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Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure

World Journal of Clinical Cases 2024年第8期12卷 1382-1387页

作者： Christos Kourek alexandros briasoulis Dimitrios E Magouliotis John Skoularigis Andrew Xanthopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Surgery University Hospital of LarissaLarissa 41110Greece of Cardiology University Hospital of LarissaLarissa 41110Greece

Chronic heart failure(HF)is a clinical syndrome with high morbidity and mor-tality *** 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 con-sists 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 *** activity,lifestyle,and psychological support are core components of a successful 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 *** individualized exercise prescription should be developed on the basis of a baseline evaluation in all *** main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and *** is important to set the appropriate clinical outcomes from the beginning,in order to assess the effectiveness of a CR *** 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 *** the present editorial,we present all the updated knowledge and recommendations in CR programs.

关键词： Cardiac rehabilitation Heart failure Outcomes Exercise protocols Prescription Future perspectives Limitations

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Recent advances in the diagnostic methods and therapeutic strategies of transthyretin cardiac amyloidosis

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World Journal of Cardiology 2024年第7期16卷 370-379页

作者： Christos Kourek alexandros briasoulis Dimitrios E Magouliotis Panagiotis Georgoulias Grigorios Giamouzis Filippos Triposkiadis John Skoularigis Andrew Xanthopoulos Clinical Ergospirometry Exercise and Rehabilitation Laboratory1^(st)Critical Care Medicine DepartmentEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Cardiothoracic Surgery University of ThessalyLarissa BiopolisLarissa 41110Greece Department of Nuclear Medicine University Hospital of LarissaLarissa 41110Greece Department of Cardiology School of MedicineUniversity Hospital of LarissaLarissa 41110Greece

Cardiac amyloidosis is a progressive disease characterized by the buildup of amyloid fibrils in the extracellular space of the *** is divided in 2 main types,immunoglobulin light chain amyloidosis and transthyretin amyloidosis(ATTR),and ATTR amyloidosis is further divided in 2 subtypes,non-hereditary wild type ATTR and hereditary mutant variant *** and prevalence of ATTR cardiac amyloidosis is increasing over the last years due to the improvements in diagnostic *** rates are improving due to the development of novel therapeutic *** is the only disease-modifying approved therapy in ATTR amyloidosis so ***,the most recent advances in medical therapies have added more options with the potential to become part of the therapeutic armamentarium of the *** including acoramidis,eplontersen,vutrisiran,patisiran and anti-monoclonal antibody NI006 are being investigated on cardiac function in large,multicenter controlled trials which are expected to be completed within the next 2-3 years,providing promising results in patients with ATTR cardiac ***,further and ongoing research is required in order to improve diagnostic methods that could provide an early diagnosis,as well as survival and quality of life of these patients.

关键词： Transthyretin cardiac amyloidosis Tafamidis Acoramidis Eplontersen Vutrisiran Patisiran

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Advances in transcatheter aortic valve replacement

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Journal of Geriatric Cardiology 2019年第9期16卷 724-732页

作者： Tomo Ando alexandros briasoulis Sidakpal Panaich Wayne State University/Detroit Medical Center Detroit Michigan United States University of Iowa Hospitals and Clinics Iowa Iowa United States

Evidence in transcatheter aortic valve replacement(TAVR) has accumulated rapidly over the last few years and its application to clinical decision making are becoming more important. In this review, we discuss the adva... 详细信息

关键词： Aortic stenosis Periprocedural complications Surgical risk Transcatheter aortic valve replacement

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Heart failure with preserved ejection fraction in the elderly: pathophysiology, diagnostic and therapeutic approach

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Journal of Geriatric Cardiology 2019年第5期16卷 421-428页

作者： Ernesto Ruiz Duque alexandros briasoulis Paulino A Alvarez Cardiomyopathy Section Cardiology Division University of Iowa

Heart failure with preserved ejection fraction(HFpEF)is a clinical syndrome characterized by symptoms and sings of heart failure with elevated left ventricular filling pressures at rest or during *** is the most common type of heart failure in the elderly and its prevalence increases with age and is higher in females at any given *** is frequently accompanied of comorbid conditions such as diabetes mellitus,obesity,atrial fibrillation and renal *** diagnosis relies in the integration of clinical information,laboratory data and interpretation of cardiac imaging and hemodynamic findings at rest and during *** that have a specific treatment such as coronary artery disease,valvular disease,cardiac amyloidosis and constrictive pericarditis should be considered and evaluated as *** management of comorbidities,optimization of blood pressure control and volume status using diuretics as needed are among the current treatment *** are no specific therapies that have shown to decrease mortality in *** symptomatic patients with history of hospital admission for decompensated heart failure,the implantation of a wireless pulmonary artery pressure monitor should be ***,given the high mortality of this condition,goals of care discussion should be initiated early and involvement of palliative care medicine should be considered.

关键词： Echocardiography Ejection fraction Heart failure Pharmacology The elderly

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Approach to a patient with cardiac amyloidosis

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Journal of Geriatric Cardiology 2019年第7期16卷 567-574页

作者： Christopher Strouse alexandros briasoulis Rafael Fonseca Yogesh Jethava Department of Internal Medicine Division of HematologyOncologyand Blood and Marrow TransplantationUniversity of IowaIowa CityIAUSA Cardiomyopathy Section Cardiology DivisionUniversity of IowaIowa CityIowaUSA Bone Marrow Transplant Program Mayo ClinicPhoenixArizonaUSA

1 Introduction Cardiac amyloid(CA)is characterized by inexorably progressive heart failure making early diagnosis and treatment *** article will review the pathophysiology,clinical presentation,diagnosis,prognostication and treatment of patients with CA.2 Pathophysiology CA is the result of extracellular deposition of a misfolded protein into cardiac tissue,forming insoluble aggregations of rigid,nonbranching 10 nm wide *** causes impaired cardiac function by disrupting cardiac architecture,direct myotoxicity and ischemic injury secondary to infiltration of intramyocardial vessels.

关键词： Cardiac amyloidosis Heart failure The elderly

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Approach to a patient with pulmonary hypertension

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Journal of Geriatric Cardiology 2019年第6期16卷 478-481页

作者： Chakradhari Inampudi Anna R Hemnes alexandros briasoulis Division of Cardiovascular Diseases University of Iowa Hospitals and Clinics Iowa City Iowa USA Division of Allergy Pulmonary and Critical Care Medicine Vanderbilt University Medical Center Nashville Tennessee USA

Pulmonary hypertension is a common clinical condition that can complicate various cardiac and respiratory abnormalities. Interest in pulmonary hypertension has grown remarkably among the scientific community in the last decade. It is now clear based on the scientific advances have paved the way in understanding the effects of abnormal pulmonary hemodynamics development and its antecedent consequences on the right heart in reducing the quality of life and survival of the patient.

关键词： Pulmonary arterial hypertension

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Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure

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World Journal of Clinical Cases 2023年第36期11卷 8603-8605页

作者： Christos Kourek alexandros briasoulis Grigorios Giamouzis John Skoularigis Andrew Xanthopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Cardiology University Hospital of LarissaLarissa 41110Greece

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 ***’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 ***,it can promote mitochondrial metabolism and enhance the use of adenosine triphosphate in *** the present study,102 chronic heart failure(HF)patients were randomly assigned to a control and an observation group consisting of 51 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 *** 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 ***,cardiac function was also improved,as left ventricular ejection fraction and stroke volume were significantly higher in the observation group than in the control ***,adverse reactions were not different between the 2 ***,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.

关键词： Heart failure Recombinant Brain natriuretic peptide Outcomes

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Spontaneous coronary artery dissection:A review of diagnostic methods and management strategies

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World Journal of Cardiology 2022年第10期14卷 522-536页

作者： Nikolaos Lionakis alexandros briasoulis Virginia Zouganeli Stavros Dimopoulos Dionisios Kalpakos Christos Kourek Department of Cardiology 417 Army Share Fund Hospital of Athens(NIMTS)Athens 11521Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Division of Cardiovascular Medicine Section of Heart Failure and TransplantationUniversity of Iowa Hospitals and ClinicsIA 52242United States Second Cardiology Department Attikon University HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 12462Greece Clinical Ergospirometry Exercise&Rehabilitation Laboratory1 st Department of Critical Care MedicineEvangelismos HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 10676Greece Cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece

Spontaneous coronary artery dissection(SCAD)is a rare non-atherosclerotic cause of acute coronary syndromes defined as non-iatrogenic,non-traumatic separation of the coronary artery *** most common profile is a middle-aged woman between 44 and 53 years with few cardiovascular risk *** is frequently linked with predisposing factors,such as postpartum,fibromuscular dysplasia or other vasculopathies,connective tissue disease and hormonal therapy,and it is often triggered by intense physical or emotional stress,sympathomimetic drugs,childbirth and activities increasing shear stress of the coronary artery *** with SCAD usually present at the emergency department with chest discomfort,chest pain,and rapid heartbeat or *** the last decades,the most common problem of SCAD was the lack of awareness about this condition which has led to significant underdiagnosis and ***,modern imaging techniques such as optical coherence tomography,intravascular ultrasound,coronary angiography or magnetic resonance imaging have contributed to the early diagnosis of the *** of SCAD remains controversial,especially during the last years,where invasive techniques are being used more often and in more emergent cardiac *** conservative treatment combining aspirin and betablocker remains the recommended strategy in most cases,revascularization could also be suggested as a method of treatment in specific indications,but with a higher risk of *** prognosis of SCAD is usually good and long-term mortality seems to be low in these ***-up should be performed on a regular basis.

关键词： Spontaneous coronary artery dissection Non-atherosclerotic coronary artery disease Angiographic classification Percutaneous coronary intervention

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