft?md5=912109a5fc0316f3d477b096b3728722&pid=1-s2.0-S1109966624000629-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061280","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":"Current landscape in cardiology training, unmet needs, and attitudes on career development among cardiology trainees and young cardiologists in Greece: An HCS young cardiologists WG survey","authors":"","doi":"10.1016/j.hjc.2023.11.006","DOIUrl":"10.1016/j.hjc.2023.11.006","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 90-92"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623002257/pdfft?md5=0d677efab65e755756894ab1ae3e4c02&pid=1-s2.0-S1109966623002257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296602","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":"Coronary artery disease and its management in TAVI","authors":"","doi":"10.1016/j.hjc.2023.09.004","DOIUrl":"10.1016/j.hjc.2023.09.004","url":null,"abstract":"<div><h3>Objective</h3><p>Aortic stenosis and coronary artery disease (CAD) are frequently associated. The preprocedural evaluation and indications for treatment in patients undergoing transcatheter aortic valve intervention (TAVI) remain controversial.</p><p>This study sought to 1) determine the prevalence and angiographic characteristics of CAD in TAVI candidates, along with revascularization patterns, and 2) to evaluate the impact of the presence and complexity of CAD, as well as angiography-guided percutaneous coronary intervention, on prognosis after TAVI.</p></div><div><h3>Methods</h3><p>Single-center retrospective study from a prospectively collected institutional registry that included all patients that underwent TAVI between 2009 and 2018 and pre TAVI coronary angiography (CA) in our institution in the context of pre-procedure work-up. A multivariate analysis was performed to determine the effect of CAD and PCI on 2-year mortality.</p></div><div><h3>Results</h3><p>A total of 379 patients were included: 55 patients (14.5%) presented with normal coronary arteries, 120 (31.6%) with non-obstructive CAD, and 204 (53.8%) with obstructive CAD (the mean SxS was 8.2). Ultimately, 110 patients (29%) underwent PCI. Two-year survival after TAVI was decreased in patients with complex coronary lesions (SS &gt; 22), while it was not affected by the overall presence of non-obstructive CAD, obstructive CAD, residual SxS, or pre-TAVI PCI of angiographically significant lesions (OR 0.631, 95%CI 0.192-1.406).</p></div><div><h3>Conclusion</h3><p>In our population, the overall presence and management of obstructive CAD did not appear to impact mortality at 2 years after TAVI. Survival was decreased in patients with baseline complex coronary anatomies.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 36-41"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001549/pdfft?md5=fa8fc94aaca2d24073e9472d1ce2aea3&pid=1-s2.0-S1109966623001549-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10188721","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":"Use of the CHA2DS2-VASc score to predict subsequent myocardial infarction in atrial fibrillation","authors":"","doi":"10.1016/j.hjc.2023.08.010","DOIUrl":"10.1016/j.hjc.2023.08.010","url":null,"abstract":"<div><h3>Background</h3><p>The risk of subsequent myocardial infarction (MI) varies widely in patients with atrial fibrillation (AF). No convenient scoring system currently exists to identify MI in AF. While each element of the CHA2DS2-VASc (congestive heart failure; hypertension; age ≥75 years [doubled]; type 2 diabetes; previous stroke or thromboembolism [doubled]; vascular disease; age 65–75 years; and sex category) score can increase the likelihood of MI, this retrospective longitudinal study aimed to determine the accuracy of the CHA2DS2-VASc score in predicting subsequent MI risk in AF.</p></div><div><h3>Methods</h3><p>A total of 29,341 patients with AF were enrolled and followed up from January 2010 until the first occurrence of MI or until December 2020. The primary endpoint was the occurrence of subsequent MI.</p></div><div><h3>Results</h3><p>The average age of the study population was 71 years, and 43.2% were male. The mean CHA2DS2-VASc score was found to be higher in patients with AF who had experienced an MI than in those who had not (3.56 ± 1.92 vs. 3.32 ± 1.81, p &lt; 0.001). During the long-term follow-up, the risk of subsequent MI increased by 22% with every one-point increase in the CHA2DS2-VASc score (hazard ratio 1.22, 95% confidence interval 1.19–1.25; p &lt; 0.001). Kaplan–Meier analysis revealed that high CHA2DS2-VASc scores were more likely to experience an MI than those with low CHA2DS2-VASc scores (log-rank p &lt; 0.001). Furthermore, the CHA2DS2-VASc score was a significant predictor of MI in multivariate regression analysis.</p></div><div><h3>Conclusion</h3><p>The CHA₂DS₂-VASc score is a valuable predictor of subsequent MI risk in patients with AF.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 42-49"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001471/pdfft?md5=32f7340fe4cdf89bbea5f0d09e4e33b7&pid=1-s2.0-S1109966623001471-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10191975","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":"Two-year clinical outcomes of resorbable magnesium scaffold versus conventional drug-eluting stents in ST-segment elevation myocardial infarction: A propensity score matching analysis","authors":"","doi":"10.1016/j.hjc.2023.12.004","DOIUrl":"10.1016/j.hjc.2023.12.004","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"78 ","pages":"Pages 84-86"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623002300/pdfft?md5=a5487d089de1747367c8e7cd69212e09&pid=1-s2.0-S1109966623002300-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886604","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}