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1. COVID-19 and its impact on the cardiovascular system.

Author: Khawaja SA, Mohan P, Jabbour R, Bampouri T, Bowsher G, Hassan AMM, Huq F, Baghdasaryan L, Wang B, Sethi A, Sen S, Petraco R, Ruparelia N, Nijjer S, Malik I, Foale R, Bellamy M, Kooner J, Rana B, Cole G, Sutaria N, Kanaganayagam G, Nihoyannopoulos P, Fox K, Plymen C, Pabari P, Howard L, Davies R, Haji G, Lo Giudice F, Kanagaratnam P, Anderson J, Chukwuemeka A, Khamis R, Varnava A, Baker CSR, Francis DP, Asaria P, Al-Lamee R, and Mikhail GW
Subjects: Aged, Comorbidity, Female, Hospital Mortality trends, Humans, Incidence, London, Male, RNA, Viral analysis, Retrospective Studies, SARS-CoV-2 genetics, Survival Rate trends, COVID-19 epidemiology, Cardiovascular Diseases epidemiology, Pandemics
Abstract: Objectives: The clinical impact of SARS-CoV-2 has varied across countries with varying cardiovascular manifestations. We review the cardiac presentations, in-hospital outcomes and development of cardiovascular complications in the initial cohort of SARS-CoV-2 positive patients at Imperial College Healthcare National Health Service Trust, UK., Methods: We retrospectively analysed 498 COVID-19 positive adult admissions to our institute from 7 March to 7 April 2020. Patient data were collected for baseline demographics, comorbidities and in-hospital outcomes, especially relating to cardiovascular intervention., Results: Mean age was 67.4±16.1 years and 62.2% (n=310) were male. 64.1% (n=319) of our cohort had underlying cardiovascular disease (CVD) with 53.4% (n=266) having hypertension. 43.2%(n=215) developed acute myocardial injury. Mortality was significantly increased in those patients with myocardial injury (47.4% vs 18.4%, p<0.001). Only four COVID-19 patients had invasive coronary angiography, two underwent percutaneous coronary intervention and one required a permanent pacemaker implantation. 7.0% (n=35) of patients had an inpatient echocardiogram. Acute myocardial injury (OR 2.39, 95% CI 1.31 to 4.40, p=0.005) and history of hypertension (OR 1.88, 95% CI 1.01 to 3.55, p=0.049) approximately doubled the odds of in-hospital mortality in patients admitted with COVID-19 after other variables had been controlled for., Conclusion: Hypertension, pre-existing CVD and acute myocardial injury were associated with increased in-hospital mortality in our cohort of COVID-19 patients. However, only a low number of patients required invasive cardiac intervention., Competing Interests: Competing interests: GWM is director of annual Imperial Valve and Cardiovascular Course (IVCC) which receives support from industry companies. She is also a director of an international fellowship supported by Abbott Vascular between Imperial Healthcare NHS trust, Villa Maria Cecilia Hospital GVM and Columbus Hospital Italy. RA-L has received speaker honorarium from Phillips Volcano., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Published: 2021
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2. EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: a report of literature and current practice review.

Author: Steeds RP, Garbi M, Cardim N, Kasprzak JD, Sade E, Nihoyannopoulos P, Popescu BA, Stefanidis A, Cosyns B, Monaghan M, Aakhus S, Edvardsen T, Flachskampf F, Galiuto L, Athanassopoulos G, and Lancellotti P
Subjects: Adult, Europe, Guideline Adherence, Health Services Misuse, Humans, Cardiovascular Diseases diagnostic imaging, Echocardiography standards, Echocardiography statistics & numerical data
Abstract: The European Association for Cardiovascular Imaging (EACVI) has outlined the rationale for setting appropriate use criteria (AUC) in cardiovascular (CV) imaging. Transthoracic echocardiography (TTE) is the most common imaging modality in CV disease and is a central tool in diagnosis, follow-up, management planning and intervention. The purpose of AUC is to inform referrers, both to avoid under-use, which may result in incomplete or incorrect diagnosis and treatment, and also over-use, which may delay correct diagnosis, lead to 'treatment cascade', and wastes resources. The first step in defining AUC for TTE in the adult has been for a panel of experts in echocardiography to review the evidence, guidelines, recommendations, and position papers from the European Society of Cardiology, EACVI and other specialist societies, and current state-of-the-art clinical practice. The attached document summarizes this work, which will be used to under-pin the development of AUC., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)
Published: 2017
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3. Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017.

Author: Senior R, Becher H, Monaghan M, Agati L, Zamorano J, Vanoverschelde JL, Nihoyannopoulos P, Edvardsen T, and Lancellotti P
Subjects: Europe, Evidence-Based Medicine, Humans, Cardiovascular Diseases diagnostic imaging, Echocardiography methods
Abstract: Contrast echocardiography is widely used in cardiology. It is applied to improve image quality, reader confidence and reproducibility both for assessing left ventricular (LV) structure and function at rest and for assessing global and regional function in stress echocardiography. The use of contrast in echocardiography has now extended beyond cardiac structure and function assessment to evaluation of perfusion both of the myocardium and of the intracardiac structures. Safety of contrast agents have now been addressed in large patient population and these studies clearly established its excellent safety profile. This document, based on clinical trials, randomized and multicentre studies and published clinical experience, has established clear recommendations for the use of contrast in various clinical conditions with evidence-based protocols., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)
Published: 2017
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4. The association of ferritin with cardiovascular and all-cause mortality in community-dwellers: The English longitudinal study of ageing.

Author: Kadoglou NPE, Biddulph JP, Rafnsson SB, Trivella M, Nihoyannopoulos P, and Demakakos P
Subjects: Age Distribution, Aged, Aging pathology, Cardiovascular Diseases pathology, Cause of Death, England, Exercise, Female, Humans, Longitudinal Studies, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Sex Characteristics, Aging blood, Cardiovascular Diseases blood, Cardiovascular Diseases mortality, Ferritins blood
Abstract: Background: Ferritin constitutes a sensitive iron-storage index and multi-functional protein. Evidence on its association with mortality in general population is scarce and conflicting. We investigated the sex-specific associations of ferritin levels with all-cause and cardiovascular mortality in a population-based cohort., Methods: Data came from the English Longitudinal Study of Ageing and the national mortality registry. The sample comprised 5,471 participants aged ≥52 years. Blood concentration of ferritin was measured at baseline in 2004-05. Sex-specific Cox proportional hazards models were estimated with adjustment for age, major chronic diseases, marital status, educational attainment, total net household wealth, anemia, inflammatory markers, body mass index, smoking, and physical activity. Stratified analyses by chronic disease status were also performed., Results: We categorized ferritin in sex-specific quartiles. In men, we used, the following categorization: lowest (2-69ng/ml), second lowest (70-118ng/ml), second highest (reference category) (119-193ng/ml) and highest (194-598ng/ml) ferritin quartiles. In women, ferritin was categorized as follows: lowest (2-44ng/ml), second lowest (45-73ng/ml), second highest (reference category) (74-115ng/ml) and highest (116-341ng/ml) ferritin quartiles. 841 deaths of which 262 cardiovascular disease-related were recorded over a mean follow-up time of 7.7 years. Risk for all-cause mortality was found increased in men with hyperferritinemia (194-598ng/ml) and no history of major chronic diseases compared with the reference group [fully-adjusted HR: 1.49 (95%CI 1.03-2.16)]. Among women, those in the lowest ferritin quartile (2-44ng/ml) had increased risk for all-cause mortality [fully-adjusted HR: 1.59 (95%CI 1.18-2.13)] compared with the reference group after adjustment for all covariates. Regarding cardiovascular mortality, we observed a positive association with ferritin levels in men, which was blunted after adjustment for inflammatory markers and lifestyle parameters. Men with no major chronic diseases who were in the highest ferritin quartile had a significantly increased risk of cardiovascular mortality. No association between ferritin levels and cardiovascular mortality was detected in women., Conclusion: Circulating ferritin levels showed sex-specific prognostic patterns. High ferritin levels in men with no major chronic disease and low ferritin levels in all women were associated with increased all-cause mortality after adjusting for covariates. High ferritin levels in men with no major chronic diseases were also independently associated with an increased risk of cardiovascular mortality. Future research is needed to clarify the prognostic role of ferritin.
Published: 2017
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5. Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction.

Author: Sulemane S, Panoulas VF, Bratsas A, Grapsa J, Brown EA, and Nihoyannopoulos P
Subjects: Adult, Aged, Cardiovascular Diseases mortality, Cardiovascular Diseases physiopathology, Cardiovascular Diseases therapy, Chi-Square Distribution, Coronary Artery Bypass, Disease Progression, Female, Hospitalization, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Percutaneous Coronary Intervention, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Prospective Studies, Renal Insufficiency, Chronic mortality, Renal Insufficiency, Chronic physiopathology, Reproducibility of Results, Risk Factors, Time Factors, Cardiovascular Diseases diagnostic imaging, Echocardiography, Doppler, Pulsed, Kidney physiopathology, Pulse Wave Analysis, Renal Insufficiency, Chronic diagnosis, Stroke Volume, Vascular Stiffness, Ventricular Function, Left
Abstract: Emerging cardiovascular biomarkers, such as speckle tracking echocardiography (STE) and aortic pulse wave velocity (aPWV), have recently demonstrated the presence of subclinical left ventricular dysfunction and arterial stiffening in patients with chronic kidney disease (CKD) and no previous cardiovascular history. However, limited information exists on the prognostic impact of these biomarkers. We aimed to investigate whether STE and aPWV predict major adverse cardiac events (MACE) in this patient population. In this cohort study we prospectively analysed 106 CKD patients with no overt cardiovascular disease (CVD) and normal left ventricular ejection fraction. Cardiac deformation was measured using STE while aPWV was measured using arterial tonometry. The primary end-point was the composite of all-cause mortality, acute coronary syndrome, stable angina requiring revascularization (either using percutaneous coronary intervention or coronary artery bypass surgery), hospitalization for heart failure and stroke. Over a median follow up period of 49 months (interquartile range 11-63 months), 26 patients (24.5%) reached the primary endpoint. In a multivariable Cox hazards model, global longitudinal strain (GLS) (HR 1.12, 95% CI 1.02-1.29, p = 0.041) and aPWV (HR 1.31, 95% CI 1.05-1.41, p = 0.021) were significant, independent predictors of MACE. GLS and aPWV independently predict MACE in CKD patients with normal EF and no clinically overt CVD.
Published: 2017
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6. Echocardiographic assessment in patients with chronic kidney disease: Current update.

Author: Sulemane S, Panoulas VF, and Nihoyannopoulos P
Subjects: Heart diagnostic imaging, Humans, Cardiovascular Diseases complications, Cardiovascular Diseases diagnostic imaging, Echocardiography methods, Renal Insufficiency, Chronic complications
Abstract: Patients with chronic kidney disease (CKD) carry a high cardiovascular risk. An abundance of evidence has emerged in recent years establishing minor reductions in estimated glomerular filtration rate as an independent risk factor for cardiovascular mortality. Additionally, cardiac changes, such as left ventricular hypertrophy and impaired left ventricular systolic function, have been associated with an unfavorable prognosis. Despite the significant prevalence of underlying cardiac abnormalities, symptoms may not manifest in many patients with CKD. A range of available and emerging echocardiographic modalities may assist with diagnosing heart disease in CKD. Furthermore, some of these emerging techniques can give an important insight into the pathophysiology of subclinical dysfunction in CKD. This review discusses how current and emerging echocardiographic modalities such as speckle tracking echocardiography and 3D echocardiography might help cardiologists in providing important information to help with diagnosis and risk stratification of cardiac-related morbidity and mortality in patients with renal disease, as well applicability of these tools to current clinical practice., (© 2017, Wiley Periodicals, Inc.)
Published: 2017
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7. The Tree of Sirtuins and the Garden of Cardiovascular Youth.

Author: Katsi VK, Pavlidis AN, Liakos CI, Marketou ME, Raftopoulos LG, Alexopoulos NA, Makris TK, Nihoyannopoulos P, Tousoulis D, and Kallikazaros IE
Subjects: Age Factors, Animals, Cardiovascular Physiological Phenomena, Energy Metabolism physiology, Humans, NAD metabolism, Cardiovascular Diseases physiopathology, Metabolic Diseases physiopathology, Sirtuins metabolism
Abstract: Sirtuins (SIRTs) are a class of nicotine adenine dinucleotide (NAD+)-dependent proteins which participate in numerous molecular pathways involved in various age-related human diseases, such as type II diabetes, cardiovascular (CV) diseases and cancer. They have a major role in apoptosis, inflammation, oxidative stress and metabolism regulation, traits that have a great impact on CV physiology and pathology. Their unique profile of NAD+ energy dependency makes them an appealing target for human intervention in cellular and metabolic processes. This review focuses on the recent advances of SIRTs research aiming to shed light on the emerging roles of SIRTs in the pathophysiology of CV and metabolic diseases.
Published: 2016
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8. Cardiac medication during pregnancy, data from the ROPAC.

Author: Ruys TP, Maggioni A, Johnson MR, Sliwa K, Tavazzi L, Schwerzmann M, Nihoyannopoulos P, Kozelj M, Marelli A, Elkayam U, Hall R, and Roos-Hesselink JW
Subjects: Adult, Female, Follow-Up Studies, Humans, Infant, Newborn, Male, Pregnancy, Pregnancy Outcome, Retrospective Studies, Cardiovascular Agents therapeutic use, Cardiovascular Diseases drug therapy, Pregnancy Complications, Cardiovascular
Abstract: Background: Data on pharmacological management during pregnancy are scarce. The aim of this study was to describe the type and frequency of cardiac medication used in pregnancy in patients with cardiovascular disease and to assess the relationship between medication use and fetal outcome., Methods and Results: Between 2007 and 2011 sixty hospitals in 28 countries enrolled 1321 pregnant women. All patients had structural heart disease (congenital 66%, valvular 25% or cardiomyopathy 7% or ischemic 2%). Medication was used by 424 patients (32%) at some time during pregnancy: 22% used beta-blockers, 8% antiplatelet agents, 7% diuretics, 2.8% ACE inhibitors and 0.5% statins. Compared to those who did not take medication, patients taking medication were older, more likely to be parous, have valvular heart disease and were less often in sinus rhythm. The odds ratio of fetal adverse events in users versus non-users of medication was 2.6 (95% CI 2.0-3.4) and after adjustment for cardiac and obstetric parameter was 2.0 (95% CI 1.4-2.7). Babies of patients treated with beta-blockers had a significantly lower adjusted birth weight (3140 versus 3240 g, p = 0.002). The highest rate of fetal malformation was found in patients taking ACE inhibitors (8%)., Conclusion: One third of pregnant women with heart disease used cardiac medication during their pregnancy, which was associated with an increased rate of adverse fetal events. Birth weight was significantly lower in children of patients taking beta-blockers. A randomized trial is needed to distinguish the effects of the medication from the effects of the underlying maternal cardiac condition., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
Published: 2014
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9. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD).

Author: Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, Deaton C, Escaned J, Hammes HP, Huikuri H, Marre M, Marx N, Mellbin L, Ostergren J, Patrono C, Seferovic P, Uva MS, Taskinen MR, Tendera M, Tuomilehto J, Valensi P, Zamorano JL, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, De Backer G, Sirnes PA, Ezquerra EA, Avogaro A, Badimon L, Baranova E, Baumgartner H, Betteridge J, Ceriello A, Fagard R, Funck-Brentano C, Gulba DC, Hasdai D, Hoes AW, Kjekshus JK, Knuuti J, Kolh P, Lev E, Mueller C, Neyses L, Nilsson PM, Perk J, Ponikowski P, Reiner Z, Sattar N, Schächinger V, Scheen A, Schirmer H, Strömberg A, Sudzhaeva S, Tamargo JL, Viigimaa M, Vlachopoulos C, and Xuereb RG
Subjects: Adolescent, Adult, Aged, Cardiovascular Diseases etiology, Child, Child, Preschool, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 2 diagnosis, Diabetic Angiopathies diagnosis, Diet, Exercise physiology, Female, Glycated Hemoglobin metabolism, Humans, Infant, Male, Middle Aged, Patient-Centered Care, Smoking adverse effects, Smoking Prevention, Young Adult, Cardiovascular Diseases prevention & control, Diabetes Mellitus, Type 1 prevention & control, Diabetes Mellitus, Type 2 prevention & control, Diabetic Angiopathies prevention & control, Prediabetic State prevention & control
Published: 2013
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10. Pocket-size hand-held cardiac ultrasound as an adjunct to clinical examination in the hands of medical students and junior doctors.

Author: Panoulas VF, Daigeler AL, Malaweera AS, Lota AS, Baskaran D, Rahman S, and Nihoyannopoulos P
Subjects: Adult, Cardiology education, Cardiovascular Diseases diagnosis, Curriculum, Equipment Design, Female, Humans, Male, Medical Staff, Hospital, Physical Examination methods, Prospective Studies, Sampling Studies, Statistics, Nonparametric, Students, Medical, Cardiovascular Diseases diagnostic imaging, Clinical Competence, Echocardiography, Doppler, Color methods, Point-of-Care Systems
Abstract: Aims: While patient history taking and physical examination remain the cornerstones of patient evaluation in clinical practice, there has been a decline in the accuracy of the latter. Pocket-size hand-held echocardiographic (PHHE) devices have recently been introduced and could potentially improve the diagnostic accuracy of both medical students and junior doctors. The amount of training required to achieve optimal results remains a matter of debate. We hypothesized that the use of PHHE after limited training in the form of a tutorial can improve the clinical diagnosis even in the hands of medical students and inexperienced physicians., Methods and Results: Five final-year medical students and three junior doctors without prior echocardiographic experience participated in a standardized 2 h PHHE bedside tutorial. Subsequently, they assessed 122 cardiology patients using history, physical examination, ECG and PHHE. Their final clinical diagnosis was compared against that of a consultant clinician's and also expert in echocardiography. A total of 122 PHHE were performed of which 64 (53%) by final-year medical students and 58 (47%) by junior doctors. Mean ± SD for diagnostic accuracy after history, physical examination, and ECG interpretation was 0.49 ± 0.22 (maximum = 1), whereas the addition of PHHE increased its value to 0.75 ± 0.28 (Z = -7.761, P<0.001). When assessing left ventricular systolic dysfunction by means of history and physical examination, specificity was 84.9% and sensitivity only 25.9%, whereas after including findings from PHHE, these figures rose to 93.6 and 74.1%, respectively., Conclusion: The use of PHHE after brief bedside training in the form of a tutorial greatly improved the clinical diagnosis of medical students and junior doctors, over and above history, physical examination, and ECG findings.
Published: 2013
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11. [ESC guidelines for treatment of cardiovascular disease in pregnancy].

Author: Regitz-Zagrosek V, Lundqvist CB, Borghi C, Cifkova R, Ferreira R, Foidart JM, Gibbs JS, Gohlke-Baerwolf C, Görenek B, Iung B, Kirby M, Maas AH, Morais J, Nihoyannopoulos P, Pieper PG, Presbitero P, Roos-Hesselink JW, Schaufelberger M, Seeland U, and Torracca L
Subjects: Female, Humans, Pregnancy, Cardiovascular Diseases therapy, Pregnancy Complications, Cardiovascular therapy
Published: 2012

12. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography.

Author: Lang RM, Badano LP, Tsang W, Adams DH, Agricola E, Buck T, Faletra FF, Franke A, Hung J, de Isla LP, Kamp O, Kasprzak JD, Lancellotti P, Marwick TH, McCulloch ML, Monaghan MJ, Nihoyannopoulos P, Pandian NG, Pellikka PA, Pepi M, Roberson DA, Shernan SK, Shirali GS, Sugeng L, Ten Cate FJ, Vannan MA, Zamorano JL, and Zoghbi WA
Subjects: Europe, Humans, United States, Cardiology standards, Cardiovascular Diseases diagnostic imaging, Data Display standards, Echocardiography, Three-Dimensional standards
Published: 2012
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13. Recommendations for echocardiography use in the diagnosis and management of cardiac sources of embolism: European Association of Echocardiography (EAE) (a registered branch of the ESC).

Author: Pepi M, Evangelista A, Nihoyannopoulos P, Flachskampf FA, Athanassopoulos G, Colonna P, Habib G, Ringelstein EB, Sicari R, Zamorano JL, Sitges M, and Caso P
Subjects: Atrial Fibrillation complications, Echocardiography instrumentation, Echocardiography, Transesophageal instrumentation, Embolism etiology, Embolism therapy, Europe, Foramen Ovale, Patent complications, Heart Failure complications, Humans, Ischemic Attack, Transient etiology, Ischemic Attack, Transient therapy, Myocardial Infarction complications, Risk Assessment, Risk Factors, Societies, Medical, Stroke etiology, Stroke therapy, United States, Cardiovascular Diseases complications, Embolism diagnostic imaging, Ischemic Attack, Transient diagnostic imaging, Stroke diagnostic imaging
Abstract: Embolism of cardiac origin accounts for around 15-30% of ischaemic strokes. Strokes due to cardioembolism are generally severe and early and long-term recurrence and mortality are high. The diagnosis of a cardioembolic source of stroke is frequently uncertain and relies on the identification of a potential cardiac source of embolism in the absence of significant autochthone cerebrovascular occlusive disease. In this respect, echocardiography (both transthoracic and/or transoesophageal) serves as a cornerstone in the evaluation, diagnosis, and management of these patients. A clear understanding of the various types of cardiac conditions associated with cardioembolic stroke and their intrinsic risk is therefore very important. This article reviews potential cardiac sources of embolism and discusses the role of echocardiography in clinical practice. Recommendations for the use of echocardiography in the diagnosis of cardiac sources of embolism are given including major and minor conditions associated with the risk of embolism.
Published: 2010
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14. Highlights of the 2009 scientific sessions of the European Society of Cardiology.

Author: Bax JJ, Casadei B, Di Mario C, Fagard R, Filippatos G, Fox KA, Metra M, Nihoyannopoulos P, Perk J, Rademakers F, Rosenhek R, Vardas PE, Pinto FJ, and Ferrari R
Subjects: Angioplasty, Balloon, Coronary, Cardiac Pacing, Artificial, Cardiovascular Diseases genetics, Cardiovascular Diseases mortality, Critical Care, Diagnostic Imaging, Europe, Humans, Hypothermia, Induced, Myocardium pathology, Prognosis, Risk Factors, Stents, Cardiovascular Diseases therapy
Published: 2009
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15. Clinical practice 2007: echocardiography 2007.

Author: Nihoyannopoulos P
Subjects: Contraindications, Echocardiography economics, Echocardiography statistics & numerical data, Electrocardiography, Europe, Humans, Practice Patterns, Physicians', Reimbursement Mechanisms, Sensitivity and Specificity, United Kingdom, Cardiovascular Diseases diagnostic imaging, Echocardiography methods
Published: 2007

16. The future of cardiovascular imaging and non-invasive diagnosis. A joint statement from the European Association of Echocardiography, the Working Groups on Cardiovascular Magnetic Resonance, Computers in Cardiology, and Nuclear Cardiology, of the European Society of Cardiology, the European Association of Nuclear Medicine and the Association for European Paediatric Cardiology.

Author: Fraser AG, Buser PT, Bax JJ, Dassen WR, Nihoyannopoulos P, Schwitter J, Knuuti JM, Höher M, Bengel F, and Szatmári A
Subjects: Diagnostic Techniques, Cardiovascular trends, Europe, Humans, Cardiovascular Diseases diagnosis, Diagnostic Imaging trends, Practice Guidelines as Topic, Practice Patterns, Physicians' trends
Abstract: Advances in medical imaging now make it possible to investigate any patient with cardiovascular disease using multiple methods which vary widely in their technical requirements, benefits, limitations and costs. The appropriate use of alternative tests requires their integration into joint clinical diagnostic services where experts in all methods collaborate. This statement summarises the principles that should guide developments in cardiovascular diagnostic services.
Published: 2006
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17. EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: A report of literature and current practice review

Author: Steeds, Richard P., Garbi, Madalina, Cardim, Nuno, Kasprzak, Jaroslaw D., Sade, Elif, Nihoyannopoulos, Petros, Popescu, Bogdan Alexandru, Stefanidis, Alexandros, Cosyns, Bernard, Monaghan, Mark, Aakhus, Svend, Edvardsen, Thor, Flachskampf, Frank, Galiuto, Leonarda, Athanassopoulos, George, Lancellotti, Patrizio, Delgado, Victoria, Donal, Erwan, Galderisi, Maurizio, Lombardi, Massimo, Muraru, Denisa, Haugaa, Kristina, Steeds, Richard P., Garbi, Madalina, Cardim, Nuno, Kasprzak, Jaroslaw D., Sade, Elif, Nihoyannopoulos, Petro, Popescu, Bogdan Alexandru, Stefanidis, Alexandro, Cosyns, Bernard, Monaghan, Mark, Aakhus, Svend, Edvardsen, Thor, Flachskampf, Frank, Galiuto, Leonarda, Athanassopoulos, George, Lancellotti, Patrizio, Delgado, Victoria, Donal, Erwan, Galderisi, Maurizio, Lombardi, Massimo, Muraru, Denisa, Haugaa, Kristina, Steeds Richard, P, Garbi, M, Cardim, N, Kasprzak Jaroslaw, D, Sade, E, Nihoyannopoulos, P, Popescu Bogdan, A, Stefanidis, A, Cosyns, B, Monaghan, M, Aakhus, S, Edvardsen, T, Flachskampf, F, Galiuto, L, Athanassopoulos, G, Lancellotti, P, Delgado, V, Donal, E, Galderisi, M, Lombardi, M, Muraru, D, Haugaa, K, Cardio-vascular diseases, and Clinical sciences
Subjects: Adult, medicine.medical_specialty, Radiology, Nuclear Medicine and Imaging, indication, 030204 cardiovascular system & hematology, Health Services Misuse, appropriateness, Appropriate Use Criteria, Management planning, 03 medical and health sciences, transthoracic echocardiography, 0302 clinical medicine, medicine, Medical imaging, Echocardiography transthoracic, Humans, echocardiography, 030212 general & internal medicine, Intensive care medicine, indications, business.industry, General Medicine, Appropriateness criteria, Clinical Practice, Europe, Radiology Nuclear Medicine and imaging, Current practice, Cardiovascular Diseases, appropriatene, Radiology, Guideline Adherence, business, Cardiology and Cardiovascular Medicine
Abstract: The European Association for Cardiovascular Imaging (EACVI) has outlined the rationale for setting appropriate use criteria (AUC) in cardiovascular (CV) imaging. Transthoracic echocardiography (TTE) is the most common imaging modality in CV disease and is a central tool in diagnosis, follow-up, management planning and intervention. The purpose of AUC is to inform referrers, both to avoid under-use, which may result in incomplete or incorrect diagnosis and treatment, and also over-use, which may delay correct diagnosis, lead to 'treatment cascade', and wastes resources. The first step in defining AUC for TTE in the adult has been for a panel of experts in echocardiography to review the evidence, guidelines, recommendations, and position papers from the European Society of Cardiology, EACVI and other specialist societies, and current state-of-the-art clinical practice. The attached document summarizes this work, which will be used to under-pin the development of AUC.
Published: 2017

18. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)

Author: Priori, Silvia G, Blomstrom Lundqvist, Carina, Mazzanti, Andrea, Bloma, Nico, Borggrefe, Martin, Camm, John, Elliott, Perry Mark, Fitzsimons, Donna, Hatala, Robert, Hindricks, Gerhard, Kirchhof, Paulus, Kjeldsen, Keld, Kuck, Karl Heinz, Hernandez Madrid, Antonio, Nikolaou, Nikolaos, Norekval, Tone M., Spaulding, Christian, Van Veldhuisen, Dirk J., Kolh, Philippe, Lip, Gregory Y. H., Agewall, Stefan, Barón Esquivias, Gonzalo, Boriani, Giuseppe, Budts, Werner, Bueno, Héctor, Capodanno, Davide, Carerj, Scipione, Crespo Leiro, Maria G., Czerny, Martin, Deaton, Christi, Dobrev, Dobromir, Erol, Çetin, Galderisi, Maurizio, Gorenek, Bulent, Kriebel, Thomas, Lambiase, Pier, Lancellotti, Patrizio, Lane, Deirdre A., Lang, Irene, Manolis, Athanasios J., Morais, Joao, Moreno, Javier, Piepoli, Massimo F., Rutten, Frans H., Sredniawa, Beata, Zamorano, Jose Luis, Zannad, Faiez, Aboyans, Victor, Achenbach, Stephan, Badimon, Lina, Baumgartner, Helmut, Bax, Jeroen J., Dean, Veronica, Gaemperli, Oliver, Nihoyannopoulos, Petros, Ponikowski, Piotr, Roffi, Marco, Torbicki, Adam, Vaz Carneiro, Antonio, Windecker, Stephan, Piruzyan, Armen, Roithinger, Franz Xaver, Mairesse, Georges H., Goronja, Boris, Shalganov, Tchavdar, Puljević, Davor, Antoniades, Loizos, Kautzner, Josef, Larsen, Jacob Moesgaard, Aboulmaaty, Mervat, Kampus, Priit, Hedman, Antti, Kamcevska Dobrkovic, Lidija, Piot, Olivier, Etsadashvili, Kakhaber, Eckardt, Lars, Deftereos, Spyridon, Gellér, László, Gizurarson, Sigfús, Keane, David, Haim, Moti, Della Bella, Paolo, Abdrakhmanov, Ayan, Mirrakhimov, Aibek, Kalejs, Oskars, Ben Lamin, Hisham, Marinskis, Germanas, Groben, Laurent, Sammut, Mark, Raducan, Aurica, Chaib, Ali, Tande, Pål Morten, Lenarczyk, Radoslaw, Morgado, Francisco Bello, Vatasescu, Radu, Mikhaylov, Evgeny N., Hlivak, Peter, Arenal, Angel, Jensen Urstad, Mats, Sticherling, Christian, Zeppenfeld, Katja, Chettaoui, Rafik, Demir, Mesut, Duncan, Edward, Parkhomenko, Alexander, Priori, Silvia G, Blomström Lundqvist, Carina, Mazzanti, Andrea, Bloma, Nico, Borggrefe, Martin, Camm, John, Elliott, Perry Mark, Fitzsimons, Donna, Hatala, Robert, Hindricks, Gerhard, Kirchhof, Paulu, Kjeldsen, Keld, Kuck, Karl Heinz, Hernandez Madrid, Antonio, Nikolaou, Nikolao, Norekvål, Tone M., Spaulding, Christian, Van Veldhuisen, Dirk J., Kolh, Philippe, Lip, Gregory Y. H., Agewall, Stefan, Barón Esquivias, Gonzalo, Boriani, Giuseppe, Budts, Werner, Bueno, Héctor, Capodanno, Davide, Carerj, Scipione, Crespo Leiro, Maria G., Czerny, Martin, Deaton, Christi, Dobrev, Dobromir, Erol, Çetin, Galderisi, Maurizio, Gorenek, Bulent, Kriebel, Thoma, Lambiase, Pier, Lancellotti, Patrizio, Lane, Deirdre A., Lang, Irene, Manolis, Athanasios J., Morais, Joao, Moreno, Javier, Piepoli, Massimo F., Rutten, Frans H., Sredniawa, Beata, Zamorano, Jose L., and Zannad, Faiez
Subjects: medicine.medical_treatment, Left, Myocardial Infarction, Coronary Artery Disease, Arrhythmias, Amiodarone, Cardiovascular, Ventricular Dysfunction, Left, Pregnancy, Implantable cardioverter defibrillator, Myocardial infarction, Child, Sleep Apnea, Obstructive, Terminal Care, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Primary Prevention, Practice Guideline, Acute Disease, Ventricular arrhythmia, Catheter Ablation, Stable coronary artery disease, Drug Therapy, Combination, Acute coronary syndrome, Autopsy, Implantable, Cardiology and Cardiovascular Medicine, Cardiomyopathies, Cardiac, Human, Sports, Heart Defects, Congenital, medicine.medical_specialty, Sleep Apnea, Cardiotonic Agents, Electric Countershock, Heart failure, Guidelines, Risk Assessment, Drug Therapy, Physiology (medical), Humans, Emergency Treatment, Congenital heart disease, Aged, Cardiac arrhythmia, medicine.disease, Valvular heart disease, Pregnancy Complications, Sudden cardiac death, Death, Sudden, Cardiac, Early Diagnosis, Medizin, Heart Valve Diseases, Guideline, Coronary artery disease, Cardiac Resynchronization Therapy, Defibrillator, Congenital, Risk Factors, Tachycardia, Ventricular Dysfunction, Cardiac resynchronization therapy, Cardiomyopathy, Resuscitation, Anti-Arrhythmia Agents, Arrhythmias, Cardiac, Defibrillators, Female, Heart Transplantation, Mental Disorders, Myocarditis, Nervous System Diseases, Out-of-Hospital Cardiac Arrest, Pregnancy Complications, Cardiovascular, Quality of Life, Stroke Volume, Heart Defects, Atrial fibrillation, Combined Modality Therapy, Death, Treatment Outcome, Anti-Arrhythmia Agent, Combination, Cardiology, medicine.drug, Catheter ablation, Acute coronary syndrome † Cardiac resynchronization therapy † Cardiomyopathy † Congenital heart disease † Defibrillator † Guidelines † Heart failure † Implantable cardioverter defibrillator † Myocardial infarction † Resuscitation † Stable coronary artery disease † Sudden cardiac death † Tachycardia † Valvular heart disease † Ventricular arrhythmia, Internal medicine, medicine, Journal Article, cardiovascular diseases, business.industry, Obstructive, Risk Factor, Sudden, business
Abstract: ACC : American College of Cardiology ACE : angiotensin-converting enzyme ACS : acute coronary syndrome AF : atrial fibrillation AGNES : Arrhythmia Genetics in the Netherlands AHA : American Heart Association AMIOVIRT : AMIOdarone Versus Implantable cardioverter-defibrillator
Published: 2015

19. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA)

Author: Kristensen, Steen Dalby, Knuuti, Juhani, Saraste, Antti, Anker, Stefan, Bøtker, Hans Erik, De Hert, Stefan, Ford, Ian, Gonzalez-Juanatey, Jose Ramón, Gorenek, Bulent, Heyndrickx, Guy Robert, Hoeft, Andreas, Huber, Kurt, Iung, Bernard, Kjeldsen, Keld Per, Longrois, Dan, Lüscher, Thomas F, Pierard, Luc, Pocock, Stuart, Price, Susanna, Roffi, Marco, Sirnes, Per Anton, Sousa-Uva, Miguel, Voudris, Vasilis, Funck-Brentano, Christian, Zamorano, Jose Luis, Achenbach, Stephan, Baumgartner, Helmut, Bax, Jeroen J, Bueno, Héctor, Dean, Veronica, Deaton, Christi, Erol, Cetin, Fagard, Robert, Ferrari, Roberto, Hasdai, David, Hoes, Arno W, Kirchhof, Paulus, Kolh, Philippe, Lancellotti, Patrizio, Linhart, Ales, Nihoyannopoulos, Petros, Piepoli, Massimo F, Ponikowski, Piotr, Tamargo, Juan Luis, Tendera, Michal, Torbicki, Adam, Wijns, William, Joergensen, Torben, University of Zurich, Kristensen, Steen Dalby, Kristensen, Sd, DE ROBERTIS, Edoardo, and Anesthesiology
Subjects: medicine.medical_treatment, Arrhythmias, Coronary artery disease, Beta-blockers, Anesthesiology, Medicine, Cerebrovascular disease, Pre-operative cardiac risk assessment, Societies, Medical, Pre-operative coronary artery revascularization, Ejection fraction, Disease Management, Atrial fibrillation, Post-operative cardiac surveillance, Implantable cardioverter-defibrillator, Cardiac surgery, Europe, Anaesthesiology, Anti-thrombotic therapy, Guidelines, Heart failure, Non-cardiac surgery, Perioperative cardiac management, Pre-operative cardiac testing, Pulmonary disease, Renal disease, Valvular disease, Cardiovascular Diseases, Practice Guidelines as Topic, cardiovascular system, Cardiology, 10209 Clinic for Cardiology, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Advisory Committees, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, NO, Internal medicine, Humans, cardiovascular diseases, ta3126, business.industry, Percutaneous coronary intervention, ta3121, medicine.disease, Clinical medicine, business, Kidney disease
Abstract: AAA : abdominal aortic aneurysm ACEI : angiotensin converting enzyme inhibitor ACS : acute coronary syndromes AF : atrial fibrillation AKI : acute kidney injury AKIN : Acute Kidney Injury Network ARB : angiotensin receptor blocker ASA : American Society of Anesthesiologists b.i.d. : bis in diem (twice daily) BBSA : Beta-Blocker in Spinal Anesthesia BMS : bare-metal stent BNP : B-type natriuretic peptide bpm : beats per minute CABG : coronary artery bypass graft CAD : coronary artery disease CARP : Coronary Artery Revascularization Prophylaxis CAS : carotid artery stenting CASS : Coronary Artery Surgery Study CEA : carotid endarterectomy CHA2DS2-VASc : cardiac failure, hypertension, age ≥75 (doubled), diabetes, stroke (doubled)-vascular disease, age 65–74 and sex category (female) CI : confidence interval CI-AKI : contrast-induced acute kidney injury CKD : chronic kidney disease CKD-EPI : Chronic Kidney Disease Epidemiology Collaboration Cmax : maximum concentration CMR : cardiovascular magnetic resonance COPD : chronic obstructive pulmonary disease CPG : Committee for Practice Guidelines CPX/CPET : cardiopulmonary exercise test CRP : C-reactive protein CRT : cardiac resynchronization therapy CRT-D : cardiac resynchronization therapy defibrillator CT : computed tomography cTnI : cardiac troponin I cTnT : cardiac troponin T CVD : cardiovascular disease CYP3a4 : cytochrome P3a4 enzyme DAPT : dual anti-platelet therapy DECREASE : Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography DES : drug-eluting stent DIPOM : DIabetic Post-Operative Mortality and Morbidity DSE : dobutamine stress echocardiography ECG : electrocardiography/electrocardiographically/electrocardiogram eGFR : estimated glomerular filtration rate ESA : European Society of Anaesthesiology ESC : European Society of Cardiology EVAR : endovascular abdominal aortic aneurysm repair FEV1 : Forced expiratory volume in 1 second HbA1c : glycosylated haemoglobin HF-PEF : heart failure with preserved left ventricular ejection fraction HF-REF : heart failure with reduced left ventricular ejection fraction ICD : implantable cardioverter defibrillator ICU : intensive care unit IHD : ischaemic heart disease INR : international normalized ratio IOCM : iso-osmolar contrast medium KDIGO : Kidney Disease: Improving Global Outcomes LMWH : low molecular weight heparin LOCM : low-osmolar contrast medium LV : left ventricular LVEF : left ventricular ejection fraction MaVS : Metoprolol after Vascular Surgery MDRD : Modification of Diet in Renal Disease MET : metabolic equivalent MRI : magnetic resonance imaging NHS : National Health Service NOAC : non-vitamin K oral anticoagulant NSQIP : National Surgical Quality Improvement Program NSTE-ACS : non-ST-elevation acute coronary syndromes NT-proBNP : N-terminal pro-BNP O2 : oxygen OHS : obesity hypoventilation syndrome OR : odds ratio P gp : platelet glycoprotein PAC : pulmonary artery catheter PAD : peripheral artery disease PAH : pulmonary artery hypertension PCC : prothrombin complex concentrate PCI : percutaneous coronary intervention POBBLE : Peri-Operative Beta-BLockadE POISE : Peri-Operative ISchemic Evaluation POISE-2 : Peri-Operative ISchemic Evaluation 2 q.d. : quaque die (once daily) RIFLE : Risk, Injury, Failure, Loss, End-stage renal disease SPECT : single photon emission computed tomography SVT : supraventricular tachycardia SYNTAX : Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery TAVI : transcatheter aortic valve implantation TdP : torsades de pointes TIA : transient ischaemic attack TOE : transoesophageal echocardiography TOD : transoesophageal doppler TTE : transthoracic echocardiography UFH : unfractionated heparin VATS : video-assisted thoracic surgery VHD : valvular heart disease VISION : Vascular Events In Noncardiac Surgery Patients Cohort Evaluation VKA : vitamin K antagonist VPB : ventricular premature beat VT : ventricular tachycardia Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a particular issue with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic …
Published: 2014

20. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology

Author: Montalescot, Gilles, Sechtem, Udo, Achenbach, Stephan, Andreotti, Felicita, Arden, Chris, Budaj, Andrzej, Bugiardini, Raffaele, Crea, Filippo, Cuisset, Thomas, Di Mario, Carlo, Ferreira, J Rafael, Gersh, Bernard J, Gitt, Anselm K, Hulot, Jean-Sebastien, Marx, Nikolaus, Opie, Lionel H, Pfisterer, Matthias, Prescott, Eva, Ruschitzka, Frank, Sabaté, Manel, Senior, Roxy, Taggart, David Paul, van der Wall, Ernst E, Vrints, Christiaan J M, Zamorano, Jose Luis, Baumgartner, Helmut, Bax, Jeroen J, Bueno, Héctor, Dean, Veronica, Deaton, Christi, Erol, Cetin, Fagard, Robert, Ferrari, Roberto, Hasdai, David, Hoes, Arno W, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, Lancellotti, Patrizio, Linhart, Ales, Nihoyannopoulos, Petros, Piepoli, Massimo F, Ponikowski, Piotr, Sirnes, Per Anton, Tamargo, Juan Luis, Tendera, Michal, Torbicki, Adam, Wijns, William, Windecker, Stephan, Valgimigli, Marco, Claeys, Marc J, Donner-Banzhoff, Norbert, Frank, Herbert, Funck-Brentano, Christian, Gaemperli, Oliver, Gonzalez-Juanatey, José R, Hamilos, Michalis, Husted, Steen, James, Stefan K, Kervinen, Kari, Kristensen, Steen Dalby, Maggioni, Aldo Pietro, Pries, Axel R, Romeo, Francesco, Rydén, Lars, Simoons, Maarten L, Steg, Ph Gabriel, Timmis, Adam, Yildirir, Aylin, G. Montalescot, U. Sechtem, S. Achenbach, F. Andreotti, C. Arden, A. Budaj, R. Bugiardini, F. Crea, T. Cuisset, C. Di Mario, J. R. Ferreira, B. J. Gersh, A. K. Gitt, J.-S. Hulot, N. Marx, L. H. Opie, M. Pfisterer, E. Prescott, F. Ruschitzka, M. Sabate, R. Senior, D. P. Taggart, E. E. van der Wall, C. J. M. Vrint, J. L. Zamorano, H. Baumgartner, J. J. Bax, H. Bueno, V. Dean, C. Deaton, C. Erol, R. Fagard, R. Ferrari, D. Hasdai, A. W. Hoe, P. Kirchhof, J. Knuuti, P. Kolh, P. Lancellotti, A. Linhart, P. Nihoyannopoulo, M. F. Piepoli, P. Ponikowski, P. A. Sirne, J. L. Tamargo, M. Tendera, A. Torbicki, W. Wijn, S. Windecker, M. Valgimigli, M. J. Claey, N. Donner-Banzhoff, H. Frank, C. Funck-Brentano, O. Gaemperli, J. R. Gonzalez-Juanatey, M. Hamilo, S. Husted, S. K. Jame, K. Kervinen, S. D. Kristensen, A. P. Maggioni, A. R. Prie, F. Romeo, L. Ryden, M. L. Simoon, P. G. Steg, A. Timmi, A. Yildirir, University of Zurich, and Montalescot, G
Subjects: Male, medicine.medical_specialty, Acute coronary syndrome, Cardiotonic Agents, Angina pectoris, anti-ischaemic drugs, medicine.medical_treatment, 610 Medicine & health, Coronary Artery Disease, Fractional flow reserve, Myocardial ischaemia, Coronary revascularization, GUIDELINES, Risk Assessment, 2705 Cardiology and Cardiovascular Medicine, Angina, Coronary artery disease, Electrocardiography, Coronary artery bypass surgery, Percutaneous Coronary Intervention, Internal medicine, Myocardial Revascularization, Humans, Medicine, Angina, Stable, cardiovascular diseases, Myocardial infarction, Coronary Artery Bypass, Aged, Evidence-Based Medicine, Primary Health Care, business.industry, Coronary flow reserve, Percutaneous coronary intervention, Prognosis, medicine.disease, Cardiac Imaging Techniques, Risk factors, CHRONIC STABLE ANGINA, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, 10209 Clinic for Cardiology, Cardiology, Stable coronary artery disease, Female, Cardiology and Cardiovascular Medicine, business, Risk Reduction Behavior
Abstract: 99mTc : technetium-99m 201TI : thallium 201 ABCB1 : ATP-binding cassette sub-family B member 1 ABI : ankle-brachial index ACC : American College of Cardiology ACCF : American College of Cardiology Foundation ACCOMPLISH : Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension ACE : angiotensin converting enzyme ACIP : Asymptomatic Cardiac Ischaemia Pilot ACS : acute coronary syndrome ADA : American Diabetes Association ADP : adenosine diphosphate AHA : American Heart Association ARB : angiotensin II receptor antagonist ART : Arterial Revascularization Trial ASCOT : Anglo-Scandinavian Cardiac Outcomes Trial ASSERT : Asymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial AV : atrioventricular BARI 2D : Bypass Angioplasty Revascularization Investigation 2 Diabetes BEAUTIFUL : Morbidity-Mortality Evaluation of the If Inhibitor Ivabradine in Patients With Coronary Artery Disease and Left Ventricular Dysfunction BIMA : bilateral internal mammary artery BMI : body mass index BMS : bare metal stent BNP : B-type natriuretic peptide BP : blood pressure b.p.m. : beats per minute CABG : coronary artery bypass graft CAD : coronary artery disease CAPRIE : Clopidogrel vs. Aspirin in Patients at Risk of Ischaemic Events CASS : Coronary Artery Surgery Study CCB : calcium channel blocker CCS : Canadian Cardiovascular Society CFR : coronary flow reserve CHARISMA : Clopidogrel for High Atherothrombotic Risk and Ischaemic Stabilization, Management and Avoidance CI : confidence interval CKD : chronic kidney disease CKD-EPI : Chronic Kidney Disease Epidemiology Collaboration CMR : cardiac magnetic resonance CORONARY : The CABG Off or On Pump Revascularization Study COURAGE : Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation COX-1 : cyclooxygenase-1 COX-2 : cyclooxygenase-2 CPG : Committee for Practice Guidelines CT : computed tomography CTA : computed tomography angiography CV : cardiovascular CVD : cardiovascular disease CXR : chest X-ray CYP2C19*2 : cytochrome P450 2C19 CYP3A : cytochrome P3A CYP3A4 : cytochrome P450 3A4 CYP450 : cytochrome P450 DANAMI : Danish trial in Acute Myocardial Infarction DAPT : dual antiplatelet therapy DBP : diastolic blood pressure DECOPI : Desobstruction Coronaire en Post-Infarctus DES : drug-eluting stents DHP : dihydropyridine DSE : dobutamine stress echocardiography EACTS : European Association for Cardiothoracic Surgery EECP : enhanced external counterpulsation EMA : European Medicines Agency EASD : European Association for the Study of Diabetes ECG : electrocardiogram Echo : echocardiogram ED : erectile dysfunction EF : ejection fraction ESC : European Society of Cardiology EXCEL : Evaluation of XIENCE PRIME or XIENCE V vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization FAME : Fractional Flow Reserve vs. Angiography for Multivessel Evaluation FDA : Food & Drug Administration (USA) FFR : fractional flow reserve FREEDOM : Design of the Future Revascularization Evaluation in patients with Diabetes mellitus: Optimal management of Multivessel disease GFR : glomerular filtration rate HbA1c : glycated haemoglobin HDL : high density lipoprotein HDL-C : high density lipoprotein cholesterol HR : hazard ratio HRT : hormone replacement therapy hs-CRP : high-sensitivity C-reactive protein HU : Hounsfield units ICA : invasive coronary angiography IMA : internal mammary artery IONA : Impact Of Nicorandil in Angina ISCHEMIA : International Study of Comparative Health Effectiveness with Medical and Invasive Approaches IVUS : intravascular ultrasound JSAP : Japanese Stable Angina Pectoris KATP : ATP-sensitive potassium channels LAD : left anterior descending LBBB : left bundle branch block LIMA : Left internal mammary artery LDL : low density lipoprotein LDL-C : low density lipoprotein cholesterol LM : left main LMS : left main stem LV : left ventricular LVEF : left ventricular ejection fraction LVH : left ventricular hypertrophy MACE : major adverse cardiac events MASS : Medical, Angioplasty, or Surgery Study MDRD : Modification of Diet in Renal Disease MERLIN : Metabolic Efficiency with Ranolazine for Less Ischaemia in Non-ST-Elevation Acute Coronary Syndromes MERLIN-TIMI 36 : Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndromes: Thrombolysis In Myocardial Infarction MET : metabolic equivalents MI : myocardial infarction MICRO-HOPE : Microalbuminuria, cardiovascular and renal sub-study of the Heart Outcomes Prevention Evaluation study MPI : myocardial perfusion imaging MRI : magnetic resonance imaging NO : nitric oxide NSAIDs : non-steroidal anti-inflammatory drugs NSTE-ACS : non-ST-elevation acute coronary syndrome NYHA : New York Heart Association OAT : Occluded Artery Trial OCT : optical coherence tomography OMT : optimal medical therapy PAR-1 : protease activated receptor type 1 PCI : percutaneous coronary intervention PDE5 : phosphodiesterase type 5 PES : paclitaxel-eluting stents PET : positron emission tomography PRECOMBAT : Premier of Randomized Comparison of Bypass Surgery vs. Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease PTP : pre-test probability PUFA : polyunsaturated fatty acid PVD : peripheral vascular disease QoL : quality of life RBBB : right bundle branch block REACH : Reduction of Atherothrombosis for Continued Health RITA-2 : Second Randomized Intervention Treatment of Angina ROOBY : Veterans Affairs Randomized On/Off Bypass SAPT : single antiplatelet therapy SBP : systolic blood pressure SCAD : stable coronary artery disease SCORE : Systematic Coronary Risk Evaluation SCS : spinal cord stimulation SES : sirolimus-eluting stents SIMA : single internal mammary artery SPECT : single photon emission computed tomography STICH : Surgical Treatment for Ischaemic Heart Failure SWISSI II : Swiss Interventional Study on Silent Ischaemia Type II SYNTAX : SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery TC : total cholesterol TENS : transcutaneous electrical neural stimulation TERISA : Type 2 Diabetes Evaluation of Ranolazine in Subjects With Chronic Stable Angina TIME : Trial of Invasive vs. Medical therapy TIMI : Thrombolysis In Myocardial Infarction TMR : transmyocardial laser revascularization TOAT : The Open Artery Trial WOEST : What is the Optimal antiplatElet and anticoagulant therapy in patients with oral anticoagulation and coronary StenTing Guidelines summarize and evaluate all evidence available, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well …
Published: 2013

21. 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)

Author: Brignole, Michele, Auricchio, Angelo, Baron-Esquivias, Gonzalo, Bordachar, Pierre, Boriani, Giuseppe, Breithardt, Ole-A, Cleland, John, Deharo, Jean-Claude, Delgado, Victoria, Elliott, Perry M, Gorenek, Bulent, Israel, Carsten W, Leclercq, Christophe, Linde, Cecilia, Mont, Lluís, Padeletti, Luigi, Sutton, Richard, Vardas, Panos E, Zamorano, Jose Luis, Achenbach, Stephan, Baumgartner, Helmut, Bax, Jeroen J, Bueno, Héctor, Dean, Veronica, Deaton, Christi, Erol, Cetin, Fagard, Robert, Ferrari, Roberto, Hasdai, David, Hoes, Arno W, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, Lancellotti, Patrizio, Linhart, Ales, Nihoyannopoulos, Petros, Piepoli, Massimo F, Ponikowski, Piotr, Sirnes, Per Anton, Tamargo, Juan Luis, Tendera, Michal, Torbicki, Adam, Wijns, William, Windecker, Stephan, Blomstrom-Lundqvist, Carina, Badano, Luigi P, Aliyev, Farid, Bänsch, Dietmar, Bsata, Walid, Buser, Peter, Charron, Philippe, Daubert, Jean-Claude, Dobreanu, Dan, Faerestrand, Svein, Le Heuzey, Jean-Yves, Mavrakis, Hercules, McDonagh, Theresa, Merino, Jose Luis, Nawar, Mostapha M, Nielsen, Jens Cosedis, Pieske, Burkert, Poposka, Lidija, Ruschitzka, Frank, Van Gelder, Isabelle C, Wilson, Carol M, University of Zurich, Brignole, Michele, Department of Cardiology, Ospedali del Tigullio, CHU Bordeaux [Bordeaux], Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Cardiology, Karolinska University Hospital, Karolinska Institutet [Stockholm], Cardiology Department, University of Barcelona, European Society of Cardiology (ESC) - European Heart Rhythm Association (EHRA), M. Brignole, A. Auricchio, G. Baron-Esquivia, P. Bordachar, G. Boriani, O.-A. Breithardt, J. Cleland, J.-C. Deharo, V. Delgado, P. M. Elliott, B. Gorenek, C. W. Israel, C. Leclercq, C. Linde, L. Mont, L. Padeletti, R. Sutton, P. E. Varda, J. L. Zamorano, S. Achenbach, H. Baumgartner, J. J. Bax, H. Bueno, V. Dean, C. Deaton, C. Erol, R. Fagard, R. Ferrari, D. Hasdai, A. W. Hoe, P. Kirchhof, J. Knuuti, P. Kolh, P. Lancellotti, A. Linhart, P. Nihoyannopoulo, M. F. Piepoli, P. Ponikowski, P. A. Sirne, J. L. Tamargo, M. Tendera, A. Torbicki, W. Wijn, S. Windecker, C. Blomstrom-Lundqvist, L. P. Badano, F. Aliyev, D. Bansch, W. Bsata, P. Buser, P. Charron, J.-C. Daubert, D. Dobreanu, S. Faerestrand, J.-Y. Le Heuzey, H. Mavraki, T. McDonagh, J. L. Merino, M. M. Nawar, J. C. Nielsen, B. Pieske, L. Poposka, F. Ruschitzka, I. C. Van Gelder, C. M. Wilson, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_treatment, Heart Valve Diseases, Myocardial Infarction, 030204 cardiovascular system & hematology, Ventricular tachycardia, 0302 clinical medicine, 2737 Physiology (medical), Bicuspid Aortic Valve Disease, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, Pregnancy, Secondary Prevention, 030212 general & internal medicine, Child, ComputingMilieux_MISCELLANEOUS, Heart Valve Prosthesis Implantation, Cardiac resynchronization therapy, Cardiac Pacing, Artificial, Atrial fibrillation, Implantable cardioverter-defibrillator, Magnetic Resonance Imaging, 3. Good health, Defibrillators, Implantable, Europe, Pacemaker, Aortic Valve, Cardiology, Catheter Ablation, cardiovascular system, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Algorithms, Heart Defects, Congenital, Reoperation, medicine.medical_specialty, Prosthesis-Related Infections, Defibrillation, Pregnancy Complications, Cardiovascular, Heart failure, 610 Medicine & health, Syncope, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, Sick sinus syndrome, 03 medical and health sciences, Rare Diseases, Internal medicine, Physiology (medical), medicine, Bradycardia, Humans, cardiovascular diseases, Emergency Treatment, Postoperative Care, business.industry, Contraindications, Remote Consultation, Arrhythmias, Cardiac, Stroke Volume, Cardiomyopathy, Hypertrophic, ta3121, medicine.disease, Cardiac pacing, Ventricular fibrillation, Heart Transplantation, business
Abstract: Abbreviations 1st AV : First-degree atrioventricular block AF : atrial fibrillation AT : atrial tachyarrhythmia ATP : Anti-tachycardia pacing AV : atrioventricular BBB : bundle branch block CHF : congestive heart failure CI : confidence interval CPG : Committee for Practice Guidelines CRT : cardiac resynchronization therapy CRT-D : cardiac resynchronization therapy and defibrillator CRT-P : cardiac resynchronization therapy and pacemaker ECG : electrocardiogram EDMD : Emery-Dreifuss muscular dystrophy EF : ejection fraction EPS : electrophysiological study ESC : European Society of Cardiology HCM : hypertrophic cardiomyopathy HF : heart failure HR : hazard ratio HV : His-ventricular ICD : implantable cardioverter defibrillator ILR : implantable loop recorder IVCD : intraventricular conduction delay LBBB : left bundle branch block LQTS : long QT syndrome LV : left ventricular LVEF : left ventricular ejection fraction LVSD : left ventricular systolic dysfunction MR : mitral regurgitation MRI : magnetic resonance imaging NYHA : New York Heart Association PM : pacemaker OR : odds ratio QALY : quality-adjusted life year RBBB : right bundle branch block RCT : randomized controlled trial RV : right ventricular SB : sinus bradycardia SNRT : sinus node recovery time SR : sinus rhythm SSS : sick sinus syndrome TAVI : transcatheter aortic valve implantation VF : ventricular fibrillation VT : ventricular tachycardia VV : interventricular (delay) ### Acronyms of the trials referenced in the recommendations or reported in the tables ADEPT : ADvanced Elements of Pacing Randomized Controlled Trial ADOPT : Atrial Dynamic Overdrive Pacing Trial AOPS : Atrial Overdrive Pacing Study APAF : Ablate and Pace in Atrial Fibrillation ASSERT : ASymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial ATTEST : ATrial Therapy Efficacy and Safety Trial AVAIL CLS/CRT : AV Node Ablation with CLS and CRT Pacing Therapies for Treatment of AF trial B4 : Bradycardia detection in Bundle Branch Block BELIEVE : Bi vs. Left Ventricular Pacing: an International Pilot Evaluation on Heart Failure Patients with Ventricular Arrhythmias BIOPACE : Biventricular pacing for atrioventricular block to prevent cardiac desynchronization BLOCK-HF : Biventricular versus right ventricular pacing in patients with AV block B-LEFT : Biventricular versus LEFT Univentricular Pacing with ICD Back-up in Heart Failure Patients CARE-HF : CArdiac REsynchronization in Heart Failure CLEAR : CLinical Evaluation on Advanced Resynchronization COMBAT : COnventional vs. Biventricular Pacing in Heart Failure and Bradyarrhythmia COMPANION : COmparison of Medical Therapy, Pacing and Defibrillation in Heart Failure DANPACE : DANish Multicenter Randomized Trial on Single Lead Atrial PACing vs. Dual Chamber Pacing in Sick Sinus Syndrome DECREASE-HF : The Device Evaluation of CONTAK RENEWAL 2 and EASYTRAK 2: Assessment of Safety and Effectiveness in Heart Failure FREEDOM : Optimization Study Using the QuickOpt Method GREATER-EARTH : Evaluation of Resynchronization Therapy for Heart Failure in Patients with a QRS Duration GREATER Than 120 ms LESSER-EARTH : Evaluation of Resynchronization Therapy for Heart Failure in Patients with a QRS Duration Lower Than 120 ms HOBIPACE : HOmburg BIventricular PACing Evaluation IN-CHF : Italian Network on Congestive Heart Failure ISSUE : International Study on Syncope of Unexplained Etiology MADIT : Multicenter Automatic Defibrillator Trial MIRACLE : Multicenter InSync RAndomized CLinical Evaluation MOST : MOde Selection Trial in Sinus-Node Dysfunction MUSTIC : MUltisite STimulation In Cardiomyopathies OPSITE : Optimal Pacing SITE PACE : Pacing to Avoid Cardiac Enlargement PAVE : Left Ventricular-Based Cardiac Stimulation Post AV Nodal Ablation Evaluation PATH-CHF : PAcing THerapies in Congestive Heart Failure II Study Group PIPAF : Pacing In Prevention of Atrial Fibrillation Study PIRAT : Prevention of Immediate Reinitiation of Atrial Tachyarrhythmias POT : Prevention Or Termination Study PREVENT-HF : PREventing VENTricular Dysfunction in Pacemaker Patients Without Advanced Heart Failure PROSPECT : PRedictors Of Response to Cardiac Resynchronization Therapy RAFT : Resynchronization–Defibrillation for Ambulatory Heart Failure Trial RethinQ : Cardiac REsynchronization THerapy IN Patients with Heart Failure and Narrow QRS REVERSE : REsynchronization reVErses Remodelling in Systolic left vEntricular dysfunction SAFARI : Study of Atrial Fibrillation Reduction SCD HeFT : Sudden Cardiac Death in Heart Failure Trial SMART-AV : The SMARTDelay Determined AV Optimization: a Comparison with Other AV Delay Methods Used in Cardiac Resynchronization Therapy SYDIT : The SYncope DIagnosis and Treatment SYNPACE : Vasovagal SYNcope and PACing TARGET : TARgeted Left Ventricular Lead Placement to Guide Cardiac Resynchronization Therapy THEOPACE : Effects of Oral THEOphylline and of Permanent PACEmaker on the Symptoms and Complications of Sick Sinus Syndrome VASIS-PM : VAsovagal Syncope International Study on PaceMaker therapy V-HeFT : Vasodilator in HEart Failure Trial VPSII : Second Vasovagal Pacemaker Study (VPS II) Additional references are mentioned with ‘w’ in the main text and can be found on the online addenda along with 5 figures (1, 6, 7, 9, 11, 12) and 10 tables (3, 4, 5, 9, 11, 12, 19, 21, 22, 23). They are available on the ESC website only at http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/cardiac-pacing-and-cardiac-resynchronisation-therapy.aspx Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a …
Published: 2013

22. 2015 ESC Guidelines for the Diagnosis and Management of Pericardial Diseases

Author: Adler, Yehuda, Charron, Philippe, Imazio, Massimo, Badano, Luigi, Barón Esquivias, Gonzalo, Bogaert, Jan, Brucato, Antonio, Gueret, Pascal, Klingel, Karin, Lionis, Christos, Maisch, Bernhard, Mayosi, Bongani, Pavie, Alain, Ristić, Arsen D., Tenas, Manel Sabaté, Seferovic, Petar, Swedberg, Karl, Tomkowski, Witold, Achenbach, Stephan, Agewall, Stefan, Al Attar, Nawwar, Ferrer, Juan Angel, Arad, Michael, Asteggiano, Riccardo, Bueno, Héctor, Caforio, Alida L. P., Carerj, Scipione, Ceconi, Claudio, Evangelista, Arturo, Flachskampf, Frank, Giannakoulas, George, Gielen, Stephan, Habib, Gilbert, Kolh, Philippe, Lambrinou, Ekaterini, Lancellotti, Patrizio, Lazaros, George, Linhart, Ales, Meurin, Philippe, Nieman, Koen, Piepoli, Massimo F., Price, Susanna, Roos Hesselink, Jolien, Zamorano, Jose Luis, Aboyans, Victor, Badimon, Lina, Baumgartner, Helmut, Bax, Jeroen J., Dean, Veronica, Erol, Cetin, Fitzimons, Donna, Gaemperli, Oliver, Kirchhof, Paulus, Lip, Gregory Y. H., Nihoyannopoulos, Petros, Ponikowski, Piotr, Roffi, Marco, Torbicki, Adam, Carneiro, Antonio Vaz, Windecker, Stephan, Adler, Y, Charron, P, Imazio, M, Badano, L, Baron-Esquivias, G, Bogaert, J, Brucato, A, Gueret, P, Klingel, K, Lionis, C, Maisch, B, Mayosi, B, Pavie, A, Ristic, A, Tenas, M, Seferovic, P, Swedberg, K, Tomkowski, W, Achenbach, S, Agewall, S, Al-Attar, N, Ferrer, J, Arad, M, Asteggiano, R, Bueno, H, Caforio, A, Carerj, S, Ceconi, C, Evangelista, A, Flachskampf, F, Giannakoulas, G, Gielen, S, Habib, G, Kolh, P, Lambrinou, E, Lancellotti, P, Lazaros, G, Linhart, A, Meurin, P, Nieman, K, Piepoli, M, Price, S, Roos-Hesselink, J, Zamorano, J, Aboyans, V, Badimon, L, Baumgartner, H, Bax, J, Dean, V, Erol, C, Fitzimons, D, Gaemperli, O, Kirchhof, P, Lip, G, Nihoyannopoulos, P, Ponikowski, P, Roffi, M, Torbicki, A, Carneiro, A, and Windecker, S
Subjects: Male, Cardiac Catheterization, Pathology, Multimodal Imaging, Heart Neoplasms, Kidney Failure, Pericarditis, Myocardial infarction, Aetiology, Chronic, Tomography, Societies, Medical, Pericardiocentesis, General Medicine, Constrictive pericarditis, Diagnosis, Guidelines, Myopericarditis, Pericardial effusion, Pericardium, Prognosis, Tamponade, Therapy, Cardiothoracic surgery, Echocardiography, Acute Disease, Pericardial diseases, cardiovascular system, Drainage, Antibody, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Congenital cytomegalovirus infection, Guidelines, Aetiology, Constrictive pericarditis, Diagnosis, Myopericarditis, Pericardial effusion, Pericardiocentesis, Pericarditis, Pericardium, Prognosis, Tamponade, Therapy, Text mining, Humans, Radiation Injuries, Physical Examination, medicine.disease, Cardiac Tamponade, Heart Injuries, chemistry, Positron-Emission Tomography, Kidney Failure, Chronic, Creatine kinase, Triage, Biomarkers, Magnetic Resonance Angiography, Biopsy, Basic fibroblast growth factor, Anti-Inflammatory Agents, Medical and Health Sciences, chemistry.chemical_compound, Postoperative Complications, Adenosine deaminase, Recurrence, reproductive and urinary physiology, Age Factors, Autoimmune Diseases, Bacterial Infections, Chronic Disease, Endoscopy, Hospitalization, Sex Factors, Syndrome, Tomography, X-Ray Computed, Treatment Outcome, Virus Diseases, Pericardial Effusion, biology, Medicine (all), Thoracic Surgery, X-Ray Computed, Europe, medicine.anatomical_structure, Infective endocarditis, embryonic structures, Cardiology, Female, biological phenomena, cell phenomena, and immunity, Esc Guidelines, Heart Diseases, Acute pericarditis, Internal medicine, medicine, Diseases of the circulatory (Cardiovascular) system, cardiovascular diseases, urogenital system, Task force, business.industry, RC666-701, biology.protein, business
Abstract: ADA : adenosine deaminase AMI : acute myocardial infarction ANA : anti-nuclear antibody bFGF : basic fibroblast growth factor CK : creatine kinase CMR : cardiac magnetic resonance CMV : cytomegalovirus CP : Child–Pugh CRP : C-reactive protein CT : computed tomography EBV
Published: 2015

23. Left ventricular twist mechanics and its relation with aortic stiffness in chronic kidney disease patients without overt cardiovascular disease.

Author: Sulemane, Samir, Panoulas, Vasileios F., Konstantinou, Klio, Bratsas, Athanasios, Tam, Frederick W., Brown, Edwina A., and Nihoyannopoulos, Petros
Subjects: KIDNEY diseases, FOCAL segmental glomerulosclerosis, ALBUMINURIA, CARDIOVASCULAR diseases, CARDIOVASCULAR system, CHRONIC kidney failure complications, HEART ventricle diseases, AORTA, CHRONIC kidney failure, DIAGNOSTIC imaging, ECHOCARDIOGRAPHY, ELASTICITY, LEFT heart ventricle, HEART ventricles, COMPUTERS in medicine, RESEARCH evaluation, SYMPTOMS
Abstract: Background: Recent studies hypothesized left ventricular (LV) twist as a potential biomarker for evaluation of sub clinical myocardial disease, however its relationship with aortic stiffness has yet to be investigated. Chronic kidney disease (CKD) has been identified as a risk factor for both myocardial and arterial disease. As such we sought to explore the relationship between aortic stiffness and LV twist in CKD patients without known cardiovascular disease (CVD).Methods: In this prospective, observational study we enrolled 106 CKD patients (Stages 1 to 5) with normal LVEF as assessed by conventional echocardiography. Aortic stiffness was measured using aortic pulse wave velocity (aPWV). We defined increased aPWV as ≥10 m/s. LV Twist was measured using two-dimensional speckle tracking echocardiography.Results: Patients with increased aPWV had higher LV twist (p = 0.002) but similar LVEF (p = 0.486). Aortic PWV correlated crudely with age (p < 0.001), the presence of diabetes (p < 0.001), hypertension (p < 0.001), eGFR (p < 0.001), LVMI (p = 0.01), e/e' (p < 0.001) and LV twist (p = 0.003). In multivariable analyses after adjusting for age, gender, cardiovascular risk factors and hypertensive medication, aPWV was independently associated with LV twist (β = 0.163, p = 0.025).Conclusions: Aortic stiffness independently associates with LV Twist in asymptomatic CKD patients. These findings suggest a close interaction between LV twist mechanics and arterial remodeling even before CVD becomes clinically relevant. [ABSTRACT FROM AUTHOR]
Published: 2016
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24. Cardiac Resynchronization Therapy Part 2—Issues During and After Device Implantation and Unresolved Questions

Author: Bax, Jeroen J., Abraham, Theodore, Barold, S. Serge, Breithardt, Ole A., Fung, Jeffrey W.H., Garrigue, Stephane, Gorcsan, John, Hayes, David L., Kass, David A., Knuuti, Juhani, Leclercq, Christophe, Linde, Cecilia, Mark, Daniel B., Monaghan, Mark J., Nihoyannopoulos, Petros, Schalij, Martin J., Stellbrink, Christophe, and Yu, Cheuk-Man
Subjects: genetic structures, cardiovascular system, cardiovascular diseases, equipment and supplies, circulatory and respiratory physiology
Abstract: Encouraged by the clinical success of cardiac resynchronization therapy (CRT), the implantation rate has increased exponentially, although several limitations and unresolved issues of CRT have been identified. This review concerns issues that are encountered during implantation of CRT devices, including the role of electroanatomical mapping, whether CRT implantation should be accompanied by simultaneous atrioventricular nodal ablation in patients with atrial fibrillation, procedural complications, and when to consider surgical left ventricular lead positioning. Furthermore, (echocardiographic) CRT optimization and assessment of CRT benefits after implantation are highlighted. Also, controversial issues such as the potential value of CRT in patients with mild heart failure or narrow QRS complex are addressed. Finally, open questions concerning when to combine CRT with implantable cardioverter-defibrillator therapy and the cost-effectiveness of CRT are discussed.
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25. Randomized Comparison of Percutaneous Coronary Intervention With Coronary Artery Bypass Grafting in Diabetic Patients 1-Year Results of the CARDia (Coronary Artery Revascularization in Diabetes) Trial

Author: Kapur, Akhil, Hall, Roger J., Malik, Iqbal S., Qureshi, Ayesha C., Butts, Jeremy, de Belder, Mark, Baumbach, Andreas, Angelini, Gianni, de Belder, Adam, Oldroyd, Keith G., Flather, Marcus, Roughton, Michael, Nihoyannopoulos, Petros, Bagger, Jens Peder, Morgan, Kenneth, and Beatt, Kevin J.
Subjects: surgical procedures, operative, diabetes, multivesssel disease, cardiovascular diseases, coronary revascularization
Abstract: ObjectivesThe purpose of this study was to compare the safety and efficacy of percutaneous coronary intervention (PCI) with stenting against coronary artery bypass grafting (CABG) in patients with diabetes and symptomatic multivessel coronary artery disease.BackgroundCABG is the established method of revascularization in patients with diabetes and multivessel coronary disease, but with advances in PCI, there is uncertainty whether CABG remains the preferred method of revascularization.MethodsThe primary outcome was a composite of all-cause mortality, myocardial infarction (MI), and stroke, and the main secondary outcome included the addition of repeat revascularization to the primary outcome events. A total of 510 diabetic patients with multivessel or complex single-vessel coronary disease from 24 centers were randomized to PCI plus stenting (and routine abciximab) or CABG. The primary comparison used a noninferiority method with the upper boundary of the 95% confidence interval (CI) not to exceed 1.3 to declare PCI noninferior. Bare-metal stents were used initially, but a switch to Cypher (sirolimus drug-eluting) stents (Cordis, Johnson & Johnson, Bridgewater, New Jersey) was made when these became available.ResultsAt 1 year of follow-up, the composite rate of death, MI, and stroke was 10.5% in the CABG group and 13.0% in the PCI group (hazard ratio [HR]: 1.25, 95% CI: 0.75 to 2.09; p = 0.39), all-cause mortality rates were 3.2% and 3.2%, and the rates of death, MI, stroke, or repeat revascularization were 11.3% and 19.3% (HR: 1.77, 95% CI: 1.11 to 2.82; p = 0.02), respectively. When the patients who underwent CABG were compared with the subset of patients who received drug-eluting stents (69% of patients), the primary outcome rates were 12.4% and 11.6% (HR: 0.93, 95% CI: 0.51 to 1.71; p = 0.82), respectively.ConclusionsThe CARDia (Coronary Artery Revascularization in Diabetes) trial is the first randomized trial of coronary revascularization in diabetic patients, but the 1-year results did not show that PCI is noninferior to CABG. However, the CARDia trial did show that multivessel PCI is feasible in patients with diabetes, but longer-term follow-up and data from other trials will be needed to provide a more precise comparison of the efficacy of these 2 revascularization strategies. (The Coronary Artery Revascularisation in Diabetes trial; ISRCTN19872154)
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26. Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal

Author: Bax, Jeroen J, Ansalone, Gerardo, Breithardt, Ole A, Derumeaux, Genevieve, Leclercq, Christophe, Schalij, Martin J, Sogaard, Peter, St. John Sutton, Martin, and Nihoyannopoulos, Petros
Subjects: genetic structures, cardiovascular system, cardiovascular diseases, circulatory and respiratory physiology
Abstract: Cardiac resynchronization therapy (CRT) has been proposed as an alternative treatment in patients with severe, drug-refractory heart failure. The clinical results are promising, and improvement in symptoms, exercise capacity, and systolic left ventricular (LV) function have been demonstrated after CRT, accompanied by a reduction in hospitalization and a superior survival as compared with optimized medical therapy alone. However, 20% to 30% of patients do not respond to CRT. Currently, patients are selected mainly on electrocardiogram criteria (wide QRS complex, left bundle branch block configuration). In view of the 20% to 30% of nonresponders, additional selection criteria are needed. Echocardiography (and, in particular, tissue Doppler imaging) may allow further identification of potential responders to CRT, based on assessment of inter- and intraventricular dyssynchrony. In addition, echocardiography may allow optimal LV lead positioning and follow-up after CRT. In the current review, the different echocardiographic approaches to predict response to CRT are discussed. In addition, the use of echocardiography to guide LV lead positioning and follow-up after CRT are addressed.
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27. Cardiac Resynchronization Therapy Part 1—Issues Before Device Implantation

Author: Bax, Jeroen J., Abraham, Theodore, Barold, S. Serge, Breithardt, Ole A., Fung, Jeffrey W.H., Garrigue, Stephane, Gorcsan, John, Hayes, David L., Kass, David A., Knuuti, Juhani, Leclercq, Christophe, Linde, Cecilia, Mark, Daniel B., Monaghan, Mark J., Nihoyannopoulos, Petros, Schalij, Martin J., Stellbrink, Christophe, and Yu, Cheuk-Man
Subjects: cardiovascular system, cardiovascular diseases
Abstract: Cardiac resynchronization therapy (CRT) has been used extensively over the last years in the therapeutic management of patients with end-stage heart failure. Data from 4,017 patients have been published in eight large, randomized trials on CRT. Improvement in clinical end points (symptoms, exercise capacity, quality of life) and echocardiographic end points (systolic function, left ventricular size, mitral regurgitation) have been reported after CRT, with a reduction in hospitalizations for decompensated heart failure and an improvement in survival. However, individual results vary, and 20% to 30% of patients do not respond to CRT. At present, the selection criteria include severe heart failure (New York Heart Association functional class III or IV), left ventricular ejection fraction 120 ms). Assessment of inter- and particularly intraventricular dyssynchrony as provided by echocardiography (predominantly tissue Doppler imaging techniques) may allow improved identification of potential responders to CRT. In this review a summary of the clinical and echocardiographic results of the large, randomized trials is provided, followed by an extensive overview on the currently available echocardiographic techniques for assessment of LV dyssynchrony. In addition, the value of LV scar tissue and venous anatomy for the selection of potential candidates for CRT are discussed.
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28. Effect of enhanced external counterpulsation on dobutamine-induced left ventricular wall motion abnormalities in severe chronic angina pectoris

Author: Bagger, Jens Peder, Hall, Roger J.C., Koutroulis, George, and Nihoyannopoulos, Petros
Subjects: *ARTIFICIAL blood circulation, *STRESS echocardiography, *ANGINA pectoris, *CARDIOVASCULAR diseases, *PATIENTS
Abstract: We studied the effect of enhanced external counterpulsation (EECP) in 23 consecutive patients with stable angina pectoris who had a positive dobutamine stress echocardiogram. After EECP, stress-induced wall motion score (WMS) improved by ≥2 grades in 43% of the patients (n = 10); the average improvement was 5.3 ± 3.8 compared with −0.6 ± 3.0 in the remaining 13 patients (p = 0.007). The diastolic/systolic augmentation ratio increased by 217% in response to the full course of EECP (p = 0.0002) among patients with improved WMS, and by 71% (p = 0.004) among the other patients; the increase was greater among patients with improved WMS than among patients with no improvement (p = 0.01). After EECP, Canadian Cardiovascular Society angina class improved from 3.1 ± 0.6 to 2.2 ± 0.7 (p <0.0001) in the entire group and exercise capacity increased by 73 seconds (p = 0.0002) in patients who were able to exercise (n = 18). [Copyright &y& Elsevier]
Published: 2004
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29. The relationship between aortic stiffness, health related quality of life and post-operative organs recovery (cardiac, renal and cognitive) following aortic valve replacement

Author: Kidher, Emaddin, Athanasiou, Thanos, Francis, Darrel, Nihoyannopoulos, Petros, Xu, Yun, and Imperial College London
Subjects: cardiovascular system, cardiovascular diseases, circulatory and respiratory physiology
Abstract: Background: Aortic stiffness as measured by pulse wave velocity (PWV) is a predictor of cardiovascular disease and other outcomes in different diseased and healthy populations, independent of traditional risk factors. The relationships between PWV measurement, global functional outcome and injury to the brain, kidney, and heart have never been examined in cardiac surgery patients. Objective: The objective of this project was to assess the relationship between aortic stiffness and health related quality of life (QoL), cognitive function, acute kidney injury (AKI), and cardiac function in patients undergoing aortic valve replacement (AVR). Methods: Aortic PWV, QoL, cognitive function, left ventricular (LV) function and NYHA class were assessed pre- and post-operatively (409 ± 159 days). The brain injury biomarker, N-methyl-D-aspartate receptor antibody (NR2Ab), was measured pre-operatively only. The biomarker of myocardial strain, B-type natriuretic peptide (BNP), and the novel AKI biomarker, neutrophil gelatinase-associated lipocalin (NGAL), were measured pre-operatively, and at 3 h and 18-24 h post-CPB. Results: Fifty-six patients (16 females; mean age, 71 ± 8.4 years) were included in this study, of which 50 (89%) patients attended the follow-up visit. No relationship was found between the degree of aortic stenosis (AS) and PWV, and AVR had no effect on aortic stiffness post-operatively. QoL and NYHA class significantly improved, while cognitive function did not deteriorate after AVR. High PWV is independently related to poorer QoL, cognitive function levels and NYHA class both pre- and post-operatively. PWV was not related to LV function, BNP or NGAL levels, but it was independently related to the level of NR2Ab. PWV did not correlate with AKI which was developed in 30% of the cases. Early post-operative plasma level of NGAL is the earliest predictive marker of post-operative AKI and the need for early medical renal intervention. Pre-operative BNP level was significantly and negatively correlated with pre-operative LV function, AS (valve area), and NYHA class in the post-operative follow-up period. Conclusion: In AVR patients, PWV is independently related to global functional status, cognitive function and brain injury biomarkers, but is not related to AKI or myocardial strain. Open Access
Published: 2014
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30. The heart in Sickle Cell Disease. Role of non invasive cardiac imaging by advanced echocardiography and cardiac magnetic resonance assessment of myocardial function

Author: Cabrita, Ines Zimbarra, Gibbs, J. Simon, Nihoyannopoulos, Petros, and Fundacao para a Ciencia e a Tecnologia
Subjects: congenital, hereditary, and neonatal diseases and abnormalities, cardiovascular diseases
Abstract: Sickle cell disease (SCD) is one of the most prevalent genetic disorders worldwide that affects approximately 12,000 people in the United Kingdom. Raised tricuspid regurgitant velocity (TRV), which may be related to left ventricular diastolic dysfunction (LV DD), occurs in approximately 30% of adults with SCD, and has been shown to be an independent risk factor for death. This thesis examines aspects of the role of LV DD in the development of increased tricuspid regurgitant velocity and investigates the hypothesis that myocardial dysfunction, affecting the right and left ventricle, is an important cardiovascular risk factor in patients with SCD. In the retrospective study, we determine the 5 year- survival of a cohort of patients with SCD based on their TRV. The association between raised TRV and mortality in a UK SCD population has been confirmed. Higher values of TRV were associated with a greater than 4 fold increased risk of death (HR: 4.48, 99%CI 1.01-19.8). In the prospective study, sixty-one patients with SCD were included in the study (mean duration of follow-up 17.13±3 months). In the serial echocardiographic study , left ventricular average E/E´ ratio which is a predictor of increased left ventricular filling pressures, was independently associated with an increased tricuspid regurgitation velocity (p=0.007). In addition, blood urea nitrogen and global function index lateral showed independent association with an increased LV lateral E/E´ ratio. Biventricular myocardial deformation by 2D and 3D speckle tracking revealed significant changes in the serial measurements of systolic function. These findings provide novel insight into the pathophysiology of the cardiovascular complications of SCD and support the implementation of echocardiographic screening of adult patients with SCD to identify high-risk individuals for further evaluation. Open Access
Published: 2013
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30 results on '"Nihoyannopoulos, Petros"'

1. COVID-19 and its impact on the cardiovascular system.

2. EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: a report of literature and current practice review.

3. Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017.

4. The association of ferritin with cardiovascular and all-cause mortality in community-dwellers: The English longitudinal study of ageing.

5. Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction.

6. Echocardiographic assessment in patients with chronic kidney disease: Current update.

7. The Tree of Sirtuins and the Garden of Cardiovascular Youth.

8. Cardiac medication during pregnancy, data from the ROPAC.

10. Pocket-size hand-held cardiac ultrasound as an adjunct to clinical examination in the hands of medical students and junior doctors.

11. [ESC guidelines for treatment of cardiovascular disease in pregnancy].

12. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography.

13. Recommendations for echocardiography use in the diagnosis and management of cardiac sources of embolism: European Association of Echocardiography (EAE) (a registered branch of the ESC).

14. Highlights of the 2009 scientific sessions of the European Society of Cardiology.

15. Clinical practice 2007: echocardiography 2007.

17. EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: A report of literature and current practice review

18. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)

19. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA)

20. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology

21. 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)

22. 2015 ESC Guidelines for the Diagnosis and Management of Pericardial Diseases

23. Left ventricular twist mechanics and its relation with aortic stiffness in chronic kidney disease patients without overt cardiovascular disease.

24. Cardiac Resynchronization Therapy Part 2—Issues During and After Device Implantation and Unresolved Questions

25. Randomized Comparison of Percutaneous Coronary Intervention With Coronary Artery Bypass Grafting in Diabetic Patients 1-Year Results of the CARDia (Coronary Artery Revascularization in Diabetes) Trial

26. Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal

27. Cardiac Resynchronization Therapy Part 1—Issues Before Device Implantation

28. Effect of enhanced external counterpulsation on dobutamine-induced left ventricular wall motion abnormalities in severe chronic angina pectoris

29. The relationship between aortic stiffness, health related quality of life and post-operative organs recovery (cardiac, renal and cognitive) following aortic valve replacement

30. The heart in Sickle Cell Disease. Role of non invasive cardiac imaging by advanced echocardiography and cardiac magnetic resonance assessment of myocardial function

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