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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

Congenital heart“Challenges”in Down syndrome

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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

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,pp=0.003)and 26%lower risk of CV death/HF hospitalization(HR=0.74,95%CI:0.68−0.80,I^(2)=0,pplacebo 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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Arrhythmic risk stratification in ischemic,non-ischemic and hypertrophic cardiomyopathy:A two-step multifactorial,electrophysiology study inclusive approach

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World Journal of Cardiology 2022年第3期14卷 139-151页

作者： petros Arsenos konstantinos A Gatzoulis Dimitrios Tsiachris polychronis Dilaveris Skevos Sideris Ilias Sotiropoulos Stefanos Archontakis Christos-konstantinos Antoniou Athanasios Kordalis Ioannis Skiadas konstantinos Toutouzas Charalambos Vlachopoulos Dimitrios Tousoulis konstantinos tsioufis First Department of Cardiology National and Kapodistrian University of AthensHippokration HospitalAthens 11527AttikaGreece Athens Heart Center Athens Medical CenterAthens 15125AttikaGreece Department of Cardiology Hippokration HospitalAthens 11527AttikaGreece Fifth Department of Cardiology Hygeia HospitalMarousi 15123AttikaGreece

Annual arrhythmic sudden cardiac death ranges from 0.6%to 4%in ischemic cardiomyopathy(ICM),1%to 2%in non-ischemic cardiomyopathy(NICM),and 1%in hypertrophic cardiomyopathy(HCM).Towards a more effective arrhythmic risk stratification(ARS)we hereby present a two-step ARS with the usage of seven non-invasive risk factors:Late potentials presence(≥2/3 positive criteria),premature ventricular contractions(≥30/h),non-sustained ventricular tachycardia(≥1episode/24 h),abnormal heart rate turbulence(onset≥0%and slope≤2.5 ms)and reduced deceleration capacity(≤4.5 ms),abnormal T wave alternans(≥65μV),decreased heart rate variability(SDNNprolonged QT_(c)interval(>440 ms in males and>450 ms in females)which reflect the arrhythmogenic mechanisms for the selection of the intermediate arrhythmic risk patients in the first *** the second step,these intermediate-risk patients undergo a programmed ventricular stimulation(pVS)for the detection of inducible,truly high-risk ICM and NICM patients,who will benefit from an implantable cardioverter *** HCM patients,we also suggest the incorporation of the pVS either for the low HCM Risk-score patients or for the patients with one traditional risk factor in order to improve the inadequate sensitivity of the former and the low specificity of the latter.

关键词： Arrhythmic sudden cardiac death Risk stratification Non-invasive risk factors Electrophysiology study Two-step approach Arrhythmias in cardiomyopathy

Cardiac arrest and cardiopulmonary resuscitation in“hostile”environments:Using automated compression devices to minimize the rescuers’danger

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World Journal of Cardiology 2023年第2期15卷 45-55页

作者： George Latsios Marianna Leopoulou Andreas Synetos Antonios Karanasos Angelos papanikolaou pavlos Bounas Evangelia Stamatopoulou konstantinos Toutouzas Kostas tsioufis 1^(st)University Department of Cardiology "Hippokration"University HospitalAthens Medical SchoolAthens 11527Greece 1^(st)Cardiology Clinic 'Hippokration'University HospitalNational and Kapodistrian University of AthensSchool of MedicineAthens 11527Greece Department of Cardiology "Elpis"Athens General HospitalAthens 11522Greece 1^(st)Department of Cardiology Athens Medical SchoolUniversity AthensHippokrat HospitalAthens 11527Greece 1^(st)Cardiology Department Athens Medical School Hippokration General HospitalAthens 11527Greece Department of Cardiology “Thriasio”General HospitalThriasio General HospitalElefsina 19600Greece CathLab 2nd Department of CardiologyMedical SchoolNational and Kapodistrian University of Athens“Attikon”University HospitalAttikon University HospitalAthens 12462Greece The First Department of Cardiology Athens Medical SchoolAthens 11527Greece 1^(st)Department of Cardiology Medical SchoolNational and Kapodistrian University of Athens“Hippokration”General Hospital"Hippokration"University HospitalAthens 11527Greece

Mechanical automated compression devices are being used in cardiopulmonary resuscitation instead of manual,“hands-on”,rescuer-delivered chest ***-theoretical-advantages include high-quality non-stop compressions,thus freeing the rescuer performing the compressions and additionally the ability of the rescuer to stand reasonably away from a potentially“hazardous”victim,or from hazardous and/or difficult resuscitation *** circumstances involve cardiopulmonary resuscitation(CpR)in the Cardiac Catheterization Laboratory,especially directly under the fluoroscopy panel,where radiation is well known to cause detrimental effects to the rescuer,and CpR during/after land or air transportation of cardiac arrest ***,CpR in a coronavirus disease 2019 patient/ward,where the danger of contamination and further serious illness of the health provider is very *** scope of this review is to review and present literature and current guidelines regarding the use of mechanical compressions in these“hostile”and dangerous settings,while comparing them to manual compressions.

关键词： Automated compression devices Cardiopulmonary resuscitation Cathlab Computed tomography Transfer COVID-19

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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原发性高血压患者左心室向心性重构与C-反应蛋白和血清淀粉样蛋白A水平之间的关系

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 32-33页

作者： tsioufis C. Stougiannos p. Kakkavas A. 王亭忠 Dr. Department of Cardiology Hippokration Hospital Athens Greece

In this study, we investigated possible relations between left ventricular(LV) concentric remodeling and plasma levels of high-sensitivity C-reactive protein(hs-CRp) and serum amyloid-A(SAA) in subjects who had essential hypertension; 65 consecutive subjects who had hypertension, did not have diabetes, and had normal LV mass were categorized as those whose LV relative wall thickness wasples were collected for determination of metabolic profile and plasma levels of hs-CRp and SAA. Subjects whose relative LV wall thickness was ≥0.44 compared with those whose relative LV wall thickness waspressure by 4.5 mm Hg(p=0.015) and higher levels of plasma hs-CRp(1.80 vs 1.39mg/L, p=0.001) and SAA(10.22 vs 4.86 mg/dl, p=0.000), although the 2 groups did not differ with regard to age, gender, waist-to-hip ratio, and diastolic blood pressure(p=NS for all). In the entire study population, log hs-CRp and SAA exhibited positive relations with systolic blood pressure(r=0.21 and r=0.29, respectively; ppectively; pple linear regression analysis showed that age, gender, and diastolic blood pressure were significantly associated with LV mass index(pp, and SAA were significantly associated with relative wall thickness (pp and SAA were significantly different between subjects whose relative LV wall thickness was ≥0.44 and those whose relative LV wall thickness waspressure(pp and SAA levels in patients who are newly diagnosed with essential hypertension.

关键词：原发性高血压患者血清淀粉样蛋白A 高敏C-反应蛋白向心性重构左心室平之相对室壁厚度水 hs-CRp 代谢状况

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阻塞性睡眠呼吸暂停综合征对新近诊断为原发性高血压患者动脉硬度的增效作用

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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 58-59页

作者： tsioufis C. Thomopoulos K. Dimitriadis K. 黄浙勇 43 Agias Marinas Street Melissia 151 27 Athens Greece

目的:尽管阻塞性睡眠呼吸暂停综合征(OSAS)伴随有动脉粥样硬化性心血管疾病负荷的增加,但其与动脉硬度的关系尚不明确。本研究拟探讨伴有OSAS的原发性高血压患者其动脉硬度是否增加。方法:纳入连续46例新近诊断且未经治疗的I～II期原发... 详细信息

目的:尽管阻塞性睡眠呼吸暂停综合征(OSAS)伴随有动脉粥样硬化性心血管疾病负荷的增加,但其与动脉硬度的关系尚不明确。本研究拟探讨伴有OSAS的原发性高血压患者其动脉硬度是否增加。方法:纳入连续46例新近诊断且未经治疗的I～II期原发性高血压合并OSAS患者(男性35例,年龄49±8岁),以及53例

关键词：阻塞性睡眠呼吸暂停综合征动脉硬度原发性高血压患者 OSAS 增效作用

原发性高血压男性患者微量白蛋白尿与脂联素和高敏C-反应蛋白水平的关系

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世界核心医学期刊文摘(心脏病学分册) 2006年第2期 41-42页

作者： tsioufis C. Dimitriadis K. Chatzis D. 朱冰坡 Department of Cardiology Hippokration Hospital Athens Greece Dr.

Microalbuminuria, and recently, hypoadiponectinemia, have been associated with progression of atherosclerotic disease and increased cardiovascular risk. We examined the possible associations of urinary albumin excretion, expressed as the ratio of albumin to creatinine(ACR),with plasma adiponectin and high-sensitivity C-reactive protein(hs-CRp) levels in men who had essential hypertension. The study population consisted of 108 men who did not have diabetes and were newly diagnosed with stage I to II essential hypertension(age 44.6 years, office blood pressure 148/95 mm Hg) and 110 men matched according to age and body mass index as controls. According to ACR values, which were determined as the average of 2 nonconsecutive overnight spot urine samples, subjects who had hypertension were categorized into 2 groups: those who had microalbuminuria(n=28; mean ACR 30 to 300 mg/g) and those who had normal albuminuria(n=80; mean ACRpertension compared with controls exhibited higher ACR and log hs-CRp levels and a trend toward lower log adiponectin values(p=0.062), whereas those who had normal albuminuria compared with controls had similar log adiponectin levels but significantly higher levels of ACR and log hs-CRp. Moreover, subjects who had hypertension and microalbuminuria compared with those who had hypertension and normal albuminuria had higher log hs-CRp and lower log adiponectin concentrations independently of confounding factors. Among those who had hypertension, ACR exhibited an independent positive correlation with log hs-CRp and a negative correlation with log adiponectin. Multiple linear regression analysis showed that age, body mass index, systolic blood pressure, log hs-CRp, and log adiponectin were significant independent predictors of the ACR. In conclusion, microalbuminuria is accompanied by decreased adiponectin and increased hs-CRp levels in the setting of essential hypertension, reflecting a rather diffuse atherosclerotic proc

关键词：微量白蛋白尿原发性高血压脂联素反应蛋白男性患者高敏