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  1. Article ; Online: Type 2 Diabetes Mellitus Treatment and Beyond: A Glance in Our Armamentarium.

    Iliodromitis, Konstantinos / Iliodromitis, Efstathios K

    JACC. Basic to translational science

    2023  Volume 8, Issue 2, Page(s) 201–203

    Language English
    Publishing date 2023-02-27
    Publishing country United States
    Document type Editorial
    ISSN 2452-302X
    ISSN (online) 2452-302X
    DOI 10.1016/j.jacbts.2022.10.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Empagliflozin in Heart Failure with a Preserved Ejection Fraction.

    Triposkiadis, Filippos K / Xanthopoulos, Andrew / Iliodromitis, Efstathios K

    The New England journal of medicine

    2022  Volume 386, Issue 21, Page(s) e57

    MeSH term(s) Benzhydryl Compounds/therapeutic use ; Glucosides/therapeutic use ; Heart Failure/drug therapy ; Humans ; Stroke Volume
    Chemical Substances Benzhydryl Compounds ; Glucosides ; empagliflozin (HDC1R2M35U)
    Language English
    Publishing date 2022-05-26
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc2118470
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  3. Article ; Online: Remote Ischemic Conditioning: more explanations and more expectations.

    Iliodromitis, Efstathios K / Cohen, Michael V / Downey, James M

    Basic research in cardiology

    2022  Volume 117, Issue 1, Page(s) 49

    MeSH term(s) Humans ; Ischemia ; Ischemic Postconditioning ; Ischemic Preconditioning ; Motivation
    Language English
    Publishing date 2022-10-11
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 189755-x
    ISSN 1435-1803 ; 0300-8428 ; 0175-9418
    ISSN (online) 1435-1803
    ISSN 0300-8428 ; 0175-9418
    DOI 10.1007/s00395-022-00959-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Myocardial Protection and Current Cancer Therapy: Two Opposite Targets with Inevitable Cost.

    Efentakis, Panagiotis / Andreadou, Ioanna / Iliodromitis, Konstantinos E / Triposkiadis, Filippos / Ferdinandy, Péter / Schulz, Rainer / Iliodromitis, Efstathios K

    International journal of molecular sciences

    2022  Volume 23, Issue 22

    Abstract: Myocardial protection against ischemia/reperfusion injury (IRI) is mediated by various ligands, activating different cellular signaling cascades. These include classical cytosolic mediators such as cyclic-GMP (c-GMP), various kinases such as ... ...

    Abstract Myocardial protection against ischemia/reperfusion injury (IRI) is mediated by various ligands, activating different cellular signaling cascades. These include classical cytosolic mediators such as cyclic-GMP (c-GMP), various kinases such as Phosphatydilinositol-3- (PI3K), Protein Kinase B (Akt), Mitogen-Activated-Protein- (MAPK) and AMP-activated (AMPK) kinases, transcription factors such as signal transducer and activator of transcription 3 (STAT3) and bioactive molecules such as vascular endothelial growth factor (VEGF). Most of the aforementioned signaling molecules constitute targets of anticancer therapy; as they are also involved in carcinogenesis, most of the current anti-neoplastic drugs lead to concomitant weakening or even complete abrogation of myocardial cell tolerance to ischemic or oxidative stress. Furthermore, many anti-neoplastic drugs may directly induce cardiotoxicity via their pharmacological effects, or indirectly via their cardiovascular side effects. The combination of direct drug cardiotoxicity, indirect cardiovascular side effects and neutralization of the cardioprotective defense mechanisms of the heart by prolonged cancer treatment may induce long-term ventricular dysfunction, or even clinically manifested heart failure. We present a narrative review of three therapeutic interventions, namely VEGF, proteasome and Immune Checkpoint inhibitors, having opposing effects on the same intracellular signal cascades thereby affecting the heart. Moreover, we herein comment on the current guidelines for managing cardiotoxicity in the clinical setting and on the role of cardiovascular confounders in cardiotoxicity.
    MeSH term(s) Humans ; Cardiotoxicity ; Drug-Related Side Effects and Adverse Reactions/complications ; Myocardium/pathology ; Myocytes, Cardiac ; Neoplasms/drug therapy ; Vascular Endothelial Growth Factor A ; Antineoplastic Agents/adverse effects
    Chemical Substances Vascular Endothelial Growth Factor A ; Antineoplastic Agents
    Language English
    Publishing date 2022-11-15
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms232214121
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  5. Article ; Online: Myocardial infarction or acute coronary syndrome with non-obstructive coronary arteries and sudden cardiac death: a missing connection.

    Kosmas, Nikolaos / Manolis, Antonis S / Dagres, Nikolaos / Iliodromitis, Efstathios K

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2020  Volume 22, Issue 9, Page(s) 1303–1310

    Abstract: Myocardial infarction with non-obstructive coronary arteries or any acute coronary syndrome (ACS) with normal or near-normal (non-obstructive) coronary arteries (ACS-NNOCA) is an heterogeneous clinical entity, which includes different pathophysiology ... ...

    Abstract Myocardial infarction with non-obstructive coronary arteries or any acute coronary syndrome (ACS) with normal or near-normal (non-obstructive) coronary arteries (ACS-NNOCA) is an heterogeneous clinical entity, which includes different pathophysiology mechanisms and is challenging to treat. Sudden cardiac death (SCD) is a catastrophic manifestation of ACS that is crucial to prevent and treat urgently. The concurrence of the two conditions has not been adequately studied. This narrative review focuses on the existing literature concerning ACS-NNOCA pathophysiology, with an emphasis on SCD, together with risk and outcome data from clinical trials. There have been no large-scale studies to investigate the incidence of SCD within ACS-NNOCA patients, both early and late in the disease. Some pathophysiology mechanisms that are known to mediate ACS-NNOCA, such as atheromatous plaque erosion, anomalous coronary arteries, and spontaneous coronary artery dissection are documented causes of SCD. Myocardial ischaemia, inflammation, and fibrosis are probably at the core of the SCD risk in these patients. Effective treatments to reduce the relevant risk are still under research. ACS-NNOCA is generally considered as an ACS with more 'benign' outcome compared to ACS with obstructive coronary artery disease, but its relationship with SCD remains obscure, especially until its incidence and effective treatment are evaluated.
    MeSH term(s) Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/epidemiology ; Coronary Artery Disease ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/prevention & control ; Humans ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Risk Factors
    Language English
    Publishing date 2020-09-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euaa156
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  6. Article ; Online: Cardiopulmonary Exercise Testing: The ABC for the Clinical Cardiologist.

    Triantafyllidi, Helen / Birmpa, Dionyssia / Benas, Dimitrios / Trivilou, Paraskevi / Fambri, Anastasia / Iliodromitis, Efstathios K

    Cardiology

    2021  Volume 147, Issue 1, Page(s) 62–71

    Abstract: Background: Cardiopulmonary exercise testing (CPET) is the most comprehensive technique which allows a holistic approach to cardiopulmonary diseases.: Summary: This article provides basic information addressed to the Clinical Cardiologist regarding ... ...

    Abstract Background: Cardiopulmonary exercise testing (CPET) is the most comprehensive technique which allows a holistic approach to cardiopulmonary diseases.
    Summary: This article provides basic information addressed to the Clinical Cardiologist regarding the utility and the indications of the CPET technique in the everyday clinical practice. Clinical application of CPET continues to evolve and protocols should be adapted to each specific patient to obtain the most reliable and useful information. Key Messages: Clinical Cardiologists with an interest over CPET may become familiar with this exercise method and its main measured variables, refresh their knowledge regarding the underlying pathophysiological mechanisms of oxygen transport chain, learn how to interpret the CPET results and promote appropriate patient referrals to experts.
    MeSH term(s) Cardiologists ; Exercise ; Exercise Test/methods ; Exercise Tolerance ; Heart ; Heart Failure ; Humans
    Language English
    Publishing date 2021-10-14
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 80092-2
    ISSN 1421-9751 ; 0008-6312
    ISSN (online) 1421-9751
    ISSN 0008-6312
    DOI 10.1159/000520024
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  7. Article ; Online: Peak exercise myocardial deformation indices during cardiopulmonary exercise testing are associated with exercise capacity and ventilatory efficiency in patients with dilated cardiomyopathy.

    Triantafyllidi, Helen / Birmpa, Dionyssia / Ikonomidis, Ignatios / Benas, Dimitrios / Makavos, George / Cokkinos, Dennis V / Triposkiadis, Filippos / Iliodromitis, Efstathios K

    Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese

    2022  Volume 70, Page(s) 28–35

    Abstract: Objective: Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same ... ...

    Abstract Objective: Little is known about the exercise-induced changes in the multidimensional mechanical properties of the heart. We aimed to evaluate the myocardial deformation indices (MDI) at rest and their response at peak exercise during the same cardiopulmonary exercise testing (CPET) session, investigating their relationship to exercise capacity and ventilatory sufficiency in dilated cardiomyopathy (DCM) patients.
    Methods: We evaluated left ventricular (LV) function using speckle tracking imaging (STI) at rest and peak exercise during the same CPET session in 57 idiopathic DCM patients in New York Heart Association (NYHA) I-II class [54 ± 12 years, 42 males, ejection fraction (EF) 33 ± 9%]. We measured global longitudinal strain (GLS), longitudinal strain rate at systole (LSRS) and diastole (LSRD), and circumferential strain rate (CircS).
    Results: Resting GLS, LSRS, and LSRD were impaired compared with the predicted values but were improved at peak exercise (p < 0.001). All MDI at rest and/or at peak exercise were related to several CPET-derived parameters, including peak VO
    Conclusions: Peak exercise LSRS and GLS in NYHA I-II DCM patients subjected to CPET were associated with aerobic exercise capacity and ventilatory efficiency. Consequently, LSRS and GLS at peak exercise, through their association with CPET-derived CV risk indices, may underline the severity of heart failure and predict future CV events in this DCM population.
    MeSH term(s) Male ; Humans ; Exercise Test/methods ; Cardiomyopathy, Dilated ; Exercise Tolerance/physiology ; Ventricular Function, Left/physiology ; Heart Failure ; Exercise/physiology ; Oxygen Consumption/physiology ; Stroke Volume/physiology
    Language English
    Publishing date 2022-12-28
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2215027-4
    ISSN 2241-5955 ; 1109-9666
    ISSN (online) 2241-5955
    ISSN 1109-9666
    DOI 10.1016/j.hjc.2022.12.009
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  8. Article ; Online: The burden of atrial fibrillation and heart failure in hospitalized patients: A real-world survey in a nationwide snapshot.

    Iliodromitis, Konstantinos / Tzeis, Stylianos / Xintarakou, Anastasia / Pyrgakis, Vlasios / Zarifis, Ioannis / Patsilinakos, Sotirios / Draganigos, Antonios / Triposkiadis, Filippos / Hahalis, George / Karanasios, Athanasios / Goudevenos, Ioannis / Michalis, Lampros / Karvounis, Charalampos / Parthenakis, Fraggiskos / Kanakakis, Ioannis / Tousoulis, Dimitrios / Iliodromitis, Efstathios / Vardas, Panos

    Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese

    2023  Volume 74, Page(s) 18–23

    Abstract: ... anticoagulant and 124 (30.5%) were on a vitamin K antagonist.: Conclusion: Hospitalized patients with AF and ...

    Abstract Purpose: Atrial fibrillation (AF) and heart failure (HF) are common and commonly coexisting cardiovascular diseases in hospitalized patients. We report the absolute number and interrelation between AF and HF, assess the daily burden of both diseases on the healthcare system, and describe the medical treatment in a real-world, nationwide conducted snapshot survey.
    Methods: A questionnaire was equally distributed to various healthcare institutions. Data on the baseline characteristics, prior hospitalizations, and medical treatments of all hospitalized patients with AF and HF at a predefined date were collected and analyzed.
    Results: Seventy-five cardiological departments participated in this multicenter Greek nationwide study. A total of 603 patients (mean age, 74.5 ± 11.4 years) with AF, HF, or the combination of both were nationwide admitted. AF, HF, and the combination of both were registered in 122 (20.2%), 196 (32.5%), and 285 (47.3%) patients, respectively. First-time hospital admission was recorded in 273 (45.7%) of 597 patients, whereas 324 (54.3%) of 597 patients had readmissions in the past 12 months. Of the entire population, 453 (75.1%) were on beta-blockers (BBs), and 430 (71.3%) were on loop diuretics. Furthermore, 315 patients with AF (77.4%) were on oral anticoagulation, of whom 191 (46.9%) were on a direct oral anticoagulant and 124 (30.5%) were on a vitamin K antagonist.
    Conclusion: Hospitalized patients with AF and/or HF have more than one admission within a year. Coexistence of AF and HF is more common. BBs and loop diuretics are the most commonly used drugs. More than three-quarters of the patients with AF were on oral anticoagulation.
    MeSH term(s) Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/epidemiology ; Sodium Potassium Chloride Symporter Inhibitors/therapeutic use ; Anticoagulants/therapeutic use ; Heart Failure/complications ; Heart Failure/epidemiology ; Heart Failure/drug therapy ; Surveys and Questionnaires
    Chemical Substances Sodium Potassium Chloride Symporter Inhibitors ; Anticoagulants
    Language English
    Publishing date 2023-05-02
    Publishing country Netherlands
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2215027-4
    ISSN 2241-5955 ; 1109-9666
    ISSN (online) 2241-5955
    ISSN 1109-9666
    DOI 10.1016/j.hjc.2023.04.008
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  9. Article: Cellular Communications in the Heart.

    Fountoulaki, Katerina / Dagres, Nikolaos / Iliodromitis, Efstathios K

    Cardiac failure review

    2017  Volume 1, Issue 2, Page(s) 64–68

    Abstract: Heart failure is one of the leading causes of morbidity and mortality worldwide. Cardiac remodelling is first an adaptive, becoming a maladaptive, compensatory mechanism that finally causes ventricular dysfunction independently of the etiology of the ... ...

    Abstract Heart failure is one of the leading causes of morbidity and mortality worldwide. Cardiac remodelling is first an adaptive, becoming a maladaptive, compensatory mechanism that finally causes ventricular dysfunction independently of the etiology of the initial insult. In the present article the authors describe the elements of the human heart, examining their basic functions and their inter-communication under both normal and pathological circumstances. Cardiac myocytes carry out mechanical and electrical functions of the heart and cardiac fibroblasts maintain its structural integrity. Several factors can affect fibroblast activation and under pathological stress they transdifferentiate into myofibroblasts. Endothelial cells have complex biological functions, including the control of vascular permeability, vasomotion, regulation of haemostasis, immune responses and angiogenesis. The extracellular matrix is a complex architectural network consisting of a variety of proteins. Various routes using a plethora of products and mediators contribute to the cross-talk of the myocytes with endothelial cells, extracellular matrix and cardiac fibroblasts. A better understanding of the entire mechanism of cellular communication by the established or the more recently discovered agents will certainly emerge promising new perspectives when looking at the prevention of heart failure and leading to more substantial therapeutic interventions.
    Language English
    Publishing date 2017-08-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2960293-2
    ISSN 2057-7559 ; 2057-7540
    ISSN (online) 2057-7559
    ISSN 2057-7540
    DOI 10.15420/cfr.2015.1.2.64
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  10. Article ; Online: Association of hydroxytyrosol enriched olive oil with vascular function in chronic coronary disease.

    Ikonomidis, Ignatios / Katogiannis, Konstantinos / Chania, Christina / Iakovis, Nikolaos / Tsoumani, Maria / Christodoulou, Andriana / Brinia, Evangelia / Pavlidis, George / Thymis, John / Tsilivarakis, Damianos / Kountouri, Aikaterini / Korakas, Emmanouil / Lambadiari, Vaia / Triposkiadis, Filippos / Skaltsounis, Leandros / Tseti, Ioulia / Iliodromitis, Efstathios K / Andreadou, Ioanna

    European journal of clinical investigation

    2023  Volume 53, Issue 7, Page(s) e13983

    Abstract: Background: Hydroxytyrosol reduces low-density lipoprotein oxidation, contributing to prevention of atherosclerosis progression.: Methods: In a prospective, crossover, double-blind, placebo-controlled trial, 30 chronic coronary artery syndrome (CCAS) ...

    Abstract Background: Hydroxytyrosol reduces low-density lipoprotein oxidation, contributing to prevention of atherosclerosis progression.
    Methods: In a prospective, crossover, double-blind, placebo-controlled trial, 30 chronic coronary artery syndrome (CCAS) patients were randomized to 4 capsules/day, containing 412.5 mg olive oil with 2.5 mg hydroxytyrosol (OOHT) each one or placebo for 1 month and then were crossed over to the alternate treatment (placebo or OOHT). We measured (a) perfused boundary region (PBR) of the sublingual arterial microvessels (increased PBR indicates reduced glycocalyx thickness), (b) flow-mediated dilation (FMD), (c) Coronary Flow Reserve (CFR) and markers of LV diastolic function by Doppler echocardiography, (d) pulse wave velocity (PWV), and (e) oxidative stress, inflammatory biomarkers and blood lipids at baseline and after treatment.
    Results: Treatment with OOHT improved PBR, FMD, CFR and PWV compared to baseline (1.8 ± .3 vs. 1.7 ± .4 μm, p = .040, 3.7 ± 2.1 vs. 6.5% ± 2.3%, p < .001, 2.3 ± .4 vs. 2.5 ± .4, p = .030 and 11.1 ± 1.8 vs. 11.8 ± 2.3 m/s, p = .002) while there was no effect after placebo (p = NS). No effect of OOHT treatment was observed on blood pressure. There was a parallel improvement of E' of the mitral annulus and deceleration time of the E wave of mitral inflow after OOHT (p < .05) but not after placebo. Compared to baseline, treatment with OOHT reduced malondialdehyde, a marker of lipid peroxidation, oxidized LDL, triglycerides, PCSK9 and CRP blood levels (p < .05) in contrast to placebo.
    Conclusions: Hydroxytyrosol-enriched olive oil may have beneficial effects on endothelial, arterial and LV diastolic function likely by reducing oxidative and inflammatory burden in CCAS, though further studies are needed to confirm this mechanism.
    MeSH term(s) Humans ; Proprotein Convertase 9 ; Olive Oil ; Pulse Wave Analysis ; Prospective Studies ; Heart Diseases ; Coronary Disease
    Chemical Substances PCSK9 protein, human (EC 3.4.21.-) ; Proprotein Convertase 9 (EC 3.4.21.-) ; Olive Oil ; 3,4-dihydroxyphenylethanol (10597-60-1)
    Language English
    Publishing date 2023-03-24
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 186196-7
    ISSN 1365-2362 ; 0014-2972 ; 0960-135X
    ISSN (online) 1365-2362
    ISSN 0014-2972 ; 0960-135X
    DOI 10.1111/eci.13983
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