Hellenic Journal of Cardiology最新文献

{"title":"Shifting paradigms in hypertrophic cardiomyopathy: the role of exercise in disease management","authors":"Lara-Marie Yamagata ,&nbsp;Kentaro Yamagata ,&nbsp;Alexander Borg ,&nbsp;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 ,&nbsp;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}

{"title":"Impact of reduced apolipoprotein A-I levels on pulmonary arterial hypertension","authors":"Yuxia Huang ,&nbsp;Ji Zhang ,&nbsp;Qinhua Zhao ,&nbsp;Xiaoyi Hu ,&nbsp;Hui Zhao ,&nbsp;Shang Wang ,&nbsp;Lan Wang ,&nbsp;Rong Jiang ,&nbsp;Wenhui Wu ,&nbsp;Jinming Liu ,&nbsp;Ping Yuan ,&nbsp;Sugang Gong","doi":"10.1016/j.hjc.2023.10.004","DOIUrl":"10.1016/j.hjc.2023.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>The significance of apolipoprotein A-I (ApoA-I) is the anti-inflammatory functional component of high-density lipoprotein, which needs to be further studied in relation to pulmonary arterial hypertension (PAH). This study aimed to identify the predictive value of ApoA-1 on the risk and prognosis of PAH, as well as the underlying anti-inflammatory mechanism.</div></div><div><h3>Methods</h3><div>Proteomic analysis was conducted on lung tissue from 6 PAH patients and 4 lung donors. Prediction of risk and mortality risk factors associated with PAH in 343 patients used logistic analysis and Cox regression analysis, respectively. The protective function of ApoA-I was assessed in human pulmonary arterial endothelial cells (HPAEC), while its anti-inflammatory function was evaluated in THP-1 macrophages.</div></div><div><h3>Results</h3><div>In the lung tissues of patients with PAH, 168 differentially expressed proteins were associated with lipid metabolism according to GO and KEGG enrichment analysis. A protein-protein interaction network identified ApoA-I as a key protein associated with PAH. Lower ApoA-I levels were independent risk factors for PAH and displayed a stronger predictive value for PAH mortality. Plasma interleukin 6 (IL-6) levels were positively correlated with risk stratification and were higher in PAH patients with lower ApoA-I levels. ApoA-I was downregulated in the lung tissues of monocrotaline (MCT) -induced rats. ApoA-I could reduce the IL-6-induced pro-proliferative and pro-migratory abilities of HPAEC and inhibit the secretion of IL-6 from macrophages, which is compromised under hypoxic conditions.</div></div><div><h3>Conclusion</h3><div>Our study identified the significance of ApoA-I as a biomarker for predicting the survival outcome of PAH patients, which might relate to its altered anti-inflammatory properties.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 31-46"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523355","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":"Sex-based differences in complex percutaneous coronary intervention—insights from the COMPLEX registry","authors":"Sylwia Iwańczyk ,&nbsp;Samir Ahmad Dit Al Hakim ,&nbsp;Marta Skrzypińska ,&nbsp;Zofia Stanisz ,&nbsp;Patrycja Woźniak ,&nbsp;Weronika Gościniak ,&nbsp;Aleksander Araszkiewicz ,&nbsp;Fatima Al Salman ,&nbsp;Ali Hok ,&nbsp;Marwan Mhanna ,&nbsp;Wiktoria Chylinska ,&nbsp;Włodzimierz Skorupski ,&nbsp;Michał Lesiak ,&nbsp;Marek Grygier ,&nbsp;Maciej Lesiak","doi":"10.1016/j.hjc.2024.04.005","DOIUrl":"10.1016/j.hjc.2024.04.005","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 107-111"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830404","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":"Sports cardiology: not a sprint but a marathon—and, above all, a team sport","authors":"Charalambos Vlachopoulos,&nbsp;Alexandros Kasiakogias","doi":"10.1016/j.hjc.2024.11.003","DOIUrl":"10.1016/j.hjc.2024.11.003","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 1-3"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711630","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":"Temporal trends in percutaneous coronary intervention in Australia: A retrospective analysis from 2000–2021","authors":"Netsanet B. Kumsa ,&nbsp;Thu-Lan Kelly ,&nbsp;Elizabeth E. Roughead ,&nbsp;Rosanna Tavella ,&nbsp;Marianne H. Gillam","doi":"10.1016/j.hjc.2023.10.002","DOIUrl":"10.1016/j.hjc.2023.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to describe the trend in percutaneous coronary intervention (PCI) with insertion of a stent in Australia from 2000/01 to 2020/21 and investigate trends in same-day versus non-same-day discharge following PCI. A secondary aim was to compare the rate of coronary artery bypass grafting (CABG) with PCI procedures, while a third aim was to compare marked PCI trend changes with the PCI guidelines during the study period.</div></div><div><h3>Background</h3><div>PCI with stent deployment is the most common form of interventional treatment for coronary artery disease, and its use has been expanding since 2000. However, there is a lack of descriptive studies of the national trend in Australia.</div></div><div><h3>Methods</h3><div>All procedures for PCI and CABG were extracted across 21 years (2000/01 to 2020/21) from the Australian Institute of Health and Welfare data. Age-standardized rates were calculated using the Australian standard population as of June 2001. The ratio of PCI to CABG procedures was also calculated. Trends for PCI were stratified by age, gender, and same-day or overnight discharge episodes. Linear regression analysis was done to compare the age-standardized rates across different age categories. Segmented regression analysis was performed to ascertain the change in the age-standardized rates of PCI during the study period. Whether the changepoints in the trend were matched with guideline updates was also assessed.</div></div><div><h3>Results</h3><div>There were 751 728 PCI procedures in persons aged 30 years and above between 2000/01 and 2020/21. The age-standardized rate for the study period showed that persons aged 60-74 years had a higher rate of procedures (102.7) compared to persons aged 30-59 years (81.3) and 75 years and older (61.8) (P &lt; 0.001). There were two statistically significant changepoints in the overall trend; 2005/06 and 2013/14, matched with the change in PCI guidelines. Despite the lower number of procedures for same-day discharge episodes, there has been an increasing trend since 2014/15. More than two-thirds of all stenting procedures were the insertion of a single stent. PCI to CABG procedure ratio increased from 0.6 in 2000/01 to 1.8 in 2020/21.</div></div><div><h3>Conclusions</h3><div>There was a varying trend in the age-standardized rate of PCI with a peak in 2005/06. The trend appears to be stabilizing in the later part of the study period, but the rate for same-day discharge episodes showed an increasing trend after 2014/15. There is consistency with changepoints in the trend and updated PCI guideline recommendations. The ratio of PCI with insertion of a stent to CABG procedure increased substantially across the study period.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 21-30"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685255","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":"Impact of left ventricular end-diastolic pressure as a marker for diastolic dysfunction on long-term outcomes in patients undergoing transcatheter aortic valve replacement","authors":"Mariia Emelianova ,&nbsp;Vanessa Sciacca ,&nbsp;Regine Brinkmann ,&nbsp;Smita Scholtz ,&nbsp;Volker Rudolph ,&nbsp;Sabine Bleiziffer ,&nbsp;Tanja K. Rudolph ,&nbsp;Muhammed Gerçek ,&nbsp;Maria Vanezi","doi":"10.1016/j.hjc.2023.10.005","DOIUrl":"10.1016/j.hjc.2023.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to investigate the proportion of elevated left ventricular end-diastolic pressure (LVEDP) as an indicator of diastolic function after transcatheter aortic valve replacement (TAVR) and its implication in predicting long-term mortality.</div></div><div><h3>Methods</h3><div>We analyzed retrospectively collected data on 3328 patients with severe aortic stenosis undergoing TAVR in our institution between July 2009 and June 2021. Patients were stratified into two groups based on invasive post-procedural LVEDP measurements: normal (&lt;15 mmHg) vs. elevated (≥15 mmHg) LVEDP.</div></div><div><h3>Results</h3><div>Mean age of the patients was 81.6 years, and 53.3% were female. Elevated post-procedural LVEDP was identified in 2408 (72.3%) patients. The 5-year mortality rates were higher in the group with elevated LVEDP compared with the group with normal LVEDP (27.4% vs. 8.3%, p = 0.01; hazard ratio [HR] 1.22, 95% CI 1.05-1.41). A multivariate model revealed the following independent predictors of mortality after TAVR: post-procedural elevated LVEDP (HR 1.24, 95% CI 1.01-1.53), pre-procedural significant tricuspid regurgitation (HR 1.24, 95% CI 1.02-1.52) and pulmonary hypertension (PH) (HR 1.53, 95% CI 1.26-1.86). In the present study, a significant paravalvular leak after TAVR was not associated with higher mortality (HR 1.45, 95% CI-0.95-2.19, p = 0.75).</div></div><div><h3>Conclusion</h3><div>Elevated post-procedural LVEDP in patients who undergo TAVR is an independent predictor of all-cause mortality. Furthermore, PH and tricuspid regurgitation were also identified as predictors of mortality. These data confirm that diastolic dysfunction is an important predictor of mortality in TAVR and should be considered to guide procedure timing, favoring an early interventional approach and management in aortic stenosis patients.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"80 ","pages":"Pages 4-11"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016213","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":"Comparison of continuous flow centrifugal left ventricular assist devices as a bridge to transplant strategy in a low organ donation environment: single center experience.","authors":"Michael Bonios, Dimitris Miliopoulos, Angeliki Gkouziouta, Nektarios Kogerakis, Sokratis Fragkoulis, Iakovos Armenis, Dimitrios Zarkalis, Konstantinos Ieromonachos, Antigoni Koliopoulou, Evangelos Leontiadis, Panagiota Georgiadou, Vasiliki Vartela, Dimitrios Tsiapras, Petros Sfirakis, Christos Kapelios, Stavros Dimopoulos, Loukas Kaklamanis, Dimitrios Ntegiannis, Theofani Antoniou, Themistokles Chamogeorgakis, Stamatis Adamopoulos","doi":"10.1016/j.hjc.2024.10.004","DOIUrl":"10.1016/j.hjc.2024.10.004","url":null,"abstract":"<p><strong>Objective: </strong>In patients with advanced heart failure, heart transplantation is currently the most effective treatment. However, in a low-organ donation environment, it is usually necessary to proceed in long-term mechanical circulatory support through left ventricular assist device (LVAD) implantation as bridge-to-transplantation.</p><p><strong>Methods: </strong>The study included all patients with advanced heart failure who underwent continuous flow LVAD implantation as a bridge to transplant strategy in our center (n = 68). Following LVAD implantation and for the period that patients were on LVAD support, pump thrombosis, strokes, gastrointestinal bleeding, and right heart failure occurrence rates were recorded. Outcomes were compared between patients implanted with HeartMate 3 (HM3) and HeartWare LVADs, as well as between patients who did reach heart transplantation (HTx group) and those who did not (noHTx group).</p><p><strong>Results: </strong>A total of 35 out of 68 patients underwent heart transplantation at a mean time of 691 ± 457 days; 41 received a HeartWare and 27 a HM3 device. HM3 patients had significantly better survival (p = 0.010) and lower complication rates (p = 0.025). In addition, the noHTx group had significantly higher complication rates compared with the HTx group (p = 0.00041). The 5-year estimated Kaplan-Meier survival rate following heart transplantation was 77%.</p><p><strong>Conclusion: </strong>Patients with advanced heart failure gain substantial benefit from LVADs awaiting heart transplantation. In a low organ donation environment, the need for reliable LVADs can further improve the outcomes through the reduction of complications provided by current devices.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481331","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 three-month treatment with pitavastatin on arterial stiffness in patients with hypercholesterolemia: a prospective observational study.","authors":"Hack-Lyoung Kim, Soonil Kwon, Hyun Sung Joh, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Joo-Hee Zo, Myung-A Kim","doi":"10.1016/j.hjc.2024.10.005","DOIUrl":"10.1016/j.hjc.2024.10.005","url":null,"abstract":"<p><strong>Objective: </strong>Although several studies have highlighted the benefits of statins in improving arterial stiffness, there is limited research on whether pitavastatin, a more recently developed statin, has similar effects. This study aimed to investigate the impact of pitavastatin on arterial stiffness in patients with hypercholesterolemia.</p><p><strong>Methods: </strong>This prospective study enrolled 115 patients with hypercholesterolemia (mean age, 59 years; 22% female) who had not previously been treated with statins. Participants underwent lifestyle interventions followed by administration of pitavastatin (2 or 4 mg daily) if target low-density lipoprotein (LDL) cholesterol levels were not achieved. The primary outcome measured was the change in brachial-ankle pulse wave velocity (baPWV) from baseline after three months of treatment.</p><p><strong>Results: </strong>Pitavastatin treatment significantly reduced LDL cholesterol by 41.1% (from 158 ± 28 to 93.0 ± 29.6 mg/dL; P < 0.001). Additionally, systolic blood pressure (SBP) decreased significantly from 130 ± 14 to 126 ± 14 mmHg (P < 0.001), representing a 2.9% reduction, and baPWV decreased significantly from 1522 ± 325 to 1407 ± 289 cm/s (P < 0.001), a 7.6% reduction. There was a significant correlation between changes in SBP and changes in baPWV (r = 0.565; P < 0.001). Even after adjusting for changes in SBP, the reduction in baPWV induced by pitavastatin remained statistically significant (P < 0.001).</p><p><strong>Conclusion: </strong>A three-month treatment with pitavastatin effectively reduced arterial stiffness in patients with hypercholesterolemia, alongside significant improvements in lipid profiles and blood pressure reductions. These findings support the use of pitavastatin for managing key cardiovascular risk factors.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481332","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":"Multimodality imaging for the diagnosis of giant cavernous hemangioma of the right ventricle.","authors":"Leizhi Ku, Youping Chen, Yuhang Wang, Zheng Liu, Xiaojing Ma","doi":"10.1016/j.hjc.2024.10.003","DOIUrl":"10.1016/j.hjc.2024.10.003","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481333","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}