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Anticoagulation for atrial fibrillation in heart failure patients:balancing between Scylla and Charybdis

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Journal of Geriatric Cardiology 2021年第5期18卷 352-361页

作者： Grigorios Tsigkas Anastasiοs Apostolos Stefanos Despotopoulos Georgios Vasilagkos Angeliki Papageorgiou Eleftherios Kallergis Georgios Leventopoulos Virginia Mplani Ioanna Koniari Dimitrios Velissaris John parissis Department of Cardiology University Hospital of PatrasPatrasGreece Department of Cardiology University Hospital of HeraklionHeraklionGreece Department of Cardiology University Hospital of South ManchesterNHS Foundation TrustManchesterUnited Kingdom Department of Internal Medicine University Hospital of PatrasPatrasGreece Second Department of Cardiology National and Kapodistrian University of AthensAttikon University HospitalAthensGreece

The management of heart failure(HF)and atrial fibrillation(AF)in realworld practice remains a debating issue,while the number of HF patients with AF increase *** it is unclear if rhythm or rate control therapy is more beneficial and under which circumstances,anticoagulation therapy is the cornerstone of the AFHF patients’*** antagonists were the goldstandard during the past,but currently their usage is limited in specific *** K oral anticoagulants(NOACs)have gained ground during the last ten years and considered as goldstandard of a wide spectrum of HF *** current manuscript aims to review the current literature regarding the indications and the optimal choice and usage of NOACs in HF patients with AF.

关键词： patients fibrillation vitamin

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Association of arterial stiffness with coronary flow reserve in revascularized coronary artery disease patients

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World Journal of Cardiology 2016年第2期8卷 231-239页

作者： Vlassis Tritakis Stavros Tzortzis Ignatios Ikonomidis Kleanthi Dima Georgios Pavlidis Paraskevi Trivilou ioannis Paraskevaidis Giorgos Katsimaglis John parissis John Lekakis Second Department of Cardiology Athens University Medical SchoolAttikon Hospital

AIM: To investigate the association of arterial wave reflection with coronary flow reserve(CFR) in coronary artery disease(CAD) patients after successful ***: We assessed 70 patients with angiographically documented CAD who had undergone recent successful revascularization. We measured(1) reactive hyperemia index(RHI) using fingertip peripheral arterial tonometry(RH-PAT Endo-PAT);(2) carotid to femoral pulse wave velocity(PWVc-Complior);(3) augmentation index(AIx), the diastolic area(DAI%) and diastolic reflection area(DRA) of the central aortic pulse wave(Arteriograph);(4) CFR using Doppler echocardiography; and(5) blood levels of lipoprotein-phospholipase A2(LpPLA2).RESULTS: After adjustment for age, sex, blood pressure parameter, lipidemic, diabetic and smoking status, we found that coronary flow reserve was independently related to AIx(b =-0.38, r = 0.009), DAI(b = 0.36, P = 0.014), DRA(b = 0.39, P = 0.005) and RT(b =-0.29,P = 0.026). Additionally, patients with CFR < 2.5 had higher PWVc(11.6 ± 2.3 vs 10.2 ± 1.4 m/s, P = 0.019), SBPc(139.1 ± 17.8 vs 125.2 ± 19.1 mm Hg, P = 0.026), AIx(38.2% ± 14.8% vs 29.4% ± 15.1%, P = 0.011) and lower RHI(1.26 ± 0.28 vs 1.50 ± 0.46, P = 0.012), DAI(44.3% ± 7.9% vs 53.9% ± 6.7%, P = 0.008), DRA(42.2 ± 9.6 vs 51.6 ± 11.4, P = 0.012) and Lp PLA2(268.1 ± 91.9 vs 199.5 ± 78.4 ng/m L, P = 0.002) compared with those with CFR ≥ 2.5. Elevated Lp PLA2 was related with reduced CFR(r =-0.33, P = 0.001), RHI(r =-0.37, P < 0.001) and DRA(r =-0.35, P = 0.001) as well as increased PWVc(r = 0.34, P = 0.012) and AIx(r = 0.34, P = 0.001). CONCLUSION: Abnormal arterial wave reflections are related with impaired coronary flow reserve despite successful revascularization in CAD patients. There is a common inflammatory link between impaired aortic wall properties, endothelial dysfunction and coronary flow impairment in CAD.

关键词： LpPLA2 Coronary artery disease Arterial stiffness Coronary flow reserve Reactive hyperemia index

左西孟旦对继发于缺血性或扩张性心肌病的失代偿性晚期心力衰竭患者室性心律失常和预后自主神经系统指标的影响

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世界核心医学期刊文摘(心脏病学分册) 2007年第5期 12-13页

作者： Flevari P. parissis J.T. Leftheriotis D. P. Flevari 郭俊 Second Department of Cardiology Attikon University Hospital Athens Greece Dr.

用于治疗心力衰竭的正变力性药物具有致心律失常作用。左西孟旦是一种具有血管舒张性质和复杂作用机制的新型钙增敏剂,其对室性心律失常和24hHolter心电图检测的预后自主神经系统相关指标的作用随心脏功能和神经激素反应的改变而发生,... 详细信息

用于治疗心力衰竭的正变力性药物具有致心律失常作用。左西孟旦是一种具有血管舒张性质和复杂作用机制的新型钙增敏剂,其对室性心律失常和24hHolter心电图检测的预后自主神经系统相关指标的作用随心脏功能和神经激素反应的改变而发生,还未曾被系统地

关键词：左西孟旦自主神经系统植物神经系统周围神经系统心力衰竭室性心律失常预后患者

重度心力衰竭患者连续多次输注左西孟旦对左室功能、心肌损伤生物标记以及神经内分泌及免疫激活生物标记的影响作用

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世界核心医学期刊文摘(心脏病学分册) 2007年第5期 34-34页

作者： parissis J.T. Adamopoulos S. Farmakis D. 奚群英 Aftocratoros Irakliou 17 Maroussi 15122 Athens Greece

背景:左西孟旦是一种新型的正性肌力血管扩张剂,可改善失代偿性慢性心力衰竭患者的中心血流动力学和症状。但是,尚未有研究对重复输注左西孟旦在治疗失代偿性慢性心力衰竭中的作用进行评定。目的:在

关键词：左西孟旦心力衰竭左室功能免疫激活输注心肌损伤生物标记患者神经内分泌重度

左西孟旦降低血浆B型利钠肽和白介素-6,改善重度心衰患者的中心血流动力学

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世界核心医学期刊文摘（心脏病学分册） 2005年第9期1卷 49-49页

作者： Kyrzopoulos S. Adamopoulos S. parissis J. T. 孙凯 Second Dept. of Cardiovasc. Medicine Lab. Molec. Immunol. H. Onassis Cardiac Surgery Center Riga Ferreou Street 18-20 Maroussi Athens 15122 Greece

Background: Plasma B-type natriuretic peptide(BNP) and interleukin 6(IL-6) levels have recently been demonstrated as significant neurohormonal markers associated with the progression of chronic heart failure(CHF). Additionally, clinical studies have shown that the calcium sensitizer, levosimendan, beneficially affects the central hemodynamics of CHF patients and improves their long-term prognosis. This study investigates whether levosimendan-induced hemodynamic improvement of CHF patients is related to the respective changes of NT-proBNP and IL-6 levels. Methods: Circulating levels of NT-pro BNP and IL-6 were measured by enzyme-linked immunosorbent assay(ELISA) in 12 patients with decompensated advanced CHF at baseline, immediately after the end of a 24-h levosimendan infusion and 72 h after the initiation of treatment. Hemodynamic parameters of patients(pulmonary wedge and pulmonary artery pressure(PAP), systemic and pulmonary vascular resistance(PVR), stroke volume, and cardiac output and index) were also monitored during the same period. Results: NT-proBNP and IL-6 levels were significantly reduced in severe CHF patients within 72 h after the initiation of levosimendan treatment(p< 0.01 and p< 0.05, respectively). A significant reduction of pulmonary wedge(p< 0.01) and artery pressure values(p< 0.05) was also found during the same period. A good correlation between the levosimendan-induced changes in NT-proBNP levels and the respective reduction of pulmonary wedge pressure(rs=0.65, p< 0.05) was observed. Conclusions: Our results indicate that changes of NT-pro BNP and IL-6 levels may be useful biochemical markers related with the levosimendan-induced improvement in central hemodynamics and the clinical status of decompensated advanced CHF patients.

关键词：利钠肽重度心衰血流动力学慢性心衰失代偿性氨基末端心脏指数肺楔压心输出量心搏出量

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磁共振成像诊断未破裂的右乏氏窦巨大假性动脉瘤

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 34-34页

作者： parissis J.T. Bistola V. Kostakis G.D. Adamopoulos S. 任付先 Amalia F leming Hospital Riga Ferreou Str. 18-20 Maroussi 15122 Athens Greece

This report describes a 58 -year -old patient with a giant unruptured asympt omatic aneurysmof right valsava sinus, as well as the significant contribution o f magnetic resonance imaging in diagnosis of this cardiovas... 详细信息

关键词：磁共振成像诊断巨大假性动脉瘤心血管疾病

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