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Background: Aging is characterized by an insidious decline in cognitive function. Several genetic and lifestyle factors have been implicated in the increased risk or early onset of dementia Aim: We sought to assess the role of tumor necrosis factor (TNF) and angiotensin-converting enzyme (ACE) polymorphisms on the development of impaired mental health in respect to indices of arterial aging in nonagenarian individuals. Design: 178 consecutive subjects above 75 years that permanently inhabit in the island of IKARIA, Greece were recruited. Methods: Aortic distensibility (AoD) was calculated and genetic evaluation was performed on the ACE Insertion/Deletion gene polymorphism (intron 16) and the G/A transition (position -308) of the TNF gene. Cognitive function was evaluated using the Mini-mental State Examination (MMSE). Results: The DD genotype for ACE was independently associated (b = 0.44, P = 0.007) with AD while AoD remained an independent determinant of mental status (OR = 1.82, P = 0.036). Interestingly though, when a combined genetic index (GI) was calculated for both genes (ACE and TNF), subjects being double homozygous (DD for ACE and GG for TNF) for these loci presented significantly decreased MMSE (adjusted OR = 0.259, P = 0.033). This GI independently associated with AD (beta coefficient = 0.785, P = 0.002). When AoD was included, GI lost its predictive role (OR = 0.784, P = 0.783) towards MMSE. AoD has marginal indirect mediating effect in the association of the GI with MMSE (P = 0.07). Conclusion: Vascular aging may modulates the genetic substrate of elderly subjects on the risk for developing dementia. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the effect of high intensity, interval exercise on quality of life (QoL) and depression status, in chronic heart failure (CHF) patients.Methods: A randomized controlled trial (phase III). Of the 100 consecutive CHF patients (NYHA classes II–IV, ejection fraction &leq; 50%) that were randomly allocated to exercise intervention (n = 50, high-intensity intermittent endurance training 30 s at 100% of max workload, 30 s at rest, for 45 min/day-by-12 weeks) or no exercise advice (n = 50), 72 (exercise group, n = 33, 63 ± 9 years, 88% men, 70% ischemic CHF and control group, n = 39, 56 ± 11 years, 82% men, 70% ischemic CHF) completed the study. QoL was assessed using the validated and translated Minnesota Living with Heart Failure questionnaire. Depressive symptomatology was evaluated using the validated and translated Zung Depression Rating Scale (ZDRS). Maximal oxygen uptake ( O2max) and carbon dioxide production ( CO2max) were also measured breath-by-breath.Results: Data analysis demonstrated that in the intervention group MLHFQ score was reduced by 66% (P = 0.003); 6-min-walk distance increased by 13% (P < 0.05), O2max level increased by 31% (P = 0.001), CO2max level increased by 28% (P = 0.001) and peak power output increased by 25% (P = 0.001), as compared with the control group.Conclusion: High intensity, systematic aerobic training, could be strongly encouraged in CHF patients, since it improves QoL, by favorably modifying their fitness level. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity (PA) has shown substantial cardiac benefits. We sought to investigate whether habitual PA is associated with changes of the electrical action potential duration, as it is represented by the QT duration on a rest ECG, in a population based sample of middle-aged and elderly individuals of Ikaria island.Methods: In a cross-sectional survey 1071 inhabitants of Ikaria Island (65 ± 13 years, 47% males) were enrolled. PA was estimated by means of IPAQ classifying the participants into low, moderate and vigorous group. QT duration was measured from a surface electrocardiogram; while using Bazett's formula the heart-rate-corrected QT (QTc) was calculated.Results: Among participants, 85% reported at least moderate PA levels. Women in the ‘vigorous’ and ‘moderate’ PA level compared to those in the ‘low’ PA level had significantly shorter QTc (408 ± 2 ms vs. 411 ± 1 ms vs. 419 ± 2 ms, P = 0.001, respectively). In contrast, no significant difference in QTc according to PA levels was observed in men (P = 0.053). Linear regression analysis revealed that PA level was significantly associated with shorter QTc in women after adjustment for established confounders; while no such association was evident in men. Furthermore, compared to the ‘low’ PA group, women in the ‘vigorous’ PA group were 5.5-times less likely to have QTc interval above 450 ms (P = 0.031).Conclusion: Increased PA is associated with shorter QTc interval only in middle-aged and elderly women of Ikaria Island irrespectively of participant's habits or medical conditions, illustrating gender differences in the cardioprotective effect of habitual exercise. [ABSTRACT FROM PUBLISHER]

Background: We aimed to evaluate the association between renal function and various cardiovascular disease (CVD) risk factors, as well as 5-year incidence of CVD, in a sample of CVD free adults. [ABSTRACT FROM PUBLISHER]

Background: The influence of different types of exercise on risk factors for cardiovascular diseases has rarely been investigated. The aim of the present work was to evaluate the effect of adding resistance exercise to aerobic activities on lipid–lipoprotein profile, in a representative sample of men and women from the province of Attica, Greece. [ABSTRACT FROM PUBLISHER]

Aims Heat released from atherosclerotic plaques as a result of the local inflammatory process, may be measured in vivo by a thermography catheter. Statins seem to have an antiinflammatory effect which results in plaque stabilization. The aim of this study was to investigate the effect of statins on plaque temperature.Methods and Results The study population included 72 patients: 21 with effort angina, 32 with unstable angina and 19 with acute myocardial infarction. In the study group, 37 patients received statins for more than 4 weeks and 35 were not receiving statins. We measured the temperature difference (ΔT) between the atherosclerotic plaque and the proximal vessel wall (background temperature) using a thermography catheter. The statistical analysis showed that the mean value of ΔT was higher in the untreated group compared to the treated-with-statin, group (0·56±0·41 vs 0·29±0·33°C, P<0·01). Moreover, a progressive increase in ΔT by type of clinical syndrome was observed in both groups (statin group; effort angina: 0·24±0·15, unstable angina: 0·26±0·26, acute myocardial infarction: 0·40±0·28, vs untreated group; effort angina: 0·41±0·26, unstable angina: 0·44±0·28, acute myocardial infarction: 0·84±0·52, P<0·05). Multivariate analysis showed that treatment with statins was an independent factor in temperature variation, after taking into account the effect of the clinical syndrome (P<0·05).Conclusions Patients on statin treatment produce less heat from the culprit coronary lesion than those not treated. Thus, statins seem to have a favourable effect on heat release from atherosclerotic plaques, and whether this effect has an impact on plaque stabilization needs to be investigated in future studies. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved. [ABSTRACT FROM PUBLISHER]

To evaluate the differential effects of β-blockers on serum lipids and apolipoproteins in normolipidaemic and dyslipidaemic hypertensives, 330 patients with mild to moderate essential hypertension were studied 1 month after placebo therapy and 6 months after monotherapy with propranolol (n = 53), atenolol (n = 66), metoprolol (n = 58), pindolol (n = 53), or celiprolol (n = 100). Serum total cholesterol, triglycerides, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and apolipoproteins ( Apo ) A, and B were measured at baseline and study end. A total of 136 (41·2%) patients were considered normolipidaemic (pretreatment LDL-C < 160 mg . dl) and 194 (58·8%) were considered dyslipidaemic ( LDL-C > 160 mg . dl). Changes in total cholesterol differed between normolipidaemics and dyslipidaemics with propranolol ( + 13% in normolipidaemics vs –0·5% in dyslipidaemics, P<0·001), atenolol ( + 7% vs –2%, P = 0·01), metoprolol ( + 9% vs –4%, P0·0006), pindolol( +8% vs–9%, P<0·001 ), and celiprolol ( −1% vs – 13%, P = 0·002). HDL-C differed less, with propranolol (−18% vs –13%), atenolol (−6% vs −2%), metoprolol (−2% vs–6%), pindolol ( + 4% vs + 1% ), and celiprolol ( + 9% vs +4%); none of these changes between normolipidaemic and dyslipidaemic patients were statistically significant. LDL-C changes differed the most, with propranolol ( + 35% vs–1%, P<0·0001), atenolol (+15% vs–4%, P = 0·001), metoprolol ( + 12% vs –6%, P = 0·004), pindolol (+12% vs–13%, P<0·0001), and celiprolol ( + 3% vs–16%, P = 0·0001). No overall differences between normolipidaemic and dyslipidaemic patients were observed for triglycerides and Apo A, while changes in Apo B differed to a degree with propranolol ( + 23% vs +18, P=NS), atenolol (−1% vs +4%, P = NS), metoprolol (+13% vs +1%, P = NS), pindolol ( + 14% vs –7%>, P = 002), and celiprolol (−10% vs –8%, P = NS). Patient age did not influence overall serum lipid changes. It is concluded that older non-cardioselective β-blockers, such as propranolol, have significant dyslipidaemic effects, particularly in normolipidaemic hypertensive patients. Cardioselective β-blockers, such as atenolol and metoprolol and non-selective agents with partial agonist activity such as pindolol, have milder effects. Newer cardioselective β-blockers with partial agonist activity, such as celiprolol, have favourable lipid effects, particularly in dyslipidaemic hypertensive patients. [ABSTRACT FROM PUBLISHER]

AimsThe aim of the present study was to detect significant relationships between lipid and fibrinogen measurements and several biological factors in young men.Methods and resultsMedical history was obtained, and plasma lipids, lipoprotein (a) and fibrinogen levels were measured in 2009 male Greek army recruits (mean age 22·37±3·03 years) not taking any drugs. Plasma levels were as follows: total cholesterol, 171±34mg.dl−1, low density lipoprotein (LDL) cholesterol, 111±34mg.dl−1, high density lipoprotein (HDL) cholesterol, 45±10mg.dl1, and triglycerides, 74±32mg.dl−1. Lipo-protein (a) and fibrinogen were 18±13 and 278±67mg.dl−1. The atherosclerotic index, calculated as the ratio of total cholesterol/HDL, was 4±1. Analysis of multivariate models that included potentially confounding factors revealed the following: body mass index, season of year during which blood examinations were performed, alcohol consumption, and place of residence were found to be significantly associated with plasma levels of total cholesterol, LDL-cholesterol, fibrinogen and the athero-sclerotic index in the pooled population. Season and physical activity were significantly associated with HDL-cholesterol, whereas season and family history of acute myocardial infarction were associated with triglycerides levels. Body mass index, family history of myocardial infarction and physical activity were associated with lipoprotein (a).ConclusionBody mass index, season, alcohol consumption and place of residence are markers of plasma lipid profile and fibrinogen in young men. A family history of acute myocardial infarction and physical activity are related to lipoprotein (a).The European Society of Cardiology [ABSTRACT FROM PUBLISHER]

Aims Coronary arteries affected by atherosclerosis undergo focal compensatory enlargement, which can be detected by intracoronary ultrasound but not by angiography. Diabetic patients when compared with non-diabetics have a more accelerated progression of coronary artery disease and a more diffuse narrowing of the coronary arteries. Intracoronary ultrasound can clarify if this is due to less compensatory coronary artery enlargement as a response to atherosclerosis. Methods and results Ten non-diabetic and 15 diabetic patients with coronary artery disease, with angiographically determined one- or two-vessel disease, underwent intracoronary ultrasound examination of the non-stenotic coronary artery. Forty-five sites with luminal stenosis, detected by intracoronary ultrasound, were analysed (15 in non-diabetics, 30 in diabetics). Vessel and lumen area, atherosclerotic plaque area and plaque composition were evaluated. Vessel area was also measured proximal and distal to the healthy segment. In the diabetic patients, there was less vessel area increase from the proximal healthy segment into the atherosclerotic segment than in the non-diabetic patients (99% separate-variance confidence intervals for differences between diabetics' and non-diabetics' means=0·29 mm2, 2·71 mm2). The proximal plaque free vessel area, the atherosclerotic plaque area and plaque composition were similar between the two groups. Conclusion Diabetics with atherosclerosis have less compensatory coronary artery enlargement than non-diabetics. This may explain the diffuse and accelerated course of coronary artery disease in these patients. [ABSTRACT FROM PUBLISHER]

Aim The reliability of Doppler echocardiography in determining the mitral valve area after balloon mitral valvuloplasty has been questioned, as discrepancies were noted between measurements obtained by the pressure half-time method and those derived haemodynamically, immediately following completion of the procedure. Recent investigations, however, have indicated that these discrepancies may be attributable to the over-estimation of the mitral valve area by haemodynamic measurements, caused by the presence of the iatrogenic atrial septal defect complicating transseptal catheterization. The aim of the present study was to further test this hypothesis. Methods and Results Measurements of the mitral valve area by the Doppler pressure half-time method and the Gorlin formula were obtained and compared in 238 consecutive patients before and immediately after retrograde non-transseptal balloon mitral valvuloplasty, which does not involve puncture and/or dilatation of the inter-atrial septum. No significant difference was found between Doppler- and Gorlin-derived measurements, neither before (1·04±0·23 vs 1·03±0·23cm2, P=ns) nor immediately after (2·14±0·47 vs 2·12±0·49cm 2, P=ns) valvuloplasty. Linear regression analysis demonstrated a high degree of correlation between Doppler and Gorlin measurements before (r=0·778) and after (r=0·886) the procedure. Good agreement was confirmed by the Bland—Altman method. Conclusion Doppler echocardiography yields accurate measurements of the mitral valve area immediately after retrograde non-transseptal balloon mitral valvuloplasty. This finding supports the hypothesis that the creation of an iatrogenic atrial septal defect during transseptal catheterization may contribute to the poor agreement between Doppler and Gorlin data after balloon mitral valvuloplasty. [ABSTRACT FROM PUBLISHER]

An abstract of the article "Positive Pre-Ejection Velocity Changes During Dobutamine Stress Test in Identifying Hibernating Myocardium and Predicting Functional Recovery" by C.I. Aggeli and colleagues is presented.

An abstract of the article "MCE is superior to DSE in predicting myocardial recovery after revascularization in patients with occluded left anterior descending artery" by C. I. Aggeli, N. Georgiadis and M. S. Bonou is presented.

An abstract of the article "Myocardial contrast echocardiography accurately predicts functional recovery early after acute myocardial infarction in elderly people" by C. S. Theocharis is presented.