Georgios Benetos

• MD, PhD
• Academic Scholar at National and Kapodistrian University of Athens, Faculty of Medicine

Background: We explored the value of myocardial radiomics by computed tomography angiography (CTA) for detection of transthyretin amyloidosis cardiomyopathy (ATTR-CM). Methods: The study included 589 patients with aortic stenosis and CTA datasets. Radiomics were extracted from LV myocardium. Arm 1 (n = 400) served for method optimisation and rem...

This is a case report of a 54-year-old patient with hepatocellular cancer under palliative chemotherapy who admitted with dyspnea on minimal exertion and peripheral oedema over the past 5 days. Echocardiogram revealed a large echogenic mass in the right atrial cavity which did not enhance with intravenous echo contrast agent, and a distended inferi...

The Bicuspid Aortic Valve (BAV) is the most common congenital anomaly in adults, with a global incidence of 1.3%. Despite being well documented, BAV presents significant clinical challenges due to its phenotypic heterogeneity, diverse clinical manifestations, and variable outcomes. Pathophysiologically, BAV differs from tricuspid valves in calcific...

Coronary artery spasm Accelerated atherosclerosis Vascular toxicity Multimodality imaging approach a b s t r a c t Vascular toxicity caused by cancer treatment can present as vasospasm, arterial thrombosis , and accelerated atherosclerosis. We report a case of a 60-year-old man with metastatic renal cell carcinoma under cabozantinib treatment for 3...

Background: The presence of an electrocardiographic (ECG) strain pattern—among other ECG features—has been shown to be predictive of adverse cardiovascular outcomes in asymptomatic patients with aortic stenosis. However, data evaluating its impact on symptomatic patients undergoing TAVI are scarce. Therefore, we tried to investigate the prognostic...

1991, οπότε και χρησιμοποιήθηκε για πρώ-τη φορά για την ποσοτικοποίηση της ασβέστωσης των στε-φανιαίων αγγείων. Έκτοτε, αυξάνεται συνεχώς η χρήση του για την ακριβέστερη εκτίμηση του καρδιαγγειακού κιν-δύνου σε ασυμπτωματικά άτομα, ενώ αρχίζει να βρίσκει εφαρμογή και στο θωρακικό άλγος και στην ποσοτικοποί-ηση της ασβέστωσης της αορτικής και μιτροε...

Background Computed Tomography Coronary Angiography (CTCA) is an effective non-invasive imaging modality for anatomo-functional assessment of coronary artery disease (CAD). Radiomics features have been used for diagnosis or outcome prediction, however, their potential value for characterizing flow limiting coronary lesions has not been explored. P...

The role of lipoprotein(a) (Lp[a]) as a significant and possibly causal cardiovascular disease (CVD) risk factor has been well established. Many studies, mostly experimental, have supported inflammation as a mediator of Lp(a)-induced increase in CVD risk. Lp(a), mainly through oxidized phospholipids bound to its apolipoprotein(a) part, leads to mon...

We describe a patient with symptomatic severe mitral regurgitation, due to a failed 33‐mm Epic (St. Jude Medical, St. Paul, MN) bioprosthetic heart valve surgically implanted 10‐year before. For this specific purpose, we implanted a novel balloon‐expandable transcatheter heart valve, the MyVal (Meril Life Science, Vapi, India). To the best of our k...

The ACURATE neo transcatheter aortic valve is a self-expanding device. Several studies have investigated safety and efficacy, but meta-analysis and pooled data are lacking. We aimed to provide a comprehensive systematic review and meta-analysis on the clinical outcomes of transcatheter aortic valve implantation with the ACURATE neo valve. A systema...

Introduction Myocardial infarction with non-obstructive coronary arteries (MINOCA) occurs in 5%–15% of all patients with acute myocardial infarction. Cardiac MR (CMR) and optical coherence tomography have been used to identify the underlying pathophysiological mechanism in MINOCA. The role of cardiac CT angiography (CCTA) in patients with MINOCA, h...

Purpose To assess the prognostic value of regional quantitative myocardial flow measures as assessed by ¹³ N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI) in patients with suspected coronary artery disease (CAD). Methods We retrospectively included 150 consecutive patients with suspected CAD who underwent clinically...

Background: Microwave radiometry (MWR) assesses non-invasive carotid artery temperatures reflecting inflammation. In the present study, we aimed to investigate the impact of hypolipidemic therapy either with simvastatin or with combination simvastatin plus ezetimibe on carotid artery temperatures of patients with familial hyperlipidemia syndromes...

Background Access options for transcatheter aortic valve implantation (TAVI) are vital, since use of large sheaths may lead to access-related complications and bleeding. Purpose To determine the access-related vascular and bleeding complications of patients undergoing transfemoral TAVI. Methods Consecutive patients scheduled for transfemoral TAVI...

Introduction Transcatheter aortic valve implantation is the treatment of choice in a consistently expanding group of patients with severe aortic valve stenosis. Tricuspid and mitral annular dilatation with consequent valvular regurgitation are associated with adverse outcome. Computed tomography angiography (CTA) is routinely performed for preproce...

Background/Introduction Arterial stiffness and aortic hemodynamics are independent predictors of adverse cardiovascular events. Indications for transcatheter aortic valve implantation (TAVI) are expanding and aortic valve calcifications (AVC) are an important prognostic factor of the success of TAVI. Purpose We sought to investigate the associatio...

Aims Paravalvular leak (PVL) remains a frequent complication after transcatheter aortic valve implantation (TAVI) and seems to affect short- and long-term survival. Purpose The aim of this study was: 1) to identify anatomical predictors of PVL after TAVI and 2) assess the impact of PVL on cumulative survival. Methods and results Patients with sev...

Background: Chemotherapy regimens for breast cancer treatment can promote vascular dysfunction and lead to high cardiovascular risk. Purpose: To investigate the cardiovascular burden and vascular inflammation in metastatic breast cancer patients receiving CDK 4/6 inhibitors or everolimus in addition to standard hormonal treatment. Methods: 22 conse...

PurposeMisalignment between positron emission tomography (PET) datasets and attenuation correction (AC) maps is a potential source of artifacts in myocardial perfusion imaging (MPI). We assessed the impact of adenosine on the alignment of AC maps derived from magnetic resonance (MR) and PET datasets during MPI on a hybrid PET/MR scanner.Methods Twe...

Transcatheter aortic valve implantation (TAVI) is an established method for treating patients with aortic valve stenosis. We sought to determine the long-term clinical outcomes and performance of a self-expanding bioprosthesis beyond 5 years. Consecutive patients scheduled for TAVI were included in the analysis. Primary end points were all-cause an...

Background: The role of adipose tissue (AT) in arterial inflammation in familial dyslipidaemias is poorly studied. We investigated the relationship between AT and arterial inflammation in patients with heterozygous familial hypercholesterolemia (heFH) and familial combined hyperlipidemia (FCH). Methods and results: A total of 40 patients (20 heF...

The GREECE trial (NCT04631809) aims to compare CCTA-guided ICA (CTgICA) versus the ICA alone. It is a multicenter, randomized, controlled study which will be conducted in 9 Greek hospitals for 24 months. Our aim is to investigate whether the information obtained by CCTA will guide ICA in everyday clinical practice, targeting on decision-making with...

Objectives Coronary artery volume indexed to left myocardial mass (CAVi), derived from coronary computed tomography angiography (CCTA), has been proposed as an indicator of diffuse atherosclerosis. We investigated the association of CAVi with quantitative flow parameters and its ability to predict ischemia as derived from ¹³ N-ammonia positron emis...

Background No methodology is available to distinguish truly reduced myocardial flow reserve (MFR) in positron emission tomography myocardial perfusion imaging (PET MPI) from seemingly impaired MFR due to inadequate adenosine response. The adenosine-induced splenic switch-off (SSO) sign has been proposed as a potential marker for adequate adenosine...

Objective To present 1 year clinical and echocardiographic outcomes of the randomized DIRECT (Pre‐dilatation in Transcatheter Aortic Valve Implantation Trial) trial. Background Intermediate‐term data from randomized studies investigating the safety and efficacy of direct implantation are lacking. Methods DIRECT trial randomized 171 consecutive pa...

Introduction Transcatheter aortic valve implantation (TAVI) has become the standard of care for high-risk and inoperable surgical patients and a valid alternative in intermediate-risk patients with severe aortic stenosis.The DIRECT trial (Predilatation in Transcatheter Aortic Valve Implantation Trial) was a multicenter, randomized, clinical trial d...

Introduction The DIRECT trial (Predilatation in Transcatheter Aortic Valve Implantation (TAVI) Trial) was a multicenter, randomized, clinical trial designed to evaluate the safety and efficacy of TAVI with or without balloon aortic valvuloplasty (BAV) in patients with symptomatic, severe aortic valve stenosis. Purpose To investigate by echocardiog...

Background Familial hypercholesterolemia (FH) syndromes constitute an important risk factor for premature atherosclerosis. Microwave radiometry (MWR) assess non-invasively carotid artery temperatures reflecting inflammation. Recent data support that statin therapy, that constitutes the cornerstone for the treatment of FH, reduces systemic inflammat...

Background Positron emission tomography myocardial perfusion imaging (PET MPI) is a robust and excellent tool for assessing ischemia. So far, however, no methodology has been established to distinguish truly reduced MFR due to microvascular dysfunction or three-vessel coronary disease (CAD) from seemingly impaired MFR due to inadequate adenosine re...

Introduction The DIRECT trial (Predilatation in Transcatheter Aortic Valve Implantation Trial) evaluated in a randomized fashion the safety and efficacy of direct (without balloon pre-dilatation) implantation of a self-expanding valve in all comers undergoing TAVI. Purpose To investigate the impact of direct implantation of a self-expanding valve...

Objectives: The aim of this study was to investigate the prognostic and clinical value of quantitative positron emission tomographic (PET) metrics in patients with ischemic heart failure. Background: Although myocardial flow reserve (MFR) is a strong predictor of cardiac risk in patients without heart failure, it is unknown whether quantitative PET...

Background Coronary computed tomography angiography (CCTA)-based transluminal attenuation gradient (TAG) was suggested to determine the functional significance of a stenosis. However, evidence that TAG acquired by wide-volume scanners can assess the hemodynamic significance of stenosis assessed by single-photon emission computed tomography (SPECT)...

Coronary computed tomography angiography (CCTA) provides critical prognostic information on plaque burden and stenosis severity of coronary arteries. We aimed to investigate the long-term prognostic value of coronary artery volume per myocardial mass as a potential new imaging parameter. Consecutive patients with suspected coronary artery disease (...

Objective: The purpose of this study was to quantify the reduction in radiation dose achievable by using the optimal z-axis coverage in coronary computed tomography (CT) angiography (CCTA) on a latest-generation 256-slice scanner. Methods: A total of 408 scans were reviewed that were performed on a wide-range detector scanner allowing up to 16-c...

Purpose/Background/Objectives: Aortic stiffness and hemodynamics are independent predictors of adverse cardiovascular events. Transcatheter aortic valve implantation (TAVI) is growingly used in high surgical risk patients with aortic valve stenosis. We sought to investigate the effect of TAVI on aortic stiffness. Methods: Fifty-five high-risk patie...

Introduction: To accomplish further decrease in radiation exposure and/or improvement in assessment of coronary computed tomography angiography (CCTA), advances in image reconstruction are necessary. While iterative reconstruction algorithms resulted in plastic appearance at high strength, deep-learning image reconstruction (DLIR) offers unique opp...

Background: Advances in image reconstruction are necessary to decrease radiation exposure from coronary CT angiography (CCTA) further, but iterative reconstruction has been shown to degrade image quality at high levels. Deep-learning image reconstruction (DLIR) offers unique opportunities to overcome these limitations. The present study compared t...

Purpose The human pathophysiology of stunned, hibernating and scarred myocardium in ischemic cardiomyopathy is a subject of controversy. While the “smart heart” theory postulates that reduced myocardial blood flow (MBF) at rest is responsible for myocytes switching to a state of hibernation, other theories suggest that a reduced myocardial flow res...

Introduction The association of carotid plaque inflammation with cerebrovascular events is a matter of rigorous research. Microwave Radiometry (MWR) allows in vivo noninvasive measurement of the internal temperatures of tissues, reflecting inflammation. Purpose To investigate whether increased carotid temperatures in patients with documented coron...

Background Adipose tissue regulates energy balance and glucose homeostasis via the secretion of circulating molecules, termed adipokines, such as leptin and adiponectin. Excess adiposity and adipose tissue dysfunction have been involved in the pathogenesis of dyslipidemias. Positron emission tomography/computed tomography (PET/CT) with F-18-Fluorod...

Background The adipose tissue is now established as a major regulator of cardiovascular status, mediated by the secretion of several bioactive molecules, including adipocytokines. Individuals with genetic dyslipidaemias of either familial combined hyperlipidemia (FCH) or heterozygous familial hypercholesterolemia (heFH) subtype are characterized by...

Aim/Introduction: Misalignment of positron emission tomography (PET) datasets and maps for attenuation correction (AC) is a well-known potential source of artifacts in myocardial perfusion imaging (MPI). A hybrid PET/MR scanner offers inherent spatial co-registration of the PET dataset an AC-maps from MRI (MRAC). Therefore, occurrence of misalignme...

Background Coronary computed tomography angiography (CCTA) provides incremental prognostic information over traditional risk factors in patients with suspected coronary artery disease. However, little is known about the long-term predictive performance of CCTA-derived coronary volumes and mid-diastolic left ventricular (LV) mass. Purpose To assess...

Objectives: The aim of this study was to compare the implantation of a self-expanding valve with or without balloon aortic valvuloplasty (BAV) in an open-label, noninferiority, randomized trial. Background: There are no randomized studies comparing the implantation of a self-expanding valve with (pre-BAV) or without BAV. Methods: Consecutive p...

Aims: To test the hypothesis that virtual functional assessment index (vFAI) is related with regional flow parameters derived by quantitative positron emission tomography (PET) and can be used to assess abnormal vasodilating capability in coronary vessels with stenotic lesions at coronary computed tomography angiography (CCTA). Methods and result...

Background: Microwave Radiometry (MWR) is a new validated method, which allows evaluation of thermal heterogeneity of carotid arteries and is associated with inflammation.Purpose: The aim of this pilot study was to determine if thermal heterogeneity in the carotid arteries is associated with aortic elastic properties in patients with dyslipidemia a...

Purpose/Background/Objectives: Aortic stiffness and central hemodynamics are established vascular biomarkers. Transcatheter aortic valve implantation (TAVI) is a promising new technique for the treatment of aortic valve stenosis in elderly patients. We examined the effect of TAVI on the elastic properties of the aorta and on central hemodynamics. M...

Background: Vulnerable plaque plays crucial role in prognosis of diabetes mellitus (DM). Microwave radiometry (MWR) allows measurement of the temperature of tissues, thus indirectly reflecting inflammation, a characteristic of atherosclerotic plaque stability. Aim of the study was to evaluate the relation of carotid artery inflammation with glycem...

Background Familial dyslipidemias of either heterozygous (heFH) or combined (FCH) type lead to accelerated atherogenesis and increased cardiovascular risk. Objective The aim of this study was to investigate in statin-naïve adult patients with familial dyslipidemias whether inflammatory activation and liver, spleen and bone marrow metabolic activit...

Background and aims: Limited prospective data have been reported regarding the impact of carotid inflammation on cardiovascular events in patients with coronary artery disease (CAD). Microwave radiometry (MWR) is a noninvasive, simple method that has been used for evaluation of carotid artery temperature which, when increased, predicts 'inflamed'...

NSTEMI and DIABETES

Atrial fibrillation (AF) is a major cause of stroke. The restoration of sinus rhythm through cardioversion, either chemical or electrical is a common practice. Interestingly, there is an incremental increase from the baseline risk for embolisation in the immediate post-cardioversion period, with most events occurring within 10 days from cardioversi...