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Tsoporis JN, Triantafyllis AS, Kalogeropoulos AS, Izhar S, Rigopoulos AG, Rallidis LS, Sakadakis E, Toumpoulis IK, Salpeas V, Leong-Poi H, Parker TG, Rizos I. Differential Expression of Circulating Damage-Associated Molecular Patterns in Patients with Coronary Artery Ectasia. Biomolecules 2023; 14:10. [PMID: 38275751 PMCID: PMC10813324 DOI: 10.3390/biom14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Coronary artery ectasia (CAE) is defined as abnormal dilation of a coronary artery with a diameter exceeding that of adjacent normal arterial segment by >1.5 times. CAE is a pathological entity of the coronary arteries and characterized as a variant of coronary atherosclerosis. CAE frequently coexists with coronary artery disease (CAD). While inflammation appears to be involved, the pathophysiology of CAE remains unclear. Damage-associated molecular patterns (DAMPs), defined as endogenous molecules released from stressed or damaged tissue, are deemed as alarm signals by the innate immune system. Inflammatory agents can generate DAMPs and DAMPs can create a pro-inflammatory state. In a prospective cross-sectional study, we enrolled 29 patients with CAE and non-obstructive CAD, 19 patients with obstructive CAD without CAE, and 14 control subjects with normal (control) coronary arteries age- and sex-matched with the CAE patients, to investigate the differential expression of plasma DAMPs. Patients with CAE and non-obstructive CAD had increased plasma levels of the DAMPs S100B, S100A12, HMGB1, and HSP70, the DAMPs receptor TLR4, and miR328a-3p compared to CAD and controls. Plasma levels of the mir328a-3p target the protective soluble form of the DAMPs receptor for advanced glycation end products (sRAGE), and the antioxidant DJ-1 was decreased in both CAE and CAD compared to controls. In an in vitro human umbilical vein endothelial cells model, circulating levels of S100B, HMGB1, HSP70 as well as CAE patient plasma induced inflammatory responses. The differential expression of the DAMPs S100B, HSP70, HMGB1, and their receptors TLR4 and sRAGE in CAE versus CAD makes them attractive novel biomarkers as therapeutic targets and therapeutics.
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Affiliation(s)
- James N. Tsoporis
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Andreas S. Triantafyllis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
- Askepeion General Hospital, 16673 Athens, Greece
| | - Andreas S. Kalogeropoulos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
- Hygeia HealthCare Group, Department of Cardiology, Mitera General Hospital, 15123 Athens, Greece
| | - Shehla Izhar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Angelos G. Rigopoulos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Loukianos S. Rallidis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Eleftherios Sakadakis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Ioannis K. Toumpoulis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Vasileios Salpeas
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
| | - Howard Leong-Poi
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Thomas G. Parker
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada; (S.I.); (H.L.-P.); (T.G.P.)
| | - Ioannis Rizos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (A.S.T.); (A.S.K.); (A.G.R.); (L.S.R.); (E.S.); (I.K.T.); (V.S.); (I.R.)
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Gkavogiannakis NA, Tsoporis JN, Drosatos IA, Tsirebolos G, Izhar S, Sakadakis E, Triantafyllis AS, Parker TG, Kalogiros LA, Leong-Poi H, Rallidis LS, Rizos I. Emergent Inflammatory Markers and Echocardiographic Indices in Patients with Bronchial Asthma. Biomolecules 2023; 13:955. [PMID: 37371535 DOI: 10.3390/biom13060955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Asthma is a heterogeneous disease, characterized by chronic inflammation and oxidative stress of the airways. Several inflammatory pathways including activation of the receptor for advanced glycation end products (RAGE) have been described in the course of the disease. DJ-1 is a redox-sensitive protein with multifaceted roles in mast cell homeostasis and an emerging role in the pathogenesis of asthma. Moreover, cardiac function abnormalities have been described via echocardiography in patients with asthma. The main aim of this study was to investigate the plasma levels of RAGE, its ligands and DJ-1 in asthmatic patients pre- and post-treatment along with echocardiographic indices of cardiovascular function. The study population was divided into two groups. Group A included 13 patients with newly diagnosed bronchial asthma who were free of treatment for at least two weeks and Group B included 12 patients without asthma. An echocardiography examination was performed on all patients. The plasma levels of RAGE, its ligands (AGEs, S100A12, S100B, S100A8/A9), the interleukins (IL-6, IL-1β) and DJ-1 were measured. No differences were noted among the two groups for baseline characteristics and echocardiographic indices of cardiac function. In Group A, 31% suffered from mild asthma, 54% from moderate asthma and 15% from severe asthma. Plasma levels of IL-6, AGEs and AGE/RAGE ratio were increased and those of S100A12 and DJ-1 were decreased in asthmatics. Pharmacotherapy with corticosteroids/β2-agonists decreased IL-6, and AGEs, and increased DJ-1. In search of novel approaches in diagnosing and treating patients with asthma, S100A12, ratio AGE/sRAGE, and DJ-1 in addition to IL-6 may prove to be useful tools.
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Affiliation(s)
- Nikolaos A Gkavogiannakis
- Allergy Unit "D. Kalogeromitros", Attikon University Hospital, 124 62 Athens, Greece
- Allergy & Clinical Immunology Department, 401 General Military Hospital of Athens, 115 27 Athens, Greece
| | - James N Tsoporis
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada
| | - Ioannis-Alexandros Drosatos
- Second Department of Cardiology, Attikon University Hospital, 124 62 Athens, Greece
- Department of Cardiology, 414 Military Hospital, P. Penteli, 152 36 Athens, Greece
| | - George Tsirebolos
- Second Department of Cardiology, Attikon University Hospital, 124 62 Athens, Greece
- Department of Cardiology, 401 General Military Hospital of Athens, 115 27 Athens, Greece
| | - Shehla Izhar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada
| | | | | | - Thomas G Parker
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada
| | - Lampros A Kalogiros
- Allergy & Clinical Immunology Department, 401 General Military Hospital of Athens, 115 27 Athens, Greece
| | - Howard Leong-Poi
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada
| | - Loukianos S Rallidis
- Second Department of Cardiology, Attikon University Hospital, 124 62 Athens, Greece
| | - Ioannis Rizos
- Second Department of Cardiology, Attikon University Hospital, 124 62 Athens, Greece
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Tsirebolos G, Tsoporis JN, Drosatos IA, Izhar S, Gkavogiannakis N, Sakadakis E, Triantafyllis AS, Parker TG, Rallidis LS, Rizos I. Emerging markers of inflammation and oxidative stress as potential predictors of coronary artery disease. Int J Cardiol 2023; 376:127-133. [PMID: 36758863 DOI: 10.1016/j.ijcard.2023.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND AND AIMS The multi-ligand receptor for advanced glycation end products (RAGE) and its ligands AGEs and S100/calgranulin proteins are important mediators of inflammation and oxidative stress whereas the soluble form of RAGE (sRAGE) by acting as a decoy and the antioxidant PARK7/DJ-1 exert antiatherogenic effects. We examined whether sRAGE and its ligands AGEs, S100A8/A9, S100B, S100A12 and DJ-1 are associated with the presence of angiographic coronary artery disease (CAD) in asymptomatic patients with and without diabetes. METHODS AND RESULTS Plasma levels of RAGE ligands, sRAGE and DJ-1 were determined in 50 patients with angiographically proven CAD and in 50 age-matched healthy controls. In the whole cohort, lower levels of sRAGE and higher levels of interleukin-6 (IL-6), the RAGE ligands S100B, S100A12 and the AGEs/sRAGE ratio were associated with CAD. In patients without diabetes (n = 72), lower levels of sRAGE and DJ-1 and higher levels of IL-6 and AGEs/sRAGE ratio were associated with CAD. In multivariable analysis, AGEs/sRAGE ratio was an independent predictor of CAD both in the whole cohort (p = 0.034, OR = 1.247, [95%CI: 1.024, 1.0519]) and in the subgroup of patients without diabetes (p = 0.021, OR = 1.363, 95%CI [1.048, 1.771]) on top of established cardiovascular risk factors. CONCLUSION Alterations in plasma RAGE axis inflammatory mediators are associated with atherosclerosis, and higher levels of AGEs/sRAGE ratio are independently associated with CAD in asymptomatic patients and may act as a novel biomarker for predicting CAD. DJ-1 emerges as promising marker of oxidative stress in CAD patients without diabetes, a finding that deserves further study.
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Affiliation(s)
- George Tsirebolos
- Second Department of Cardiology, Attikon University Hospital, Athens, Greece; Department of Cardiology, 401 General Military Hospital of Athens, Athens, Greece
| | - James N Tsoporis
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Ontario, Canada.
| | - Ioannis-Alexandros Drosatos
- Second Department of Cardiology, Attikon University Hospital, Athens, Greece; Department of Cardiology, 414 Military Hospital, P.Penteli, Athens, Greece
| | - Shehla Izhar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Ontario, Canada
| | - Nikolaos Gkavogiannakis
- Second Department of Cardiology, Attikon University Hospital, Athens, Greece; Department of Cardiology, 401 General Military Hospital of Athens, Athens, Greece
| | | | | | - Thomas G Parker
- Department of Cardiology, 414 Military Hospital, P.Penteli, Athens, Greece
| | | | - Ioannis Rizos
- Second Department of Cardiology, Attikon University Hospital, Athens, Greece
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Tsoporis JN, Amatullah H, Gupta S, Izhar S, Ektesabi AM, Vaswani CM, Desjardins JF, Kabir G, Teixera Monteiro AP, Varkouhi AK, Kavantzas N, Salpeas V, Rizos I, Marshall JC, Parker TG, Leong-Poi H, Dos Santos CC. DJ-1 Deficiency Protects against Sepsis-Induced Myocardial Depression. Antioxidants (Basel) 2023; 12:antiox12030561. [PMID: 36978809 PMCID: PMC10045744 DOI: 10.3390/antiox12030561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/07/2023] [Accepted: 02/20/2023] [Indexed: 03/30/2023] Open
Abstract
Oxidative stress is considered one of the early underlying contributors of sepsis-induced myocardial depression. DJ-1, also known as PARK7, has a well-established role as an antioxidant. We have previously shown, in a clinically relevant model of polymicrobial sepsis, DJ-1 deficiency improved survival and bacterial clearance by decreasing ROS production. In the present study, we investigated the role of DJ-1 in sepsis-induced myocardial depression. Here we compared wildtype (WT) with DJ-1 deficient mice at 24 and 48 h after cecal ligation and puncture (CLP). In WT mice, DJ-1 was increased in the myocardium post-CLP. DJ-1 deficient mice, despite enhanced inflammatory and oxidative responses, had an attenuated hypertrophic phenotype, less apoptosis, improved mitochondrial function, and autophagy, that was associated with preservation of myocardial function and improved survival compared to WT mice post-CLP. Collectively, these results identify DJ-1 as a regulator of myocardial function and as such, makes it an attractive therapeutic target in the treatment of early sepsis-induced myocardial depression.
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Affiliation(s)
- James N Tsoporis
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Hajera Amatullah
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Sahil Gupta
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Shehla Izhar
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Amin M Ektesabi
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Chirag M Vaswani
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jean-Francois Desjardins
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Golam Kabir
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Ana Paula Teixera Monteiro
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Amir K Varkouhi
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Nikolaos Kavantzas
- 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Vasileios Salpeas
- 1st Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Ioannis Rizos
- 2nd Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece
| | - John C Marshall
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Thomas G Parker
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Howard Leong-Poi
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
| | - Claudia C Dos Santos
- The Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
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Chondrogianni M, Lambadiari V, Katsanos AH, Stefanou MI, Palaiodimou L, Triantafyllou AS, Karagiannis G, Konstantakos V, Ioakeimidis M, Triantafyllou S, Zompola C, Liantinioti C, Pappa A, Rizos I, Voumvourakis K, Tsivgoulis G, Boutati E. Omentin Is Independently Associated with Stroke Severity and Ipsilateral Carotid Artery Stenosis in Patients with Acute Cerebral Ischemia. J Clin Med 2021; 10:jcm10245797. [PMID: 34945092 PMCID: PMC8703878 DOI: 10.3390/jcm10245797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/27/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Mounting evidence indicates an association between adipokines and inflammation-related atherosclerosis. Here, we sought to investigate the association of vaspin and omentin with clinical characteristics and outcomes of patients with acute cerebral ischemia (ACI). Consecutive ACI patients were evaluated within 24 h from symptom-onset. Stroke aetiology was classified using TOAST criteria. Adipokines were assayed using quantikine enzyme immunoassay commercially available kits. Stroke severity was assessed by NIHSS-score, and ipsilateral carotid stenosis (≥50% by NASCET criteria) by ultrasound and CT/MR angiography. Major cerebrovascular events were assessed at three months. We included 135 ACI patients (05 (78%) and 30 (22%) with acute ischemic stroke and transient ischemic attack, respectively; mean age ± SD: 59 ± 10 years; 68% men; median NIHSS-score: 3 (IQR:1–7)). Omentin was strongly correlated to admission stroke severity (Spearman rho coefficient: +0.303; p < 0.001). Patients with ipsilateral carotid stenosis had higher omentin levels compared to patients without stenosis (13.3 ± 8.9 ng/mL vs. 9.5 ± 5.5 ng/mL, p = 0.014). Increasing omentin levels were independently associated with higher stroke severity (linear regression coefficient = 0.290; 95%CI: 0.063–0.516; p = 0.002) and ipsilateral carotid stenosis (linear regression coefficient = 3.411; 95%CI: 0.194–6.628; p = 0.038). No association of vaspin with clinical characteristics and outcomes was found. Circulating omentin may represent a biomarker for the presence of atherosclerotic plaque, associated with higher stroke severity in ACI patients.
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Affiliation(s)
- Maria Chondrogianni
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Vaia Lambadiari
- Second Department of Internal Medicine, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (V.L.); (E.B.)
| | - Aristeidis H. Katsanos
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
- Division of Neurology, McMaster University and Population Health Research Institute, Hamilton, ON L8S 3L8, Canada
| | - Maria Ioanna Stefanou
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Lina Palaiodimou
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Alexandros Stavros Triantafyllou
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Georgios Karagiannis
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Vasileios Konstantakos
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Michael Ioakeimidis
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Sokratis Triantafyllou
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Christina Zompola
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Chryssa Liantinioti
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Alexandra Pappa
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Ioannis Rizos
- Second Department of Cardiology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece;
| | - Konstantinos Voumvourakis
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
| | - Georgios Tsivgoulis
- Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (M.C.); (A.H.K.); (M.I.S.); (L.P.); (A.S.T.); (G.K.); (V.K.); (M.I.); (S.T.); (C.Z.); (C.L.); (A.P.); (K.V.)
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Correspondence: ; Tel.: +30-6937178635; Fax: +30-2105832471
| | - Eleni Boutati
- Second Department of Internal Medicine, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece; (V.L.); (E.B.)
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Drosatos IA, Tsoporis JN, Izhar S, Gupta S, Tsirebolos G, Sakadakis E, Triantafyllis AS, Rigopoulos A, Rigopoulos D, Rallidis LS, Rizos I, Parker TG. Differential Regulation of Circulating Soluble Receptor for Advanced Glycation End Products (sRAGEs) and Its Ligands S100A8/A9 Four Weeks Post an Exercise Intervention in a Cohort of Young Army Recruits. Biomolecules 2021; 11:1354. [PMID: 34572568 PMCID: PMC8469473 DOI: 10.3390/biom11091354] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 12/17/2022] Open
Abstract
Apart from its beneficial effects on cardiovascular risk factors, an anti-inflammatory effect of exercise is strongly implicated. Yet, data regarding the effect of an exercise intervention on healthy individuals are limited and contradictory. The present study aimed to investigate the effects of a physical activity intervention on the soluble form of the receptor for advanced glycation end products (sRAGEs) and its ligands S100A8/A9. A total of 332 young army recruits volunteered and 169 completed the study. The participants underwent the standard basic training of Greek army recruits. IL-6, IL-1β, S100A8/A9, and sRAGEs were measured at the beginning and at the end of the training period. Primary rodent adult aortic smooth muscle cells (ASMCs) were analyzed for responsiveness to direct stimulation with S100A8/A9 alone or in combination with sRAGEs. At the end of the training period, we observed a statistically significant reduction in S100A8/A9 (630.98 vs. 472.12 ng/mL, p = 0.001), IL-1β (9.39 [3.8, 44.14] vs. 5.03 [2.44, 27.3] vs. pg/mL, p = 0.001), and sRAGEs (398.38 vs. 220.1 pg/mL, p = 0.001). IL-6 values did not change significantly after exercise. S100A8/A9 reduction was positively correlated with body weight (r = 0.236 [0.095, 0.370], p = 0.002) and BMI (r = 0.221 [0.092, 0.346], p = 0.004). Direct stimulation of ASMCs with S100A8/A9 increased the expression of IL-6, IL-1β, and TNF-α and, in the presence of sRAGEs, demonstrated a dose-dependent inhibition. A 4-week military training resulted in significant reduction in the pro-inflammatory cytokines IL-1β and S100A8/A9 complex. The observed reduction in sRAGEs may possibly reflect diminished RAGE axis activation. Altogether, our findings support the anti-inflammatory properties of physical activity.
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Affiliation(s)
- Ioannis-Alexandros Drosatos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
- Department of Preventive Medicine, 414 Military Hospital, 15236 Athens, Greece;
| | - James N. Tsoporis
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
| | - Shehla Izhar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
| | - Sahil Gupta
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
| | - George Tsirebolos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
- Department of Cardiology, 401 General Military Hospital of Athens, 11525 Athens, Greece
| | - Eleftherios Sakadakis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Andreas S. Triantafyllis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Angelos Rigopoulos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | | | - Loukianos S. Rallidis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Ioannis Rizos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Thomas G. Parker
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
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Rigopoulos AG, Kalogeropoulos AS, Tsoporis JN, Sakadakis EA, Triantafyllis AS, Noutsias M, Gupta S, Parker TG, Rizos I. Heat Shock Protein 70 Is Associated With Cardioversion Outcome and Recurrence of Symptomatic Recent Onset Atrial Fibrillation in Hypertensive Patients. J Cardiovasc Pharmacol 2021; 77:360-369. [PMID: 33298735 DOI: 10.1097/fjc.0000000000000962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 11/11/2020] [Indexed: 11/26/2022]
Abstract
ABSTRACT Accumulating evidence indicates that heat shock proteins (HSPs) may represent a suitable biomarker to predict atrial fibrillation (AF). We investigated the relation of circulating serum HSP70 (sHSP70) with inflammatory cytokines and recurrence of symptomatic recent onset AF (ROAF). We enrolled 90 patients with ROAF (the duration from onset of symptoms ≤24 hours) and 30 controls. Patients received amiodarone for cardioversion and rhythm control. The association of serum HSP70, serum interleukin-2 (sIL-2), and serum interleukin-4 (sIL-4) with the presence of cardioversion and AF recurrence within a year was investigated. Toll-like receptor 4 (TLR4) signaling dependence for IL-2 and IL-4 induction in response to stimulation with HSP70 was tested in rat aortic vascular smooth muscle cell cultures. Patients had higher sHSP70 and sIL-2 and lower sIL-4 compared with controls. Serum HSP70 was independently associated with ROAF (P = 0.005) and correlated with sIL-2 (r = 0.494, P < 0.001) and sIL-4 (r = -0.550, P < 0.001). By 48 hours, 71 of the 90 patients were cardioverted, with noncardioverted patients having higher sHSP70 and sIL-2 and lower sIL-4, which were the only independent factors associated with cardioversion. AF recurred in 38 of the 71 cardioverted patients in 1 year. A cutoff value of sHSP70 ≥0.65 ng/mL and sIL-2 ≥0.21 pg/mL was the only independent factor associated with AF recurrence (hazard ratio: 3.311, 95% confidence interval: 1.503-7.293, P = 0.003 and hazard ratio: 3.144, 95% confidence interval: 1.341-7.374, P = 0.008, respectively). The exposure of smooth muscle cell to HSP70 in vitro increased the expression of IL-2 (5×) and IL-4 (1.5×) through TLR4-dependent and receptor-independent mechanisms. In conclusion, sHSP70 and sIL-2 might constitute a prognostic tool for determining the cardioversion and recurrence likelihood in ROAF.
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Affiliation(s)
- Angelos G Rigopoulos
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
- Department of Internal Medicine III, Mid-German Heart Center, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany ; and
| | - Andreas S Kalogeropoulos
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - James N Tsoporis
- The Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Eleftherios A Sakadakis
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Andreas S Triantafyllis
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Michel Noutsias
- Department of Internal Medicine III, Mid-German Heart Center, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany ; and
| | - Sahil Gupta
- The Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Thomas G Parker
- The Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Ioannis Rizos
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
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Rigopoulos AG, Panou F, Sakadakis E, Frogoudaki A, Papadopoulou K, Triantafyllidi H, Ali M, Iliodromitis E, Rizos I, Noutsias M. Cardiopulmonary Exercise Test Parameters at Three Months After Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy Are Associated With Late Clinical Outcome. Heart Lung Circ 2020; 29:202-210. [DOI: 10.1016/j.hlc.2018.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/27/2018] [Accepted: 12/15/2018] [Indexed: 11/27/2022]
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Tsoporis J, Izhar S, Desjardins J, Rizos I, Salpeas V, Guo G, Parker T. ACTIVATION OF FARNESOID X RECEPTOR SIGNALING MEDIATES ATRIAL MYOCYTE APOPTOSIS IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING AND VENTRICULAR REMODELING AFTER EXPERIMENTAL MYOCARDIAL INFARCTION. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Affiliation(s)
- M. Hatzopoulos
- Department of InformaticsUniversity of Athens, Ktiria Typa, Panepistimiopolis 15771 Ilisia, Athens Greece
| | - M. Vazirgiannis
- Department of InformaticsUniversity of Athens, Ktiria Typa, Panepistimiopolis 15771 Ilisia, Athens Greece
| | - I. Rizos
- Department of InformaticsUniversity of Athens, Ktiria Typa, Panepistimiopolis 15771 Ilisia, Athens Greece
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Rigopoulos AG, Rizos I, Parissis J. Rate of intramyocardial NCAM re-expression in dilated cardiomyopathy: More pronounced in the left than in the right ventricle? Int J Cardiol 2017; 249:332. [PMID: 29121738 DOI: 10.1016/j.ijcard.2017.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 06/06/2017] [Indexed: 11/25/2022]
Affiliation(s)
- A G Rigopoulos
- Department of Internal Medicine, Leopoldina Hospital, Schweinfurt, Germany.
| | - I Rizos
- 2nd Department of Cardiology, University of Athens, Athens, Greece
| | - J Parissis
- 2nd Department of Cardiology, University of Athens, Athens, Greece
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Katsanos AH, Makris K, Stefani D, Koniari K, Gialouri E, Lelekis M, Chondrogianni M, Zompola C, Dardiotis E, Rizos I, Parissis J, Boutati E, Voumvourakis K, Tsivgoulis G. Plasma Glial Fibrillary Acidic Protein in the Differential Diagnosis of Intracerebral Hemorrhage. Stroke 2017; 48:2586-2588. [PMID: 28751552 DOI: 10.1161/strokeaha.117.018409] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/14/2017] [Accepted: 06/29/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND PURPOSE Plasma GFAP (glial fibrillary acidic protein) has recently emerged as a potential biomarker for the differentiation of acute intracerebral hemorrhage (ICH) from acute ischemic stroke (AIS). We prospectively assessed the diagnostic accuracy of GFAP in the differential diagnosis of ICH. METHODS Consecutive patients presenting to the emergency department within 6 hours from symptom onset were evaluated. All patients underwent extensive diagnostic work-up and were classified according to discharge diagnosis in AIS, ICH, subarachnoid hemorrhage, and stroke mimics. GFAP was also measured in healthy volunteers (controls). Baseline stroke severity was evaluated using National Institutes of Health Stroke Scale. Receiver operating characteristic curve analysis was used to identify the optimal cutoff point for the differentiation between subgroups. Correlation analyses of GFAP plasma concentrations with baseline National Institutes of Health Stroke Scale and onset to sampling time were performed with the nonparametric Spearman rank test and fractional polynomial regression, respectively. RESULTS Our study population consisted of 270 individuals (AIS: 121, ICH: 34, stroke mimics: 31, subarachnoid hemorrhage: 5, controls: 79). No differences on baseline stroke severity and onset to sampling time were detected between AIS and ICH. Higher median plasma GFAP values were documented in ICH compared with AIS, stroke mimics, and controls (P<0.001). Receiver operating characteristic analysis highlighted a cutoff value of 0.43 ng/mL as the optimal threshold for the differentiation between ICH and AIS (sensitivity: 91%, specificity: 97%). No association was detected between plasma GFAP concentrations and baseline stroke severity for both AIS (P=0.515) and ICH (P=0.387). In the fractional polynomial analysis, the association between GFAP concentration and onset to sampling time was best described by a J-shaped curve for AIS and an inverted U-shaped curve for ICH, with a peak at 2 hours. CONCLUSIONS Plasma GFAP seems to be a sensitive and specific biomarker for the differentiation of ICH from both AIS and other acute neurological disorders, with the optimal diagnostic yield being present in the second hour from symptom onset.
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Affiliation(s)
- Aristeidis H Katsanos
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Konstantinos Makris
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Dimitra Stefani
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Katerina Koniari
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Eleni Gialouri
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Moses Lelekis
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Maria Chondrogianni
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Christina Zompola
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Efthymios Dardiotis
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Ioannis Rizos
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - John Parissis
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Eleni Boutati
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Konstantinos Voumvourakis
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.)
| | - Georgios Tsivgoulis
- From the Second Department of Neurology (A.H.K., M.C., C.Z., K.V., G.T.), Second Department of Cardiology (I.R., J.P.), and Second Department of Internal Medicine (E.B.), Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.); Clinical Biochemistry Department (K.M.) and Department of Internal Medicine (D.S., K.K., E.G., M.L.), KAT General Hospital, Athens, Greece; Department of Neurology, University Hospital of Larissa, Greece (E.D.); and Department of Neurology, University of Tennessee Health Science Center, Memphis (G.T.).
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Oikonomidis N, Kavantzas N, Korou LM, Konstantopoulos P, Pergialiotis V, Misiakos E, Rizos I, Verikokos C, Perrea DN. Pre-treatment with simvastatin prevents the induction of diet-induced atherosclerosis in a rabbit model. Biomed Rep 2016; 5:667-674. [PMID: 28101339 PMCID: PMC5228082 DOI: 10.3892/br.2016.780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/19/2016] [Indexed: 01/03/2023] Open
Abstract
The aim of the present study was to investigate the potential antiatherosclerotic activities of simvastatin in rabbits. Twenty-two, male, New Zealand rabbits were divided into the following groups: Control group (group C); cholesterol group (group A), in which the rabbits were fed a commercial rabbit chow supplemented with 0.5% w/w cholesterol for 8 weeks and then fed with normal chow for an additional 8 weeks; and a treatment group (group B), in which the rabbits initially received standard commercial rabbit chow along with being administered simvastatin for 8 weeks, following which they consumed a high-cholesterol diet for a further 8 weeks. The rabbits pre-treated with simvastatin presented significantly lower serum cholesterol and low-density lipoprotein cholesterol levels when compared with the non simvastatin-treated cholesterol-fed animals. Furthermore, none of the rabbits in the simvastatin group presented with atherosclerotic lesions in the aorta. Thus, simvastatin was demonstrated to exhibit preventive properties against the formation of atherosclerosis in the atherosclerosis model in the current study, predominantly via its hypolipidemic activity.
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Affiliation(s)
- Nikolaos Oikonomidis
- Laboratory of Experimental Surgery and Surgical Research 'N.S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens 11527, Greece
| | - Nikolaos Kavantzas
- 1st Department of Pathology, National and Kapodistrian University of Athens, Medical School, Laiko University Hospital, Athens 11527, Greece
| | - Laskarina-Maria Korou
- Laboratory of Experimental Surgery and Surgical Research 'N.S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens 11527, Greece
| | - Panagiotis Konstantopoulos
- Laboratory of Experimental Surgery and Surgical Research 'N.S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens 11527, Greece
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research 'N.S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens 11527, Greece
| | - Evangelos Misiakos
- 3rd Department of Surgery, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, Athens 12462, Greece
| | - Ioannis Rizos
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, Athens 12462, Greece
| | - Christos Verikokos
- 2nd Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Laiko University Hospital, Athens 11527, Greece
| | - Despina N Perrea
- Laboratory of Experimental Surgery and Surgical Research 'N.S. Christeas', National and Kapodistrian University of Athens, Medical School, Athens 11527, Greece
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Polymeropoulos E, Bagos P, Papadimitriou M, Rizos I, Patsouris E, Τoumpoulis I. Vitamin C for the Prevention of Postoperative Atrial Fibrillation after Cardiac Surgery: A Meta-Analysis. Adv Pharm Bull 2016; 6:243-50. [PMID: 27478787 DOI: 10.15171/apb.2016.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Several studies have investigated the administration of vitamin C (vitC) for the prevention of postoperative atrial fibrillation (AF) after cardiac surgery. However, their findings were inconsistent. The purpose of this meta-analysis was to evaluate the efficacy of vitC as prophylaxis for the prevention of postoperative AF in cardiac surgery. METHODS A systematic search of PubMed, EMBASE, Google Scholar, the Cochrane Library, and clinical trial registries, was performed. 9 studies, published from August 2001 to May 2015, were included, with a total of 1,037 patients. Patients were randomized to receive vitC, or placebo. RESULTS Cardiac surgery patients who received vitC as prophylaxis, had a significantly lower incidence of postoperative AF (random effects OR=0.478, 95% CI 0.340 - 0.673, P < 10(-4)). No significant heterogeneity was detected across the analyzed studies (I(2)=21.7%), and no publication bias or other small study-related bias was found. CONCLUSION Our findings suggest that VitC is effective as prophylaxis for the prevention of postoperative AF. The administration of vitC may be considered in all patients undergoing cardiac surgery.
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Affiliation(s)
| | - Pantelis Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | | | - Ioannis Rizos
- Cardiology Department, Attiko Hospital, Athens, Greece
| | - Efstratios Patsouris
- Department of Pathology, Medical School of the National University of Athens, Greece
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15
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Karaglani M, Toumpoulis I, Goutas N, Poumpouridou N, Vlachodimitropoulos D, Vasilaros S, Rizos I, Kroupis C. Development of novel real-time PCR methodology for quantification of COL11A1 mRNA variants and evaluation in breast cancer tissue specimens. BMC Cancer 2015; 15:694. [PMID: 26466668 PMCID: PMC4606509 DOI: 10.1186/s12885-015-1725-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 10/08/2015] [Indexed: 12/26/2022] Open
Abstract
Background Collagen XI is a key structural component of the extracellular matrix and consists of three alpha chains. One of these chains, the α1 (XI), is encoded by the COL11A1 gene and is transcribed to four different variants at least (A, B, C and E) that differ in the propensity to N-terminal domain proteolysis and potentially in the way the extracellular matrix is arranged. This could affect the ability of tumor cells to invade the remodeled stroma and metastasize. No study in the literature has so far investigated the expression of these four variants in breast cancer nor does a method for their accurate quantitative detection exist. Methods We developed a conventional PCR for the general detection of the general COL11A1 transcript and real-time qPCR methodologies with dual hybridization probes in the LightCycler platform for the quantitative determination of the variants. Data from 90 breast cancer tissues with known histopathological features were collected. Results The general COL11A1 transcript was detected in all samples. The developed methodologies for each variant were rapid as well as reproducible, sensitive and specific. Variant A was detected in 30 samples (33 %) and variant E in 62 samples (69 %). Variants B and C were not detected at all. A statistically significant correlation was observed between the presence of variant E and lymph nodes involvement (p = 0.037) and metastasis (p = 0.041). Conclusions With the newly developed tools, the possibility of inclusion of COL11A1 variants as prognostic biomarkers in emerging multiparameter technologies examining tissue RNA expression should be further explored. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1725-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Makrina Karaglani
- Department of Clinical Biochemistry and Molecular Diagnostics, Attikon University General Hospital, University of Athens Medical School, Rimini 1 St., Haidari, 12462, Greece.
| | - Ioannis Toumpoulis
- Department of Cardiothoracic Surgery, Attikon University General Hospital, University of Athens Medical School, Athens, Greece.
| | - Nikolaos Goutas
- Pathologic Anatomy Laboratory, Evgenidio Hospital, University of Athens Medical School, Athens, Greece.
| | - Nikoleta Poumpouridou
- Department of Clinical Biochemistry and Molecular Diagnostics, Attikon University General Hospital, University of Athens Medical School, Rimini 1 St., Haidari, 12462, Greece.
| | | | | | - Ioannis Rizos
- Department of Cardiology, Attikon University General Hospital, University of Athens Medical School, Athens, Greece.
| | - Christos Kroupis
- Department of Clinical Biochemistry and Molecular Diagnostics, Attikon University General Hospital, University of Athens Medical School, Rimini 1 St., Haidari, 12462, Greece.
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16
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Rizos E, Siafakas N, Katsantoni E, Skourti E, Salpeas V, Rizos I, Tsoporis JN, Kastania A, Filippopoulou A, Xiros N, Margaritis D, Parker TG, Papageorgiou C, Zoumpourlis V. Correction: Let-7, Mir-98 and Mir-181 as Biomarkers for Cancer and Schizophrenia. PLoS One 2015; 10:e0135863. [PMID: 26266816 PMCID: PMC4534206 DOI: 10.1371/journal.pone.0135863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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Rizos E, Siafakas N, Katsantoni E, Skourti E, Salpeas V, Rizos I, Tsoporis JN, Kastania A, Filippopoulou A, Xiros N, Margaritis D, Parker TG, Papageorgiou C, Zoumpourlis V. Let-7, mir-98 and mir-183 as biomarkers for cancer and schizophrenia [corrected]. PLoS One 2015; 10:e0123522. [PMID: 25856466 PMCID: PMC4391828 DOI: 10.1371/journal.pone.0123522] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 02/20/2015] [Indexed: 11/18/2022] Open
Abstract
Recent evidence supports a role of microRNAs in cancer and psychiatric disorders such as schizophrenia and bipolar disorder, through their regulatory role on the expression of multiple genes. The rather rare co-morbidity of cancer and schizophrenia is an old hypothesis which needs further research on microRNAs as molecules that might exert their oncosuppressive or oncogenic activity in the context of their role in psychiatric disorders. The expression pattern of a variety of different microRNAs was investigated in patients (N = 6) suffering from schizophrenia termed control, patients with a solid tumor (N = 10) and patients with both schizophrenia and tumor (N = 8). miRNA profiling was performed on whole blood samples using the miRCURY LNA microRNA Array technology (6th & 7th generation). A subset of 3 microRNAs showed a statistically significant differential expression between the control and the study groups. Specifically, significant down-regulation of the let-7p-5p, miR-98-5p and of miR-183-5p in the study groups (tumor alone and tumorand schizophrenia) was observed (p<0.05). The results of the present study showed that let-7, miR-98 and miR-183 may play an important oncosuppressive role through their regulatory impact in gene expression irrespective of the presence of schizophrenia, although a larger sample size is required to validate these results. Nevertheless, further studies are warranted in order to highlight a possible role of these and other micro-RNAs in the molecular pathways of schizophrenia.
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Affiliation(s)
- Emmanouil Rizos
- National and Kapodistrian University of Athens, Medical School, 2nd Department of Psychiatry, University “ATTIKON” General Hospital, Athens, Greece
- * E-mail:
| | - Nikolaos Siafakas
- National and Kapodistrian University of Athens, Medical School, Microbiology Laboratory, University “ATTIKON” General Hospital, Athens, Greece
| | - Eleni Katsantoni
- Biomedical Research Foundation, Academy of Athens, Hematology-Oncology Division, Athens, Greece
| | - Eleni Skourti
- Unit of Biomedical Applications, Institute of Biology, Medicinal Chemistry & Biotechnology, National Hellenic Research Foundation, Athens, Greece
| | - Vassilios Salpeas
- National & Kapodistrian University of Athens, 2nd Cardiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - Ioannis Rizos
- National & Kapodistrian University of Athens, 2nd Cardiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - James N. Tsoporis
- Keenan Research Centre. Li Ka Shing Knowledge Institute for Biomedical Science, St. Michael’s Hospital, Toronto, Canada
| | - Anastasia Kastania
- Department of Informatics, Athens University of Economics and Business, Athens, Greece
| | - Anastasia Filippopoulou
- National and Kapodistrian University of Athens, Medical School, 2nd Department of Psychiatry, University “ATTIKON” General Hospital, Athens, Greece
- Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Department of Psychiatry, Alexandroupolis, Greece
| | - Nikolaos Xiros
- Second Department of Propaedeutic Internal Medicine, Oncology Unit, Attikon University Hospital, Athens, Greece
| | - Demetrios Margaritis
- National and Kapodistrian University of Athens, Medical School, 2nd Department of Psychiatry, University “ATTIKON” General Hospital, Athens, Greece
| | - Thomas G. Parker
- Keenan Research Centre. Li Ka Shing Knowledge Institute for Biomedical Science, St. Michael’s Hospital, Toronto, Canada
| | - Charalabos Papageorgiou
- National and Kapodistrian University of Athens, Medical School, 2nd Department of Psychiatry, University “ATTIKON” General Hospital, Athens, Greece
| | - Vassilios Zoumpourlis
- Unit of Biomedical Applications, Institute of Biology, Medicinal Chemistry & Biotechnology, National Hellenic Research Foundation, Athens, Greece
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18
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Rizos E, Siafakas N, Papageorgiou C, Katsantoni E, Skourti E, Salpeas V, Rizos I, Tsoporis J, Parker T, Xiros N, Kastania A, Zoumpourlis V. Let-7, MiR-98 and MiR-181 as Biomarkers for Cancer and Schizophrenia. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31868-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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19
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Frogoudaki A, Andreou C, Parissis J, Maniotis C, Nikolaou M, Rizos I, Filippatos G, Lekakis J. Clinical and prognostic implications of plasma NGAL and NT-proBNP in adult patients with congenital heart disease. Int J Cardiol 2014; 177:1026-30. [PMID: 25449518 DOI: 10.1016/j.ijcard.2014.09.134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 09/20/2014] [Accepted: 09/25/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prognostic value of NT-proBNP is well established in patients with congenital heart disease. Growing evidence suggests that plasma NGAL is elevated in heart failure but data is limited in congenital heart disease. This study investigates the combined prognostic value of plasma NGAL with plasma NT-proBNP in adult patients with congenital heart disease. METHODS Plasma levels of NT-proBNP and NGAL were measured in 76 consecutive adult patients (33 men, mean age 31.7 ± 14 yrs) with congenital heart disease and normal values of serum creatinine. Patients were divided in three groups: A: simple cardiac lesions, B: complex cardiac lesions and C: cyanotic lesions. Patients were also monitored for long-term major cardiovascular events: death, hospitalization, NYHA class worsening, new onset of arrhythmias, surgical or percutaneous intervention. RESULTS NGAL value was significantly different between groups: In group A median NGAL value was 64.5 ± 36.7 ng/ml, in group B median NGAL value was 88.77 ± 36.17 ng/ml and in group C median NGAL value was 121 ± 40 ng/ml (group A vs. group B: p = 0.048, group B vs. group C: p = 0.037, group A vs. group C: p = 0.003). Plasma NT-proBNP predicted all events (HR = 1.001, CI = 1.001-1.002, p = 0.0006) as well as cardiovascular death alone (HR = 1.001, CI = 1.001-1.002, p = 0.0004); plasma NGAL was the only predictor of cardiovascular death (HR = 1.017, CI = 1.001-1.033, p = 0.037). CONCLUSION Plasma NGAL levels were lower in patients with simple congenital disease compared to patients with complex congenital heart disease and cyanotic congenital heart disease. Plasma NGAL levels correlated with NT-proBNP and could predict cardiovascular death in this small cohort of patients.
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Affiliation(s)
| | | | - John Parissis
- Second Cardiology Department, Attikon University Hospital, Athens, Greece
| | | | - Maria Nikolaou
- Second Cardiology Department, Attikon University Hospital, Athens, Greece
| | - Ioannis Rizos
- Second Cardiology Department, Attikon University Hospital, Athens, Greece
| | | | - John Lekakis
- Second Cardiology Department, Attikon University Hospital, Athens, Greece
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Tsivgoulis G, Katsanos AH, Butcher KS, Boviatsis E, Triantafyllou N, Rizos I, Alexandrov AV. Intensive blood pressure reduction in acute intracerebral hemorrhage: A meta-analysis. Neurology 2014; 83:1523-9. [DOI: 10.1212/wnl.0000000000000917] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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21
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Leftheriotis D, Flevari P, Theodorakis G, Rigopoulos A, Ikonomidis I, Panou F, Sourides V, Simitsis P, Giannakakis G, Aidonidis I, Rizos I, Anastasiou-Nana M. The Effects of Ranolazine on Paroxysmal Atrial Fibrillation in Patients with Coronary Artery Disease: A Preliminary Observational Study. J Atr Fibrillation 2014; 6:940. [PMID: 27957034 DOI: 10.4022/jafib.940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/03/2014] [Accepted: 02/10/2014] [Indexed: 12/19/2022]
Abstract
The impact of ranolazine, an anti-ishemic agent with antiarrhythmic properties, on paroxysmal atrial fibrillation (PAF) in patients with coronary artery disease (CAD) remains unclear. Pacing devices can be useful tools for disclosing even asymptomatic PAF. Purpose of this study is to assess the effect of ranolazine on atrial fibrillation (AF), in patients with CAD, PAF and a dual-chamber pacemaker. We studied 74 patients with CAD, PAF, and sick sinus syndrome or atrio-ventricular block, treated with pacemakers capable to detect PAF episodes. The total time in AF, AF burden, and the number of PAF episodes within the last 6 months before enrolment in the study, mean AF duration per episode, and the QTc interval were initially assessed. Subsequently, patients were randomized into additional treatment with ranolazine (375 mg twice daily) or placebo. Following six months of treatment, all parameters were reassessed and compared to those before treatment. Ranolazine was associated with shorter total AF duration (81.56±45.24 hours versus 68.71±34.84 hours, p=0.002), decreased AF burden (1.89±1.05% versus 1.59±0.81%, p=0.002), and shortened mean AF duration (1.15±0.41 hours versus 0.92±0.35 hours, p=0.01). In the placebo group no such differences were observed. In both groups, no significant differences in the number of PAF episodes and QTc duration were observed. We conclude that in patients with CAD and PAF, ranolazine reduces the total time in AF, AF burden, and mean AF duration. These findings may imply additional antiarrhythmic properties of ranolazine on atrial myocardium and might indicate the necessity of its use in ischemic patients with PAF.
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Affiliation(s)
| | - Panayota Flevari
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
| | - George Theodorakis
- Onassis Cardiac Surgery Center, Department of Cardiology, Athens, Greece (Hellas)
| | - Angelos Rigopoulos
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
| | - Ignatios Ikonomidis
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
| | - Fotis Panou
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
| | - Vassilios Sourides
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
| | - Panagiotis Simitsis
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
| | - Georgios Giannakakis
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
| | - Isaac Aidonidis
- Medical School of Larissa, Department of Physiology, Larissa, Greece (Hellas)
| | - Ioannis Rizos
- "Attikon" University Hospital, Department of Cardiology, Athens, Greece (Hellas)
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22
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Leftheriotis D, Flevari P, Theodorakis G, Rigopoulos A, Giannakakis G, Simitsis P, Aidonidis I, Rizos I, Anastasiou-Nana M. The effects of ranolazine on paroxysmal atrial fibrillation in patients with coronary artery disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Triantafyllis AS, Kalogeropoulos AS, Rigopoulos AG, Sakadakis EA, Toumpoulis IK, Tsikrikas S, Kremastinos DT, Rizos I. Coronary artery ectasia and inflammatory cytokines: Link with a predominant Th-2 immune response? Cytokine 2013; 64:427-32. [DOI: 10.1016/j.cyto.2013.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/29/2013] [Accepted: 05/01/2013] [Indexed: 12/21/2022]
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Kalogeropoulos A, Triantafyllis AS, Sakadakis E, Rigopoulos A, Grapsa J, Tsikrikas S, Faviou E, Rizos I, Anastasiou-Nana M. Th2 predominant immune response prevails in patients with coronary artery ectasia and non-obstructive coronary artery disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Aidonidis I, Doulas K, Hatziefthimiou A, Tagarakis G, Simopoulos V, Rizos I, Tsilimingas N, Molyvdas PA. Ranolazine-Induced Postrepolarization Refractoriness Suppresses Induction of Atrial Flutter and Fibrillation in Anesthetized Rabbits. J Cardiovasc Pharmacol Ther 2012; 18:94-101. [DOI: 10.1177/1074248412453874] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ranolazine (Ran) is a novel anti-ischemic agent with electrophysiologic properties mainly attributed to the inhibition of late Na+ current and atrial-selective early Na+ current. However, there are only limited data regarding its efficacy and mechanism of action against atrial flutter (Afl) and atrial fibrillation (AF) in intact animals. Therefore, we aimed to investigate the electrophysiologic mechanism of Ran in a rabbit model of inducible atrial tachyarrhythmias elicited by acetylcholine (ACh). Arrhythmias were produced in 19 rabbits by rapid atrial burst pacing during control, after intravenous ACh and after Ran + ACh administration. Recording of right atrial monophasic action potentials (MAPs) and programmed stimulation were utilized to determine the duration of atrial repolarization at various cycle lengths and voltage levels of action potential, including 75% of total MAP duration (MAPD75), effective refractory period (ERP), and postrepolarization refractoriness (PRR = ERP − MAPD75) prior to and after Ran. Control stimulation yielded no arrhythmias or maximal nonsustained runs of Afl/AF. Upon ACh, 17 of 19 rabbits exhibited sustained Afl and AF as well as mixed forms of Afl/AF, while 2 animals revealed none or short runs of nonsustained arrhythmias and were excluded from the study. High-frequency burst pacing during the first 30 minutes after Ran + ACh failed to induce any arrhythmia in 13 of 17 rabbits (76%), while 2 animals displayed sustained Afl/AF and 2 other animals nonsustained Afl/AF. At basic stimulation cycle length of 250 milliseconds, Ran prolonged baseline atrial ERP (80 ± 8 vs 120 ± 9 milliseconds, P < .001) much more than MAPD75 (65 ± 7 vs 85 ± 7 milliseconds, P < .001), leading to atrial PRR which was more pronounced after Ran compared with control measurements (35 ± 11 vs 15 ± 10 milliseconds, P < .001). This in vivo study demonstrates that Ran exerts antiarrhythmic activity by suppressing inducibility of ACh-mediated Afl/AF in intact rabbits. Its action may predominantly be related to a significant increase in atrial PRR, resulting in depressed electrical excitability and impediment of arrhythmia initiation.
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Affiliation(s)
- Isaac Aidonidis
- Department of Physiology, Medical School of Larissa & Thoracic and Cardiovascular Surgery of the University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Konstantinos Doulas
- Department of Physiology, Medical School of Larissa & Thoracic and Cardiovascular Surgery of the University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Apostolia Hatziefthimiou
- Department of Physiology, Medical School of Larissa & Thoracic and Cardiovascular Surgery of the University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Georgios Tagarakis
- Department of Physiology, Medical School of Larissa & Thoracic and Cardiovascular Surgery of the University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Vassilios Simopoulos
- Department of Physiology, Medical School of Larissa & Thoracic and Cardiovascular Surgery of the University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Ioannis Rizos
- Department of Cardiology, Attikon University Hospital of Athens, Greece
| | - Nikolaos Tsilimingas
- Department of Physiology, Medical School of Larissa & Thoracic and Cardiovascular Surgery of the University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Paschalis-Adam Molyvdas
- Department of Physiology, Medical School of Larissa & Thoracic and Cardiovascular Surgery of the University Hospital of Larissa, University of Thessaly, Larissa, Greece
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Kalogeropoulos AS, Tsiodras S, Rigopoulos AG, Sakadakis EA, Triantafyllis A, Kremastinos DTH, Rizos I. Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation. BMC Cardiovasc Disord 2011; 11:77. [PMID: 22204652 PMCID: PMC3276440 DOI: 10.1186/1471-2261-11-77] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 12/28/2011] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are essential for the cardiac extracellular matrix (ECM) remodeling. We investigated differences in serum levels of these markers between patients with atrial fibrillation (AF) and sinus rhythm (SR). METHODS Serum levels of MMP-2, MMP-3, MMP-9 and TIMP-1 were measured in 86 patients: 27 on SR without any AF history, 33 with paroxysmal and 26 with permanent AF. All subjects had essential hypertension, normal systolic function and no coronary artery disease. RESULTS Patients with AF had higher MMP-2, MMP-3 and MMP-9 and lower TIMP-1 compared to SR subjects (all p < 0.001). Paroxysmal AF was associated with higher MMP-2 levels compared to permanent AF (p < 0.001). Matrix metalloproteinase-9 but not MMP-3 was higher in permanent compared to paroxysmal AF group (p < 0.001). Patients with AF had lower levels of TIMP-1 compared to those with SR while permanent AF subjects had lower TIMP-1 levels than those with paroxysmal AF (p < 0.001 for both comparisons). Lower TIMP-1 was the only independent factor associated with AF (OR: 0.259, 95%CI: 0.104-0.645, p = 0.004). CONCLUSIONS In hypertensives, paroxysmal AF and permanent AF differ with respect to serum MMPs. Increased MMP-2 is associated with paroxysmal, whereas increased MMP-9 with permanent AF. Additionally, lower levels of TIMP-1 had a strong association with AF incidence.
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Affiliation(s)
- Andreas S Kalogeropoulos
- Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Sotirios Tsiodras
- 4th Academic Department of Internal Medicine and Infectious Diseases, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Angelos G Rigopoulos
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Eleftherios A Sakadakis
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Andreas Triantafyllis
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Dimitrios TH Kremastinos
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Ioannis Rizos
- 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
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Kakouros N, Kakouros S, Lekakis J, Rizos I, Cokkinos D. Tissue Doppler Imaging of the Tricuspid Annulus and Myocardial Performance Index in the Evaluation of Right Ventricular Involvement in the Acute and Late Phase of a First Inferior Myocardial Infarction. Echocardiography 2011; 28:311-9. [DOI: 10.1111/j.1540-8175.2010.01318.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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28
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Triantafyllidi H, Rizos I, Rallidis L, Tsikrikas S, Triantafyllis A, Ikonomidis I, Panou F, Rigopoulos A, Kremastinos DT. Aortic distensibility associates with increased ascending thoracic aorta diameter and left ventricular diastolic dysfunction in patients with coronary artery ectasia. Heart Vessels 2010; 25:187-94. [PMID: 20512445 DOI: 10.1007/s00380-009-1196-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 08/14/2009] [Indexed: 12/18/2022]
Abstract
Coronary artery ectasia is usually linked to coronary atherosclerosis. Its primary defect is a destruction of vascular media, which leads to coronary dilatation. The aim of the present study is to evaluate whether ascending aorta present anatomical and functional wall changes in patients with coronary ectasia compared with patients without ectasia. Forty patients with known coronary ectasia (group A) underwent echocardiography in order to study aortic lumen diameter and wall properties (distensibility and stiffness index). Twenty-five patients with coronary artery disease (group B) and 40 individuals with normal coronary arteries (group C) served as control groups. Both ascending aorta diameter and ascending aorta index were significantly increased in group A compared with groups B and C (P < 0.05 and P < 0.001, respectively). Furthermore, in patients with ectatic coronary arteries ascending aorta index, systolic blood pressure and diastolic dysfunction independently associate with aortic distensibility. In patients with coronary artery ectasia, ascending aortic diameter could be enlarged while aortic stiffness is related to diastolic dysfunction. We suggest that coronary ectasia is not an isolated lesion but a reflection of a generalized vascular media defect, and should not be recognized as a benign entity.
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Affiliation(s)
- Helen Triantafyllidi
- Second Department of Cardiology, Medical School, University of Athens, Attikon Hospital, 83 Agiou Ioannou Theologou, Holargos, 155 61 Athens, Greece.
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Rigopoulos AG, Papadopoulos C, Ikonomidis I, Rokkas C, Panagiotides JG, Rizos I, Anagnostopoulos CE, Kremastinos DT. Mobile pulmonary valve thrombus as a cause of chronic thromboembolic pulmonary hypertension. Int J Cardiol 2008; 129:e81-3. [PMID: 17884197 DOI: 10.1016/j.ijcard.2007.06.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2007] [Accepted: 06/23/2007] [Indexed: 11/21/2022]
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Halapas A, Pissimissis N, Lembessis P, Rizos I, Rigopoulos AG, Kremastinos DT, Koutsilieris M. Molecular diagnosis of the viral component in cardiomyopathies: pathophysiological, clinical and therapeutic implications. Expert Opin Ther Targets 2008; 12:821-36. [PMID: 18554151 DOI: 10.1517/14728222.12.7.821] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Myocarditis is defined as the inflammation of myocardium associated with cardiac dysfunction. Despite this clear-cut definition, diagnosis and etiologic treatment continue to create considerable debate. Viral infections are frequent causes of myocarditis and there is evidence that persistent viral infection is associated with poor prognosis in different subtypes of cardiomyopathy. OBJECTIVE To review methods for diagnosis of viral myocarditis and present the use of polymerase chain reaction (PCR)-based protocols for evaluating viral infection in myocarditis/cardiomyopathies. METHODS A review of published literature. RESULTS/CONCLUSION There is increasing evidence that PCR-based protocols can provide reliable molecular evidence for the presence of viral infection in myocardium. Thus application of molecular techniques will allow collection and analysis of more information on the epidemiology of viral cardiomyopathies, patient risk stratification and appropriate medical treatment.
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Affiliation(s)
- A Halapas
- University of Athens, Department of Experimental Physiology, Medical School, 75 Micras Asias, Goudi-Athens, 115 27, Greece
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Rizos I, Tsiodras S, Rigopoulos AG, Dragomanovits S, Kalogeropoulos AS, Papathanasiou S, Sakadakis EA, Kremastinos DT. Interleukin-2 serum levels variations in recent onset atrial fibrillation are related with cardioversion outcome. Cytokine 2007; 40:157-64. [PMID: 17923414 DOI: 10.1016/j.cyto.2007.08.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Revised: 07/29/2007] [Accepted: 08/28/2007] [Indexed: 12/01/2022]
Abstract
We evaluated the hypothesis that a relationship exists between inflammation and the outcome of pharmaceutical cardioversion with amiodarone in recent onset atrial fibrillation. We studied 86 patients with symptomatic recent onset AF and coexisting hypertension and/or chronic stable coronary artery disease. All study participants underwent evaluation with a standardized protocol including echocardiography, cytokine level measurement [interleukin-2 (IL-2), interleukin-6 (IL-6) and high sensitivity C reactive protein (hsCRP)] on admission and at 48h, and administration of intravenous amiodarone. By 48h, 70 patients cardioverted to sinus rhythm. Median serum IL-2 levels on admission were higher in non-cardioverted compared to cardioverted patients (P=0.002). At 48h, non-cardioverted had significantly higher IL-6 (P=0.005) and hsCRP values (P=0.001) compared to cardioverted. Multivariate logistic regression analysis showed that lower IL-2 admission levels were a powerful independent predictor for successful cardioversion (OR: 0.154, 95% CI: 0.043-0.552, P=0.004). In patients with hypertension and/or chronic stable coronary artery disease and symptomatic recent onset AF, low serum IL-2 levels on admission are associated with successful cardioversion with amiodarone. This observation highlights the role of inflammation in AF and might have further prognostic and therapeutic implications.
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Affiliation(s)
- Ioannis Rizos
- 2nd Academic Department of Cardiology, Attikon University Hospital, University of Athens Medical School, 19 Kentauron Street, 15237 Filothei, Athens, Greece.
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Triantafyllidi H, Rizos I, Faviou E, Sakadakis E, Triantafyllis A, Tsikrikas S, Rigopoulos A, Kremastinos A. PO19-558 CORONARY ARTERY ECTASIA AND ITS CORRELATION WITH CIRCULATING LEVELS OF MATRIX METALLOPROTEINASES. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71568-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rizos I, Tsiodras S, Papathanasiou S, Rigopoulos A, Barbetseas J, Stefanadis C. Prosthetic Valve Endocarditis due to Acinetobacter spp: A Rare Case and Literature Review. Am J Med Sci 2007; 333:197-9. [PMID: 17496743 DOI: 10.1097/maj.0b013e31803193c4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A rare case of prosthetic valve endocarditis from Acinetobacter spp occurring 9 months postoperatively is described. The patient initially received empirical therapy against pathogens commonly associated with prosthetic valve endocarditis, but his condition did not improve. Identification of bacteremia due to Acinetobacter spp was not attributed to any of the classic nosocomial factors such as presence of a catheter or a recent invasive procedure. The patient did well with an intravenous regimen of meropenem and tobramycin instituted according to susceptibility testing. Physicians should be aware of this rare association of a nosocomial pathogen such as Acinetobacter spp with prosthetic valve endocarditis occurring long after the initial cardiothoracic procedure.
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Affiliation(s)
- Ioannis Rizos
- Department of Cardiology, Hippokration Hospital, Athens, Greece
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Rigopoulos A, Rizos I, Kremastinos DT. Left Ventricular Noncompaction of the Ventricular Myocardium: Ever a Challenging Diagnosis. South Med J 2006; 99:1057-8. [PMID: 17100023 DOI: 10.1097/01.smj.0000235458.15859.9c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Doulalas AD, Rallidis LS, Gialernios T, Moschonas DN, Kougioulis MN, Rizos I, Tselegaridis TS, Kremastinos DT. Association of depressive symptoms with coagulation factors in young healthy individuals. Atherosclerosis 2006; 186:121-5. [PMID: 16076469 DOI: 10.1016/j.atherosclerosis.2005.06.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2004] [Revised: 06/16/2005] [Accepted: 06/21/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression has been reported to be an independent risk factor for coronary heart disease (CHD). We investigated the association of depressive symptoms with lipids and coagulation factors in young individuals free of CHD. METHODS We recruited 1073 young healthy individuals candidates for military academies (mean age=18.4+/-0.8 years, males 762) in whom the presence of depressive symptoms was assessed by using the depression scale of Minnesota Multiphasic Personality Inventory test. Total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein (a), fibrinogen, factors VII, VIII and X were measured. RESULTS The depression score ranged from 22 to 90. The participants were divided into quartiles according to the depression score. Three hundred twenty-two subjects were classified in the upper quartile (score>48) and 269 in the lower quartile (score<37) of the depression score. Factor VII (102.95+/-24 versus 98.5+/-20%) and X levels (92+/-11 versus 89.7+/-10%) were significantly higher in individuals in the upper quartile compared to the lower quartile of the depression score. In a logistic regression model with factor VII as dependent variable (upper versus lower quartile) and depression score, age, gender, body mass index, exercise and smoking as predictor variables, depression was an independent predictor of factor VII levels with an adjusted odds ratio for high levels of factor VII of 1.05 (95% confidence interval 1.008-1.09, p=0.01). Factor VII levels were associated with triglycerides (r=0.21, p=0.001) while factor X with triglycerides (r=0.22, p<0.001) and cholesterol levels (r=0.12, p<0.001). CONCLUSIONS Depressed mood is associated with a hypercoagulant profile as it is expressed by the higher levels of coagulation factors VII and X. This might partially explain the higher propensity for CHD of people with depressive symptoms.
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Massias S, Vyssoulis G, Rizos I, Barbetseas I, Stefanadis C. Progressive heart failure in a patient after coronary artery bypass grafting. Hellenic J Cardiol 2006; 47:114-7. [PMID: 16752532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
A 60-year-old man suffered progressive heart failure caused by restrictive cardiomyopathy after coronary artery bypass grafting. The cardiomyopathy was due to cardiac amyloidosis coexisting with coronary artery disease. Repeated echocardiographic assessment of cardiac structure and function was crucial for diagnosis.
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Affiliation(s)
- Spiridon Massias
- 1st Department of Cardiology, Medical School of Athens University, Hippokration Hospital, Athens, Greece.
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Rallidis LS, Vikelis M, Panagiotakos DB, Rizos I, Zolindaki MG, Kaliva K, Kremastinos DT. Inflammatory markers and in-hospital mortality in acute ischaemic stroke. Atherosclerosis 2006; 189:193-7. [PMID: 16388807 DOI: 10.1016/j.atherosclerosis.2005.11.032] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Revised: 11/09/2005] [Accepted: 11/21/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is substantial evidence that cerebral ischaemia triggers an inflammatory response. We examined the short-term prognostic value on mortality of C-reactive protein (CRP), interleukin-6 (IL-6) and serum amyloid A (SAA) in patients with ischaemic stroke. METHODS We recruited 203 consecutive patients, under the age of 66 years (mean age=54.2+/-8.1 years, men=132) who admitted to the Neurology Department with the diagnosis of non-haemorrhagic stroke. Patients in atrial fibrillation or with evidence of inflammatory or malignant disease were excluded. The diagnosis was confirmed with a computed tomography or magnetic resonance imaging of the brain within 24h of admission. CRP, IL-6 and SAA levels were determined within 12h from admission. RESULTS Fourteen (6.9%) patients died during hospitalization. Serum concentrations of CRP, IL-6 and SAA were significantly higher in patients who died compared with those who survived and were independently associated with early death, after adjusting for various confounding factors. For one unit increase in IL-6, CRP and SAA there was an 18%, 14% and 9% higher risk of dying during hospitalization, respectively. Comparisons of the areas under the ROC curve showed that IL-6 had the best predictive ability. Age-adjusted cut-off point analysis showed that IL-6 levels >13 pg/ml were the optimal point that discriminated those who died from the rest of the patients (sensitivity=85% and specificity=93%). CONCLUSIONS We demonstrated that in-hospital mortality in ischaemic stroke is associated with an exacerbation of inflammatory response as it is reflected by the higher serum levels of IL-6, CRP and SAA. From the inflammatory markers high IL-6 levels had the strongest independent predictive value for in-hospital mortality.
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Affiliation(s)
- Loukianos S Rallidis
- Second Department of Cardiology, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece.
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Triantafyllidi H, Rizos I, Arvaniti C, Stefanadis C. Incidental aneurysms of aorta and basilar artery in patients with coronary artery ectasia. A magnetic resonance angiography study. Acta Cardiol 2005; 60:619-23. [PMID: 16385923 DOI: 10.2143/ac.60.6.2004934] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Incidental intracranial aneurysms have been revealed in 0.5-1% of adult patients undergoing cerebral angiography, while only 8% of those aneurysms are located in the basilar artery. Those aneurysms running usually symptomless, may lead to life-threatening situations due to rupture. Intracranial aneurysms could co-exist with abdominal aneurysms. Another dilating arterial lesion, coronary artery ectasia was linked in previous studies with aneurysms of the abdominal aorta. The aim of the present study is to investigate the coexistence of coronary artery ectasia with other aneurysms since dilating arterial lesions seem to share a similar pathogenesis, a thin or absent media of the arterial wall. METHODS AND RESULTS Ten consecutive patients with coronary artery ectasia after coronary angiography underwent magnetic angiography (MRA) of the brain, thoracic and abdominal aorta. Three incidental aneurysms were revealed: one intracranial aneurysm located in the basilar artery, one extended thoracic/abdominal aneurysm and one abdominal aneurysm. Embolism was used for the management of the basilar artery aneurysm while the extended aneurysm of the descending thoracic and abdominal aorta was surgically repaired in part. CONCLUSIONS Whether our results are just a coincidence or they announce a common pathogenesis is a subject of further screening studies of the population. Nevertheless, a high index of suspicion is expected for patients with coronary ectasia about the presence of other vascular defects at different locations, especially when non-typical symptoms are mentioned.
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Affiliation(s)
- Helen Triantafyllidi
- Department of Cardiology, Medical School, University of Athens, Hippokration Hospital, Athens, Greece.
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Miliou A, Anastasakis A, D'Cruz LG, Theopistou A, Rigopoulos A, Rizos I, Stamatelopoulos S, Toutouzas P, Stefanadis C. Low prevalence of cardiac troponin T mutations in a Greek hypertrophic cardiomyopathy cohort. Heart 2005; 91:966-7. [PMID: 15958377 PMCID: PMC1768994 DOI: 10.1136/hrt.2003.029819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kaloterakis A, Rizos I, Goumas G, Filiotou A, Barbetseas J, Papathanasiou S, Toutouzas P. Isolated native tricuspid valve Candida endocarditis in a non-drug-addicted patient: case report and review of the literature. J Heart Valve Dis 2003; 12:652-8. [PMID: 14565721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
A case is reported of isolated native tricuspid calve Candida parapsilosis endocarditis (INTVCE) in a male patient with no history of drug abuse or heart disease. The patient had received hyperalimentation and antibiotics for four months via a central venous catheter after abdominal surgery. He underwent successful treatment with tricuspid valve debridement, liposomal amphotericin (AmBisome) and fluconazole, and remained without relapse during an eight-year follow up. A literature review of 12 similar cases (including the present patient) without history of drug abuse or heart disease, dating from 1970, is included.
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Affiliation(s)
- Andreas Kaloterakis
- Department of Cardiology, Medical School, University of Athens, Hippocration Hospital, Athens, Greece
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41
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Triantafillidi H, Rizos I, Androulakis A, Stratos K, Arvaniti C, Toutouzas P. Coronary artery ectasia, aneurysm of the basilar artery and varicose veins: common presentation or generalized defect of the vessel wall? A case report. Angiology 2001; 52:287-91. [PMID: 11330513 DOI: 10.1177/000331970105200410] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A young man who suffered from an acute myocardial infarction is presented. He presented coronary artery ectasia along with coronary artery disease. Further evaluation revealed the presence of both a saccular aneurysm of the basilar artery as well as varicose veins of the lower limbs. A common pathogenic mechanism is discussed since all these findings are characterized by similar histologic substrate with the most profound defect being destruction of the myoelastic elements of the media.
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Affiliation(s)
- H Triantafillidi
- Department of Cardiology, Medical School, University of Athens, Hippokration Hospital, Greece
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42
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Salpeas V, Rizos I, Patsouris E, Vitalis D, Vitalis M, Sakadakis E, Vyssoulis G, Kokkinos D, Asimacopoulos P, Toutouzas P. Ventricular-aorta mismatch of heat-shock protein 72 expression in spontaneous hypertensive rats. Eur J Heart Fail 2000. [DOI: 10.1016/s1388-9842(00)80291-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- V. Salpeas
- Cardiology; University of Athens Medical School; Athens Greece
| | - I. Rizos
- Cardiology; University of Athens Medical School; Athens Greece
| | - E. Patsouris
- Pathology; University of Athens Medical School; Athens Greece
| | - D. Vitalis
- Cardiology; University of Athens Medical School; Athens Greece
| | - M. Vitalis
- Cardiology; University of Athens Medical School; Athens Greece
| | - E. Sakadakis
- Cardiology; University of Athens Medical School; Athens Greece
| | - G. Vyssoulis
- Cardiology; University of Athens Medical School; Athens Greece
| | - D. Kokkinos
- Cardiology; University of Athens Medical School; Athens Greece
| | - P. Asimacopoulos
- Cardiosurgery; University of Athens Medical School; Athens Greece
| | - P. Toutouzas
- Cardiology; University of Athens Medical School; Athens Greece
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Abstract
We examined the efficacy of long-term L-carnitine administration for the treatment of heart failure caused by dilated cardiomyopathy in adult patients. To accomplish this, we studied 80 patients with moderate to severe heart failure (New York Heart Association classification III to IV) caused by dilated cardiomyopathy. This article reports on the nearly 3 years of follow-up data on patient mortality. Primary results will be published in the future. After a period of stable cardiac function up to 3 months, patients were randomly assigned to receive either L-carnitine (2 g/d orally) or placebo. There were no statistical differences between the 2 groups at baseline examination in clinical and hemodynamic parameters, such as ejection fraction, Weber classification, maximal time of cardiopulmonary exercise test, peak VO(2) consumption, arterial and pulmonary blood pressure, and cardiac output. After a mean of 33.7 +/- 11.8 months of follow-up (range 10 to 54 months), 70 patients were in the study: 33 in the placebo group and 37 in the L-carnitine group. At the time of analysis, 63 patients were alive. There were 6 deaths in the placebo group and 1 death in the L-carnitine group. Survival analysis with the Kaplan-Meier method showed that patients' survival was statistically significant (P <.04) in favor of the L-carnitine group. L-carnitine appears to possess considerable potential for the long-term treatment of patients with heart failure attributable to dilated cardiomyopathy.
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Affiliation(s)
- I Rizos
- University of Athens Medical School, Greece
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Dionyssiou-Asteriou A, Rizos I. Serum lipoprotein(a) levels in a Greek population sample without a history of premature myocardial infarction. J Cardiovasc Risk 1996; 3:277-280. [PMID: 8863099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To investigate lipoprotein(a) levels in a Greek population sample. METHOD Serum apolipoprotein [Apo(a)] concentrations were measured in 220 men and 190 women aged 55-65 years without a history of effort angina or myocardial infarction. RESULTS The distributions of Apo(a) and lipoprotein(a) [LP(a)] levels were highly skewed both in men and in women. The level of 30 mg/dl Lp(a) corresponded to the 77th percentile of the Lp(a) distribution in men but to the 66th percentile in women. Women had significantly higher values of Apo(a) or Lp(a) concentration than men. High-density lipoprotein cholesterol levels tended to be higher in women, but not in men, belonging to the fourth and fifth quintiles of the Lp(a) distribution than in those belonging to the three lower quintiles.
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Gatzoulis KA, Carlson MD, Biblo LA, Rizos I, Gialafos J, Toutouzas P, Waldo AL. Time domain analysis of the signal averaged electrocardiogram in patients with a conduction defect or a bundle branch block. Eur Heart J 1995; 16:1912-9. [PMID: 8682026 DOI: 10.1093/oxfordjournals.eurheartj.a060847] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Doubts have been expressed about the clinical usefulness of time domain analysis of the signal averaged electrocardiogram in patients with prolonged QRS complex duration. We studied 147 patients using a signal averaged ECG (40-250 Hz) whose QRS complex was longer than 100 ms. A baseline electrophysiology study was also performed in 128 of these patients. Seventy-seven patients had a minor (QRS < 120 and > 100 ms) conduction defect. Thirty-seven of these 77 had either induced or spontaneous sustained ventricular tachycardia (group I) and 40 had no sustained ventricular tachycardia (group II). Seventy patients had a major (QRS > or = 120 ms) conduction defect, 44 of whom had sustained ventricular tachycardia (group A). The remaining 26 without this condition formed Group B. Group I compared to group II patients had a longer filtered QRS duration (120.8 +/- 14 vs 104.5 +/- 9.5 ms, P < 0.001), a longer low amplitude signal duration (41 +/- 12.1 vs 31 +/- 12.6 ms, P < 0.0001) and a lower root mean square of the last 40 ms of the filtered QRS complex (27 +/- 29.8 vs 35 +/- 25.3 microV, P = ns). Group A compared to group B had a longer filtered QRS duration (157.7 +/- 20.2 vs 140.7 +/- 15.7 ms, P < 0.001), a longer low amplitude signal duration (57.3 +/- 24.9 vs 37.8 +/- 20.3 ms P < 0.001) and a lower root mean square of the last 40 ms of the filtered QRS complex (14.3 +/- 11.2 vs 22.0 +/- 10.5 microV, P < 0.01). Using conventional late potential criteria, the sensitivity and specificity of the signal averaged ECG for the detection of sustained ventricular tachycardia patients with a minor conduction defect were 89% and 75%, respectively. The same criteria applied to patients with a major conduction defect were sensitive (sensitivity: 87%) but non-specific (specificity: 50%). However, by using modified late potential criteria, such as the presence of two of any of the following three signal averaged parameters: filtered QRS duration > or = 145 ms, low amplitude signal duration > or = 50 ms, root mean square of the last 40 ms of the filtered QRS complex < or = 17.5 microV, we derived a non-optimal but still acceptable combination of sensitivity (68%) and specificity (73%). We conclude that traditional late potential criteria can be applied in patients with a minor conduction defect, but modification of these criteria is necessary to derive useful clinical information for risk stratification of patients with a QRS complex duration > or = 120 ms.
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Affiliation(s)
- K A Gatzoulis
- Department of Cardiology, Hippokration General Hospital, University of Athens, Greece
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Aidonidis I, Brachmann J, Rizos I, Zacharoulis A, Stavridis I, Toutouzas P, Kübler W. Electropharmacology of the bradycardic agents alinidine and zatebradine (UL-FS 49) in a conscious canine ventricular arrhythmia model of permanent coronary artery occlusion. Cardiovasc Drugs Ther 1995; 9:555-63. [PMID: 8547205 DOI: 10.1007/bf00878087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Myocardial infarction was produced in 27 anesthetized dogs by ligating the left anterior descending (LAD) coronary artery proximal to the septal branch. Nineteen of these animals survived the operation and were studied by programmed stimulation in a random sequence between the third and seventh days after the infarct. Complete electrophysiologic testing was implemented in each animal prior to and after single doses of either alinidine (1 mg/kg IV) or zatebradine (0.5 mg/kg IV). Alinidine prevented reinduction of sustained ventricular tachycardia (SVT) in only 2 of 9 dogs and zatebradine in 1 of 8 dogs. The SVT cycle length was not significantly changed in all cases in which it was still inducible despite drug administration (p > 0.05). Alinidine lengthened the effective refractory period (ERP) in the AV node (p < 0.01), whereas zatebradine did not induce a statistically significant prolongation. Conversely, zatebradine increased the left ventricular ERP, while alinidine left it almost unchanged. The rate-corrected QT interval (QTc) did not significantly differ from control values after the administration of either agents. Also, the duration and the ERP of infarctzone potentials, defined as late potentials, remained unaltered. The results indicate that the bradycardic agents alinidine and zatebradine do not exert antiarrhythmic efficacy against SVT induced during subacute myocardial infarction in conscious dogs. None of these drugs substantially changed ventricular electrophysiology or showed a drug-specific proarrhythmic effect.
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Affiliation(s)
- I Aidonidis
- Department of Cardiology, University of Heidelberg, Germany
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Aidonidis I, Egel E, Hilbel T, Rizos I, Kuebler W, Brachmann J. Electrophysiological mechanisms of action of ethmozine that explain its antiarrhythmic efficacy in the late stage of experimental myocardial infarction in dogs. Eur Heart J 1994; 15:1698-704. [PMID: 7698141 DOI: 10.1093/oxfordjournals.eurheartj.a060454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The effects of intravenous ethmozine (3 mg.kg-1) on electrophysiological parameters of ischaemically damaged myocardium and induced ventricular tachyarrhythmias were studied by programmed stimulation in 17 conscious dogs with 4 to 8 day-old ligation of the left anterior descending coronary artery. Ethmozine showed a beneficial effect on sustained ventricular tachycardia by suppressing its inducibility in five of 14 animals or by slowing its rate in six of 14 animals. Ethmozine prolonged the ventricular effective refractory period in normal and infarcted myocardium, and impaired depressed conduction in ischaemically damaged tissue. The latter was indicated by significant lengthening of late potentials recorded from the infarction zone. The QT interval was only slightly increased with ethmozine. Our findings indicate an antiarrhythmic action of ethmozine in the late stage of myocardial infarction. Major mechanisms accounting for its efficacy may predominantly be associated with marked depression of slow conduction in the infarction zone, as well as with prolongation of ventricular refractoriness without significant changes of ventricular repolarization.
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Affiliation(s)
- I Aidonidis
- Department of Cardiology, University of Heidelberg, Germany
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Aidonidis I, Rizos I, Hilbel T, Kuebler W, Brachmann J. Electrophysiological mechanisms of action of the levorotatory isomer of sotalol in a canine infarct model of inducible ventricular tachycardia: comparison with the beta-1 receptor antagonist bisoprolol. J Mol Cell Cardiol 1994; 26:841-8. [PMID: 7966352 DOI: 10.1006/jmcc.1994.1101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To evaluate the antiarrhythmic efficacy of l-sotalol and bisoprolol on inducible ventricular arrhythmias, conscious dogs with 4- to 8-day-old myocardial infarction were studied by programmed electrical stimulation. Direct recordings from infarcted and adjacent normal subepicardium were made using a specially designed composite electrode. From 18 dogs developing sustained ventricular tachycardia (sVT) during control stimulation, l-sotalol (1.5 mg/kg i.v.) prevented reinducibility of sVT in 10 animals, while in seven other animals it significantly reduced the rate of tachycardia. Bisoprolol (0.2 mg/kg i.v.), tested in a separate group of 10 dogs susceptible to sVT, was mostly ineffective in preventing or slowing the tachycardia. Both agents significantly prolonged conduction time and refractoriness within the atrioventricular conduction system, and decreased heart rate. However, while l-sotalol lengthened ventricular refractoriness and QT interval, bisoprolol exerted only a minor effect on these parameters. Neither of the drugs affected conduction in normal and infarcted myocardium, as indicated by almost unchanged QRS complex width and duration of ventricular late potentials, respectively. The results indicate that acute beta-blockade is ineffective against sVT induced during the subacute stage of myocardial infarction. The antiarrhythmic efficacy of l-sotalol may predominantly be related to its prolonging effect on ventricular refractoriness, supporting the concept of pure class III action.
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Affiliation(s)
- I Aidonidis
- Department of Cardiology, University of Heidelberg, Germany
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Aidonidis I, Brachmann J, Rizos I, Toutouzas P, Kübler W. Lidocaine converts inducible ventricular fibrillation into sustained ventricular tachycardia in conscious dogs with recent myocardial infarction. Cardiology 1994; 85:378-87. [PMID: 7697673 DOI: 10.1159/000176739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of the present study was to investigate the effect of lidocaine (L) on ventricular tachyarrhythmias with special reference to ventricular fibrillation (VF). Myocardial infarction (MI) was created in 39 dogs by doubly ligating the left anterior descending (LAD) coronary artery. All animals surviving the infarction (n = 33) were subjected to programmed ventricular stimulation 7.6 +/- 3.2 days later. Local electrical activity was recorded from the subepicardium of the left ventricular wall by means of a specially designed composite electrode. L (2 and 4 mg/kg i.v.) facilitated the induction of sustained monomorphic ventricular tachycardia (sVT) in 8 dogs with nonsustained polymorphic ventricular tachycardia (nsVT) in the control. In 13 dogs developing sVT during control stimulation, L slowed the rate of tachycardia in 8 animals (first-dose effect), while it abolished arrhythmia induction in 5 animals (second-dose effect). It was interesting that L (2 mg/kg) abolished reproduction of control VF in 12 animals by converting it into sVT. L significantly depressed conduction and prolonged ventricular refractoriness in the infarction zone. The results suggest that L facilitates induction of sVT in conscious dogs with recent MI, thereby decreasing susceptibility of infarcted myocardium to aggressive polymorphic nsVT or VF. The capability of L to exacerbate slow conduction in the infarction zone seems not to favor the development of VF during this stage of MI.
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Affiliation(s)
- I Aidonidis
- Department of Cardiology, University of Heidelberg, Germany
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Rizos I, Seidl KH, Aidonidis I, Stamou S, Senges J, Toutouzas P. Intraindividual comparison of diltiazem and verapamil on induction of paroxysmal supraventricular tachycardia. Cardiology 1994; 85:388-96. [PMID: 7697674 DOI: 10.1159/000176740] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The effects of i.v. diltiazem (0.25 mg/kg) and i.v. verapamil (0.15 mg/kg) were studied in 18 patients with recurrent paroxysmal supraventricular tachycardia (SVT) who underwent serial electrophysiological studies. In 10 of 18 patients with extranodal accessory pathways the effects of diltiazem and verapamil were similar in comparable plasma concentrations. SVT was prevented in 10/10 cases after diltiazem and 9/10 cases after verapamil, furthermore there as an increase in antegrade refractoriness of the normal AV nodal pathway of 22 and 27%, respectively; accessory pathway refractoriness and conduction remained unchanged in both drugs. In 8 of 18 patients with dual AV nodal pathways diltiazem was significantly less effective as compared to verapamil (p < 0.02) regarding prevention ov SVT (3/8 vs. 8/8 cases) and increase in the antegrade refractoriness of the slow AV nodal pathway (+21 vs. +34%). However, both drugs produced equivalent slowing of antegrade AV nodal conduction and a similar increase in antegrade refractoriness of the fast AV nodal pathway. In all 18 patients, the site of action of both drugs was the antegrade limb, regardless of SVT mechanism. The data suggest that the two calcium antagonists are equipotent in AV reentrance but verapamil may offer greater benefit in AV nodal reentrance than diltiazem.
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Affiliation(s)
- I Rizos
- Department of Cardiology, University of Athens, Greece
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