Hellenic Journal of Cardiology最新文献_第2页

To implement or to innovate? Which is the noble action for the future in heart failure 实施还是创新？这是对未来心力衰竭的崇高行动。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2025.11.003

Charalambos Vlachopoulos , Alexandros Briasoulis

引用次数: 0

Association of beat-to-beat P-wave analysis index to the extent of left atrial low-voltage areas in patients with paroxysmal atrial fibrillation 阵发性心房颤动患者逐次搏动 P 波分析指数与左心房低电压区范围的关系。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.05.011

Antigoni Sakellaropoulou , Georgios Giannopoulos , Dimitrios Tachmatzidis , Konstantinos P. Letsas , Antonios Antoniadis , Dimitrios Asvestas , Dimitrios Filos , Panagiotis Mililis , Michael Efremidis , Ioanna Chouvarda , Vassilios P. Vassilikos

Background

Left atrial (LA) fibrosis has been shown to be associated with atrial fibrillation (AF) recurrence. Beat-to-beat (B2B) index is a non-invasive classifier, based on B2B P-wave morphological and wavelet analysis, shown to be associated with AF incidence and recurrence. In this study, we tested the hypothesis that the B2B index is associated with the extent of LA low-voltage areas (LVAs) on electroanatomical mapping.

Methods

Patients with paroxysmal AF scheduled for pulmonary vein isolation, without evident structural remodeling, were included. Pre-ablation electroanatomical voltage maps were used to calculate the surface of LVAs (<0.5 mV). B2B index was compared between patients with small versus large LVAs.

Results

35 patients were included (87% male, median age 62). The median surface area of LVAs was 7.7 (4.4–15.8) cm² corresponding to 5.6 (3.3–12.1) % of LA endocardial surface. B2B index was 0.57 (0.52–0.59) in patients with small LVAs (below the median) compared to 0.65 (0.56–0.77) in those with large LVAs (above the median) (p = 0.009). In the receiver operator characteristic curve analysis for predicting large LVAs, the c-statistic was 0.75 (p = 0.006) for B2B index and 0.81 for the multivariable model including B2B index (multivariable p = 0.04) and P-wave duration.

Conclusion

In patients with paroxysmal AF without overt atrial myopathy, B2B P-wave analysis appears to be a useful non-invasive correlate of low-voltage areas—and thus fibrosis—in the LA. This finding establishes a pathophysiological basis for B2B index and its potential usefulness in the selection process of patients who are likely to benefit most from further invasive treatment.

背景：左心房（LA）纤维化已被证明与房颤（AF）复发有关。逐搏（B2B）指数是一种无创分类器，基于 B2B P 波形态学和小波分析，显示与房颤发生率和复发率相关。在本研究中，我们测试了 B2B 指数与电解剖图上 LA 低电压区（LVA）范围相关的假设：方法：纳入计划进行肺静脉隔离且无明显结构重塑的阵发性房颤患者。采用消融前电解剖电压图来计算 LVA 的表面（结果：35 名患者（87% 为男性）被纳入研究：共纳入 35 名患者（87% 为男性，中位年龄为 62 岁）。LVA 的中位表面积为 7.7 (4.4-15.8) 平方厘米，相当于 LA 心内膜表面的 5.6 (3.3-12.1) %。小 LVA（低于中位值）患者的 B2B 指数为 0.57（0.52-0.59），而大 LVA（高于中位值）患者的 B2B 指数为 0.65（0.56-0.77）（P=0.009）。在预测大LVA的接收器操作特征曲线分析中，B2B指数的c统计量为0.75（p=0.006），包括B2B指数（多变量p=0.04）和P波持续时间在内的多变量模型的c统计量为0.81：对于没有明显心房肌病的阵发性房颤患者，B2B P 波分析似乎是 LA 低电压区--也就是纤维化--的一个有用的无创相关指标。这一发现为 B2B 指数奠定了病理生理学基础，并有助于筛选出可能从进一步有创治疗中获益最多的患者。

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引用次数: 0

Metabolic dysfunction–associated fatty liver disease is associated with the presence of coronary atherosclerotic plaques and plaque burden 代谢功能障碍相关性脂肪肝与冠状动脉粥样硬化斑块的存在和斑块负荷有关。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.06.002

Xueli Cai , Xin Su , Yanli Zhang , Suying Wang , Yuesong Pan , Aoming Jin , Jing Jing , Jingping Sun , Lerong Mei , Xia Meng , Shan Li , Zhang Xia , Yuhao Li , Zijun Liu , Yongjun Wang , Yan He , Tiemin Wei

Objective

Atherosclerosis is closely related to cardiovascular disease risk. The present study aims to evaluate the association between metabolic dysfunction–associated fatty liver disease (MAFLD) and the presence of coronary atherosclerotic plaques and plaques burden, as detected by computed tomography angiography (CTA), and further test the screening value of MAFLD on the presence of coronary atherosclerotic plaques and plaques burden.

Methods

We used data from the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events study, a community-based cohort. Hepatic steatosis was assessed using the fatty liver index. Coronary atherosclerotic plaques and burden were detected by CTA. The association of MAFLD with the presence of coronary atherosclerotic plaques and burden was assessed by binary and ordinal logistic regression models, respectively.

Results

Among the 3029 participants (mean age 61.2 ± 6.7 years), 47.9% (1452) presented with MAFLD. MAFLD was associated with an increased odds of the presence of coronary atherosclerotic plaques (OR, 1.27; 95% CI: 1.03–1.56), segment involvement score [cOR (common odds ratio), 1.25; 95% CI, 1.03–1.51], and segment stenosis score (cOR, 1.29; 95% CI, 1.06–1.57). Participants with severe fibrosis or diagnosed as DM-MAFLD subtypes had with higher odds for the presence of coronary atherosclerotic plaques and plaques burden. In addition, MAFLD demonstrated a higher sensitivity for detecting the presence of coronary atherosclerotic plaques and plaque burden (54%–64%) than conventional CVD risk factors (such as diabetes, obesity, and dyslipidemia).

Conclusion

MAFLD is associated with higher odds of having coronary atherosclerotic plaques and plaque burden. Moreover, MAFLD may offer better screening potential for coronary atherosclerosis than established CVD risk factors.

背景：动脉粥样硬化与心血管疾病风险密切相关：动脉粥样硬化与心血管疾病风险密切相关。本研究旨在评估代谢功能障碍相关性脂肪肝（MAFLD）与计算机断层扫描血管造影（CTA）检测到的冠状动脉粥样硬化斑块的存在和斑块负荷之间的关联，并进一步检验MAFLD对冠状动脉粥样硬化斑块的存在和斑块负荷的筛查价值：我们使用了基于社区的队列研究 "认知障碍和血管事件的多血管评估 "的数据。肝脏脂肪变性通过脂肪肝指数进行评估。通过 CTA 检测冠状动脉粥样硬化斑块和负担。通过二元和序数逻辑回归模型分别评估了MAFLD与冠状动脉粥样硬化斑块和负荷的相关性：在 3029 名参与者（平均年龄为 61.2±6.7 岁）中，47.9%（1452 人）患有 MAFLD。MAFLD与出现冠状动脉粥样硬化斑块（OR，1.27；95% CI：1.03-1.56）、节段受累评分[cOR（常见几率比），1.25；95% CI，1.03-1.51]和节段狭窄评分（cOR，1.29；95% CI，1.06-1.57）的几率增加有关。严重纤维化或被诊断为 DM-MAFLD 亚型的参与者出现冠状动脉粥样硬化斑块和斑块负荷的几率更高。此外，与传统的心血管疾病风险因素（如糖尿病、肥胖和血脂异常）相比，MAFLD在检测冠状动脉粥样硬化斑块的存在和斑块负荷方面表现出更高的灵敏度（54%-64%）：结论：MAFLD与冠状动脉粥样硬化斑块和斑块负荷较高的几率相关。此外，与已确定的心血管疾病风险因素相比，MAFLD可能具有更好的冠状动脉粥样硬化筛查潜力。

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引用次数: 0

Is endocarditis always the answer? 心内膜炎一定能解决问题吗？

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.09.004

Dimitrios Oikonomidis, Alexandros Pappas, Evangelos Tatsis, Athanasios Tasoulis, Constantinos Papadopoulos

引用次数: 0

Prevalence, awareness, and control of hypertension in Greece before and after the COVID-19 pandemic: May Measurement Month survey 2019–2022 COVID-19 大流行前后希腊的高血压患病率、认知度和控制情况：2019-2022年五月测量月调查。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.05.017

Ariadni Menti , Anastasios Kollias , John A. Papadakis , Rigas G. Kalaitzidis , Haralampos Milionis , Xenophon Krokidis , George Nikitas , Spyridon Maragkoudakis , Emmanouil Makaris , Evangelos Papachristou , Vasilios Sarakis , Leonidas Lanaras , Eugenia Gkaliagkousi , Dimitrios Goumenos , Charalampos Grassos , Manolis S. Kallistratos , Vasiliki Katsi , Dimitrios Konstantinidis , Vasileios Kotsis , Konstantinos G. Kyriakoulis , George S. Stergiou

Objective

The COVID-19 pandemic had an adverse impact on several cardiovascular risk factors. This study investigated the prevalence, awareness and treatment of hypertension in Greece before and after the pandemic. Data were collected in the context of the May Measurement Month (MMM) global survey initiated by the International Society of Hypertension.

Methods

Adult volunteers (age ≥ 18 years) were recruited through opportunistic screening in public areas across cities in Greece in 2019 and 2022. Medical history and triplicate sitting blood pressure (BP) measurements were taken using validated automated upper-arm cuff devices. The data were uploaded to the international MMM cloud platform. Hypertension was defined as systolic BP ≥ 140 mm Hg and/or diastolic ≥90 mm Hg and/or self-reported use of drugs for hypertension. The same threshold was used to define uncontrolled BP in treated individuals.

Results

Data from 12,080 adults were collected (5,727/6,353 in MMM 2019/2022; men 46/49%, p < 0.01; mean age 52.7 ± 16.6/54.8 ± 16.2, p < 0.001; smokers, 24.7/30.5, p < 0.001; diabetics 12/11.5%, p = NS; cardiovascular disease 5/5.8%, p = NS). The prevalence of hypertension was 41.6/42.6% (MMM 2019/2022, p = NS), with 21.3/27.5% of individuals with hypertension being unaware of their condition (p < 0.001), 5.6/2.4% aware untreated (p < 0.001), 24.8/22.1% treated uncontrolled (p < 0.05), and 48.3/47.8% treated controlled (p = NS).

Conclusion

In Greece, the COVID-19 pandemic did not appear to affect the prevalence and control of hypertension; however, the rate of undiagnosed hypertension was higher after the pandemic. National strategies need to be implemented for the early detection and optimal management of hypertension in the general population in Greece.

背景：COVID-19 大流行对多种心血管风险因素产生了不利影响。本研究调查了大流行前后希腊高血压的患病率、认知度和治疗情况。数据是在国际高血压学会发起的五月测量月（MMM）全球调查中收集的：方法：2019 年和 2022 年在希腊各城市的公共场所通过机会性筛查招募成年志愿者（年龄≥18 岁）。使用经过验证的自动上臂袖带装置测量病史和一式三份的坐位血压（BP）。数据上传到国际 MMM 云平台。高血压的定义是收缩压≥140 mmHg 和/或舒张压≥90 mmHg，和/或自述服用过治疗高血压的药物。同样的阈值也用于界定治疗者血压未受控制的情况：收集了来自 12080 名成年人的数据（MMM 2019/2022 中为 5727/6353 人；男性占 46/49%，女性占 pConclusions）：在希腊，COVID-19大流行似乎并未影响高血压的患病率和控制率，但大流行后未确诊的高血压发病率较高。希腊需要实施国家战略，以便及早发现和优化管理普通人群中的高血压。

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引用次数: 0

Pulmonary venous flow patterns associated with long-term mitral transcatheter edge-to-edge outcomes 与二尖瓣经导管边缘对边缘长期疗效相关的肺静脉血流模式

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.05.015

Tomer Dvir , Itshak Amsalem , Shemy Carasso , Or Gilad , Elad Asher , Danny Dvir , Yael Yan Postell , Michael Glikson , David Marmor , Mony Shuvy

Objective

Transcatheter edge-to-edge repair (TEER) is a prominent therapeutic option for mitral regurgitation (MR) patients. However, it lacks objective parameters to assess procedural efficacy. This study aims to investigate pulmonary venous (PV) flow as a surrogate for valvular hemodynamics and its associations to clinical outcomes.

Methods

Consecutive MR patients who underwent TEER in our center from January 2020 to October 2021 were retrospectively investigated. PV flow parameters were measured before and after TEER, including velocity (cm/s), velocity time integral (VTI) (cm), and systolic/diastolic ratios. Primary outcomes were 1, 6, and 12 months heart failure hospitalizations (HFH) and 1 year all-cause mortality.

Results

The cohort consisted of 80 patients. The mean age was 74.76 ± 10.13 years, 26 with primary and 54 with secondary MR. Systolic wave parameters improved significantly after TEER: mean peak velocity increased from 9.94 ± 31.95 to 35.74 ± 15.03 cm/s, and VTI from 3.62 ± 5.99 to 8.33 ± 4.72 cm. Furthermore, systolic to diastolic VTI and peak-velocities ratios showed significant improvement of 0.39 ± 0.63 to 0.81 ± 0.47 and 0.23 ± 0.66 to 0.91 ± 0.43, respectively. Using multivariable analysis, higher post-procedural S_VTI was associated with less HFH: 1-month (OR = 0.72, CI [0.52,0.98]), 6-months (OR = 0.8, CI [0.66,0.97]), 1-year (OR = 0.85, CI [0.73,0.99]), as well as reduced 1-year mortality (OR = 0.64 95% CI [0.45,0.91]). Furthermore, compared to patients with SVTI ≥ 3, patients with SVTI < 3 had a higher risk for HFH at: 1-month (OR = 16.59, CI [1.48,186.02]), 6-months (OR = 12.2, CI [1.69,88.07]), and 1-year (OR = 8.61, CI [1.27,58.27]), as well as elevated 1-year mortality (OR = 8.07, 95% CI [1.04,62.28]).

Conclusion

PV flow was significantly improved following TEER, and several hemodynamic parameters were associated with HFH and mortality. These results may offer a basis for establishing future procedural goals to ensure better clinical outcomes.

背景：经导管边缘到边缘修补术（TEER）是二尖瓣反流（MR）患者的主要治疗选择。然而，它缺乏评估手术疗效的客观参数。本研究旨在调查作为瓣膜血流动力学替代指标的肺静脉（PV）血流及其与临床结果的关系：方法：对 2020 年 1 月至 2021 年 10 月在本中心接受 TEER 的连续 MR 患者进行回顾性调查。在 TEER 前后测量了 PV 血流参数，包括速度（厘米/秒）、速度时间积分（VTI）（厘米）和收缩/舒张比。主要结果是1、6和12个月的心衰住院率（HFH）和1年的全因死亡率：队列由 80 名患者组成。平均年龄为（74.76±10.13）岁，26 人患有原发性 MR，54 人患有继发性 MR。TEER 治疗后收缩压波参数明显改善：平均峰值速度从（9.94±31.95）厘米/秒增至（35.74±15.03）厘米/秒，VTI 从（3.62±5.99）厘米增至（8.33±4.72）厘米。此外，收缩期与舒张期的 VTI 和峰值-心率比分别从 0.39±0.63 到 0.81±0.47 和 0.23±0.66 到 0.91±0.43 有了显著改善。通过多变量分析，术后 SVTI 越高，HFH 越低：1 个月（OR=0.72,CI[0.52,0.98]）、6 个月（OR=0.8,CI[0.66,0.97]）、1 年（OR=0.85,CI[0.73,0.99]），以及 1 年死亡率降低（OR=0.64 95% CI[0.45,0.91]）。此外，与 SVTI≥3 的患者相比，SVTIConclusions 的患者在接受 TE 治疗后 PV 流量明显改善：TEER 治疗后，PV 流量明显改善，一些血液动力学参数与 HFH 和死亡率相关。这些结果可为确定未来的程序目标提供依据，以确保更好的临床效果。

{"title":"Pulmonary venous flow patterns associated with long-term mitral transcatheter edge-to-edge outcomes","authors":"Tomer Dvir , Itshak Amsalem , Shemy Carasso , Or Gilad , Elad Asher , Danny Dvir , Yael Yan Postell , Michael Glikson , David Marmor , Mony Shuvy","doi":"10.1016/j.hjc.2024.05.015","DOIUrl":"10.1016/j.hjc.2024.05.015","url":null,"abstract":"<div><h3>Objective</h3><div>Transcatheter edge-to-edge repair (TEER) is a prominent therapeutic option for mitral regurgitation (MR) patients. However, it lacks objective parameters to assess procedural efficacy. This study aims to investigate pulmonary venous (PV) flow as a surrogate for valvular hemodynamics and its associations to clinical outcomes.</div></div><div><h3>Methods</h3><div>Consecutive MR patients who underwent TEER in our center from January 2020 to October 2021 were retrospectively investigated. PV flow parameters were measured before and after TEER, including velocity (cm/s), velocity time integral (VTI) (cm), and systolic/diastolic ratios. Primary outcomes were 1, 6, and 12 months heart failure hospitalizations (HFH) and 1 year all-cause mortality.</div></div><div><h3>Results</h3><div>The cohort consisted of 80 patients. The mean age was 74.76 ± 10.13 years, 26 with primary and 54 with secondary MR. Systolic wave parameters improved significantly after TEER: mean peak velocity increased from 9.94 ± 31.95 to 35.74 ± 15.03 cm/s, and VTI from 3.62 ± 5.99 to 8.33 ± 4.72 cm. Furthermore, systolic to diastolic VTI and peak-velocities ratios showed significant improvement of 0.39 ± 0.63 to 0.81 ± 0.47 and 0.23 ± 0.66 to 0.91 ± 0.43, respectively. Using multivariable analysis, higher post-procedural S<sub>VTI</sub> was associated with less HFH: 1-month (OR = 0.72, CI [0.52,0.98]), 6-months (OR = 0.8, CI [0.66,0.97]), 1-year (OR = 0.85, CI [0.73,0.99]), as well as reduced 1-year mortality (OR = 0.64 95% CI [0.45,0.91]). Furthermore, compared to patients with SVTI ≥ 3, patients with SVTI < 3 had a higher risk for HFH at: 1-month (OR = 16.59, CI [1.48,186.02]), 6-months (OR = 12.2, CI [1.69,88.07]), and 1-year (OR = 8.61, CI [1.27,58.27]), as well as elevated 1-year mortality (OR = 8.07, 95% CI [1.04,62.28]).</div></div><div><h3>Conclusion</h3><div>PV flow was significantly improved following TEER, and several hemodynamic parameters were associated with HFH and mortality. These results may offer a basis for establishing future procedural goals to ensure better clinical outcomes.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 63-72"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185013","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

Prognostic impact of shock in patients with type A acute aortic syndrome. Results of a nationwide multicenter study A 型急性主动脉综合征患者休克的预后影响。全国多中心研究结果。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.05.005

Carlos Ferrera , Isidre Vilacosta , José F. Rodríguez Palomares , Francisco Calvo Iglesias , Antonio J. Barros-Membrilla , Manel Azqueta Molluna , Víctor Mosquera , Rubén Tarrío , Ana Revilla Orodea , David Toral Sepúlveda , Inés Ramos González-Cristóbal , Luis Maroto Castellanos , Augusto Sao , Artur Evangelista

Objective

To evaluate the clinical characteristics, imaging findings, treatment, and prognosis of patients with type A acute aortic syndrome (AAS-A) presenting with shock. To assess the impact of surgery on this patient population.

Methods

The study included 521 patients with A-AAS enrolled in the Spanish Registry of Acute Aortic Syndrome (RESA-III) from January 2018 to December 2019. The RESA-III is a prospective, multicenter registry that contains AAS data from 30 tertiary-care hospitals. Patients were classified into two groups according to their clinical presentation, with or without shock. Shock was defined as persistent systolic blood pressure <80 mmHg despite adequate volume resuscitation.

Results

97 (18.6%) patients with A-AAS presented with shock. Clinical presentation with syncope was much more common in the Shock group (45.4% vs 10.1%, p = 0.001). Patients in the Shock group had more complications at diagnosis and before surgery: cardiac tamponade (36.2% vs 9%, p < 0.001), acute renal failure (28.9% vs 18.2%, p = 0.018), and need for orotracheal intubation (40% vs 9.1%, p < 0.001). There were no significant differences in aortic regurgitation (51.6% vs 46.7%, p = 0.396) between groups. In-hospital mortality was higher among patients with shock (48.5% vs 27.4%, p < 0.001). Surgery was associated with a significant mortality reduction both in patients with and without shock. Surgery had an independent protective effect on mortality (OR 0.03, 95% CI (0.00–0.32)).

Conclusion

Patients with AAS-A admitted with shock have a heavily increased risk of mortality. Syncope and pericardial effusion at diagnosis are strongly associated with shock. Surgery was independently associated with a mortality reduction in patients with AAS-A and shock.

目的评估出现休克的A型急性主动脉综合征（AAS-A）患者的临床特征、影像学检查结果、治疗和预后。评估手术对这类患者的影响：研究纳入了 2018 年 1 月至 2019 年 12 月期间在西班牙急性主动脉综合征登记处（RESA-III）登记的 521 名 A-AAS 患者。RESA-III是一个前瞻性多中心登记系统，包含来自30家三级医院的AAS数据。患者根据临床表现分为有休克和无休克两组。休克的定义是收缩压持续升高：97名（18.6%）A-AAS患者出现休克。休克组中出现晕厥的临床表现更为常见（45.4% 对 10.1%，P=0.001）。休克组患者在诊断时和手术前出现更多并发症：心脏填塞（36.2% 对 9%，P=0.001）：因休克入院的 AAS-A 患者的死亡风险大大增加。诊断时的晕厥和心包积液与休克密切相关。手术治疗与降低 AAS-A 和休克患者的死亡率密切相关。

{"title":"Prognostic impact of shock in patients with type A acute aortic syndrome. Results of a nationwide multicenter study","authors":"Carlos Ferrera , Isidre Vilacosta , José F. Rodríguez Palomares , Francisco Calvo Iglesias , Antonio J. Barros-Membrilla , Manel Azqueta Molluna , Víctor Mosquera , Rubén Tarrío , Ana Revilla Orodea , David Toral Sepúlveda , Inés Ramos González-Cristóbal , Luis Maroto Castellanos , Augusto Sao , Artur Evangelista","doi":"10.1016/j.hjc.2024.05.005","DOIUrl":"10.1016/j.hjc.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical characteristics, imaging findings, treatment, and prognosis of patients with type A acute aortic syndrome (AAS-A) presenting with shock. To assess the impact of surgery on this patient population.</div></div><div><h3>Methods</h3><div>The study included 521 patients with A-AAS enrolled in the Spanish Registry of Acute Aortic Syndrome (RESA-III) from January 2018 to December 2019. The RESA-III is a prospective, multicenter registry that contains AAS data from 30 tertiary-care hospitals. Patients were classified into two groups according to their clinical presentation, with or without shock. Shock was defined as persistent systolic blood pressure <80 mmHg despite adequate volume resuscitation.</div></div><div><h3>Results</h3><div>97 (18.6%) patients with A-AAS presented with shock. Clinical presentation with syncope was much more common in the Shock group (45.4% vs 10.1%, p = 0.001). Patients in the Shock group had more complications at diagnosis and before surgery: cardiac tamponade (36.2% vs 9%, p < 0.001), acute renal failure (28.9% vs 18.2%, p = 0.018), and need for orotracheal intubation (40% vs 9.1%, p < 0.001). There were no significant differences in aortic regurgitation (51.6% vs 46.7%, p = 0.396) between groups. In-hospital mortality was higher among patients with shock (48.5% vs 27.4%, p < 0.001). Surgery was associated with a significant mortality reduction both in patients with and without shock. Surgery had an independent protective effect on mortality (OR 0.03, 95% CI (0.00–0.32)).</div></div><div><h3>Conclusion</h3><div>Patients with AAS-A admitted with shock have a heavily increased risk of mortality. Syncope and pericardial effusion at diagnosis are strongly associated with shock. Surgery was independently associated with a mortality reduction in patients with AAS-A and shock.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 27-35"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904769","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

The burden of cardiovascular disease and related risk factors in Greece: the ATTICA epidemiological study (2002–2022) 希腊心血管疾病负担及相关风险因素；ATTICA 流行病学研究（2002-2022 年）。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.05.009

Demosthenes Panagiotakos , Evangelia G. Sigala , Evangelia Damigou , Asimina Loukina , Dimitriοs Dalmyras , Georgios Mentzantonakis , Fotios Barkas , Petros S. Adamidis , Evrydiki Kravvariti , Evangelos Liberopoulos , Petros P. Sfikakis , Costas Tsioufis , Christos Pitsavos , Christina Chrysohoou

Objective

The aim of this study was to present the burden of cardiovascular disease (CVD) and its related risk factors based on a 20-year observation period (2002–2022).

Methods

In 2002, 3042 Greek adults (aged: 45 (12) years) free of CVD, cancer, or any other chronic infections were enrolled. In 2022, the 20-year follow-up was performed on 2169 participants (1988 had complete data for CVD). Lifetime risk for CVDs and disability-adjusted-life-years (DALYs) lost were also calculated.

Results

The 20-year CVD incidence was 3600 cases/10,000 individuals (man-to-woman ratio 5:4). At the index age of 40 years, the lifetime risk for developing CVD was 68% for men and 63% for women; as the participants were getting older, the lifetime risk declined by approximately 19% and 13% for men and women, respectively, but remained at high levels, reaching 55% for both sexes. Participants between 45 and 55 years exhibited the highest CVD burden concerning aggregated DALYs. The burden was greater in men than in women, at ages below 35 years; beyond this age threshold, this trend shifted, and women exhibited a higher CVD burden.

Conclusion

The burden of CVD in Greece has shown increasing trends over the past 20 years as a result of the accumulative growth of the prevalence of modifiable CVD risk factors. The disability-adjusted life-years lost are the most observed ever before, urging for efficient public health strategies and measures.

目的：本研究旨在根据 20 年的观察期（2002-2022 年）介绍心血管疾病（CVD）的负担及其相关风险因素：方法：2002 年，3,042 名希腊成年人（年龄为方法：2002 年，3,042 名无心血管疾病、癌症或任何其他慢性感染的希腊成年人（年龄：45 (12)岁）接受了调查。2022 年，对 2,169 名参与者（1,988 人有完整的心血管疾病数据）进行了为期 20 年的随访。同时还计算了心血管疾病的终生风险和残疾调整寿命损失年数（DALYs）：结果：20 年的心血管疾病发病率为 3,600 例/10,000 人（男女比例为 5:4）。随着年龄的增长，男性和女性终生罹患心血管疾病的风险分别下降了约 19% 和 13%，但仍保持在较高水平，男性和女性均达到 55%。45-55 岁的参与者的心血管疾病负担（DALYs）总和最高。在35岁以下的年龄段，男性的心血管疾病负担大于女性；超过这个年龄段后，这一趋势发生了变化，女性的心血管疾病负担更高：结论：在过去的20年中，由于可改变的心血管疾病风险因素发病率的累积增长，希腊的心血管疾病负担呈上升趋势。根据残疾调整寿命年数计算，希腊的心血管疾病造成的损失是有史以来最大的，因此需要采取有效的公共卫生战略和措施。

{"title":"The burden of cardiovascular disease and related risk factors in Greece: the ATTICA epidemiological study (2002–2022)","authors":"Demosthenes Panagiotakos , Evangelia G. Sigala , Evangelia Damigou , Asimina Loukina , Dimitriοs Dalmyras , Georgios Mentzantonakis , Fotios Barkas , Petros S. Adamidis , Evrydiki Kravvariti , Evangelos Liberopoulos , Petros P. Sfikakis , Costas Tsioufis , Christos Pitsavos , Christina Chrysohoou","doi":"10.1016/j.hjc.2024.05.009","DOIUrl":"10.1016/j.hjc.2024.05.009","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to present the burden of cardiovascular disease (CVD) and its related risk factors based on a 20-year observation period (2002–2022).</div></div><div><h3>Methods</h3><div>In 2002, 3042 Greek adults (aged: 45 (12) years) free of CVD, cancer, or any other chronic infections were enrolled. In 2022, the 20-year follow-up was performed on 2169 participants (1988 had complete data for CVD). Lifetime risk for CVDs and disability-adjusted-life-years (DALYs) lost were also calculated.</div></div><div><h3>Results</h3><div>The 20-year CVD incidence was 3600 cases/10,000 individuals (man-to-woman ratio 5:4). At the index age of 40 years, the lifetime risk for developing CVD was 68% for men and 63% for women; as the participants were getting older, the lifetime risk declined by approximately 19% and 13% for men and women, respectively, but remained at high levels, reaching 55% for both sexes. Participants between 45 and 55 years exhibited the highest CVD burden concerning aggregated DALYs. The burden was greater in men than in women, at ages below 35 years; beyond this age threshold, this trend shifted, and women exhibited a higher CVD burden.</div></div><div><h3>Conclusion</h3><div>The burden of CVD in Greece has shown increasing trends over the past 20 years as a result of the accumulative growth of the prevalence of modifiable CVD risk factors. The disability-adjusted life-years lost are the most observed ever before, urging for efficient public health strategies and measures.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 17-26"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909369","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

Comparative outcomes of aortic root preservation versus root replacement for acute type A aortic dissection: balancing survival, durability, and reoperation 急性A型主动脉夹层主动脉根保留与根置换的比较结果：平衡生存、耐久性和再手术。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2025.05.008

Dimitrios E. Magouliotis , Serge Sicouri , Massimo Baudo , Francesco Cabrucci , Yoshiyuki Yamashita , Basel Ramlawi

Objective

We reviewed the available literature on patients undergoing aortic repair for acute type A aortic dissection (ATAAD) with either aortic root preservation (RP) or root replacement (RR).

Methods

Original research studies that evaluated the long-term outcomes of the RP versus RR group were identified from 2000 to 2025. Median overall survival (OS) was the primary endpoint. Reoperation-free OS was the secondary endpoint. Sensitivity analyses were performed including risk-adjusted populations, subgroups, and using the leave-one-out method.

Results

Seventeen studies were included in the qualitative and quantitative synthesis, incorporating data from 7569 patients with a follow-up period of up to 25 years. According to our analysis, RP (4266 patients) demonstrated higher OS compared to RR (2589 patients) groups (HR: 0.83; 95% CI:0.76, 0.91; p < 0.01). The median OS was 13.57 years for the RP group and 13.48 years for the RR group. Nonetheless, the reoperation-free OS was higher in the RR group (HR: 1.39; 95% CI: 1.16, 1.67; p < 0.01). Valve-sparing RR (VSRR) demonstrated the highest long-term OS (p < 0.05).

Conclusion

RP is associated with superior OS but a higher risk of reoperation, while RR offers greater durability with fewer reoperations, and VSRR may provide the optimal balance of longevity and native valve preservation, warranting further prospective studies.

目的：我们回顾了急性A型主动脉夹层（ATAAD）患者行主动脉修复术(主动脉根保留（RP）或主动脉根置换（RR）的现有文献。方法：从2000年到2025年，对RP组与RR组的长期结果进行了评估的原始研究。中位总生存期（OS）是主要终点。无再手术OS是次要终点。进行敏感性分析，包括风险调整人群、亚组，并使用留一法。结果：定性和定量综合纳入了17项研究，纳入了7,569例患者的数据，随访时间长达25年。根据我们的分析，RP组（4266例）比RR组（2589例）表现出更高的OS (HR: 0.83；95% ci:0.76, 0.91；结论：根保存术总体生存率更高，但再手术风险更高，而根置换术可减少再手术次数，提供更大的耐久性，VSRR可能提供寿命和天然瓣膜保存的最佳平衡，值得进一步的前瞻性研究。

{"title":"Comparative outcomes of aortic root preservation versus root replacement for acute type A aortic dissection: balancing survival, durability, and reoperation","authors":"Dimitrios E. Magouliotis , Serge Sicouri , Massimo Baudo , Francesco Cabrucci , Yoshiyuki Yamashita , Basel Ramlawi","doi":"10.1016/j.hjc.2025.05.008","DOIUrl":"10.1016/j.hjc.2025.05.008","url":null,"abstract":"<div><h3>Objective</h3><div>We reviewed the available literature on patients undergoing aortic repair for acute type A aortic dissection (ATAAD) with either aortic root preservation (RP) or root replacement (RR).</div></div><div><h3>Methods</h3><div>Original research studies that evaluated the long-term outcomes of the RP versus RR group were identified from 2000 to 2025. Median overall survival (OS) was the primary endpoint. Reoperation-free OS was the secondary endpoint. Sensitivity analyses were performed including risk-adjusted populations, subgroups, and using the leave-one-out method.</div></div><div><h3>Results</h3><div>Seventeen studies were included in the qualitative and quantitative synthesis, incorporating data from 7569 patients with a follow-up period of up to 25 years. According to our analysis, RP (4266 patients) demonstrated higher OS compared to RR (2589 patients) groups (HR: 0.83; 95% CI:0.76, 0.91; <em>p</em> < 0.01). The median OS was 13.57 years for the RP group and 13.48 years for the RR group. Nonetheless, the reoperation-free OS was higher in the RR group (HR: 1.39; 95% CI: 1.16, 1.67; <em>p</em> < 0.01). Valve-sparing RR (VSRR) demonstrated the highest long-term OS (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>RP is associated with superior OS but a higher risk of reoperation, while RR offers greater durability with fewer reoperations, and VSRR may provide the optimal balance of longevity and native valve preservation, warranting further prospective studies.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"86 ","pages":"Pages 131-141"},"PeriodicalIF":3.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251880","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

Impact of the COVID-19 pandemic on CTO PCI: analysis from the PROGRESS-CTO registry COVID-19 大流行对 CTO PCI 的影响：PROGRESS-CTO 登记的分析。

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Hellenic Journal of Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.hjc.2024.11.005

Dimitrios Strepkos , Michaella Alexandrou , Deniz Mutlu , Pedro E.P. Carvalho , Ali Bahbah , James W. Choi , Sevket Gorgulu , Farouc A. Jaffer , Raj Chandwaney , Khaldoon Alaswad , Mir B. Basir , Lorenzo Azzalini , Bavana V. Rangan , Olga C. Mastrodemos , Konstantinos Voudris , Ahmed Al-Ogaili , M. Nicholas Burke , Yader Sandoval , Emmanouil S. Brilakis , Luiz F. Ybarra , Ahmed Elguindy

引用次数: 0