C. Stefanadis's research while affiliated with National and Kapodistrian University of Athens and other places

Publications (776)

Article
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Aims To perform a comprehensive characterization of acute heart failure (AHF) with preserved (HFpEF), vs. mildly reduced (HFmrEF) vs. reduced ejection fraction (HFrEF). Methods and Results Of 5951 participants in the ESC HF Long-Term Registry hospitalized for AHF (acute coronary syndromes excluded), 29% had HFpEF, 18% HFmrEF, and 53% HFrEF. Hospit...
Article
Background Atrial volume-pressure loops are used to assess left atrium (LA) function. Catheter ablation of paroxysmal atrial fibrillation (PAF) by pulmonary vein (PV) antral isolation can be performed either with radiofrequency (RF) catheter or with cryoballoon and might affect LA function. Purpose We explored a potential difference in changes in...
Article
Background Atrial volume-pressure loops are considered the best method to assess left atrium (LA) function. Changes in atrial function induced by pulmonary vein (PV) antral isolation of atrial fibrillation (AF) have not been documented thus far using this approach. Purpose We aimed to evaluate changes in LA function in patients with paroxysmal atr...
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Aims To assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for LCZ696 based on EMA/FDA label, the PARADIGM‐HF trial and ESC‐Heart Failure Association (ESC‐HFA) Guidelines, and the association between eligibility and outcomes. Methods and results Outpatients with HFrEF in the ESC‐HFA Long‐Ter...
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Objectives: This study compared the performance of major heart failure (HF) risk models in predicting mortality and examined their utilization using data from a contemporary multinational registry. Background: Several prognostic risk scores have been developed for ambulatory HF patients, but their precision is still inadequate and their use limi...
Article
Introduction Whether anxiety and depression are associated with hypertension and to what extent is not clear. Aims The aim of the present study was to assess any differences in the prevalence of anxiety and depression among different groups of hypertensive patients. Methods The study cohort comprised of 127 patients (75 male, mean age 54 ± 14) wh...
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Introduction There has been an attempt to associate anxiety and depression with arterial stiffness. In the present study, we assessed differences in arterial stiffness among 3 groups of hypertensive patients compared to control normotensives as well as possible association with anxiety and depression scoring system. Methods The study cohort compri...
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Objective: Apo B is the major apolipoprotein of the atherogenic lipoproteins and has been suggested as an independent cardiovascular risk factor. The ratio between Apo B and Apo A1 has been used in large prospective studies as indicator of risk, but its wide implementation is not recommended for risk stratification. Left ventricular hypertrophy (L...
Article
Background: How the genetic determinants contribute to cardiovascular disease (CVD) has provoked great interest; genes may account for 10% – 50% of the variability in human life span. FOXO3 is generally recognized as an important gene in aging. The newly discovered Gly566Ala variant (rs138174682) of FOXO3 gene has not been yet evaluated with any fu...
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Introduction: In view of recent therapeutic breakthroughs in acute coronary syndromes (ACS) and essential demographic and socioeconomic changes in Greece, we conducted the prospective, multi-center, nationwide PHAETHON study (An Epidemiological Cohort Study of Acute Coronary Syndromes in the Greek Population) that aimed to recruit a representative...
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Although hypertension, hypercholesterolemia and diabetes mellitus (DM) are recognized as major cardio-metabolic risk factors in primary Acute Coronary Syndrome (ACS) prevention, studies focusing on secondary ACS incidence are scarce. In the present study, the association between the aforementioned factors and 10-year ACS prognosis was evaluated. Fr...
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We report a case of an 83-year-old female with symptomatic severe aortic stenosis and mitral valve prolapse, who was treated with trans-catheter aortic-valve implantation (TAVI). Due to a hyperdynamic "ballerina foot" pattern of left ventricular contraction, the extra stiff wire was repeatedly ejected from the left ventricle into the aorta at systo...
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Background and Aims: The protective role of Mediterranean diet on cardiovascular disease (CVD) risk has been extensively discussed in the literature, but its incremental effect over the use of CVD risk reducing agents (such as hypolipidemic treatment) has rarely been evaluated. Methods: The ATTICA study was carried out in the Athens area during 200...
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The purpose of this work was to investigate the association between coffee drinking and diabetes development and potential mediation by oxidative stress and inflammatory biomarkers. In 2001-2002, a random sample of 1514 men (18-87 years old) and 1528 women (18-89 years old) were selected to participate in the ATTICA study (Athens metropolitan area,...
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The purpose of this work was to investigate the potential mediating effect of oxidative stress, inflammation and coagulation on Mediterranean diet- diabetes link. In 2001-02, a random sample of 1514 men (18-87 years old) and 1528 women (18-89 years old) was selected to participate in the ATTICA study, where Athens is a major metropolis. A validated...
Article
Objective: Ikaria, the Greek island of the East Aegean, is among the five places in the world with the highest rates of octagenarians. Aortic stiffness, assessed by aortic pulse wave velocity (PWV), is an independent prognostic factor of cardiovascular and all-cause mortality. However, data on the assessment of aortic stiffness in long-living popul...
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Objective: Vascular aging, as assessed by structural and functional properties of the arteries, is an independent indicator of cardiovascular risk. We investigated the effect of cardiovascular risk factors (RFs) on the progression of vascular aging. Design and method: One hundred and forty-two subjects (mean age 51.9 +/- 10.8 years, 94 men) attendi...
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Objective: Metabolic syndrome (MS) is associated with increased prothrombotic state. Arterial stiffness and microalbuminuria, markers of target organ damage, predict cardiovascular events and are closely related to MS. However, whether prothrombotic status is associated with arterial stiffness and microalbuminuria in hypertensive patients with MS i...
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Objective: Vascular aging, as assessed by structural and functional properties of the arteries, is an independent indicator of cardiovascular risk. We hypothesized that the number presence of hypertension and dyslipidemia determine the progression of arterial stiffening. Design and method: One hundred and forty-two subjects (mean age 51.9 +/- 10.8...
Article
OBJECTIVE Patients with heart failure (HF) experience many different problems that affect their quality of life (QoL) and possibly trigger the onset of anxiety and depression. The purpose of this study was to explore the impact of anxiety and depression on the QoL of patients with HF. METHOD Data were collected from 127 patients with HF by self-com...
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Background: Right ventricular (RV) dysfunction at rest has a significant prognostic role in heart failure (HF) syndrome and its combination with pulmonary artery systolic pressure (PASP) is useful for risk stratification. Different response to exercise of echo-derived tricuspid annular systolic excursion (TAPSE) as RV function indicator may provide...
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Purpose: 3D echocardiography (3DE) enables fast 3D acquisition but subsequent manual navigation to find 2D diagnostic planes can be time consuming. We have developed and validated an automated machine learning-based technique to find apical 2-, 3- and 4-chamber (A2C, A3C, A4C) views that enables fast volume navigation and analysis. Methods: 3DE vol...
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OBJECTIVE Ageing of the population is increasing and the current predictive models of mortality in the elderly are not accurate. New biomarkers that predict cardiovascular (CV) risk and mortality in the elderly are demanding. Aortic stiffness, assessed by carotid-to-femoral pulse wave velocity (PWV), often fails to predict CV risk and mortality in...
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AIMS: Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasive measures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different ava...
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A Mediterranean diet has been associated with lower all-cause and cardiovascular disease (CVD) morbidity and mortality, but the clinical and behavioral pathway has not been well understood and appreciated. The aim of this work was to explore the path between adherence to a Mediterranean-type diet, lifestyle behaviors, clinical status, and a 10-year...
Article
The epidemiology of selenium (Se) is mainly based on the determination of total serum selenium levels (TSe) which by many aspects is an inadequate marker of Se status. In this study we applied a recently developed LC-ICP-MS method, for the determination of the selenium content of the three main serum selenium-containing proteins, in a subcohort of...
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Aim The purpose of this prospective study was to investigate the effect of alcohol consumption on the 10-year diabetes incidence. Methods In 2001–2002, a random sample of 1514 men (18–89 years old) and 1528 women (18–87 years old) was selected to participate in the ATTICA study (Athens metropolitan area, Greece). Among various other characteristic...
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Background: Diabetic cardiomyopathy is characterized by microvascular disease and interstitial fibrosis, which lead to progressive heart failure; however, its pathogenesis remains uncertain. Perfusion cardiac magnetic resonance (CMR) has been proven efficient to detect subclinical myocardial perfusion reserve abnormalities in context of diabetes ty...
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Aim: The variance in hypertension-related sequelae between different ethnic groups is highly related to differences in socioeconomic conditions and lifestyle habits, but also to disparities in the awareness and treatment of the disease. In the present study, we sought to evaluate the target organ damage in a vulnerable hypertensive population, suc...
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Background Elevated blood pressure levels (BP) continue to comprise one of the most important public health problems worldwide. Hypertension is among the most serious risk factors that relates to myocardial infarction, stroke and kidney failure. The purpose of the study was to examine factors that may contribute to presentation of hypertension in m...
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Aim: Diabetes mellitus (DM) is an independent risk factor for stroke. In a DM population, carotid atheromatosis is a major cause of stroke. The role of carotid plaque inflammation remains conflicting. Microwave radiometry (MWR) is a new non-invasive method allowing in vivo measurement of the temperature of tissues, so reflecting inflammation. The...
Chapter
Over the last decade, it has become clearly evident that vascular endothelium is not just a vascular layer, rather than a paracrine organ responsible for the secretion of several substances, exerting anti-atherogenic effects. Nitric oxide bioavailability mediates most of the anti-atherogenic properties of the vascular endothelium, while decreased b...
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Intracoronary optical coherence tomography (OCT) is increasingly being used for real-time visualization of coronary arteries aiming to help in the identification of highrisk atherosclerotic plaques associated with geometrical and morphological features of the arterial wall. This paper presents a framework towards the automatic detection of the inne...
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Erectile dysfunction confers an independent risk for cardiovascular events and total mortality. Aortic pulse wave velocity (PWV) is an important predictor of cardiovascular events and all-cause mortality. We investigated whether PWV predicts major adverse cardiovascular events (MACEs) in patients with erectile dysfunction beyond traditional risk fa...
Poster
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Purpose: With the advent of percutaneous transcatheter device closures in congenital heart defects and the emergence of percutaneous left atrial appendage closure, there is an increasingly important role for echocardiographic guidance and control of device position and function. Disc occluder devices frequently present as an unexplained ‘figure-of-...
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Objectives: Evidence points towards a grading effect of the severity of ED in the predictive ability of this condition for CV events and all-cause mortality. We conducted a meta-analysis of all longitudinal studies for investigating the role of severity of ED in predicting risk of clinical events. Methods: A comprehensive search of electronic datab...
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Objectives: Erectile dysfunction (ED) represents an early marker of vascular damage and a potent factor for future cardiovascular events. Our study aims to investigate interrelationships between ED, arterial stiffness and left ventricular geometry. Methods: We analyzed data from 85 ED patients (mean age: 56±7 y/o). Diagnosis and grading of the erec...
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Objectives: Hypertension is associated with increased arterial stiffness, which is an independent predictor of cardiovascular risk. Aortic systolic blood pressure (SBP) and/or pulse pressure (PP) better predicts cardiovascular events than peripheral blood pressure. The present study compared the discriminative ability for increased arterial stiffne...
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Objectives: Androgen deficiency confers an independent risk for cardiovascular events and total mortality. Hypertension, a major contributory factor to the development of cardiovascular disease (CVD), has been associated with increased prevalence of low testosterone. We investigated whether low androgen concentration predicts major adverse cardiova...
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Purpose: Music has been correlated to cardiovascular health and used as additional therapy in patients with cardiovascular disease, however, few are known on the impact of music on arterial stiffness and central hemodynamics which are both predictors of cardiovascular risk. We investigated the effect of rock and classical music on arterial stiffnes...
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Objective: The Mediterranean diet, rich in fruits, legumes and vegetables is a healthy dietary pattern, gaining widely recognition as a non-pharmaceutical mean of cardiovascular disease prevention, due to antioxidant and anti-inflammatory properties. Erectile dysfunction (ED), represents an early marker of vascular damage, reflecting endothelial dy...
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Surgical or critically ill patients often require continuous assessment of cardiac output (CO) for diagnostic purposes or guiding therapeutic interventions. A new method of non-invasive estimation of CO, based on pressure wave analysis, has been recently developed, but its validity has been examined only in silico. Aim of this study was to evaluate...
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Importance: Type 2 diabetes mellitus and associated chronic kidney disease (CKD) have become major public health problems. Little is known about the influence of diet on the incidence or progression of CKD among individuals with type 2 diabetes. Objective: To examine the association between (healthy) diet, alcohol, protein, and sodium intake, an...
Article
Introduction: The aim of the study is to assess reported changes in medical students' capacity to attain five basic cardiological clinical skills, following a one-month intensive cardiology course provisioned in the core curriculum. Materials and methods: An anonymous questionnaire comprising self reported performance in the five skills, namely...
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Purpose: Left ventricular hypertrophy (LVH) regression has been associated with reduced risk of future cardiovascular events, while microalbuminuria is a marker of renal damage and cardiovascular risk. We sought to investigate the predictive value of albuminuria on LVH regression in treated hypertensive subjects after a mean follow up period of 3.5...