Hellenic Journal of Cardiology最新文献

英文中文

Myocardial inflammation after elective percutaneous coronary intervention 选择性经皮冠状动脉介入治疗后的心肌炎症。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2024-07-01 DOI: 10.1016/j.hjc.2024.06.010

Ioannis Merinopoulos , U. Bhalraam , Bahman Kasmai , David Hewson , Richard Greenwood , Simon C. Eccleshall , James Smith , Vasiliki Tsampasian , Vassilios Vassiliou

Objective

It is well established that inflammation plays a central role in the sequelae of percutaneous coronary intervention (PCI). Most of the studies to date have focused on the inflammatory reaction affecting the vessel wall after angioplasty. However, there are data to suggest that the main foci of inflammation are in fact in the myocardium beyond the vessel wall. The main aim of our study was to investigate the myocardial inflammation after elective, uncomplicated angioplasty with cardiovascular magnetic resonance (CMR) enhanced by ultrasmall superparamagnetic particles of iron oxide (USPIO) and also blood biomarkers. This is the first study to report such findings after elective angioplasty.

Methods

We assessed patients undergoing elective angioplasty for stable angina with USPIO-enhanced CMR two weeks after the procedure and compared the results with those of healthy volunteers who constituted the control group. We excluded patients with previous myocardial infarction, previous PCI, or any significant inflammatory condition. All patients also underwent blood biomarker testing at baseline (pre-PCI), 4 h, and two weeks later.

Results

A total of five patients and three controls were scanned. There was a small absolute increase, although statistically insignificant, in R2∗ values in the PCI area compared with either remote myocardium from the same patient (PCI area [left anterior descending artery (LAD)] vs remote myocardium [circumflex area]: 19.3 ± 10.8 vs 9.2 ± 7.9, p = 0.1) or healthy myocardium from healthy volunteers (PCI area [LAD] vs healthy myocardium [LAD]: 19.3 ± 10.8 vs 12.2 ± 4.0, p = 0.2). PTX3 and IL-6 were the only biomarkers that changed significantly from baseline to 4 h and 2 weeks. Both biomarkers peaked at 4 h.

Conclusion

We used USPIO-enhanced CMR for the first time to assess myocardial inflammation after elective, uncomplicated PCI. We have demonstrated a small numerical increase in inflammation, which was not statistically significant. This study opens the way for future studies to use this method as a means to target inflammation.

背景：炎症在经皮冠状动脉介入治疗（PCI）后遗症中起着核心作用，这一点已得到公认。迄今为止，大多数研究都侧重于血管成形术后影响血管壁的炎症反应。然而，有数据表明，炎症的主要病灶实际上在血管壁以外的心肌中。我们研究的主要目的是利用超小型超顺磁性氧化铁粒子（USPIO）增强的心血管磁共振（CMR）和血液生物标记物，研究择期、无并发症血管成形术后的心肌炎症。这是第一项报告选择性血管成形术后此类发现的研究：我们对因稳定型心绞痛接受选择性血管成形术的患者进行了评估，两周后进行了 USPIO 增强 CMR，并将结果与作为对照组的健康志愿者的结果进行了比较。我们排除了既往患有心肌梗死、既往接受过 PCI 或任何严重炎症的患者。所有患者还分别在基线（PCI 前）、4 小时和 2 周后接受了血液生物标记物检测：共扫描了五名患者和三名对照组。与同一患者的远端心肌（PCI 区（LAD）与远端心肌（Cx）（19.3 ± 10.8 vs 9.2±7.9，p =0.1））或健康志愿者的健康心肌（PCI 区（LAD）与健康心肌（LAD）（19.3 ± 10.8 vs 12.2 ± 4.0，p =0.2））相比，PCI 区的 R2* 值绝对值略有增加，但无统计学意义。PTX3 和 IL6 是唯一从基线到 4 小时再到 2 周发生显著变化的生物标志物。这两种生物标志物均在 4 小时内达到峰值：我们首次利用 USPIO 增强 CMR 评估了择期、无并发症 PCI 术后的心肌炎症。我们已证明炎症在数量上略有增加，但无统计学意义。这项首次研究为今后使用这种方法作为炎症靶点终点的研究开辟了道路。

{"title":"Myocardial inflammation after elective percutaneous coronary intervention","authors":"Ioannis Merinopoulos , U. Bhalraam , Bahman Kasmai , David Hewson , Richard Greenwood , Simon C. Eccleshall , James Smith , Vasiliki Tsampasian , Vassilios Vassiliou","doi":"10.1016/j.hjc.2024.06.010","DOIUrl":"10.1016/j.hjc.2024.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>It is well established that inflammation plays a central role in the sequelae of percutaneous coronary intervention (PCI). Most of the studies to date have focused on the inflammatory reaction affecting the vessel wall after angioplasty. However, there are data to suggest that the main foci of inflammation are in fact in the myocardium beyond the vessel wall. The main aim of our study was to investigate the myocardial inflammation after elective, uncomplicated angioplasty with cardiovascular magnetic resonance (CMR) enhanced by ultrasmall superparamagnetic particles of iron oxide (USPIO) and also blood biomarkers. This is the first study to report such findings after elective angioplasty.</div></div><div><h3>Methods</h3><div>We assessed patients undergoing elective angioplasty for stable angina with USPIO-enhanced CMR two weeks after the procedure and compared the results with those of healthy volunteers who constituted the control group. We excluded patients with previous myocardial infarction, previous PCI, or any significant inflammatory condition. All patients also underwent blood biomarker testing at baseline (pre-PCI), 4 h, and two weeks later.</div></div><div><h3>Results</h3><div>A total of five patients and three controls were scanned. There was a small absolute increase, although statistically insignificant, in R2∗ values in the PCI area compared with either remote myocardium from the same patient (PCI area [left anterior descending artery (LAD)] vs remote myocardium [circumflex area]: 19.3 ± 10.8 vs 9.2 ± 7.9, p = 0.1) or healthy myocardium from healthy volunteers (PCI area [LAD] vs healthy myocardium [LAD]: 19.3 ± 10.8 vs 12.2 ± 4.0, p = 0.2). PTX3 and IL-6 were the only biomarkers that changed significantly from baseline to 4 h and 2 weeks. Both biomarkers peaked at 4 h.</div></div><div><h3>Conclusion</h3><div>We used USPIO-enhanced CMR for the first time to assess myocardial inflammation after elective, uncomplicated PCI. We have demonstrated a small numerical increase in inflammation, which was not statistically significant. This study opens the way for future studies to use this method as a means to target inflammation.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"87 ","pages":"Pages 4-12"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementation of a cardiogenic shock team in a tertiary academic center 在三级学术中心成立心源性休克小组。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2024-07-02 DOI: 10.1016/j.hjc.2024.06.011

Grigoris V. Karamasis , Effie Polyzogopoulou , Charalampos Varlamos , Frantzeska Frantzeskaki , Vassiliki-Maria Dragona , Antonios Boultadakis , Vasiliki Bistola , Katerina Fountoulaki , Christos Pappas , Fotios Kolokathis , Dionysios Pavlopoulos , Ioannis K. Toumpoulis , Vasilios D. Kollias , Dimitrios Farmakis , Loukianos S. Rallidis , Dimitrios C. Angouras , Iraklis Tsangaris , John T. Parissis , Gerasimos Filippatos

Objective

Observational studies have shown that the management of patients with cardiogenic shock (CS) by dedicated multidisciplinary teams improves clinical outcomes. Nevertheless, these studies reflect a specific organizational setting with most patients being transferred from referring hospitals, hospitalized in cardiac intensive care units (ICU), or treated with mechanical circulatory support (MCS) devices. The purpose of this study was to document the organization and outcomes of a CS team offering acute care in an all-comer population.

Methods

A CS team was developed in a large academic tertiary institution. The team consisted of emergency care physicians, critical care cardiologists, interventional cardiologists, cardiac surgeons, ICU physicians, and heart failure specialists and was supported by a predefined operating protocol, a dedicated communication platform, and regular team meetings.

Results

Over 12 months, 70 CS patients (69 ± 13 years old, 67% males) were included. Acute myocardial infarction (AMI-CS) was the most common cause (64%); 31% of the patients presented post-resuscitated cardiac arrest and 56% needed invasive mechanical ventilation (IMV). Coronary angiography was performed in 70% and 53% had percutaneous coronary intervention. MCS was used in 10% and 6% were referred for urgent cardiac surgery. The in-hospital mortality in our center was 40% with 39% of the patients dying within 24 h from presentation. Overall, 76% of the live patients were discharged home.

Conclusion

Across an all-comer population, AMI was the most common cause of CS. A significant number of patients presented post-cardiac arrest, and the majority required IMV. Mortality was high with a significant number dying within hours of presentation.

背景：观察性研究表明，由专门的多学科团队管理心源性休克（CS）患者可改善临床疗效。然而，这些研究反映的是一种特定的组织环境，即大多数患者是从转诊医院转来，在心脏重症监护病房（ICU）住院，或使用机械循环支持（MCS）装置进行治疗。本研究旨在记录为所有患者提供急症护理的 CS 团队的组织和成果：方法：一家大型三级学术机构成立了一个 CS 团队。该团队由急诊科医生、重症监护心脏病学家、介入心脏病学家、心脏外科医生、重症监护病房医生和心衰专家组成，并由预定的操作规程、专用通信平台和定期团队会议提供支持：在 12 个月的时间里，共纳入了 70 名 CS 患者（69±13 岁，67% 为男性）。急性心肌梗死（AMI-CS）是最常见的病因（64%）；31%的患者在复苏后心脏骤停，56%的患者需要有创机械通气（IMV）。70%的患者接受了冠状动脉造影术，53%的患者接受了经皮冠状动脉介入治疗。10%的患者使用了MCS，6%的患者被转诊接受紧急心脏手术。我们中心的院内死亡率为40%，其中39%的患者在发病后24小时内死亡。76%的存活患者出院回家：在所有人群中，急性心肌梗死是导致CS的最常见原因。结论：在所有人群中，急性心肌梗死是导致心肌梗死的最常见原因。很多患者都是在心脏骤停后出现的，其中大多数都需要进行 IMV。死亡率很高，很多患者在发病后数小时内死亡。

{"title":"Implementation of a cardiogenic shock team in a tertiary academic center","authors":"Grigoris V. Karamasis , Effie Polyzogopoulou , Charalampos Varlamos , Frantzeska Frantzeskaki , Vassiliki-Maria Dragona , Antonios Boultadakis , Vasiliki Bistola , Katerina Fountoulaki , Christos Pappas , Fotios Kolokathis , Dionysios Pavlopoulos , Ioannis K. Toumpoulis , Vasilios D. Kollias , Dimitrios Farmakis , Loukianos S. Rallidis , Dimitrios C. Angouras , Iraklis Tsangaris , John T. Parissis , Gerasimos Filippatos","doi":"10.1016/j.hjc.2024.06.011","DOIUrl":"10.1016/j.hjc.2024.06.011","url":null,"abstract":"<div><h3>Objective</h3><div>Observational studies have shown that the management of patients with cardiogenic shock (CS) by dedicated multidisciplinary teams improves clinical outcomes. Nevertheless, these studies reflect a specific organizational setting with most patients being transferred from referring hospitals, hospitalized in cardiac intensive care units (ICU), or treated with mechanical circulatory support (MCS) devices. The purpose of this study was to document the organization and outcomes of a CS team offering acute care in an all-comer population.</div></div><div><h3>Methods</h3><div>A CS team was developed in a large academic tertiary institution. The team consisted of emergency care physicians, critical care cardiologists, interventional cardiologists, cardiac surgeons, ICU physicians, and heart failure specialists and was supported by a predefined operating protocol, a dedicated communication platform, and regular team meetings.</div></div><div><h3>Results</h3><div>Over 12 months, 70 CS patients (69 ± 13 years old, 67% males) were included. Acute myocardial infarction (AMI-CS) was the most common cause (64%); 31% of the patients presented post-resuscitated cardiac arrest and 56% needed invasive mechanical ventilation (IMV). Coronary angiography was performed in 70% and 53% had percutaneous coronary intervention. MCS was used in 10% and 6% were referred for urgent cardiac surgery. The in-hospital mortality in our center was 40% with 39% of the patients dying within 24 h from presentation. Overall, 76% of the live patients were discharged home.</div></div><div><h3>Conclusion</h3><div>Across an all-comer population, AMI was the most common cause of CS. A significant number of patients presented post-cardiac arrest, and the majority required IMV. Mortality was high with a significant number dying within hours of presentation.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"87 ","pages":"Pages 62-70"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nationwide mortality trends from 2001 to 2020 in Greece: health policy implications under the scope of aging societies 希腊 2001 至 2020 年全国死亡率趋势：老龄化社会范围内的卫生政策影响》。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2024-08-28 DOI: 10.1016/j.hjc.2024.08.009

Maria Nikolaou , Nikolaos Theodorakis , Georgios Feretzakis , Georgia Vamvakou , Christos Hitas , Sofia Kalantzi , Aikaterini Spyridaki , Anastasios Apostolos , Vassilios S. Verykios , Konstantinos Toutouzas

Objective

This nationwide study aims to analyze mortality trends for all individual causes in Greece from 2001 to 2020, with a specific focus on 2020, a year influenced by the COVID-19 pandemic. As Greece is the fastest-aging country in Europe, the study’s findings can be generalized to other aging societies, guiding the reevaluation of global health policies.

Methods

Data on the population and the number of deaths were retrieved from the Hellenic Statistical Authority. We calculated age-standardized mortality rates (ASMR) and cause-specific mortality rates by sex in three age groups (0–64, 65–79, and 80+ years) from 2001 to 2020. Proportional mortality rates for 2020 were determined. Statistical analysis used generalized linear models with Python Programming Language.

Results

From 2001 to 2020, the ASMR of cardiovascular diseases (CVD) decreased by 42.7% (p < 0.0001), with declines in most sub-causes, except for hypertensive diseases, which increased by 2.8-fold (p < 0.0001). In 2020, the proportional mortality rates of the three leading causes were 34.9% for CVD, 23.5% for neoplasms, and 9.6% for respiratory diseases (RD). In 2020, CVD were the leading cause of death among individuals aged 80+ years (39.3%), while neoplasms were the leading cause among those aged 0–79 years (37.7%). Among cardiovascular sub-causes, cerebrovascular diseases were predominant in the 80+ year age group (30.3%), while ischemic heart diseases were most prevalent among those aged 0–79 years (up to 60.0%).

Conclusions

The global phenomenon of population aging necessitates a reframing of health policies in our aging societies, focusing on diseases with either a high mortality burden, such as CVD, neoplasms, and RD, or those experiencing increasing trends, such as hypertensive diseases.

导言：这项全国性研究旨在分析 2001 年至 2020 年期间希腊各种原因导致的死亡率趋势，重点关注受冠状病毒大流行影响的 2020 年。由于希腊是欧洲老龄化速度最快的国家，研究结果可用于指导全球卫生政策的重新评估：方法：从希腊统计局获取人口和死亡人数数据。我们计算了 2001 年至 2020 年三个年龄组（0-64 岁、65-79 岁和 80 岁以上）按性别划分的年龄标准化死亡率（ASMR）和特定原因死亡率。确定了 2020 年的比例死亡率。统计分析使用了 Python 编程语言的广义线性模型：结果：从 2001 年到 2020 年，心血管疾病（CVD）的 ASMR 下降了 42.7%（pConclusions）：全球人口老龄化现象要求我们在老龄化社会中重新制定卫生政策，重点关注死亡率高的疾病（如心血管疾病、肿瘤和脊髓灰质炎）或呈上升趋势的疾病（如高血压疾病）。

{"title":"Nationwide mortality trends from 2001 to 2020 in Greece: health policy implications under the scope of aging societies","authors":"Maria Nikolaou , Nikolaos Theodorakis , Georgios Feretzakis , Georgia Vamvakou , Christos Hitas , Sofia Kalantzi , Aikaterini Spyridaki , Anastasios Apostolos , Vassilios S. Verykios , Konstantinos Toutouzas","doi":"10.1016/j.hjc.2024.08.009","DOIUrl":"10.1016/j.hjc.2024.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>This nationwide study aims to analyze mortality trends for all individual causes in Greece from 2001 to 2020, with a specific focus on 2020, a year influenced by the COVID-19 pandemic. As Greece is the fastest-aging country in Europe, the study’s findings can be generalized to other aging societies, guiding the reevaluation of global health policies.</div></div><div><h3>Methods</h3><div>Data on the population and the number of deaths were retrieved from the Hellenic Statistical Authority. We calculated age-standardized mortality rates (ASMR) and cause-specific mortality rates by sex in three age groups (0–64, 65–79, and 80+ years) from 2001 to 2020. Proportional mortality rates for 2020 were determined. Statistical analysis used generalized linear models with Python Programming Language.</div></div><div><h3>Results</h3><div>From 2001 to 2020, the ASMR of cardiovascular diseases (CVD) decreased by 42.7% (p < 0.0001), with declines in most sub-causes, except for hypertensive diseases, which increased by 2.8-fold (p < 0.0001). In 2020, the proportional mortality rates of the three leading causes were 34.9% for CVD, 23.5% for neoplasms, and 9.6% for respiratory diseases (RD). In 2020, CVD were the leading cause of death among individuals aged 80+ years (39.3%), while neoplasms were the leading cause among those aged 0–79 years (37.7%). Among cardiovascular sub-causes, cerebrovascular diseases were predominant in the 80+ year age group (30.3%), while ischemic heart diseases were most prevalent among those aged 0–79 years (up to 60.0%).</div></div><div><h3>Conclusions</h3><div>The global phenomenon of population aging necessitates a reframing of health policies in our aging societies, focusing on diseases with either a high mortality burden, such as CVD, neoplasms, and RD, or those experiencing increasing trends, such as hypertensive diseases.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"87 ","pages":"Pages 13-28"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Navigating the silence: reconsidering treatment paradigms in asymptomatic severe aortic stenosis 在沉默中航行：重新考虑无症状严重主动脉瓣狭窄的治疗模式。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2025-06-16 DOI: 10.1016/j.hjc.2025.06.004

Konstantinos Karampinos , Nikolaos Ktenopoulos , Anastasios Apostolos , Leonidas Koliastasis , Ioannis Kachrimanidis , Panayotis Vlachakis , Odysseas Katsaros , Sotirios Tsalamandris , Antonios Karanasos , Maria Drakopoulou , Andreas Synetos , George Latsios , Konstantinos Tsioufis , Konstantinos Toutouzas

Aortic stenosis (AS) remains the leading valvular heart disease worldwide, affecting up to 5% of older adults and posing a significant risk if left untreated. The evolution of transcatheter aortic valve replacement (TAVR) and its expanding indications for symptomatic patients with severe AS, coupled with the evolving understanding of the pathophysiology and natural history of AS, have heightened the focus on asymptomatic patients with severe AS. Although current clinical practice guidelines recommend aortic valve replacement (AVR) therapy in asymptomatic severe aortic stenosis (ASAS) only in specific clinical settings, recent studies have challenged traditional treatment paradigms, advocating for a more individualized strategy, particularly for patients exhibiting high-risk characteristics. In this review, we provide an in-depth analysis of ASAS, focusing on the intricacies of its clinical management, novel risk-stratification modalities, and predictors of symptom onset and disease progression. We also determine the role of echocardiography in assessing AS severity, highlighting inconsistencies in diagnostic criteria and the need for supplementary testing. Evolving and recently published randomized controlled trials—namely EARLY-TAVR, EVoLVeD, and TAVR-UNLOAD—randomizing asymptomatic patients to early intervention or a watchful waiting strategy provide significant evidence that has the potential to change treatment paradigms, lower the threshold for intervention, and pave the way for more individualized management strategies in ASAS.

主动脉瓣狭窄（AS）仍然是世界范围内主要的瓣膜性心脏病，影响多达5%的老年人，如果不及时治疗，将造成重大风险。经导管主动脉瓣置换术（TAVR）的发展及其对有症状的严重AS患者适应症的扩大，加上对AS病理生理和自然史的不断了解，使得对无症状的严重AS患者的关注日益增加。尽管目前的临床实践指南建议仅在特定的临床环境下对无症状严重主动脉瓣狭窄（ASAS）进行主动脉瓣置换术（AVR）治疗，但最近的研究挑战了传统的治疗模式，提倡更个性化的治疗策略，特别是对表现出高风险特征的患者。在这篇综述中，我们对ASAS进行了深入分析，重点关注其临床管理的复杂性、新的风险分层模式、症状发作和疾病进展的预测因素，同时也深入探讨了超声心动图在评估AS严重程度中的作用，强调了诊断标准的不一致性和补充检测的必要性。不断发展和最近发表的随机对照试验-即early - tavr， EVoLVeD和TAVR-UNLOAD-将无症状患者随机分配到早期干预或观察等待策略，提供了重要的证据，有可能改变治疗范例，降低干预门槛，并为ASAS更个性化的管理策略铺平道路。

{"title":"Navigating the silence: reconsidering treatment paradigms in asymptomatic severe aortic stenosis","authors":"Konstantinos Karampinos , Nikolaos Ktenopoulos , Anastasios Apostolos , Leonidas Koliastasis , Ioannis Kachrimanidis , Panayotis Vlachakis , Odysseas Katsaros , Sotirios Tsalamandris , Antonios Karanasos , Maria Drakopoulou , Andreas Synetos , George Latsios , Konstantinos Tsioufis , Konstantinos Toutouzas","doi":"10.1016/j.hjc.2025.06.004","DOIUrl":"10.1016/j.hjc.2025.06.004","url":null,"abstract":"<div><div>Aortic stenosis (AS) remains the leading valvular heart disease worldwide, affecting up to 5% of older adults and posing a significant risk if left untreated. The evolution of transcatheter aortic valve replacement (TAVR) and its expanding indications for symptomatic patients with severe AS, coupled with the evolving understanding of the pathophysiology and natural history of AS, have heightened the focus on asymptomatic patients with severe AS. Although current clinical practice guidelines recommend aortic valve replacement (AVR) therapy in asymptomatic severe aortic stenosis (ASAS) only in specific clinical settings, recent studies have challenged traditional treatment paradigms, advocating for a more individualized strategy, particularly for patients exhibiting high-risk characteristics. In this review, we provide an in-depth analysis of ASAS, focusing on the intricacies of its clinical management, novel risk-stratification modalities, and predictors of symptom onset and disease progression. We also determine the role of echocardiography in assessing AS severity, highlighting inconsistencies in diagnostic criteria and the need for supplementary testing. Evolving and recently published randomized controlled trials—namely EARLY-TAVR, EVoLVeD, and TAVR-UNLOAD—randomizing asymptomatic patients to early intervention or a watchful waiting strategy provide significant evidence that has the potential to change treatment paradigms, lower the threshold for intervention, and pave the way for more individualized management strategies in ASAS.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"87 ","pages":"Pages 101-120"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiovascular events in hospitalized patients with COVID-19: incidence, in-hospital mortality, and fatality rates. Results from the HERICCO study by the Working Group of Echocardiology of the Hellenic Cardiology Society COVID-19住院患者心血管事件：发病率、院内死亡率和病死率希腊心脏病学会超声心脏病学工作组HERICCO研究结果。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2025-05-30 DOI: 10.1016/j.hjc.2025.05.007

Ilias Karabinos , Ilias Gkartzonikas , Christos Gogos , Iosif Karantoumanis , Christoforos Komporozos , Konstantinos I. Karampinos , Anastasios Theodosis Georgillas , Athanasios Papadogiannis , Georgios Diakakis , Damianos Eleftheriadis , Vasilios A. Vasilakopoulos , Estela Kiouri , Vasileios Sachpekidis , Loukianos Rallidis , Constantinos H. Papadopoulos

引用次数: 0

Role of Life’s Essential 8 score in mediating socioeconomic status in the incidence of atrial fibrillation and heart failure: a population-based cohort study 一项基于人群的队列研究：Life's Essential 8评分在心房颤动和心力衰竭发病率中中介社会经济地位的作用

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2024-12-30 DOI: 10.1016/j.hjc.2024.12.006

Nana Wang , Xiaocan Jia , Zhixing Fan , Chaojun Yang , Yuping Wang , Jingwen Fan , Chenyu Zhao , Yongli Yang , Xuezhong Shi

Objective

To assess whether the Life’s Essential 8 (LE8) score mediates the association of socioeconomic status (SES) with atrial fibrillation (AF) and heart failure (HF).

Methods

A total of 236,754 participants from the UK Biobank were included. SES was determined based on household income, education attainment, and employment status using latent class analysis. Cox regression was utilized to explore the association of SES with AF and HF after adjusting for age, sex, ethnicity, and alcohol status. Counterfactual mediation analysis was employed to calculate the mediation proportion of the LE8 score. Stratified analysis was conducted based on age and sex.

Results

With a median of 13.61 years of follow-up, 14,635 cases of AF and 6878 cases of HF were documented. The HR (95% CI) of the total effect of SES on AF was 1.43 (1.36, 1.48). The indirect effect mediated by the LE8 score was 1.14 (1.13, 1.15), with the mediation proportion being 40.84 (36.97, 47.01)%. The total effect of SES on HF was 2.44 (2.26, 2.59). The indirect effect was 1.28 (1.25, 1.29), with the mediation proportion being 36.77 (34.59, 39.06)%. The mediation proportion was greater for AF in age < 60 years compared to age ≥ 60 years, and it was also higher in males than females for both AF and HF.

Conclusion

Approximately one-third of the socioeconomic inequalities in AF and HF could be explained by the LE8 score. These findings highlighted the importance of integrating cardiovascular health promotion into public health policies aimed at mitigating socioeconomic health inequalities.

目的：探讨生活基本8 （Life’s Essential 8, LE8）评分是否介导社会经济地位（SES）与心房颤动（AF）和心力衰竭（HF）的关联。方法：来自UK Biobank的236,754名参与者被纳入研究。社会经济地位以家庭收入、受教育程度和就业状况为基础，采用潜在类别分析。在调整了年龄、性别、种族和酒精状况后，采用Cox回归来探讨SES与房颤和心衰的关系。采用反事实中介分析计算LE8得分的中介比例。根据年龄和性别进行分层分析。结果：在中位13.61年的随访中，记录了14635例房颤和6878例心衰。SES对AF总影响的HR （95% CI）为1.43（1.36,1.48）。LE8评分介导的间接效应为1.14(1.13,1.15)，中介比例为40.84(36.97,47.01)%。SES对HF的总影响为2.44（2.26,2.59）。间接效应为1.28(1.25,1.29)，中介比例为36.77(34.59,39.06)%。年龄< 60岁房颤的中介比例大于年龄≥60岁房颤的中介比例，男性房颤和HF的中介比例均高于女性。结论：房颤和心衰中大约三分之一的社会经济不平等可以用LE8评分来解释。这些发现强调了将心血管健康促进纳入旨在减轻社会经济健康不平等的公共卫生政策的重要性。

{"title":"Role of Life’s Essential 8 score in mediating socioeconomic status in the incidence of atrial fibrillation and heart failure: a population-based cohort study","authors":"Nana Wang , Xiaocan Jia , Zhixing Fan , Chaojun Yang , Yuping Wang , Jingwen Fan , Chenyu Zhao , Yongli Yang , Xuezhong Shi","doi":"10.1016/j.hjc.2024.12.006","DOIUrl":"10.1016/j.hjc.2024.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether the Life’s Essential 8 (LE8) score mediates the association of socioeconomic status (SES) with atrial fibrillation (AF) and heart failure (HF).</div></div><div><h3>Methods</h3><div>A total of 236,754 participants from the UK Biobank were included. SES was determined based on household income, education attainment, and employment status using latent class analysis. Cox regression was utilized to explore the association of SES with AF and HF after adjusting for age, sex, ethnicity, and alcohol status. Counterfactual mediation analysis was employed to calculate the mediation proportion of the LE8 score. Stratified analysis was conducted based on age and sex.</div></div><div><h3>Results</h3><div>With a median of 13.61 years of follow-up, 14,635 cases of AF and 6878 cases of HF were documented. The HR (95% CI) of the total effect of SES on AF was 1.43 (1.36, 1.48). The indirect effect mediated by the LE8 score was 1.14 (1.13, 1.15), with the mediation proportion being 40.84 (36.97, 47.01)%. The total effect of SES on HF was 2.44 (2.26, 2.59). The indirect effect was 1.28 (1.25, 1.29), with the mediation proportion being 36.77 (34.59, 39.06)%. The mediation proportion was greater for AF in age < 60 years compared to age ≥ 60 years, and it was also higher in males than females for both AF and HF.</div></div><div><h3>Conclusion</h3><div>Approximately one-third of the socioeconomic inequalities in AF and HF could be explained by the LE8 score. These findings highlighted the importance of integrating cardiovascular health promotion into public health policies aimed at mitigating socioeconomic health inequalities.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"87 ","pages":"Pages 91-100"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Verification of persistent pulmonary vein isolation with electroanatomical mapping 3 months after ablation using a novel PFA platform 使用新型 PFA 平台，在消融 3 个月后通过电解剖图验证持续性肺静脉隔离。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2024-11-19 DOI: 10.1016/j.hjc.2024.11.002

Athanasios Kordalis, Dimitrios Tsiachris, Christos-Konstantinos Antoniou, Ioannis Doundoulakis, Konstantinos Tsioufis

引用次数: 0

Congenital left aortic sinus of valsalva to left ventricle tunnel 先天性左主动脉窦至左心室隧道。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2026-01-01 Epub Date: 2025-01-03 DOI: 10.1016/j.hjc.2024.12.008

Leizhi Ku , Shengpeng Guo , Xiaojing Ma