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

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

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World Journal of Clinical Cases 2022年第32期10卷 12052-12055页

作者： filippos triposkiadis Grigorios Giamouzis John Skoularigis Andrew Xanthopoulos Department of Cardiology University Hospital of LarissaLarissa 41110Greece

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.

关键词： Heart failure Preserved Nomenclature Left ventricular ejection fraction Pathophysiology Phenotypic persistence

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Heart failure with reduced,mildly reduced,or preserved left ventricular ejection fraction:Has reasoning been lost?

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World Journal of Cardiology 2022年第7期14卷 438-445页

作者： Andrew Xanthopoulos Grigorios Giamouzis John Skoularigis filippos triposkiadis Department of Cardiology University Hospital of LarissaLarissa 41110Greece

Left ventricular(LV)ejection fraction(LVEF),defined as LV stroke volume divided by end-diastolic volume,has been systematically used for the diagnosis,classification,and management of heart failure(HF)over the last three *** is classified as HF with reduced LVEF,HF with midrange or mildly reduced LVEF,and HF with preserved LVEF using arbitrary,continuously changing LVEF cutoffs.A prerequisite for using this LVEF-based terminology is knowledge of the LVEF normal range,which is lacking and may lead to erroneous conclusions in HF,especially at the higher end of the LVEF spectrum.

关键词： Arbitrary Cut off Guidelines Limitations Normal left ventricular ejection fraction range Phenotypic persistence

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Glucose lowering does not necessarily reduce cardiovascular risk in type 2 diabetes

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World Journal of Cardiology 2022年第4期14卷 266-270页

作者： Angeliki Bourazana Grigorios Giamouzis John Skoularigis filippos triposkiadis Andrew Xanthopoulos Department of Cardiology University Hospital of LarissaLarissa 41110Greece

Diabetes mellitus(DM)is a health condition characterized by glucose dysregulation and affects millions of people *** presentation of heart failure in diabetic cardiomyopathy extends over a wide phenotypic spectrum,commencing from asymptomatic,subclinical structural abnormalities to severely symptomatic biventricular dysfunction with increased mortality ***,the spectrum of systolic dysfunction in diabetic-induced heart failure is *** leads also to cardiac electrical remodeling reacting on various *** peptidase-4(DPP-4)inhibitors reduce glucagon and blood glucose levels by raising levels of the endogenous hormones glucagon-like-peptide 1 and glucose-dependent insulinotropic peptide and constitute a safe and effective glucose lowering treatment option in patients with type 2 *** DPP-4 inhibitors’efficacy regarding glycemic control,their effect on cardiovascular outcomes(myocardial infarction,stroke,hospitalization for heart failure,hospitalization for unstable angina,hospitalization for coronary revascularization,and cardiovascular death)in diabetic patients has been *** potential correlation between atrial flutter and DPP-4 inhibitors administration needs further investigation.

关键词： Dipeptidyl peptidase-4 inhibitors Diabetes mellitus Outcomes Metaanalysis Heart failure Atrial flutter

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Patent hemostasis of radial artery:Comparison of two methods

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World Journal of Cardiology 2021年第10期13卷 574-584页

作者： Vassileios Kyriakopoulos Andrew Xanthopoulos Michail Papamichalis Spyridon Skoularigkis Chara Tzavara Emmanouil Papadakis Sotirios Patsilinakos filippos triposkiadis John Skoularigis Department of Cardiology Konstantopoulio General HospitalAthens 14233Greece Department of Cardiology University Hospital of LarissaLarissa 41110Greece Department of Health Medical SchoolUniversity of AthensAthens 11527Greece

BACKGROUND Radial artery obstruction is the most common complication of coronary angiography performed via transradial *** hemostasis can significantly reduce the risk of radial artery *** studies utilized sophisticated methods to evaluate radial artery *** and easily applicable methods for successful patent hemostasis are currently *** To determine which method(pulse oximeter vs the traditional radial artery palpation)is better to achieve patent *** This prospective,single center study included 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention between November 2017 and July *** less than 18 years old,with a history of radial artery disease,or no palpable artery pulse were excluded from the *** were randomly assigned to two *** the first group,radial artery flow was assessed by palpation of the artery during hemostasis(traditional method).In the second group,radial artery patency was estimated with the use of a pulse *** different compression devices were used for hemostasis(air chamber and pressure valve).The primary study endpoint was the achievement of successful patent *** The two groups(pulse oximeter vs artery palpation)had no significant differences in age,sex,body mass index,risk factors,or comorbidities except for supraventricular *** percentage of patients with successful patent hemostasis was significantly higher in the pulse oximeter group(82.2%vs 68.1%,P=0.005).A lower percentage of patients with spasm was recorded in the pulse oximeter group(9.9%vs 19.0%,P=0.024).The incidence of local complications,edema,bleeding,hematoma,vagotonia,or pain did not differ between the two *** the multivariate analysis,the use of a pulse oximeter(OR:2.35,95%CI:1.34-4.13,P=0.003)and advanced age(OR:1.04,95%CI:1.01-1.07,P=0.006),were independently associated with an increased probability of succe

关键词： Radial access Patent hemostasis Palpation Oximeter Coronary angiography Radial artery occlusion

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COVID-19 and the heart

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World Journal of Clinical Cases 2022年第28期10卷 9970-9984页

作者： Andrew Xanthopoulos Angeliki Bourazana Grigorios Giamouzis Evangelia Skoularigki Apostolos Dimos Alexandros Zagouras Michail Papamichalis Ioannis Leventis Dimitrios E Magouliotis filippos triposkiadis John Skoularigis Department of Cardiology University Hospital of LarissaLarissa 41110Greece Department of Cardiothoracic Surgery University of ThessalyLarissa BiopolisLarissa 41110Greece

An outbreak of coronavirus disease 2019(COVID-19) occurred in December 2019 due to severe acute respiratory syndrome coronavirus 2(SARS-Co V-2),which is a strain of SARS-Co *** infected with the virus present a wide spectrum of manifestations ranging from mild flu-like symptoms,cough,fever and fatigue to severe lung injury,appearing as bilateral interstitial pneumonia or acute respiratory *** SARS-Co V-2 infection predominantly offends the respiratory system,it has been associated with several cardiovascular complications as *** example,patients with COVID-19 may either develop type 2 myocardial infarction due to myocardial oxygen demand and supply imbalance or acute coronary syndrome resulting from excessive inflammatory response to the primary *** incidence of COVID-19 related myocarditis is estimated to be accountable for an average of 7% of all COVID-19 related fatal cases,whereas heart failure(HF) may develop due to infiltration of the heart by inflammatory cells,destructive action of pro-inflammatory cytokines,micro-thrombosis and new onset or aggravated endothelial and respiratory ***,SARSCo V-2 can engender arrhythmias through direct myocardial damage causing acute myocarditis or through HF decompensation or secondary,through respiratory failure or severe res-piratory distress *** this comprehensive review we summarize the COVID-19 related cardiovascular complications(acute coronary syndromes,myocarditis,HF,arrhythmias) and discuss the main underlying pathophysiological mechanisms.

关键词： COVID-19 Virus Complications Cardiac Acute coronary syndromes Heart failure Myocarditis Arrhythmias

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Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease

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World Journal of Cardiology 2021年第9期13卷 503-513页

作者： Andrew Xanthopoulos Konstantinos Tryposkiadis Apostolos Dimos Angeliki Bourazana Alexandros Zagouras Nikolaos Iakovis Michail Papamichalis Grigorios Giamouzis George Vassilopoulos John Skoularigis filippos triposkiadis Department of Cardiology University Hospital of LarissaLarissa 41110Greece Independent Biostatistician Athens 15669Greece Department of Haematology University of Thessaly Medical SchoolLarissa 41110Greece

BACKGROUND Red blood cell distribution width(RDW)is elevated in patients with cardiovascular disease(CVD).AIM To determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic *** This prospective study included 204 consecutive elderly patients(age 77.5[7.41]years,female 94[46%],left ventricular ejection fraction 53.00%[37.50,55.00])hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital(Larissa,Greece)from January 2019 to April *** patients were selected due to the high prevalence of coexisting morbidities in this patient *** patients with acute CVD(acute coronary syndromes,new-onset heart failure[HF],and acute pericarditis/myocarditis),primary isolated valvular heart disease,sepsis,and those with a history of blood transfusions or cancer were *** evaluation of the patients within 24 h from admission included clinical examination,laboratory blood tests,and *** The most common cardiac morbidities were hypertension and coronary artery disease,with acutely decompensated chronic heart failure(ADCHF)and atrial fibrillation(AF)also frequently being *** most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus,chronic obstructive pulmonary disease,and sleep *** was significantly elevated 15.48(2.15);121(59.3%)of patients had RDW>14.5%which represents the upper limit of normal in our *** associated with RDW in stepwise regression analysis were ADCHF(coefficient:1.406;95%confidence interval[CI]:0.830-1.981;P<0.001),AF(1.192;0.673 to 1.711;P<0.001),and anemia(0.806;0.256 to 1.355;P=0.004).ADCHF was the most significant factor associated with *** was on average 1.41 higher for patients with than without ADCHF,1.19 higher for patients with than without AF,and 0.81 higher for patients with than without *** patients were grouped b

关键词： Red blood cell distribution width Elderly Cardiovascular disease Coexisting morbidities

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