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Congenital heart“Challenges”in Down syndrome

World Journal of Cardiology 2024年第5期16卷 217-220页

作者： Maria Drakopoulou Panayotis K Vlachakis costas tsioufis Dimitris Tousoulis Department of First Cardiology Hippokration General HospitalAthens Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece

In this editorial,we comment on the article by Kong et al published in the recent issue of the World Journal of *** this interesting case,the authors present the challenges faced in managing a 13-year-old patient with Down syndrome(DS)and congenital heart disease(CHD)associated with pulmonary arterial *** this distinct population,the Authors underscore the need for early diagnosis and management as well as the need of a multidisciplinary approach for decision *** seems that the occurrence of CHD in patients with DS adds layers of complexity to their clinical *** editorial aims to provide a comprehensive overview of the intricate interplay between DS and congenital heart disorders,offering insights into the nuanced diagnostic and therapeutic considerations for physicians.

关键词： Down syndrome Congenital heart disease Atrioventricular septal defect Pulmonary hypertension Right heart catheterization

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Takotsubo cardiomyopathy complicating transcatheter mitral valve-in-valve replacement

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Journal of Geriatric Cardiology 2022年第7期19卷 559-561页

作者： Maria Drakopoulou George Oikonomou George Latsios Andreas Synetos George Benetos Chrysavgi Simopoulou Anastasios Apostolos Stergios Soulaidopoulos Konstantina Aggeli Vasilios Lozos Dimitrios Lymperiadis costas tsioufis Konstantinos Toutouzas First Department of Cardiology Medical SchoolNational and Kapodistrian University of AthensHippokration General Hospital of AthensAthensGreece Department of Cardiac Surgery Hippokration General Hospital of AthensAthensGreece

A 73-year-old female presented with symp-tomatic heart failure(NYHA class Ⅲ)due to a failed 29-mm Sorin(*** Medical,***,MN)bioprosthetic heart valve surgically implanted 10-year before for severe primary mitral valve regurgitation(flail of the anterior mitral leaf-let at A2 scallop).Preprocedural echocardiography showed preserved left ventricular function with severe bioprosthetic valve stenosis and concomit-ant moderate regurgitation(Video 1 in Supplement).Because of prohibitive surgical risk,a transeptal mitral valve-in-valve(ViV)replacement was planned.

关键词： valve mitral replacement

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Non-interventional management of resistant hypertension

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World Journal of Cardiology 2014年第10期6卷 1080-1090页

作者： Michael Doumas costas tsioufis Charles Faselis Antonios Lazaridis Haris Grassos Vasilios Papademetriou 2nd Propedeutic Department of Internal Medicine Aristotle University 54643 Thessaloniki Greecest 1st Cardiology Department Kapodestrian University 11527 Athens Greece Department of Internal Medicine Veterans Af-fairs Medical Center and George Washington University Department of Cardiology KAT Hospital 14561 Athens Greece Department of Cardiology Veterans Affairs Medical Center and Georgetown University

Hypertension is one of the most popular fields of re-search in modern medicine due to its high prevalence and its major impact on cardiovascular risk and con-sequently on global health. Indeed, about one third of individuals worldwide has hypertension and is under increased long-term risk of myocardial infarction, stroke or cardiovascular death. On the other hand, resistant hypertension, the "uncontrollable" part of arterial hy-pertension despite appropriate therapy, comprises a much greater menace since long-standing, high levels of blood pressure along with concomitant debilitating entities such as chronic kidney disease and diabetes mellitus create a prominent high cardiovascular risk milieu. However, despite the alarming consequences, resistant hypertension and its effective management still have not received proper scientific attention. As-pects like the exact prevalence and prognosis are yet tobe clarified. In an effort to manage patients with resis-tant hypertension appropriately, clinical doctors are still racking their brains in order to find the best therapeutic algorithm and surmount the substantial difficulties in controlling this clinical entity. This review aims to shed light on the effective management of resistant hyper-tension and provide practical recommendations for cli-nicians dealing with such patients.

关键词： Resistant hypertension Antihypertensive drugs Adherence White coat hypertension Secondary hypertension

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Impact of SGLT2 inhibitors on major clinical events and safety outcomes in heart failure patients:a meta-analysis of randomized clinical trials

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Journal of Geriatric Cardiology 2021年第10期18卷 783-795页

作者： George Bazoukis Stamatis S.Papadatos costas Thomopoulos Gary Tse Stefanos Cheilidis Konstantinos tsioufis Dimitrios Farmakis Department of Cardiology Larnaca General HospitalLarnacaCyprus Department of Anatomy Histology and EmbryologyMedical SchoolUniversity of IoanninaIoanninaGreece Department of Cardiology Helena Venizelou HospitalAthensGreece Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina University of Cyprus Medical School NicosiaCyprus First Cardiology Clinic Hippokration HospitalAthens UniversityAthensGreece

BACKGROUND Sodium-glucose co-transporter-2 inhibitors(SGLT2i)significantly reduce the risk of cardiovascular(CV)and renal adverse events in patients with diabetes mellitus,heart failure(HF)and/or chronic kidney *** performed a meta-analysis to explore the impact of several different SGLT2i on all-cause mortality,CV mortality,HF hospitalizations and the combined outcome CV death/HF hospitalization in HF patients across the spectrum of left ventricular ejection fraction(LVEF)*** A systematic search in MEDLINE database and Cochrane library through March 2021 was performed without *** clinical trials that provided data about the impact of SGLT2i on all-cause mortality,CV mortality,HF hospitalizations or the combined outcome of CV death/HF hospitalization in HF patients were included.A random effects model was used for calculating the effect *** Nine studies(n=16,723 patients,mean age:65.9 years,males:70.7%)were included in the quantitative *** to placebo,SGLT2i use was associated with 14%lower risk of all-cause mortality[hazard ratio(HR)=0.86,95%CI:0.78−0.94,I^(2)=0,P=0.0008],32%lower risk of HF hospitalizations(HR=0.68,95%CI:0.62−0.74,I^(2)=0,P<0.001),14%lower risk of CV mortality(HR=0.86,95%CI:0.77−0.95,I^(2)=0,P=0.003)and 26%lower risk of CV death/HF hospitalization(HR=0.74,95%CI:0.68−0.80,I^(2)=0,P<0.001).Regarding the safety outcomes,our data revealed no significant differences between SGLT2i and placebo groups in drug related discontinuations,amputations,severe hypoglycemia,hypotension,volume depletion,ketoacidosis and genital *** contrast,a protective role of SGLT2i against placebo was found for serious adverse events and acute kidney *** In patients with HF,regardless of LVEF phenotype,all SGLT2i had an excellent safety profile and significantly reduced the risk of all-cause mortality,CV mortality,HF hospitalizations and CV deaths/HF hospitalizations compared to placeb

关键词： patients clinical protective

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Overview of the Association Between Non-Alcoholic Fatty Liver Disease and Hypertension

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Cardiology Discovery 2024年第1期4卷 30-37页

作者： Niki S.Kakouril costas G.Thomopoulos Eirini P.Siafi Angeliki E.Valatsoul Kyriakos S.Dimitriadis Iliana P.Mani Sotirios P.Patsilinakos Dimitrios M.Tousoulis Konstantinos P.tsioufis First Department of Cardiology Medical SchoolNational and Kapodistrian University of AthensHippokration HospitalAthens 11527Greece Department of Cardiology Elena Venizelou HospitalAthens 11521Greece Department of Cardiology General Hospital Agia OlgaAthens 14233Greece

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, and its prevalence is rising. NAFLD is closely associated with metabolic syndrome, with both conditions sharing common clinical characteristics such as obesity, insulin resistance, type 2 diabetes mellitus, hypertension, and hypertriglyceridemia. Several observational studies have evaluated the relationship between NAFLD and hypertension, with the overall evidence suggesting a bidirectional relationship. It is hypothesized that activation of the sympathetic nervous and renin-angiotensin systems, observed in NAFLD with or without insulin resistance promotes the development of hypertension. In patients with hypertension, activation of these systems can lead to hepatic fibrosis and progressive inflammation through increased oxidative stress and activation of hepatic stellate cells and Kupffer cells. The present review examines the pathophysiologic and clinical evidence supporting the bidirectional association between NAFLD and hypertension.

关键词： Hypertension Non-alcoholic fatty liver disease Insulin resistance Sympathetic nervous system Metabolic syndrome

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