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  1. Article ; Online: A Case of Isolated Cardiac Sarcoidosis Diagnosed With Multimodality Cardiac Imaging.

    Ather, Kashif / Parulkar, Sanchita Singal / Levine, Daniel / Tran, Cao / Atalay, Michael K / Apostolidou, Eirini

    CASE (Philadelphia, Pa.)

    2021  Volume 5, Issue 4, Page(s) 213–216

    Language English
    Publishing date 2021-06-01
    Publishing country United States
    Document type Case Reports
    ISSN 2468-6441
    ISSN (online) 2468-6441
    DOI 10.1016/j.case.2021.05.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A Case of Bioprosthetic Mitral Valve Dysfunction, Initially Presenting with Valve Thrombosis Followed by Recurrent Thrombosis and Endocarditis.

    Apostolidou, Eirini / Beale, Charles / Poppas, Athena / Stockwell, Philip / Ehsan, Afshin

    CASE (Philadelphia, Pa.)

    2019  Volume 3, Issue 5, Page(s) 210–214

    Language English
    Publishing date 2019-07-03
    Publishing country United States
    Document type Case Reports
    ISSN 2468-6441
    ISSN (online) 2468-6441
    DOI 10.1016/j.case.2019.05.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Cryptogenic Stroke: Diagnostic Workup and Management.

    Mac Grory, Brian / Flood, Shane P / Apostolidou, Eirini / Yaghi, Shadi

    Current treatment options in cardiovascular medicine

    2019  Volume 21, Issue 11, Page(s) 77

    Abstract: Purpose of review: Cryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural ... ...

    Abstract Purpose of review: Cryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac lesion, paroxysmal atrial fibrillation, hypercoagulable state or undiagnosed malignancy. Because many of these proposed mechanisms are embolic - and based on studies of thrombus history showing commonalities between thrombus composition between cardioembolic and cryptogenic strokes - the concept of embolic stroke of undetermined source (ESUS) (Hart et al. Lancet Neurol. 13(4):429-38, 2014; Stroke. 48(4):867-72, 2017) has been proposed to describe cryptogenic strokes that may warrant systemic anticoagulation. In this review, we discuss the phenomena of cryptogenic stroke, ESUS and a proposed management pathway.
    Recent findings: 1. The concept of ESUS was proposed in 2014 as a potentially useful therapeutic entity. Two recent trials - NAVIGATE-ESUS (Hart et al. N Engl J Med. 378(23):2191-201, 2018) and RESPECT-ESUS (Diener 2018) were proposed based on this concept. They were negative for their primary endpoint and for the secondary endpoint of ischemic stroke recurrence. Post-hoc analysis of the WARSS trial (Longstreth et al. Stroke. 44(3):714-9, 2013) suggested that people with elevated pro-BNP benefited from systemic anticoagulation whereas those with a normal pro-BNP did not. This led to the hypothesis that a subgroup of patients at higher risk for embolism from the left atrium would benefit from anticoagulation, even if the WARSS trial was negative for the primary endpoint. Thus, the ARCADIA trial (Kamel et al. Int J Stroke. 14(2):207-14, 2019) was proposed - a randomized, active-control, multi-center trial comparing apixaban with aspirin for secondary stroke prevention in patients with ESUS and biomarkers of left atrial cardiopathy. This trial is actively recruiting. 2. Carotid web - an intimal form of fibromuscular dysplasia - has come to increased prominence in the literature as a cause of embolic stroke. It is a non-stenosis, non-atherosclerotic lesion in the posterior wall of the internal carotid artery that leads to pooling with stasis of blood distal to the lesion and, as a consequence, embolic stroke. It is not usually detected by a standard stroke workup as it masquerades as non-calcified atherosclerosis and does not cause hemodynamically significant stenosis. There have been two major recent papers - a meta-analysis in Stroke (Zhang et al. Stroke. 49(12):2872-6, 2018) and narrative review in JAMA Neurology (Kim et al. JAMA Neurol. 2018) - that addressed this topic. Cryptogenic stroke describes a stroke for which no cause has been found. ESUS is a more precisely-defined entity that mandates a specific workup and implicates remote embolism as a cause of stroke. In ESUS, the options for further investigation include long-term cardiac monitoring, transesophageal echocardiography, investigation for occult malignancy or arterial hypercoagulability. Options for management include anti-platelet therapy (the current standard of care), empiric anticoagulation or enrollment in to a clinical trial examining the use of NOACs compared with aspirin for secondary prevention (such as ARCADIA or ATTICUS). In a person less than 60 years old with ESUS and a patent foramen ovale the risk of a recurrent stroke is low but recent trials have suggested that percutaneous device closure reduces this risk further with an acceptable complication rate.
    Language English
    Publishing date 2019-12-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057337-6
    ISSN 1534-3189 ; 1092-8464
    ISSN (online) 1534-3189
    ISSN 1092-8464
    DOI 10.1007/s11936-019-0786-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Plugging the Hole: Diagnosis and Management of Post-Myocardial Infarction Ventricular Septal Defect.

    Sharma, Esseim / Beale, Charles / Ehsan, Afshin / Sodha, Neel / Gordon, Paul / Apostolidou, Eirini

    CASE (Philadelphia, Pa.)

    2020  Volume 4, Issue 4, Page(s) 283–287

    Language English
    Publishing date 2020-05-07
    Publishing country United States
    Document type Case Reports
    ISSN 2468-6441
    ISSN (online) 2468-6441
    DOI 10.1016/j.case.2020.04.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Primary mitral valve regurgitation: Update and review.

    Apostolidou, Eirini / Maslow, Andrew D / Poppas, Athena

    Global cardiology science & practice

    2017  Volume 2017, Issue 1, Page(s) e201703

    Abstract: Mitral regurgitation is the second most common valvular disorder requiring surgical intervention worldwide. This review summarizes the current understanding of primary, degenerative mitral regurgitation with respect to etiology, comprehensive assessment, ...

    Abstract Mitral regurgitation is the second most common valvular disorder requiring surgical intervention worldwide. This review summarizes the current understanding of primary, degenerative mitral regurgitation with respect to etiology, comprehensive assessment, natural history and management. The new concept of staging of the valvular disorders, newer predictors of adverse and controversy of "watchful waiting" versus "early surgical intervention" for severe, asymptomatic, primary mitral regurgitation are addressed.
    Language English
    Publishing date 2017-03-31
    Publishing country Qatar
    Document type Journal Article ; Review
    ZDB-ID 2738381-7
    ISSN 2305-7823
    ISSN 2305-7823
    DOI 10.21542/gcsp.2017.3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa: A Case Series with Literature Review.

    Apostolidou, Eirini / Beale, Charles / Poppas, Athena / Stockwell, Philip

    CASE (Philadelphia, Pa.)

    2017  Volume 1, Issue 6, Page(s) 221–226

    Language English
    Publishing date 2017-10-19
    Publishing country United States
    Document type Case Reports
    ISSN 2468-6441
    ISSN (online) 2468-6441
    DOI 10.1016/j.case.2017.07.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Mitral Valve Blood Cyst Diagnosed with the Use of Multimodality Imaging.

    Beale, Robert A / Russo, Ronald / Beale, Charles / Levin, William / Atalay, Michael K / Fingleton, James / Poppas, Athena / Apostolidou, Eirini

    CASE (Philadelphia, Pa.)

    2021  Volume 5, Issue 3, Page(s) 173–176

    Language English
    Publishing date 2021-02-20
    Publishing country United States
    Document type Case Reports
    ISSN 2468-6441
    ISSN (online) 2468-6441
    DOI 10.1016/j.case.2021.01.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Multimodality Imaging in Hypereosinophilic Syndrome With Cardiac Involvement.

    Arunachalam, Karuppiah / Beale, Charles / Apostolidou, Eirini / Atalay, Michael / Levine, Daniel / Aspry, Karen / Yousefzai, Rayan

    CASE (Philadelphia, Pa.)

    2019  Volume 3, Issue 4, Page(s) 149–156

    Language English
    Publishing date 2019-05-16
    Publishing country United States
    Document type Case Reports
    ISSN 2468-6441
    ISSN (online) 2468-6441
    DOI 10.1016/j.case.2019.03.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Transcatheter Aortic Valve Replacement of a Bicuspid Aortic Valve in a Heart Transplant Recipient.

    Beale, Robert / Beale, Charles / DeNofrio, David / Gordon, Paul / Levine, Daniel / Sodha, Neel / Yousefzai, Rayan / Apostolidou, Eirini

    JACC. Case reports

    2020  Volume 2, Issue 5, Page(s) 716–720

    Abstract: Patients with heart transplants who present with severe aortic stenosis may be deemed high-risk surgical candidates due to immunosuppression and multiple comorbid conditions. Appropriately selected patients may be successfully treated with transcatheter ... ...

    Abstract Patients with heart transplants who present with severe aortic stenosis may be deemed high-risk surgical candidates due to immunosuppression and multiple comorbid conditions. Appropriately selected patients may be successfully treated with transcatheter aortic valve replacement. (
    Language English
    Publishing date 2020-05-20
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2020.03.028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Identification of a High-risk Subgroup With Malignant Mitral Valve Prolapse Who Are Predisposed to Sudden Cardiac Death: A Review.

    Russo, Ronald / Maan, Abhishek / Apostolidou, Eirini / Khorasani-Zadeh, Arshia / Byrnes, Sean / Chebaya, Philip / Beale, Robert / Abbasi, Mohammad Usama / Beale, Charles

    Critical pathways in cardiology

    2020  Volume 20, Issue 1, Page(s) 31–35

    Abstract: Mitral valve prolapse (MVP) affects approximately 170 million people worldwide; however, phenotypically, there is a wide variety of heterogeneity. In particular subsets, the incidence of sudden cardiac death is calculated to be 998 per 100,000 person- ... ...

    Abstract Mitral valve prolapse (MVP) affects approximately 170 million people worldwide; however, phenotypically, there is a wide variety of heterogeneity. In particular subsets, the incidence of sudden cardiac death is calculated to be 998 per 100,000 person-years, which is significantly increased when compared with the general population of MVP patients. Individuals with high-risk features have been identified as young females with bileaflet MVP and electrocardiogram findings of frequent complex ectopy, ST-T wave changes, and inferior T wave inversions. Supplemental imaging modalities in this subgroup demonstrate redundant leaflets and chordae on 2-dimensional transthoracic echocardiography along with varying severity of mitral annular disjunction. Detailed morphologic assessment by 3-dimensional echocardiography provides a quantitative assessment of annular disjunction along with left ventricular longitudinal and basal circumferential strain patterns. Late gadolinium enhancement on cardiac magnetic resonance imaging identifies diffuse and isolated left ventricle fibrosis involving the fascicles and papillary muscles, which has been visualized in isolation during autopsy. Findings of this review propose that sudden cardiac death as a result of malignant arrhythmias arises from automaticity, complex ectopy, and reentry at the level of the fascicles and papillary muscles. The repetitive mechanical stress provides a nidus for the development of both micro- and macrofibrosis easily identified by late gadolinium enhancement on cardiac magnetic resonance imaging. Escalation to electrophysiology studies and early intervention could provide new targeted lifesaving therapies.
    MeSH term(s) Contrast Media ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/etiology ; Female ; Gadolinium ; Humans ; Mitral Valve Prolapse/diagnosis ; Mitral Valve Prolapse/diagnostic imaging ; Papillary Muscles/diagnostic imaging
    Chemical Substances Contrast Media ; Gadolinium (AU0V1LM3JT)
    Language English
    Publishing date 2020-09-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2079676-6
    ISSN 1535-2811 ; 1535-282X
    ISSN (online) 1535-2811
    ISSN 1535-282X
    DOI 10.1097/HPC.0000000000000242
    Database MEDical Literature Analysis and Retrieval System OnLINE

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