Publications (46)171.31 Total impact
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Article: Acute and Chronic Effects of Smoking on Myocardial Function in Healthy Heavy Smokers: A Study of Doppler Flow, Doppler Tissue Velocity, and Two-Dimensional Speckle Tracking Echocardiography.
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ABSTRACT: Background: The purpose of the study was to evaluate the acute and chronic effect of smoking on left ventricular function in healthy heavy smokers by conventional Doppler flow, tissue Doppler, and two-dimensional speckle tracking echocardiography (2D-STE). Methods: Echocardiograms were performed in 42 healthy heavy (>20 cigarettes/day) smokers (age 34 ± 5 years), before (group SM-1), 15 minutes (SM-2) and 30 minutes (SM-3) after starting smoking 2 cigarettes. Nonsmokers (n = 41, age 33 ± 4 years) served as controls. Transmitral flow, isovolumetric relaxation time (IVRT), and myocardial performance index (MPI) were measured. Tissue velocity measurements were averaged from lateral and septal mitral annulus. Longitudinal strain (GS), systolic (SRs), early diastolic (SRe), late diastolic (SRa), and isovolumetric relaxation (SRivr) strain rate were measured. The percent change in strain from end-systole to the first one-third of diastole (SI-DI = [(GS - strain at one-third diastole)/GS] × 100) was also measured. Results: IVRT and MPI were increased and early diastolic mitral annular velocity was decreased in SM-2; they returned to baseline in SM-3. There was no difference in GS and SRs. SRe and SRivr were reduced in SM-1 (P < 0.05), and remained significantly reduced in SM-2 and SM-3. SI-DI was lower in SM-1 (P = 0.011) and was further reduced in SM-2 and SM-3 (P < 0.001). Conclusion: Acute and chronic smoking inhalation has adverse effects on myocardial function in healthy heavy smokers. 2D-STE is able to detect both baseline differences and late acute effects of smoking.Echocardiography 11/2012; · 1.24 Impact Factor -
Article: Unprotected left main distal bifurcation lesion.
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ABSTRACT: Left main coronary artery disease is a high-risk condition with significant mortality. Currently, bypass surgery is considered the gold-standard treatment for unprotected left main disease. The introduction of drugeluting stents for the treatment of coronary artery disease has proved to reduce the rates of restenosis and, consequently, the need for repeat revascularisation; therefore, recently, percutaneous coronary intervention in the unprotected left main using drug-eluting stents has been considered another therapeutic option for patients at high risk for bypass surgery, or for patients who simply refuse bypass surgery. Based on the updated guidelines on myocardial revascularisation of the European Society of Cardiology, treating left main lesions by angioplasty is feasible and safe in selected patients. In this case report we demonstrate the successful implantation of drug-eluting stents for the treatment of an unprotected left main bifurcation lesion in an 85-year-old patient with high perioperative risk.Hellenic journal of cardiology: HJC = Hellēnikē kardiologikē epitheōrēsē 11/2012; 53(6):480-4. · 1.23 Impact Factor -
Article: High homocysteine and low folate concentrations in acute aortic dissection.
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ABSTRACT: BACKGROUND: Biomarkers for monitoring progression and prognosis of thoracic aneurysm are of great interest. Homocysteine (Hcy) induces elastolysis in arterial media and may directly affect fibrillin-1 or collagen whereas lipoprotein (Lp) (a) inhibits elastolysis by reducing activation of matrix metallopeptidase-9. METHODS: We studied 31 consecutive patients with acute aortic dissection (AAD) admitted for emergency surgery (group I, 60±13years old, 25 men), 30 consecutive patients with chronic aneurysms of the ascending aorta (group II, 67±12years old, 24 men) and 20 healthy controls (group III, 58±15years old, 14 men). We evaluated Hcy, folate, B12, Lp(a) and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism at baseline. RESULTS: Hcy, folate and B12 differed significantly among the 3 studied groups (P=0.016, P=0.004 and P=0.001, respectively). The levels of Hcy and B12 were significantly higher in group I compared to both groups II and III (P=0.05 and P=0.002, P<0.001 and P=0.017, respectively) and without significant differences between groups II and III (P=0.083 and P=0.124). Folate was significantly lower in group I compared to both groups II and III (P=0.001 and P=0.006, respectively) and without marked difference between groups II and III (P=0.409). No significant difference was found in serum levels of Lp (a) (P=0.074) or among the frequency of MTHFR C677T genotypes. CONCLUSIONS: Patients with AAD present with higher Hcy and lower folate compared to both chronic aneurysms and controls.International journal of cardiology 10/2012; · 7.08 Impact Factor -
Article: Transcatheter aortic valve implantation: restoring the qualities of life in old age.
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ABSTRACT: Transcatheter aortic valve implantation (TAVI) is a tremendous therapeutic advance for patients with severe aortic stenosis and high-surgical risk. Since TAVI-treated patients are elderly with multiple co-existing conditions, limited life expectancy and disproportionate health-care expenditures, the aspect of the health-related quality of life (HRQoL) benefits becomes of fundamental importance. Based on recent evidence, TAVI appears to improve significantly HRQoL measures compared with optimal standard care, which are restored to age-adjusted population norms over time.Age and Ageing 08/2012; · 3.09 Impact Factor -
Article: Significant peri-operative reduction in plasma osteopontin levels after coronary artery by-pass grafting.
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ABSTRACT: OBJECTIVES: Osteopontin (OPN) is a multifunctional protein associated with vascular injury and has been linked to atherosclerosis and inflammation. We sought to investigate whether OPN changes in relation to coronary artery by-pass grafting (CABG) surgery. DESIGN AND METHODS: We studied 50 consecutive patients (63±10years old, 6 women and 44 men) undergoing elective CABG. Plasma OPN levels were determined by an enzyme-linked immunosorbent assay at baseline and in 24 and 72h, post-operatively. Cardiac enzymes - creatine kinase, the MB isoenzyme of creatine kinase, troponin-I- and C-reactive protein (CRP) were also determined at all three time points. RESULTS: OPN levels 72h post-op decreased significantly compared to pre-op and 24h post-op levels (p<0.001) whereas there was no difference between the pre-op and first post-op values (p=0.57). The relative change in OPN levels between pre-op and 72h post-op correlated negatively with absolute troponin-I levels at 72h post-op (-0.51, p=0.005). OPN levels 72h post-op correlated significantly with CRP at baseline (r=0.73, p=0.002). CONCLUSIONS: OPN plasma concentrations decreased after CABG surgery in the early post-operative period. The significance of this observation needs further investigation.Clinical biochemistry 05/2012; · 2.02 Impact Factor -
Article: Heart type fatty acid binding protein in relation to pharmacologic scintigraphy in coronary artery disease.
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ABSTRACT: Heart-type fatty acid-binding protein (H-FABP) is a marker of myocardial necrosis, but whether it increases during myocardial ischemia is not known. This study investigated whether serum levels of H-FABP change during adenosine stress testing and nuclear imaging in patients with stable coronary artery disease. Thirty stable patients with established coronary artery disease on their medications were studied. Sampling was performed before the stress test, at the end of adenosine infusion, as well as 1, 2 and 3 h after the completion of the infusion. No difference in H-FABP serum levels were found at the five pre-specified time points in the overall group (p=0.99); furthermore, there was no significant difference regardless of the test result--positive (p=1) or negative (p=0.98). It is concluded that H-FABP does not change significantly during pharmacologic stress testing in patients with known coronary artery disease and there is no difference whether there is inducible ischemia or not.Clinical Chemistry and Laboratory Medicine 10/2011; 50(2):387-90. · 2.15 Impact Factor -
Article: Long term effects of cardiac resynchronization therapy in non-ambulatory NYHA IV heart failure patients.
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ABSTRACT: We aimed at evaluating the long-term effects of cardiac resynchronization therapy (CRT) in nonambulatory New York Heart Association (NYHA) IV heart failure patients (NAIVHFP). Eighteen patients, 15 men and three women, eight with ischemic and 10 with nonischemic cardiomyopathy, who underwent biventricular pacemaker implantation while they were in nonambulatory NYHA IV class, were studied. Patients' age was 58 ± 9 years and left ventricular ejection fraction (LVEF) 18 ± 3%. Follow-up data were obtained through review of follow-up visits notes, stored echocardiographic studies, device interrogation data, and death certificates. After a mean duration of 1223 ± 846 days, 11 patients were alive, including five patients who underwent heart transplantation (OCT) and seven dead. Three of 11 patients who received a CRT-defibrillator, experienced at least one appropriate discharge, but eventually they either died or received an OCT during follow-up. Sustained improvements in NYHA class (Z = 2.4, P = 0.015) and 6-minute walk distance (0 vs 212 ± 95 m, P 0.001) were documented after a median duration of 855 days postimplantation. Cumulative proportion of death or OCT at 18 months-when full follow-up data were available-was 18%, which compared favorably with historical controls. Full echocardiographic and clinical follow-up data at 12-months postimplantation were available for 10 patients, documenting a significant reduction in end-systolic volume (248 ± 82 vs 269 ± 97 mL, P = 0.039). CRT can be safely applied in this subset of extreme severity heart failure patients, achieving encouraging survival rates and reverse remodeling effects. These observations can form an evidence-based rationale for including NAIVHFP in randomized CRT trials.Pacing and Clinical Electrophysiology 09/2011; 34(11):1553-60. · 1.35 Impact Factor -
Article: Gender-specific differences in biomarkers responses to acute coronary syndromes and revascularization procedures.
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ABSTRACT: A growing body of gender-related research in coronary artery disease is beginning to gradually elucidate differences between women and men. In patients presenting with acute coronary syndromes (ACS), these sex differences include varying risk factor profiles, accuracy of diagnostic testing, clinical presentations, treatment practices and outcomes. There is also a differential expression of cardiac biomarkers by sex, which remains unexplained. This paper reviews all the available information on the effect of gender on cardiac biomarkers by search of MEDLINE using the terms gender differences, biomarkers, ACS and revascularization procedures. A better understanding of the sex disparities in biomarkers along with all other clinical information is essential to optimal management and patient care in the future.Biomarkers 09/2011; 16(6):457-65. · 2.21 Impact Factor -
Article: Long-term quality of life improvement after transcatheter aortic valve implantation.
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ABSTRACT: Transcatheter aortic valve implantation (TAVI) is a novel therapeutic option for severe aortic stenosis in old patients with high surgical risk. The aim of this study was to assess changes in quality of life (QoL) along with functional status and late survival after this procedure. Thirty-six consecutive patients (80.5 ± 5.9 years, 21 men and 15 women) with a logistic Euroscore of 29.7 ± 13.7 underwent TAVI using the 18-Fr CoreValve prosthesis. Aortic valve prosthesis was inserted retrograde using a femoral or a subclavian arterial approach. QoL was evaluated by administering the Short Form 36 (SF-36) tool and the shorter SF-12 version 2 (SF-12v2) questionnaires before and 1-year after TAVI. TAVI was successfully performed in all patients. The estimated 1-year overall survival rate using Kaplan-Meier method was 68%. One-year follow-up also showed a marked improvement in echocardiographic parameters (peak gradient 76.2 ± 26.1 vs 15.4 ± 7.8 mm Hg, P < .001; aortic valve area 0.7 ± 0.1 vs 2.6 ± 2.7 cm(2), P < .001) with a significant change in New York Heart Association class (3 ± 0.7 vs 1.2 ± 0.4, P < .001). Both preprocedural summary SF-36 and SF-12v12 physical and mental scores showed a significant improvement 1 year after TAVI (21.6 vs 46.7, P < .001; 42.9 vs 55.2, P < .001; 22 vs 48.9, P < .001; 43.3 vs 52.2, P < .001, respectively). Our results show a marked 1-year clinical benefit in functional status and physical and mental health in patients who underwent TAVI.American heart journal 08/2011; 162(2):232-7. · 4.65 Impact Factor -
Article: Heart-type fatty acid binding protein in elective cardioversion of atrial fibrillation.
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ABSTRACT: We sought to investigate whether heart-type fatty acid binding protein (H-FABP), a new marker of myocardial necrosis, increases in relation to elective cardioversion of atrial fibrillation (AF). We studied 25 consecutive patients (61 ± 16 years old, 21 men) admitted to our hospital for elective cardioversion of AF. Peripheral venous samples were drawn immediately before cardioversion, one hour and 24h after the procedure and assayed for H-FABP. A mean of 309 ± 183 J was used for cardioversion. Successful cardioversion in sinus rhythm was achieved in 18 patients (72%). Serum levels of H-FABP did not change significantly either in relation to the procedure [1385 (256-17,127)pg/mL at baseline, 1125 (290-15,238)pg/mL 1h post and 1045.5 (66-2981)pg/mL 24 h post cardioversion, p=0.37] or to the success of the procedure. H-FABP does not significantly change following elective cardioversion for AF and we, therefore, speculate that myocardial necrosis does not occur during cardioversion.Clinical biochemistry 06/2011; 44(12):947-9. · 2.02 Impact Factor -
Article: Influence of age on the clinical outcomes of coronary revascularisation for the treatment of patients with multivessel de novo coronary artery lesions: sirolimus-eluting stent vs. coronary artery bypass surgery and bare metal stent, insight from the multicentre randomised Arterial Revascularisation Therapy Study Part I (ARTS-I) and Part II (ARTS-II).
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ABSTRACT: We sought to evaluate the prognostic impact of age on the procedural results and subsequent clinical outcomes in patients with multivessel disease (MVD) treated either by coronary artery bypass surgery (CABG) or by percutaneous coronary intervention (PCI) with or without drug eluting stents, based on data of the Arterial Revascularisation Therapies Study (ARTS) part I and part II. The potential influence of age in determining the most appropriate revascularisation strategy for patients with MVD is largely unknown. Three year clinical outcome of ARTS I patients randomised to PCI with bare metal stent (BMS) (n= 600) or CABG (n= 605), and matched patients treated by PCI with sirolimus-eluting stents (SES) in ARTS II (n= 607) were reviewed according to four age quartiles. Endpoints were measured in terms of major adverse cardiac and cerebrovascular events MACCE) during hospital stay and up to three years. The frequency of female, diabetes, hypertension, peripheral vascular disease, pulmonary disease, as well as lesion complexity increased with age. At three years, MACCE free survival was comparable between patients treated by CABG or SES PCI, regardless of age quartile. The incidence of MACCE was higher among ARTS I BMS treated patients in all but the second age quartile. This was primarily related to a higher need for repeat revascularisation among BMS treated patients. However, age, which emerged as a strong independent predictor of MACCE following CABG (p<0.005), was not predictive of adverse events following PCI. Conversely, diabetes was the strongest independent predictor of MACCE among PCI treated patients (p<0.02), but didn't affect three-year outcomes following CABG. Age seems to influence the CABG outcome in-hospital but not PCI. PCI-SES could offer lower immediate risk in patients with MVD and comparable long-term outcome as CABG especially in older patients. The worst outcome of PCI-BMS group is primarily related to the need for repeat revascularisation. Diabetes is the most important predictor of MACCE following PCI.EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 02/2011; 6(7):838-45. · 3.29 Impact Factor -
Article: Cytokine gene polymorphisms are associated with markers of disease severity and prognosis in patients with idiopathic dilated cardiomyopathy.
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ABSTRACT: To identify potential genetic associations of five cytokine gene polymorphisms with disease severity and prognosis in patients with idiopathic dilated cardiomyopathy (DCM). Eighty patients with DCM were genotyped for transforming growth factor beta1 (TGF-β1)+869 T/C (codon10 Leu→Pro), TGF-β1 +915 G/C (codon25 Arg→Pro), interleukin (IL)-6 -174G/C, tumor necrosis factor-alpha (TNF-α) -308A/G, interferon-gamma (IFN-γ) +874T/A, IL-10 -1082A/G, IL-10 -819T/C and IL-10 -592A/C gene polymorphisms. In homozygous TT patients for TGF-β1 +869 T/C polymorphism mean VO(2) max was significantly higher than in CC homozygous patients (25.67±6.73ml/kg/min vs. 20.29±6.35 ml/kg/min, p = 0.046), which remained significant only for patients younger than 39 years old after adjusting for age and sex (p = 0.009). C carriers of TGF-β1 +915 G/C polymorphism are 4.2 times more likely to be in a worse NYHA stage (III-IV) than non C carriers [OR: 4.25, 95% CI (1.53-11.80), p = 0.006]. Patients GG homozygous for IL-6 -174G/C polymorphism presented greater left ventricle end-systolic (p = 0.018) and end-diastolic (p = 0.04) diameters in comparison to the CC homozygous. The AA homozygote for IFN-γ +874T/A polymorphism (p = 0.02) and the combination of the TGF-β1 +869 T/C and TGF-β1 +915 G/C genotypes were associated with adverse outcome (p = 0.014). Specific cytokine gene polymorphisms seem to be associated with worse prognosis as well as with measures of disease severity in DCM.Cytokine 01/2011; 54(1):68-73. · 3.02 Impact Factor -
Article: Ischemia modified albumin changes - review and clinical implications.
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ABSTRACT: Ischemia modified albumin (IMA), as measured using the albumin cobalt binding test, is currently the most promising biomarker for early detection of ischemia before the onset of irreversible cardiac injury. This paper reviews the information available on IMA, including its pathophysiology, analysis, clinical applications and future perspectives. The data provided was identified by a search of MEDLINE using the terms IMA, biomarkers and ischemia. IMA may be useful to cover the complete diagnostic window of patients presenting with acute coronary syndromes (ACS) in the Emergency Department, along with the electrocardiogram and cardiac troponins. Preliminary data regarding the significance of IMA in the prognosis of either ACS or following revascularization need further study.Clinical Chemistry and Laboratory Medicine 11/2010; 49(2):177-84. · 2.15 Impact Factor -
Article: Short and long term anti-inflammatory effects of bosentan therapy in patients with pulmonary arterial hypertension: relation to clinical and hemodynamic responses.
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ABSTRACT: We sought to investigate the short- and long- term effects of bosentan therapy on endothelial, inflammatory and fibrotic markers in patients with pulmonary arterial hypertension (PAH) and the relation to clinical and hemodynamic responses. We studied 16 patients with moderate-severe idiopathic PAH, in WHO functional class II-IV, despite conventional treatment. Patients received additional treatment with bosentan, 62.5 mg twice daily for 1 month, followed by 125 mg twice daily for 11 months. Study endpoints included 6-min walking distance (6MWD), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR) and plasma levels of intracellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), IL-6 and brain natriuretic peptide (BNP). Patients were assessed at baseline, 2 months and 12 months after initiation of bosentan. At 2 months there was an improvement in 6MWD (p < 0.001) and functional class (p < 0.001) and a marked fall in PVR (p < 0.001), ICAM-1 (p < 0.001), IL-6 (p < 0.001)and BNP (p = 0.001). At 12 months, 6MWD was further improved (p < 0.001), PVR remained significantly improved (p < 0.001), mPAP was significantly decreased (p < 0.001) and ICAM-1, IL-6 and BNP remained significantly lower (p < 0.001). Significant correlations were found between changes in ICAM-1 and cardiac index (r = 0.59, p = 0.01), IL-6 and PVR (r = 0.51, p = 0.04), BNP and 6MWD (r = -0.53, p = 0.03) and BNP and PAP (r = 0.51, p = 0.04) between 2- and 12-months treatment. In patients with moderate-severe PAH, the addition of bosentan to therapy, exerts favorable anti-inflammatory effects, which are associated with clinical and hemodynamic improvement.Expert opinion on therapeutic targets 10/2010; 14(12):1283-9. · 3.72 Impact Factor -
Article: Disorders of the autonomic nervous system in patients with Brugada syndrome: a pilot study.
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ABSTRACT: The aim of this study was to examine autonomic disorders in patients with Brugada syndrome by performing a cardiac sympathetic innervation evaluation, a head-up tilt-test (HUT) and heart rate variability (HRV) analysis. We enrolled 20 patients with Brugada syndrome (mean age 42.5 +/- 8.8 years), 9 with spontaneous and 11 with an induced type 1 electrocardiogram (ECG) in the setting of symptoms and 20 age-matched controls. All subjects underwent a HUT with parallel measurements of plasma catecholamines and cortisol, a (123)I-metaiodobenzylguanidine single photon emission tomography, and HRV evaluation. Ten control subjects participated in the innervation portion of the study. The tilt-test with clomipramine challenge was positive in 15 of 20 (75%) patients (7 spontaneous, 8 induced) and in 1 in controls (P < 0.01). A sympathoadrenal imbalance was shown in positive tests. The pattern of innervation in all groups was heterogenic and similar to controls with a trend towards lower measurements in patients with a spontaneous type 1 ECG and a positive HUT. HRV analysis did not reveal any significant differences during day and night. Four patients (20%) had sustained ventricular arrhythmias during a follow-up of 31.1 +/- 8.6 months, but no correlations with innervation or response to tilting were found. A high susceptibility to vasovagal syncope was observed in patients with Brugada syndrome, which could be disease-related symptoms. Conversely, sympathetic innervation was observed to follow a physiological, heterogenic pattern; however, these factors did not have prognostic value for life-threatening arrhythmias.Journal of Cardiovascular Electrophysiology 07/2010; 21(7):773-80. · 3.06 Impact Factor -
Article: Disorders of the Autonomic Nervous System in Patients With Brugada Syndrome: A Pilot Study
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ABSTRACT: Autonomic Disorders in Brugada Syndrome. Introduction: The aim of this study was to examine autonomic disorders in patients with Brugada syndrome by performing a cardiac sympathetic innervation evaluation, a head-up tilt-test (HUT) and heart rate variability (HRV) analysis.Methods and Results: We enrolled 20 patients with Brugada syndrome (mean age 42.5 ± 8.8 years), 9 with spontaneous and 11 with an induced type 1 electrocardiogram (ECG) in the setting of symptoms and 20 age-matched controls. All subjects underwent a HUT with parallel measurements of plasma catecholamines and cortisol, a 123I-metaiodobenzylguanidine single photon emission tomography, and HRV evaluation. Ten control subjects participated in the innervation portion of the study. The tilt-test with clomipramine challenge was positive in 15 of 20 (75%) patients (7 spontaneous, 8 induced) and in 1 in controls (P < 0.01). A sympathoadrenal imbalance was shown in positive tests. The pattern of innervation in all groups was heterogenic and similar to controls with a trend towards lower measurements in patients with a spontaneous type 1 ECG and a positive HUT. HRV analysis did not reveal any significant differences during day and night. Four patients (20%) had sustained ventricular arrhythmias during a follow-up of 31.1 ± 8.6 months, but no correlations with innervation or response to tilting were found.Conclusion: A high susceptibility to vasovagal syncope was observed in patients with Brugada syndrome, which could be disease-related symptoms. Conversely, sympathetic innervation was observed to follow a physiological, heterogenic pattern; however, these factors did not have prognostic value for life-threatening arrhythmias. (J Cardiovasc Electrophysiol, Vol. pp. 773-780, July 2010)Journal of Cardiovascular Electrophysiology 06/2010; 21(7):773 - 780. · 3.06 Impact Factor -
Article: Ischemia-modified albumin in acute aortic dissection.
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ABSTRACT: Acute aortic dissection (AOD) is associated with high mortality and early diagnosis and treatment are essential. Ischemia-modified albumin (IMA) is a marker of myocardial ischemia whereas cardiac enzymes are released when myocardial necrosis occurs. We investigated, for the first time, whether IMA increases in AOD either at presentation or after surgery. We studied 46 consecutive patients with documented AOD; we also evaluated 13 consecutive patients with dilated ascending aortas scheduled for elective surgery and admitted for preoperative coronary angiography; 46 age-matched normal subjects served as controls. Only patients with acute onset of symptoms were included. We evaluated IMA, cardiac enzymes, N-terminal pro-B-type natriuretic peptide, albumin, C-reactive protein (CRP), and D-dimers on admission, 24 hr post-operatively and 4 days post-operatively. Duration from symptom onset to the first sample was 23±17 hr. IMA did not differ between patients with AOD at presentation (93±19 U/ml), patients with chronic aneurysms (90±14 U/ml) and normal controls (91±9 U/ml). In addition, IMA did not change significantly after surgical repair. IMA, at baseline, however, correlated positively with time from symptom onset as well as CRP levels (P=0.05 and P=0.007, respectively). IMA is not elevated in AOD when blood sampling is performed within 23±17 hr after symptom onset nor increases after surgery.Journal of Clinical Laboratory Analysis 01/2010; 24(6):399-402. · 1.38 Impact Factor -
Article: Listen to my kidney!
The Lancet 12/2009; 374(9705):1944. · 38.28 Impact Factor -
Article: Ischaemia-modified albumin in pulmonary hypertension.
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ABSTRACT: Pulmonary hypertension (PH) may be associated with subendocardial ischaemia. We investigated whether ischaemia-modified albumin (IMA), an established marker of ischaemia, is elevated in stable patients with PH. We studied 32 patients with PH and an equal number of age-matched normal volunteers. We assessed serum IMA levels with the albumin cobalt-binding test. Patients' mean +/- SD (range) pulmonary arterial pressure was 56 +/- 12 (33-73) mmHg and their exercise capacity was 394 +/- 145 (121-688) m in the 6-min walk test. IMA was 92 +/- 14 (69-115) U ml(-1) in the patient group and 93 +/- 9.4 (76-122) U ml(-1) in the control group with no significant difference between the two (p = 0.85), although almost one-third of the patients had detectable troponin-I. We conclude that IMA, a marker of ischaemia, does not differ in patients with advanced clinically stable PH compared with normal subjects.Biomarkers 12/2009; 15(3):238-42. · 2.21 Impact Factor -
Article: Contrast-induced acute kidney injury in patients with renal dysfunction undergoing a coronary procedure and receiving non-ionic low-osmolar versus iso-osmolar contrast media.
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ABSTRACT: Although the superiority of low-osmolar over high-osmolar contrast agents in prevention of contrast-induced acute kidney injury (CI-AKI) is generally accepted, the relative nephrotoxicity of iso-osmolar over low-osmolar agents has not yet clearly defined. We examined the incidence of CI-AKI according to the type of contrast agent used in a randomized study of ascorbic acid for CI-AKI prevention. A total of 222 patients with baseline serum creatinine >or=1.2 mg/dL who were undergoing a coronary procedure and who were randomized to receive ascorbic acid or placebo were evaluated. The iso-osmolar agent iodixanol was used in 144 patients, whereas low-osmolar non-ionic agents were used in 78 patients (iomeprol, n = 40; iobitridol, n = 30; iopentol, n = 8). CI-AKI was defined by an absolute serum creatinine increase of >or=0.5 mg/dL or a relative increase of >or=25% measured 2 to 5 days after the procedure. The groups of patients who received iso-osmolar and low-osmolar non-ionic agents were well balanced in terms of demographic, clinical, and procedural characteristics. The overall CI-AKI incidence was 14.6% for the iso-osmolar iodixanol versus 14.1% for the combined low-osmolar non-ionic agents (iomeprol, 10%; iobitridol, 10%; iopentol, 50%). For iodixanol, the incidence of CI-AKI was 7.4% for patients randomized to receive ascorbic acid and 21.6% for placebo (P = 0.02). The corresponding incidences for the low-osmolar non-ionic agents were 9.1% and 20.6%, respectively (P = 0.19). No differences in CI-AKI incidence were apparent among patients receiving non-ionic iso-osmolar iodixanol and non-ionic low-osmolar contrast agents. The preventative effect of ascorbic acid was also similar.The American Journal of the Medical Sciences 12/2009; 339(1):25-30. · 1.39 Impact Factor
Top co-authors
Top Journals
Institutions
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2003–2012
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Onassis Cardiac Surgery Center
- Department of Cardiology
Kallithéa, Attiki, Greece
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2011
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Henry Dunant Hospital
Athens, Attiki, Greece
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2008
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National Cardiology Hospital, Bulgaria
Sofia, Oblast Sofiya-Grad, Bulgaria
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