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  1. Artikel ; Online: Surgical aortic valve replacement in patients aged <50 years and the choice of the prosthesis used: revisiting of the established practice based on convincing evidence or upon 'comparing apples to oranges'?

    Spiliopoulos, Kyriakos / Magouliotis, Dimitrios / Xanthopoulos, Andrew / Athanasiou, Thanos / Skoularigis, John

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

    2024  Band 65, Heft 3

    Mesh-Begriff(e) Humans ; Aortic Valve/surgery ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation
    Sprache Englisch
    Erscheinungsdatum 2024-02-26
    Erscheinungsland Germany
    Dokumenttyp Editorial ; Comment
    ZDB-ID 639293-3
    ISSN 1873-734X ; 1010-7940 ; 1567-4258
    ISSN (online) 1873-734X
    ISSN 1010-7940 ; 1567-4258
    DOI 10.1093/ejcts/ezae067
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  2. Artikel: The Neurohormonal Overactivity Syndrome in Heart Failure.

    Xanthopoulos, Andrew / Skoularigis, John / Triposkiadis, Filippos

    Life (Basel, Switzerland)

    2023  Band 13, Heft 1

    Abstract: Heart failure (HF) is categorized arbitrarily based on the left ventricular ejection fraction (LVEF) in HF with reduced (HFrEF; LVEF < 40%), mildly reduced (HFmrEF; LVEF 40−49%), or preserved ejection fraction (HFpEF; LVEF ≥ 50%). In this opinion paper, ... ...

    Abstract Heart failure (HF) is categorized arbitrarily based on the left ventricular ejection fraction (LVEF) in HF with reduced (HFrEF; LVEF < 40%), mildly reduced (HFmrEF; LVEF 40−49%), or preserved ejection fraction (HFpEF; LVEF ≥ 50%). In this opinion paper, based on (patho)physiological considerations, we contend that the neurohormonal overactivity syndrome (NOHS), which is present in all symptomatic HF patients irrespective of their LVEF, not only contributes to the development of signs and symptoms but it is also a major determinant of patients’ outcomes. In this regard, NHOS is the only currently available treatment target in HF and should be combatted in most patients with the combined use of diuretics and neurohormonal inhibitors (β-blockers, angiotensin receptor-neprilysin inhibitor/angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoid antagonists, and sodium-glucose co-transporter 2 inhibitors). Unfortunately, despite the advances in therapeutics, HF mortality remains high. Probably machine learning approaches could better assess the multiple and higher-dimension interactions leading to the HF syndrome and define clusters of HF treatment efficacy.
    Sprache Englisch
    Erscheinungsdatum 2023-01-16
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life13010250
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  3. Artikel ; Online: Association between Ranolazine, Ischemic Preconditioning, and Cardioprotection in Patients Undergoing Scheduled Percutaneous Coronary Intervention.

    Kourtis, Konstantinos / Bourazana, Angeliki / Xanthopoulos, Andrew / Skoularigkis, Spyridon / Papadakis, Emmanouil / Patsilinakos, Sotirios / Skoularigis, John

    Medicina (Kaunas, Lithuania)

    2024  Band 60, Heft 1

    Abstract: Background and ... ...

    Abstract Background and Objectives
    Mesh-Begriff(e) Humans ; Ranolazine/pharmacology ; Ranolazine/therapeutic use ; Percutaneous Coronary Intervention ; Prospective Studies ; Troponin I ; Ischemic Preconditioning
    Chemische Substanzen Ranolazine (A6IEZ5M406) ; Troponin I
    Sprache Englisch
    Erscheinungsdatum 2024-01-16
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.3390/medicina60010166
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  4. Artikel: Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure.

    Kourek, Christos / Briasoulis, Alexandros / Magouliotis, Dimitrios E / Skoularigis, John / Xanthopoulos, Andrew

    World journal of clinical cases

    2024  Band 12, Heft 8, Seite(n) 1382–1387

    Abstract: Chronic heart failure (HF) is a clinical syndrome with high morbidity and mortality worldwide. Cardiac rehabilitation (CR) is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF, recommended by ... ...

    Abstract Chronic heart failure (HF) is a clinical syndrome with high morbidity and mortality worldwide. Cardiac rehabilitation (CR) is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF, recommended by both American and European guidelines. A CR program consists of a multispecialty group including physicians, nurses, physiotherapists, trainers, nutritionists, and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF patients. Physical activity, lifestyle, and psychological support are core components of a successful CR program. CR has been shown to be beneficial in all ejection fraction categories in HF and most patients, who are stable under medication, are capable of participating. An individualized exercise prescription should be developed on the basis of a baseline evaluation in all patients. The main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and frequency. It is important to set the appropriate clinical outcomes from the beginning, in order to assess the effectiveness of a CR program. There are still significant limitations that prevent patients from participating in these programs and need to be solved. A significant limitation is the generally low quality of research in CR and the presence of negative trials, such as the rehabilitation after myocardial infarction trial, where comprehensive rehabilitation following myocardial infraction had no important effect on mortality, morbidity, risk factors, or health-related quality of life or activity. In the present editorial, we present all the updated knowledge and recommendations in CR programs.
    Sprache Englisch
    Erscheinungsdatum 2024-03-12
    Erscheinungsland United States
    Dokumenttyp Editorial
    ISSN 2307-8960
    ISSN 2307-8960
    DOI 10.12998/wjcc.v12.i8.1382
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  5. Artikel: Catheter Ablation for Atrial Fibrillation in Patients with Heart Failure: Current Evidence and Future Opportunities.

    Suzuki, Sho / Kitai, Takeshi / Skoularigis, John / Spiliopoulos, Kyriakos / Xanthopoulos, Andrew

    Journal of personalized medicine

    2023  Band 13, Heft 9

    Abstract: Atrial fibrillation (AF) and heart failure (HF) are highly prevalent cardiac disorders worldwide, and both are associated with poor prognosis. The incidence of AF and HF has been increasing substantially in recent years, mainly due to the progressive ... ...

    Abstract Atrial fibrillation (AF) and heart failure (HF) are highly prevalent cardiac disorders worldwide, and both are associated with poor prognosis. The incidence of AF and HF has been increasing substantially in recent years, mainly due to the progressive aging of the population. These disorders often coexist, and may have a causal relationship, with one contributing to the development or progression of the other. AF is a significant risk factor for adverse outcomes in HF patients, including mortality, hospitalization, and stroke. Although the optimal treatment for AF with HF remains unclear, catheter ablation (CA) has emerged as a promising treatment option. This review provides a comprehensive overview of the current scientific evidence regarding the efficacy of CA for managing AF in HF patients. In addition, the potential benefits and risks associated with CA are also discussed. We will also explore the factors that may influence treatment outcomes and highlight the remaining gaps in knowledge in this field.
    Sprache Englisch
    Erscheinungsdatum 2023-09-18
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm13091394
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  6. Artikel: Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure.

    Kourek, Christos / Briasoulis, Alexandros / Giamouzis, Grigorios / Skoularigis, John / Xanthopoulos, Andrew

    World journal of clinical cases

    2023  Band 11, Heft 36, Seite(n) 8603–8605

    Abstract: Lyophilized recombinant brain natriuretic peptide (BNP) is an exogenous peptide synthesized by artificial recombination technology, with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human ... ...

    Abstract Lyophilized recombinant brain natriuretic peptide (BNP) is an exogenous peptide synthesized by artificial recombination technology, with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human body. It's main mechanism of action is to increase cyclic guanosine monophosphate by binding with its corresponding receptor in the body, regulating, thus, the imbalance of the vascular system and cardiac hemodynamics, improving the heart's pumping capacity, and inhibiting sympathetic excitability and myocardial remodeling. Moreover, it can promote mitochondrial metabolism and enhance the use of adenosine triphosphate in cardiomyocytes. In the present study, 102 chronic heart failure (HF) patients were randomly assigned to a control and an observation group consisting of 51 patients each. Patients of the control group were treated with standard HF therapy for 3 d including oral metoprolol tartrate tablets, spironolactone, and olmesartanate while patients of the observation group were administered the recombinant human BNP injection for the same time-period, plus the standard HF therapy. The recombinant human BNP group (observation group) demonstrated better physical, emotional, social, and economic scores, as well as cardiac and inflammatory biomarkers such as serum hypersensitive C-reactive protein, N-terminal pro BNP and troponin I levels, compared to the control group. Moreover, cardiac function was also improved, as left ventricular ejection fraction and stroke volume were significantly higher in the observation group than in the control group. Interestingly, adverse reactions were not different between the 2 groups. However, these results are not generalizable and the need of large multicenter randomized controlled trials examining the safety and efficacy of recombinant human BNP in HF patients is of major importance.
    Sprache Englisch
    Erscheinungsdatum 2023-12-22
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2307-8960
    ISSN 2307-8960
    DOI 10.12998/wjcc.v11.i36.8603
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel: Heart failure with preserved ejection fraction: A distinct heart failure phenotype?

    Triposkiadis, Filippos / Giamouzis, Grigorios / Skoularigis, John / Xanthopoulos, Andrew

    World journal of clinical cases

    2022  Band 10, Heft 32, Seite(n) 12052–12055

    Abstract: The present work discusses the serious confusion resulting from the arbitrary nomenclature of heart failure with preserved ejection fraction (HFpEF), the presumed underlying pathophysiology, and the supposed features. A consequence of this misconception ... ...

    Abstract The present work discusses the serious confusion resulting from the arbitrary nomenclature of heart failure with preserved ejection fraction (HFpEF), the presumed underlying pathophysiology, and the supposed features. A consequence of this misconception is that HFpEF trials have recruited patients with entirely different characteristics rendering the extrapolation of the results of one study to the other infeasible and dramatically affecting diagnosis and treatment.
    Sprache Englisch
    Erscheinungsdatum 2022-11-02
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2307-8960
    ISSN 2307-8960
    DOI 10.12998/wjcc.v10.i32.12052
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  8. Artikel: Heart Transplantation.

    Chrysakis, Nikolaos / Magouliotis, Dimitrios E / Spiliopoulos, Kyriakos / Athanasiou, Thanos / Briasoulis, Alexandros / Triposkiadis, Filippos / Skoularigis, John / Xanthopoulos, Andrew

    Journal of clinical medicine

    2024  Band 13, Heft 2

    Abstract: Heart transplantation (HTx) remains the last therapeutic resort for patients with advanced heart failure. The present work is a clinically focused review discussing current issues in heart transplantation. Several factors have been associated with the ... ...

    Abstract Heart transplantation (HTx) remains the last therapeutic resort for patients with advanced heart failure. The present work is a clinically focused review discussing current issues in heart transplantation. Several factors have been associated with the outcome of HTx, such as ABO and HLA compatibility, graft size, ischemic time, age, infections, and the cause of death, as well as imaging and laboratory tests. In 2018, UNOS changed the organ allocation policy for HTx. The aim of this change was to prioritize patients with a more severe clinical condition resulting in a reduction in mortality of people on the waiting list. Advanced heart failure and resistant angina are among the main indications of HTx, whereas active infection, peripheral vascular disease, malignancies, and increased body mass index (BMI) are important contraindications. The main complications of HTx include graft rejection, graft angiopathy, primary graft failure, infection, neoplasms, and retransplantation. Recent advances in the field of HTx include the first two porcine-to-human xenotransplantations, the inclusion of hepatitis C donors, donation after circulatory death, novel monitoring for acute cellular rejection and antibody-mediated rejection, and advances in donor heart preservation and transportation. Lastly, novel immunosuppression therapies such as daratumumab, belatacept, IL 6 directed therapy, and IgG endopeptidase have shown promising results.
    Sprache Englisch
    Erscheinungsdatum 2024-01-18
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm13020558
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  9. Artikel: Artificial Intelligence in Heart Failure: Friend or Foe?

    Bourazana, Angeliki / Xanthopoulos, Andrew / Briasoulis, Alexandros / Magouliotis, Dimitrios / Spiliopoulos, Kyriakos / Athanasiou, Thanos / Vassilopoulos, George / Skoularigis, John / Triposkiadis, Filippos

    Life (Basel, Switzerland)

    2024  Band 14, Heft 1

    Abstract: In recent times, there have been notable changes in cardiovascular medicine, propelled by the swift advancements in artificial intelligence (AI). The present work provides an overview of the current applications and challenges of AI in the field of heart ...

    Abstract In recent times, there have been notable changes in cardiovascular medicine, propelled by the swift advancements in artificial intelligence (AI). The present work provides an overview of the current applications and challenges of AI in the field of heart failure. It emphasizes the "garbage in, garbage out" issue, where AI systems can produce inaccurate results with skewed data. The discussion covers issues in heart failure diagnostic algorithms, particularly discrepancies between existing models. Concerns about the reliance on the left ventricular ejection fraction (LVEF) for classification and treatment are highlighted, showcasing differences in current scientific perceptions. This review also delves into challenges in implementing AI, including variable considerations and biases in training data. It underscores the limitations of current AI models in real-world scenarios and the difficulty in interpreting their predictions, contributing to limited physician trust in AI-based models. The overarching suggestion is that AI can be a valuable tool in clinicians' hands for treating heart failure patients, as far as existing medical inaccuracies have been addressed before integrating AI into these frameworks.
    Sprache Englisch
    Erscheinungsdatum 2024-01-19
    Erscheinungsland Switzerland
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life14010145
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  10. Artikel ; Online: The impact of delirium on clinical and functional outcomes in hospitalized patients with acute coronary syndrome.

    Dimitriadou, Ioanna / Fradelos, Evangelos C / Skoularigis, John / Toska, Aikaterini / Vogiatzis, Ioannis / Papagiannis, Dimitrios / Saridi, Maria

    Nursing in critical care

    2024  

    Abstract: Background: Delirium, which is prevalent in critical care settings, remains underexplored in acute coronary syndrome (ACS) patients in the cardiac intensive care unit (CICU).: Aims: To investigate the prevalence and clinical significance of delirium ... ...

    Abstract Background: Delirium, which is prevalent in critical care settings, remains underexplored in acute coronary syndrome (ACS) patients in the cardiac intensive care unit (CICU).
    Aims: To investigate the prevalence and clinical significance of delirium in patients with ACS admitted to the CICU.
    Study design: A prospective study (n = 106, mean age 74.2 ± 5.7 years) assessed delirium using the confusion assessment method-intensive care unit (CAM-ICU) tool in 21.7% of ACS patients during their CICU stay. Baseline characteristics, geriatric conditions and clinical procedures were compared between delirious and nondelirious patients. The outcomes included in-hospital mortality, 30-day and 6-month mortality, acute adverse events and length of CICU stay and hospital stay (LOS).
    Results: Delirious patients who were older and had a higher incidence of coronary artery disease underwent more complex procedures (e.g., pacemaker placement). Multivariate analysis identified central venous catheter insertion, urinary catheterization and benzodiazepine use as independent predictors of delirium. Delirium was correlated with prolonged LOS (p < .001) and increased in-hospital, 30-day and 6-month mortality (p < .001).
    Conclusions: Delirium in ACS patients in the CICU extends hospitalization and increases in-hospital, 30-day and 6-month mortality. Early recognition and targeted interventions are crucial for mitigating adverse outcomes in this high-risk population.
    Relevance to clinical practice: This study highlights the critical impact of delirium on outcomes in hospitalized patients with ACS in the CICU. Delirium, often overlooked in ACS management, significantly extends hospitalization and increases mortality rates. Nurses and physicians must be vigilant in identifying delirium early, particularly in older ACS patients or those with comorbidities. Recognizing independent predictors such as catheterization and benzodiazepine use allows for targeted interventions to reduce delirium incidence. Integrating routine delirium assessments and preventive strategies into ACS management protocols can improve outcomes, optimize resource utilization and enhance overall patient care in the CICU setting.
    Sprache Englisch
    Erscheinungsdatum 2024-04-11
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2011956-2
    ISSN 1478-5153 ; 1362-1017
    ISSN (online) 1478-5153
    ISSN 1362-1017
    DOI 10.1111/nicc.13079
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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