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8. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12 440 patients of the ESC Heart Failure Long-Term Registry

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Maggioni, Aldo P, Anker, Stefan D., Dahlström, Ulf, Filippatos, Gerasimos, Ponikowski, Piotr, Zannad, Faiez, Amir, Offer, Chioncel, Ovidiu, Leiro, Marisa Crespo, Drozdz, Jaroslaw, Erglis, Andrejs, Fazlibegovic, Emir, Fonseca, Candida, Fruhwald, Friedrich, Gatzov, Plamen, Goncalvesova, Eva, Hassanein, Mahmoud, Hradec, Jaromir, Kavoliuniene, Ausra, Lainscak, Mitja, Logeart, Damien, Merkely, Bela, Metra, Marco, Persson, Hans, Seferovic, Petar, Temizhan, Ahmet, Tousoulis, Dimitris, Tavazzi, Luigi, Andarala, M., Fiorucci, E., Folkesson, E., Glemot, M., Gracia, G., Konte, M., Laroche, C., Mcneill, P. a., Missiamenou, V., Taylor, C., Fruhwald, F., Eberl, Alexander, Heller, S., Dolze, T., Platzer, V., Ablasser, K., Auer, J., Poelzl, G., Moertl, D., Podczeck Schweighofer, A., Reiter, S., Pravdic, D., Fazlibegovic, E., Muslibegovic, A., Vitlianova, K., Katova, T., Kotirkov, K., Petrov, I., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Tisheva, S., Sirakova, V., Krejci, J., Spinar, J., Mikolaskova, M., Krupicka, J., Malek, F., Hegarova, M., Pudil, R., Monhart, Z., Lazarova, M., Reda, A., Khairy, T., Farag, N., Saleh, A., Said, K., Abdel Hamid, M., Halawa, S., Ibrahim, B., Hanna, R., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Aboleineen, W., Gouda, M., Youssef, A., Elbahry, A., Abdel, A., Ebeid, H., Nasr, G., Sobhy, H., Ashmawy, M., Lefol, C., Isnard, R., Hagege, A., Thevenin, S., Jondeau, G., Logeart, D., Codjia, R., Galinier, M., Bauer, F., Delahaye, F., Lamblin, N., Fertin, M., De Groote, P., Coisne, D., Le Marcis, V., Lequeux, B., J. F., Ly, Lotton, P., Donal, E., Le Moal, V., Basquin, A., Reynaud, A., Ridard, C., Thebault, C., Behar, N., Mascle, S., Schiele, F., Seronde, M. F., Morel, M., Meneveau, N., Luporsi, P., Bernard, Y., Pillot, M., Briand, F., Damy, T., Eicher, J. C., Avgeropoulou, C., Panagiotis, T., Tousoulis, D., Kotrogiannis, I., Stefanadis, C., Chrysohoou, C., Tsitsinakis, G., Dimitroula, T., Karavidas, A., Matzaraki, V., Terrovitis, J., Kapelios, C., Sfakianaki, T., Filippatos, G., Parissis, J. T., Ntai, K., Papadopoulou, A., Tziourganou, H., Douras, A., Ntertsas, K., Karotsaki, T., Nikoloulis, N., Tsaknakis, T., Patrianakos, A., Nyktari, E., Vardas, P., Soos, P., Nyolczas, N., Csaba Nagy, A., Halmosi, R., Nemeth, F., Amon, G., Dinnyes, J., Vazan Fuhrmann, A., Shotan, A., Alony, I., Elber, J., Olaru, A., Valenti, C., Reggianini, L., Modena, M. G., Copelli, S., Leuzzi, Concetta, Dei Cas, L., Carubelli, V., Lombardi, Cecilia, Bulgari, M., Tanghetti, E., Quinzani, F., Metra, M., Rovetta, R., Brasolin, B., Fedele, F., Sergi, Daniela, Romeo, F., Scarfò, I., Vellini, M., Fabris, E., Cinquetti, Martino, Stolfo, Davide, Sinagra, Gianfranco, Merlo, Marco, Fucili, A., Ferrari, R., Vassanelli, C., Torelli, F., Marchese, G., Zanolla, L., Cicoira, M., Anselmi, Manuel, Piccinino, C., Sartori, C., Di Ruocco, M. V., Marino, P. N., Giordano, A., Brognoli, S., Zanelli, E., Cosmi, F., Cadeddu, C., Bandino, S., Mercuro, G., Deidda, M., Salvemini, G., Correale, M., Di Biase, M., Musio, S., Passero, T., Italiano, Graziella, Agostoni, P., Salvioni, E., Schiavina, G., Squeri, CARLO ATTILIO, Bosi, S., Barbieri, A., Lemme, E., Penco, M., Marcon, S., Romano, S., Di Mauro, M., Frisinghelli, A., Veniani, M., Pieri, Pietro, Novo, S., Proclemer, Alessandro, Fresco, C., Miani, Daniela, Artico, Jessica, Gaita, F., Bergerone, S., Pirelli, SALVATORE DONATO, Di Tano, G., Cattaneo, Silvana, Gualco, A., Opasich, C., Priori, S. G., Iori, Elisa, Leci, E., Melandri, F., Voronina, N., Erglis, A., Kalnins, A., Kavoliuniene, A., Rumbinaite, E., Kazakauskaite, E., Petraskiene, I., Karaliute, R., Smalinskas, V., Tamakauskas, V., Petraskiene, D., Brazyte Ramanauskiene, R., Vysniauskas, V., Nowicka, A., Grabia, J., Dankowski, R., Szyszka, A., Szymanowska, K., Straburzynska Migaj, E., Kaluzna Oleksy, M., Grajek, S., Kasztelowicz, P., Orzel, T., Bednarczyk, G., Ruszkowski, P., Klimkiewicz, J., Majzner, A., Matusiak, A., Bylicka, E., Kwiatkowska, E., Kwiatkowska, K., Ochnio, M., Krzyzewska, T., Tarnowska, A., Komuda, K., Sobieszczanska Malek, M., Leszek, P., Rywik, T., Wisniewska, J., Kozar Kaminska, K., Piotrowska, M., Zielinski, T., Mamcarz, A., Welnicki, M., Folga, A., Kaplon Cieslicka, A., Opolski, G., Marchel, M., Balsam, P., Michalek, A., Pawlak, A., Byczkowska, K., Mozenska, O., Gil, K., Gil, R. J., Skrobowski, A., Uzieblo Zyczkowska, B., Piotrowicz, K., Krzesinski, P., Stanczyk, A., Ciurzynski, M., Bienias, P., Pruszczyk, P., Juszczyk, Z., Switala, P., Stankala, S., Polonski, L., Rozentryt, P., Gabryel, J., Lazorko Piega, M., Kardaszewicz, P., Poprawa, I., Komorowska, E., Lauko Rachocka, A., Abdulkarim, A. F., Dudzik Plocica, A., Zolbach, A., Sajnaga, D., Komorowska, K., Baczynska, K., Samcik, M., Wolniewicz, L., Wozakowska Kaplon, B., Sosnowska Pasiarska, B., Bartkowiak, R., Fiega, A., Serwicka, A., Szymczyk, A., Fitas, G., Zysko, D., Poliwczak, A., Broncel, M., Bala, A., Kasprzak, J. D., Jankowski, L., Rudzinska, M., Zycinski, P., Retwinski, A., Pietka, I., Drozdz, J., Wojtczak Soska, K., Jankowska, E., Ponikowski, P., Cichy, A., Kostka, A., Kaminski, L., Weglarz, J., Bodys, A., Flis, P., Kleinrok, A., Prokop Lewicka, G., Mosakowska, K., Rynkiewicz, A., Bellwon, J., Dabrowska Kugacka, A., Lewicka, E., Raczak, G., Skorek, E., Szabowski, S., Krysiak, W., Pietrzak, J., Gilewski, W., Sinkiewicz, W., Furman, A., Zalewski, J., Nessler, J., Bury, K., Grzegorzko, A., Zabojszcz, M., Mirek Bryniarska, E., Klys, J., Przybylska, K., Szulik, M., Kalarus, Z., Kuczaj, A., Nowalany Kozielska, E., Krzeminski, A., Ventosa, A., Tavares Aguiar, C., Moura, B., Cardoso, J. S., De Jesus, I., Chin, J., Faria, R., Pereira, S., Lima, Giuseppe, Oliveira Guimarães, T., Francisco, A. R., Brito, D., Placido, R., Martins, S., Fonseca, C., Marques, F., Araujo, I., Proenca, M., Cardiga, R., Andrade, A., Castro, Alessandra, Pereira, A., Queirós, C., Silva, P., Santos, R., Lourenço, C., Moreno, N., Almeida, F., Quelhas, I., Baptista, A., Ferreira, A., Magalhaes, P., Ferreira, Clara, Moreira, I., Durao, D., Severino, D., Ferreira Da Silva, G., Marta, L., Peres, Martina, Stanescu, C., Dan, A., Dan, G. A., Daha, I., Popescu, R., Vinereanu, D., Sinescu, C. J., Macarie, C., Radoi, M., Nechita, E., Christodorescu, R., Datcu, M., Craiu, E., Otasevic, P., Ristic, A. D., Simeunovic, D., Seferovic, P., Pencic, B., Andric, A., Stojcevski, B., Lebedinski, E., Suzic Lazic, J., Celic, V., Krotin, M., Radovanovic, Slavena, Iric Cupic, V., Milanov, S., Davidovic, G., Jovic, Masa, Radin, A., Mihajlovic, B., Stojiljkovic, J., Cankovic, M., Cemerlic Adic, N., Dodic, Sara, Kecojevic, S., Stojsic, S., Petrovic, D., Deljanin Ilic, M., Ilić, Saša, Stoickov, V., Antic, S., Stanojevic, D., Pavlovic, M., Atanaskovic, V., Mitic, Vanja, Kovar, F., Goncalvesova, E., Murin, J., Pernicky, M., Klabnik, A., Kmec, J., Rajtman, D., Kovac, D., Horvat, Sara, Krunic, B., Bombek, M., Krajnc, I., Losic, R., Glavic, T., Komel, Janja, Cernic Suligoj, N., Ravnikar, T., Letonja, M., Cencic, Vanja, Savnik Iskra, M., Strasek, M., Leskovar, B., Drnovsek, B., Klen, J., Marolt, A., Kladnik, M., Slemenik Pusnik, C., Pusnik Vrckovnik, M., Jug, Barbara, Fras, Z., Bartolic, Andrej, Melihen Bartolic, C., Valentincic, M., Winkler, R., Blanco Canosa, P., Grille Cancela, Z., Crespo Leiro, M., Paniagua Martin, M. J., Marzoa Rivas, R., Barge Caballero, E., Torres Calvo, F., Bravo Marques, R., Epelde Gonzalo, F., Recio Platero, A., De La Fuente Galan, L., Lopez Diaz, J., Goncalvez Ramirez, L. Renier, Cubero Gallego, H., Sliwiski Herrera, J. F., Bierge Valero, D., Salmeron, F. M., Gallego Page, J. C., Jose Fernandez, M., Sahuquillo, A., Garcia De La Villa, B., Castro Conde, A., Iniesta Manjavacas, A. M., Salvador Montanes, O., Gonzalez Gallarza, R. Dalmau, Ofelia Rosillo, S., Araujo, A., Briceno, A., Alonso Pulpon, L., Cobo, M., Soria, T., Gomez Bueno, M., Garcia Pavia, P., Gonzalez Segovia, A., Sayago, I., Segovia Cubero, J., Delgado Jiménez, J. F., Angel Gomez Sanchez, M., Escribano Subias, P., Barrios Garrido Lestache, E., Ruiz Cano, M. J., Vicente Hernandez, M., Puga Martinez, M., Lopez Moreno, E., Serrano Martinez, J. L., Fernandez Alvarez, M., Rivera Lopez, R., Lopez Fernandez, S., Alcade Martinez, V., Sanmartin, M., Pellicer Cabo, A., Garcia Escriva, D., Ridocci Soriano, F., Perez Silvestre, J., Facila Rubio, L., Garcia Gonzalez, P., Sanchez Lazaro, I. J., Almenar Bonet, L., Garcia Pinilla, J. M., Andres, Ulrike Julia, Bayes Genis, A., Roig, E., Mirabet, S., Mendez, A., Garcia Cosio, L., Garay, A., Muntane, G., Gonzalez Costello, J., Leon, V., Diaz Molina, B., Famara Hernandez, I., Lara Padron, A., Laynez Cerdena, I., Mateo, I., Quiles, J., Bertomeu, V., Elamrani, A., Angel Rodrigez Ortega, J., Martinez Abellan, R., Valero, R., Fernandez Vivancos, C., Sanz Julve, M., Perez Martinez, M. T., Pascual Figal, D. A., Martinez Martinez Espejo, M. D., Rosario Gracia Rodenas, M., Pastor Perez, F., Melin, M., Hägglund, E., Stenberg, A., Lindahl, I. M., Asserlund, B., Olsson, L., Dahlström, U., Afzelius, M., Karlström, P., Tengvall, L., Wiklund, P. A., Olsson, B., Temizhan, A., Kalayci, S., Bozkurt, M., Taraktas, M., Cavusoglu, Y., Gunes, H., Birhan Yilmaz, M., Demir, B., Gencer, E., Maggioni, Aldo P, Anker, Stefan D., Dahlström, Ulf, Filippatos, Gerasimo, Ponikowski, Piotr, Zannad, Faiez, Amir, Offer, Chioncel, Ovidiu, Leiro, Marisa Crespo, Drozdz, Jaroslaw, Erglis, Andrej, Fazlibegovic, Emir, Fonseca, Candida, Fruhwald, Friedrich, Gatzov, Plamen, Goncalvesova, Eva, Hassanein, Mahmoud, Hradec, Jaromir, Kavoliuniene, Ausra, Lainscak, Mitja, Logeart, Damien, Merkely, Bela, Metra, Marco, Persson, Han, Seferovic, Petar, Temizhan, Ahmet, Tousoulis, Dimitri, Tavazzi, Luigi, Andarala, M., Fiorucci, E., Folkesson, E., Glemot, M., Gracia, G., Konte, M., Laroche, C., Mcneill, P. a., Missiamenou, V., Taylor, C., Fruhwald, F., Eberl, Alexander, Heller, S., Dolze, T., Platzer, V., Ablasser, K., Auer, J., Poelzl, G., Moertl, D., Podczeck Schweighofer, A., Reiter, S., Pravdic, D., Fazlibegovic, E., Muslibegovic, A., Vitlianova, K., Katova, T., Kotirkov, K., Petrov, I., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Tisheva, S., Sirakova, V., Krejci, J., Spinar, J., Mikolaskova, M., Krupicka, J., Malek, F., Hegarova, M., Pudil, R., Monhart, Z., Lazarova, M., Reda, A., Khairy, T., Farag, N., Saleh, A., Said, K., Abdel Hamid, M., Halawa, S., Ibrahim, B., Hanna, R., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Aboleineen, W., Gouda, M., Youssef, A., Elbahry, A., Abdel, A., Ebeid, H., Nasr, G., Sobhy, H., Ashmawy, M., Lefol, C., Isnard, R., Hagege, A., Thevenin, S., Jondeau, G., Logeart, D., Codjia, R., Galinier, M., Bauer, F., Delahaye, F., Lamblin, N., Fertin, M., De Groote, P., Coisne, D., Le Marcis, V., Lequeux, B., Ly, J. F., Lotton, P., Donal, E., Le Moal, V., Basquin, A., Reynaud, A., Ridard, C., Thebault, C., Behar, N., Mascle, S., Schiele, F., Seronde, M. F., Morel, M., Meneveau, N., Luporsi, P., Bernard, Y., Pillot, M., Briand, F., Damy, T., Eicher, J. C., Avgeropoulou, C., Panagiotis, T., Tousoulis, D., Kotrogiannis, I., Stefanadis, C., Chrysohoou, C., Tsitsinakis, G., Dimitroula, T., Karavidas, A., Matzaraki, V., Terrovitis, J., Kapelios, C., Sfakianaki, T., Filippatos, G., Parissis, J. T., Ntai, K., Papadopoulou, A., Tziourganou, H., Douras, A., Ntertsas, K., Karotsaki, T., Nikoloulis, N., Tsaknakis, T., Patrianakos, A., Nyktari, E., Vardas, P., Soos, P., Nyolczas, N., Csaba Nagy, A., Halmosi, R., Nemeth, F., Amon, G., Dinnyes, J., Vazan Fuhrmann, A., Shotan, A., Alony, I., Elber, J., Olaru, A., Valenti, C., Reggianini, L., Modena, M. G., Copelli, S., Leuzzi, Concetta, Dei Cas, L., Carubelli, V., Lombardi, Cecilia, Bulgari, M., Tanghetti, E., Quinzani, F., Metra, M., Rovetta, R., Brasolin, B., Fedele, F., Sergi, Daniela, Romeo, F., Scarfò, I., Vellini, M., Fabris, E., Cinquetti, Martino, Stolfo, Davide, Sinagra, Gianfranco, Merlo, Marco, Fucili, A., Ferrari, R., Vassanelli, C., Torelli, F., Marchese, G., Zanolla, L., Cicoira, M., Anselmi, Manuel, Piccinino, C., Sartori, C., Di Ruocco, M. V., Marino, P. N., Giordano, A., Brognoli, S., Zanelli, E., Cosmi, F., Cadeddu, C., Bandino, S., Mercuro, G., Deidda, M., Salvemini, G., Correale, M., Di Biase, M., Musio, S., Passero, T., Italiano, Graziella, Agostoni, P., Salvioni, E., Schiavina, G., Squeri, CARLO ATTILIO, Bosi, S., Barbieri, A., Lemme, E., Penco, M., Marcon, S., Romano, S., Di Mauro, M., Frisinghelli, A., Veniani, M., Pieri, Pietro, Novo, S., Proclemer, Alessandro, Fresco, C., Miani, Daniela, Artico, Jessica, Gaita, F., Bergerone, S., Pirelli, SALVATORE DONATO, Di Tano, G., Cattaneo, Silvana, Gualco, A., Opasich, C., Priori, S. G., Iori, Elisa, Leci, E., Melandri, F., Voronina, N., Erglis, A., Kalnins, A., Kavoliuniene, A., Rumbinaite, E., Kazakauskaite, E., Petraskiene, I., Karaliute, R., Smalinskas, V., Tamakauskas, V., Petraskiene, D., Brazyte Ramanauskiene, R., Vysniauskas, V., Nowicka, A., Grabia, J., Dankowski, R., Szyszka, A., Szymanowska, K., Straburzynska Migaj, E., Kaluzna Oleksy, M., Grajek, S., Kasztelowicz, P., Orzel, T., Bednarczyk, G., Ruszkowski, P., Klimkiewicz, J., Majzner, A., Matusiak, A., Bylicka, E., Kwiatkowska, E., Kwiatkowska, K., Ochnio, M., Krzyzewska, T., Tarnowska, A., Komuda, K., Sobieszczanska Malek, M., Leszek, P., Rywik, T., Wisniewska, J., Kozar Kaminska, K., Piotrowska, M., Zielinski, T., Mamcarz, A., Welnicki, M., Folga, A., Kaplon Cieslicka, A., Opolski, G., Marchel, M., Balsam, P., Michalek, A., Pawlak, A., Byczkowska, K., Mozenska, O., Gil, K., Gil, R. J., Skrobowski, A., Uzieblo Zyczkowska, B., Piotrowicz, K., Krzesinski, P., Stanczyk, A., Ciurzynski, M., Bienias, P., Pruszczyk, P., Juszczyk, Z., Switala, P., Stankala, S., Polonski, L., Rozentryt, P., Gabryel, J., Lazorko Piega, M., Kardaszewicz, P., Poprawa, I., Komorowska, E., Lauko Rachocka, A., Abdulkarim, A. F., Dudzik Plocica, A., Zolbach, A., Sajnaga, D., Komorowska, K., Baczynska, K., Samcik, M., Wolniewicz, L., Wozakowska Kaplon, B., Sosnowska Pasiarska, B., Bartkowiak, R., Fiega, A., Serwicka, A., Szymczyk, A., Fitas, G., Zysko, D., Poliwczak, A., Broncel, M., Bala, A., Kasprzak, J. D., Jankowski, L., Rudzinska, M., Zycinski, P., Retwinski, A., Pietka, I., Drozdz, J., Wojtczak Soska, K., Jankowska, E., Ponikowski, P., Cichy, A., Kostka, A., Kaminski, L., Weglarz, J., Bodys, A., Flis, P., Kleinrok, A., Prokop Lewicka, G., Mosakowska, K., Rynkiewicz, A., Bellwon, J., Dabrowska Kugacka, A., Lewicka, E., Raczak, G., Skorek, E., Szabowski, S., Krysiak, W., Pietrzak, J., Gilewski, W., Sinkiewicz, W., Furman, A., Zalewski, J., Nessler, J., Bury, K., Grzegorzko, A., Zabojszcz, M., Mirek Bryniarska, E., Klys, J., Przybylska, K., Szulik, M., Kalarus, Z., Kuczaj, A., Nowalany Kozielska, E., Krzeminski, A., Ventosa, A., Tavares Aguiar, C., Moura, B., Cardoso, J. S., De Jesus, I., Chin, J., Faria, R., Pereira, S., Lima, Giuseppe, Oliveira Guimarães, T., Francisco, A. R., Brito, D., Placido, R., Martins, S., Fonseca, C., Marques, F., Araujo, I., Proenca, M., Cardiga, R., Andrade, A., Castro, Alessandra, Pereira, A., Queirós, C., Silva, P., Santos, R., Lourenço, C., Moreno, N., Almeida, F., Quelhas, I., Baptista, A., Ferreira, A., Magalhaes, P., Ferreira, Clara, Moreira, I., Durao, D., Severino, D., Ferreira Da Silva, G., Marta, L., Peres, Martina, Stanescu, C., Dan, A., Dan, G. A., Daha, I., Popescu, R., Vinereanu, D., Sinescu, C. J., Macarie, C., Radoi, M., Nechita, E., Christodorescu, R., Datcu, M., Craiu, E., Otasevic, P., Ristic, A. D., Simeunovic, D., Seferovic, P., Pencic, B., Andric, A., Stojcevski, B., Lebedinski, E., Suzic Lazic, J., Celic, V., Krotin, M., Radovanovic, Slavena, Iric Cupic, V., Milanov, S., Davidovic, G., Jovic, Masa, Radin, A., Mihajlovic, B., Stojiljkovic, J., Cankovic, M., Cemerlic Adic, N., Dodic, Sara, Kecojevic, S., Stojsic, S., Petrovic, D., Deljanin Ilic, M., Ilić, Saša, Stoickov, V., Antic, S., Stanojevic, D., Pavlovic, M., Atanaskovic, V., Mitic, Vanja, Kovar, F., Goncalvesova, E., Murin, J., Pernicky, M., Klabnik, A., Kmec, J., Rajtman, D., Kovac, D., Horvat, Sara, Krunic, B., Bombek, M., Krajnc, I., Losic, R., Glavic, T., Komel, Janja, Cernic Suligoj, N., Ravnikar, T., Letonja, M., Cencic, Vanja, Savnik Iskra, M., Strasek, M., Leskovar, B., Drnovsek, B., Klen, J., Marolt, A., Kladnik, M., Slemenik Pusnik, C., Pusnik Vrckovnik, M., Jug, Barbara, Fras, Z., Bartolic, Andrej, Melihen Bartolic, C., Valentincic, M., Winkler, R., Blanco Canosa, P., Grille Cancela, Z., Crespo Leiro, M., Paniagua Martin, M. J., Marzoa Rivas, R., Barge Caballero, E., Torres Calvo, F., Bravo Marques, R., Epelde Gonzalo, F., Recio Platero, A., De La Fuente Galan, L., Lopez Diaz, J., Goncalvez Ramirez, L. Renier, Cubero Gallego, H., Sliwiski Herrera, J. F., Bierge Valero, D., Salmeron, F. M., Gallego Page, J. C., Jose Fernandez, M., Sahuquillo, A., Garcia De La Villa, B., Castro Conde, A., Iniesta Manjavacas, A. M., Salvador Montanes, O., Gonzalez Gallarza, R. Dalmau, Ofelia Rosillo, S., Araujo, A., Briceno, A., Alonso Pulpon, L., Cobo, M., Soria, T., Gomez Bueno, M., Garcia Pavia, P., Gonzalez Segovia, A., Sayago, I., Segovia Cubero, J., Delgado Jiménez, J. F., Angel Gomez Sanchez, M., Escribano Subias, P., Barrios Garrido Lestache, E., Ruiz Cano, M. J., Vicente Hernandez, M., Puga Martinez, M., Lopez Moreno, E., Serrano Martinez, J. L., Fernandez Alvarez, M., Rivera Lopez, R., Lopez Fernandez, S., Alcade Martinez, V., Sanmartin, M., Pellicer Cabo, A., Garcia Escriva, D., Ridocci Soriano, F., Perez Silvestre, J., Facila Rubio, L., Garcia Gonzalez, P., Sanchez Lazaro, I. J., Almenar Bonet, L., Garcia Pinilla, J. M., Andres, Ulrike Julia, Bayes Genis, A., Roig, E., Mirabet, S., Mendez, A., Garcia Cosio, L., Garay, A., Muntane, G., Gonzalez Costello, J., Leon, V., Diaz Molina, B., Famara Hernandez, I., Lara Padron, A., Laynez Cerdena, I., Mateo, I., Quiles, J., Bertomeu, V., Elamrani, A., Angel Rodrigez Ortega, J., Martinez Abellan, R., Valero, R., Fernandez Vivancos, C., Sanz Julve, M., Perez Martinez, M. T., Pascual Figal, D. A., Martinez Martinez Espejo, M. D., Rosario Gracia Rodenas, M., Pastor Perez, F., Melin, M., Hägglund, E., Stenberg, A., Lindahl, I. M., Asserlund, B., Olsson, L., Dahlström, U., Afzelius, M., Karlström, P., Tengvall, L., Wiklund, P. A., Olsson, B., Temizhan, A., Kalayci, S., Bozkurt, M., Taraktas, M., Cavusoglu, Y., Gunes, H., Birhan Yilmaz, M., Demir, B., and Gencer, E.

Subjects
Registrie, Male, ACE inhibitors, Angiotensin-Converting Enzyme Inhibitors, Nitrate, Beta-blockers, Ambulatory Care, Medicine, Registries, Diuretics, Mineralocorticoid Receptor Antagonists, Angiotensin Receptor Antagonist, Middle Aged, Defibrillators, Implantable, Clinical Practice, Europe, Hospitalization, Ambulatory, MRAs, Practice Guidelines as Topic, MRA, Cardiology, CRT, Female, Guideline Adherence, Implantable, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Cardiotonic Agents, cardiology and cardiovascular mediciney, Mineralocorticoid Antagonists, Adrenergic beta-Antagonists, Heart failure, ICD, Aged, Angiotensin Receptor Antagonists, Heart Failure, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Nitrates, Platelet Aggregation Inhibitors, Drug treatment, ACE inhibitor, Internal medicine, Diuretic, Cardiotonic Agent, In patient, Beta-blocker, Mineralocorticoid Receptor Antagonist, business.industry, Platelet Aggregation Inhibitor, beta-blockers, heart failure, adrenergic beta-antagonists, aged, ambulatory care, angiotensin receptor antagonists, angiotensin-converting enzyme inhibitors, cardiology, cardiotonic agents, defibrillators, implantable, diuretics, europe, female, guideline adherence, hospitalization, humans, hydroxymethylglutaryl-coa reductase inhibitors, male, middle aged, mineralocorticoid receptor antagonists, nitrates, platelet aggregation inhibitors, practice guidelines as topic, registries, Adrenergic beta-Antagonist, Angiotensin-Converting Enzyme Inhibitor, Guideline, medicine.disease, Observational study, Hydroxymethylglutaryl-CoA Reductase Inhibitor, business, Defibrillators
Abstract

AimsTo evaluate how recommendations of European guidelines regarding pharmacological and non-pharmacological treatments for heart failure (HF) are adopted in clinical practice.Methods and resultsThe ESC-HF Long-Term Registry is a prospective, observational study conducted in 211 Cardiology Centres of 21 European and Mediterranean countries, members of the European Society of Cardiology (ESC). From May 2011 to April 2013, a total of 12 440 patients were enrolled, 40.5% with acute HF and 59.5% with chronic HF. Intravenous treatments for acute HF were heterogeneously administered, irrespective of guideline recommendations. In chronic HF, with reduced EF, renin-angiotensin system (RAS) blockers, beta-blockers, and mineralocorticoid antagonists (MRAs) were used in 92.2, 92.7, and 67.0% of patients, respectively. When reasons for non-adherence were considered, the real rate of undertreatment accounted for 3.2, 2.3, and 5.4% of the cases, respectively. About 30% of patients received the target dosage of these drugs, but a documented reason for not achieving the target dosage was reported in almost two-thirds of them. The more relevant reasons for non-implantation of a device, when clinically indicated, were related to doctor uncertainties on the indication, patient refusal, or logistical/cost issues.ConclusionThis pan-European registry shows that, while in patients with acute HF, a large heterogeneity of treatments exists, drug treatment of chronic HF can be considered largely adherent to recommendations of current guidelines, when the reasons for non-adherence are taken into account. Observations regarding the real possibility to adhere fully to current guidelines in daily clinical practice should be seriously considered when clinical practice guidelines have to be written. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com

Published
2013

9. Calcium/calmodulin-dependent protein kinase II (CaMKII) inhibition ameliorates arrhythmias elicited by junctin ablation under stress conditions

Author

Tzimas, C. Terrovitis, J. Lehnart, S.E. Kranias, E.G. Sanoudou, D.

Subjects
cardiovascular system, musculoskeletal system
Abstract

Background Aberrant calcium signaling is considered one of the key mechanisms contributing to arrhythmias, especially in the context of heart failure. In human heart failure, there is significant down-regulation of the sarcoplasmic reticulum (SR) protein junctin, and junctin deficiency in mice is associated with stress-induced arrhythmias. Objective The purpose of this study was to determine whether the increased SR Ca2+ leak and arrhythmias associated with junctin ablation may be associated with increased calcium/calmodulin-dependent protein kinase II (CaMKII) activity and phosphorylation of the cardiac ryanodine receptor (RyR2) and whether pharmacologic inhibition of CaMKII activity may prevent these arrhythmias. Methods Using a combination of biochemical, cellular, and in vivo approaches, we tested the ability of KN-93 to reverse aberrant CaMKII phosphorylation of RyR2. Specifically, we performed protein phosphorylation analysis, in vitro cardiomyocyte contractility and Ca2+ kinetics, and in vivo ECG analysis in junctin-deficient mice. Results In the absence of junctin, RyR2 channels displayed CaMKII-dependent hyperphosphorylation. Notably, CaMKII inhibition by KN-93 reduced the in vivo incidence of stress-induced ventricular tachycardia by 65% in junctin null mice. At the cardiomyocyte level, KN-93 reduced the percentage of junctin null cells exhibiting spontaneous Ca2+ aftertransients and aftercontractions under stress conditions by 35% and 37%, respectively. At the molecular level, KN-93 blunted the CaMKII-mediated hyperphosphorylation of RyR2 and phospholamban under stress conditions. Conclusion Our data suggest that CaMKII inhibition is effective in preventing arrhythmogenesis in the setting of junctin ablation through modulation of both SR Ca2+ release and uptake. Thus, it merits further investigation as promising molecular therapy. © 2015 Published by Elsevier Inc. on behalf of Heart Rhythm Society.

Published
2015

10. Respiratory drive and breathing pattern abnormalities are related to exercise intolerance in chronic heart failure patients

Author

Tasoulis, A. Dimopoulos, S. Repasos, E. Manetos, C. Tzanis, G. Sousonis, V. Papazachou, O. Terrovitis, J. Nanas, S.

Abstract

Background: Patients with chronic heart failure (CHF) are characterized by exercise intolerance and ventilatory abnormalities that are related to poor prognosis. We hypothesized that CHF patients have increased respiratory drive and abnormal breathing pattern during exercise in relation to disease severity. Materials and methods: The study population consisted of 219 stable CHF patients and 30 healthy control subjects. All subjects underwent a symptom-limited cardiopulmonary exercise testing (CPET), pulmonary function tests, measurement of the maximal inspiratory pressure (PImax) and respiratory drive (P0.1).Measurements included peak oxygen uptake (VO2 peak, ml/kg/min). Respiratory drive was measured by mouth occlusion pressure P0.1 and P0.1/PImax ratio at rest, and by mean inspiratory flow (VT/TI) at rest and during exercise. CHF patients were divided into 3 groups according to VO2 peak (Group A: >20, Group B: 20-16 and Group C

Published
2014

11. Beneficial effects of combined exercise training on early recovery cardiopulmonary exercise testing indices in patients with chronic heart failure

Author

Georgantas, A. Dimopoulos, S. Tasoulis, A. Karatzanos, E. Pantsios, C. Agapitou, V. Ntalianis, A. Roditis, P. Terrovitis, J. Nanas, S.

Subjects
human activities
Abstract

PURPOSE: Exercise training induces several beneficial effects in patients with chronic heart failure (CHF). This study investigated the effects of high-intensity aerobic interval training (AIT) compared with combined AIT and strength training (COM) on early ventilatory and metabolic recovery pattern after symptom-limited cardiopulmonary exercise testing (CPET) in CHF patients. METHODS: Stable CHF patients (N = 42; 54 ± 10 years [mean ± SD], 35 males) participated in an exercise training program for 12 weeks, 3 times per week. Participants were randomly assigned to either AIT (n = 20) or COM group (n = 22). Cardiopulmonary exercise testing was performed before and after completion of the program. Primary measurements included absolute and percentage difference of oxygen uptake, carbon dioxide output, minute ventilation (VE), tidal volume (VT), respiratory rate, and the first-degree slope of oxygen uptake (VO2/t slope) and carbon dioxide output (VCO2/t slope) during the first minute of recovery after maximal exercise. RESULTS: The COM group had a greater improvement in the absolute and the percentage difference of VE (P = .03 and P = .04, respectively) and respiratory rate (P = .02 and P = .01, respectively) during the first minute of recovery period after exercise compared with the AIT group alone. No significant changes were noted for V T measurements. A significant increase in VCO2/t slope was observed in COM compared with the AIT group (P = .01). There was a trend for a greater increase in VO2/t slope in the COM group (P = .07). CONCLUSIONS: The addition of strength training to AIT induces significant beneficial effects in terms of ventilatory and metabolic recovery kinetics than AIT alone in CHF patients, possibly indicating greater ventilatory efficiency and metabolic improvement. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Published
2014

12. A decision support system for the treatment of patients with ventricular assist device support

Author

Karvounis, E.C. Tsipouras, M.G. Tzallas, A.T. Katertsidis, N.S. Stefanou, K. Goletsis, Y. Frigerio, M. Verde, A. Caruso, R. Meyns, B. Terrovitis, J. Trivella, M.G. Fotiadis, D.I.

Abstract

Background: Heart failure (HF) is affecting millions of people every year and it is characterized by impaired ventricular performance, exercise intolerance and shortened life expectancy. Despite significant advancements in drug therapy, mortality of the disease remains excessively high, as heart transplant remains the gold standard treatment for endstage HF when no contraindications subsist. Traditionally, implanted Ventricular Assist Devices (VADs) have been employed in order to provide circulatory support to patients who cannot survive the waiting time to transplantation, reducing the workload imposed on the heart. In many cases that process could recover its contractility performance. Objectives: The SensorART platform focuses on the management and remote treatment of patients suffering from HF. It provides an interoperable, extendable and VAD-independent solution, which incorporates various hardware and software components in a holistic approach, in order to improve the quality of the patients' treatment and the workflow of the specialists. This paper focuses on the description and analysis of Specialist's Decision Support System (SDSS), an innovative component of the SensorART platform. Methods: The SDSS is a Web-based tool that assists specialists on designing the therapy plan for their patients before and after VAD implantation, analyzing patients' data, extracting new knowledge, and making informative decisions. Results: SDSS offers support to medical and VAD experts through the different phases of VAD therapy, incorporating several tools covering all related fields; Statistics, Association Rules, Monitoring, Treatment, Weaning, Speed and Suction Detection. Conclusions: SDSS and its modules have been tested in a number of patients and the results are encouraging. © Schattauer 2014.

Published
2014

13. Angiogenesis, cardiomyocyte proliferation and anti-fibrotic effects underlie structural preservation post-infarction by intramyocardially-injected cardiospheres

Author

Tseliou, E. De Couto, G. Terrovitis, J. Sun, B. Weixin, L. Marbán, L. Marbán, E.

Abstract

Objective: We sought to understand the cellular and tissue-level changes underlying the attenuation of adverse remodeling by cardiosphere transplantation in acute myocardial infarction (MI). Background: Cardiospheres (CSps) are heart-derived multicellular clusters rich in stemness and capable of multilineage differentiation. Post-MI CSp transplantation improves left ventricular (LV) function and attenuates remodeling in both small and large animal studies. However, the mechanisms of benefit have not yet been fully elucidated. Methods: Four groups were studied: 1) "Sham" (Wistar Kyoto rats with thoracotomy and ligature without infarction); 2) "MI" (proximal LAD ligation with peri-infarct injection of vehicle); 3) "MI+CSp" (MI with cardiospheres injected in the peri-infarct area); 4) "Small MI" (mid-LAD ligation only). Results: In vivo 1 week after CSp transplantation, LV functional improvement was associated with an increase in cardiomyocyte proliferation. By 3 weeks, microvessel formation was enhanced, while cardiomyocyte hypertrophy and regional fibrosis were attenuated. Collagen deposition was reduced, collagen degradation was enhanced, and MMPs were upregulated. The beneficial effects of CSp transplantation were not observed in the Small MI group, indicating that the effects are not solely due to CSp-induced cardioprotection. In vitro, CSp-conditioned media reduced collagen production in coculture with fibroblasts and triggered neoangiogenesis in an ex vivo aortic ring assay. Conclusion: Cardiospheres enhance cardiomyocyte proliferation and angiogenesis, and attenuate hypertrophy and fibrosis, in the ischemic myocardium. These synergistic effects underlie the attenuation of adverse remodeling by cardiospheres. © 2014 Tseliou et al.

Published
2014

14. Cardiospheres reverse adverse remodeling in chronic rat myocardial infarction: roles of soluble endoglin and Tgf-β signaling

Author

Tseliou, E. Reich, H. de Couto, G. Terrovitis, J. Sun, B. Liu, W. Marbán, E.

Abstract

Self-assembling heart-derived stem cell clusters named cardiospheres (CSps) improve function and attenuate remodeling in rodent models of acute myocardial infarction. The effects of CSps in chronically remodeled myocardium post-MI, and the underlying mechanisms, remain unknown. One month after permanent coronary ligation, rats were randomly assigned to injection of vehicle (controls) or CSps in the peri-infarct area. One month post-injection, CSps increased left ventricular function, reduced scar mass and collagen density, and enhanced vascularity within the infarct zone compared to controls. Immunoblots revealed Tgfβ-1/smad cascade downregulation and an increase in soluble endoglin post-CSp injection. Six months post-transplantation, left ventricular function further improved and cardiomyocyte hypertrophy was attenuated in the CSp-treated group. In vitro, co-culture of CSps with fibroblasts recapitulated the suppression of the Tgf-β1/smad pathway changes, responses which were blunted by neutralizing antibody against endoglin. Thus, cardiosphere transplantation enhances angiogenesis and reduces fibrosis in chronically infarcted myocardium, leading to partial reversal of cardiac dysfunction. The underlying mechanism involves inhibition of Tgf-β1/smad signaling by CSp-secreted soluble endoglin. © 2014, Springer-Verlag Berlin Heidelberg.

Published
2014

15. The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: a report from the Euro Heart Survey on Coronary Revascularisation

Author

Lenzen M. J., Scholte Op Reimer W. J. M., Pedersen S. S., Boersma E., Maier W., Widimsky P., Simoons M. L., Mercado N. F., Wijns W., Bertrand M., Meier B., Sechtem U., Sergeant P., Stahle E., Unger F., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J. -J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Grabauskiene V., Deckers J., Asmussen I., Stepinska J., Goncalves L., Mareev V., Riecansky I., Kenda M. F., Alonso A., Lopez-Sendon J. L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Wood D., Crijns H., McGregor K., Mulder B., Priori S., Ryden L., Tavazzi L., Vahanian A., Vardas P., Sarkisyan K., Glogar H. D., Frick M., Pachinger O., Zwick R., Vrints C., Van Hertbruggen E., Vercammen M., Sysmans T., Schroeder E., Domange J., De Pril H., De Vriese J., Van Hecke T., Legrand V., Gillon M. -F., Richardy M., Doneux P., Petrov I., Jorgova J., Starcevic B., Eeckhout E., Berger A., Prudent V., Camenzind E., Masson N., Zambartas C., Kleanthous H., Stellova B., Aschermann M., Simek S., Kautzner J., Karmazin V., Svab P., Indrak J., Branny M., Hladilova K., Kala P., Cappelen H., Jensen L. O., Gitt A., Gehrke K., am Rhein L., Erbel R., Gutersohn A., Eggebrecht H., Al Khani M., Rosenberger A., Vogelsberg H., Klepzig H., Schmidt A., Silber S., Mau B., Leuner C., Czyborra K., Reuschling C., Muno E., Nauheim B., Kleber F., Rux S., Saad A., Elabady M., Beiras A. C., Fernandez J. S., del Arno F. N., Romo A. I., Fernandez J. M. C., Mayoreal A. R., Rebanal F. J. R., de la Borbolla M. G., Chaparro M., Brotons C., Miralda C. P., Vila i Perez S. I., Moris C., Aviles F. F., de la Fuente Galan L., Vinuela P. T., de Torres F. M., Mora J., Rodriguez I. S., Bustamante I. P., Fernandez P. L. S., Torrent J. L. D., Diez Gil J. L., Perpinan J., Motilla V. P., Juango M. S. A., Berjon-Reyero J., Moreno R. M., Guerrero J. C. F., Savolainen K., Syvanne M., Cohen-Solal A., Oboa A. -S., Bassand J. P., Espinosa D. P., Jouet V., Cedex B., Montalescot G., Gallois V., Daubert J. C., Clerc J. M., Machecourt J., Cottin Y., Walker D., Holland F., Prosser J., Muir L., Barber K., Cleland J. G. F., Cook J., Chapichadze Z., Christos I. S. A., Tsiavou N., Chrysohoou C., Manginas A., Terrovitis J., Kanakakis J., Vavuranakis M., Drakos S., Farmakis T., Samara C., Papakosta C., Bourantas C., Michalis L. K., Christos M., Foussas S., Adamopoulou E., Vardas P. E., Marketou M., Alotti N., Basa A. M., Vigh A., Preda I., Csoti E., Keltai M., Kerkovits G., Hendler A., Blatt A., Yakov B., Beyar R., Shefer A., Halon D., Bentzvi M., Avramovitch N., Bakst A., Saba K., Cafri C., Grosbard A., Sheva B., Margolis B., Suleiman K., Banai S., Meerkin D., Mosseri M., Guita P., Jabara R., Jafari J., Shitrit D. B., Ghasan Salameh, Brezins M., van den Akker-Berman L., Guetta V., Hashomer T., Rozenman Y., Biagini A., Berti S., Ferrero M., Colombo A., Roccaforte R., Milici C., Scarpino L., Salvi A., Desideri A., Sabbadin D., Veneto C., Galassi A., Giuffrida G., Rognoni A., Vassanelli C., Paffoni P., Cioppa A., Rubino P., de Carlo M., Petronio A. S., Naccarella F., Saia F., Marzocchi A., Maranga S. S., Presbitero P., Valsecchi F., Piscione F., Esposito G., Santini N. M., Tubaro M., Erglis A., Narbute I., Kavoliuniene A., Zaliunas R., Navickas R., Luckute D., Subkovas E., Wagner D., Vermeer F., Lousberg A., Fransen H., Breeman A., Tebbe H., De Boer M. J., van der Wal M., Vos J., Leenders C. M., Veerhoek M. J., Jansen C., Bijl M., Koppelaar C., den Linden V., Brons R., Widdershofen J. W. M. G., Broers H., Kontny F., Jonzon M., Wodniecki J., Tomasik A., Trusz-Gluza M., Nowak S., Ruzyllo W., Deptuch T., Marques J., Matias F., Madeira H., Oliveira J., Sargento L., Ionac A., Dragulescu I. S., Mut-Vitcu B., Maximov D., Dorobantu M., Apetrei E., Niculescu R., Petrescu V., Bucsa A., Deleanu D., Bucharest, Benedek I. S., Hintea T., Aronov D., Tikhomirova E., Kranjec I., Prokselj K., Kanic V., Sepetoglu A., Aytekin S., Aytekin V., Catakoglu A. B., Parlar H., Tufekcioglu S., Ozyedek Z., Baltali M., Kiziltan D., Vukovic M., Neskovic A. N., Cardiology, Lenzen, M. J., Scholte Op Reimer, W. J. M., Pedersen, S. S., Boersma, E., Maier, W., Widimsky, P., Simoons, M. L., Mercado, N. F., Wijns, W., Bertrand, M., Meier, B., Sechtem, U., Sergeant, P., Stahle, E., Unger, F., Manini, M., Bramley, C., Laforest, V., Taylor, C., Del Gaiso, S., Huber, K., De Backer, G., Sirakova, V., Cerbak, R., Thayssen, P., Lehto, S., Blanc, J. -J., Delahaye, F., Kobulia, B., Zeymer, U., Cokkinos, D., Karlocai, K., Graham, I., Shelley, E., Behar, S., Maggioni, A., Grabauskiene, V., Deckers, J., Asmussen, I., Stepinska, J., Goncalves, L., Mareev, V., Riecansky, I., Kenda, M. F., Alonso, A., Lopez-Sendon, J. L., Rosengren, A., Buser, P., Okay, T., Sychov, O., Fox, K., Wood, D., Crijns, H., Mcgregor, K., Mulder, B., Priori, S., Ryden, L., Tavazzi, L., Vahanian, A., Vardas, P., Sarkisyan, K., Glogar, H. D., Frick, M., Pachinger, O., Zwick, R., Vrints, C., Van Hertbruggen, E., Vercammen, M., Sysmans, T., Schroeder, E., Domange, J., De Pril, H., De Vriese, J., Van Hecke, T., Legrand, V., Gillon, M. -F., Richardy, M., Doneux, P., Petrov, I., Jorgova, J., Starcevic, B., Eeckhout, E., Berger, A., Prudent, V., Camenzind, E., Masson, N., Zambartas, C., Kleanthous, H., Stellova, B., Aschermann, M., Simek, S., Kautzner, J., Karmazin, V., Svab, P., Indrak, J., Branny, M., Hladilova, K., Kala, P., Cappelen, H., Jensen, L. O., Gitt, A., Gehrke, K., am Rhein, L., Erbel, R., Gutersohn, A., Eggebrecht, H., Al Khani, M., Rosenberger, A., Vogelsberg, H., Klepzig, H., Schmidt, A., Silber, S., Mau, B., Leuner, C., Czyborra, K., Reuschling, C., Muno, E., Nauheim, B., Kleber, F., Rux, S., Saad, A., Elabady, M., Beiras, A. C., Fernandez, J. S., del Arno, F. N., Romo, A. I., Fernandez, J. M. C., Mayoreal, A. R., Rebanal, F. J. R., de la Borbolla, M. G., Chaparro, M., Brotons, C., Miralda, C. P., Vila i Perez, S. I., Moris, C., Aviles, F. F., de la Fuente Galan, L., Vinuela, P. T., de Torres, F. M., Mora, J., Rodriguez, I. S., Bustamante, I. P., Fernandez, P. L. S., Torrent, J. L. D., Diez Gil, J. L., Perpinan, J., Motilla, V. P., Juango, M. S. A., Berjon-Reyero, J., Moreno, R. M., Guerrero, J. C. F., Savolainen, K., Syvanne, M., Cohen-Solal, A., Oboa, A. -S., Bassand, J. P., Espinosa, D. P., Jouet, V., Cedex, B., Montalescot, G., Gallois, V., Daubert, J. C., Clerc, J. M., Machecourt, J., Cottin, Y., Walker, D., Holland, F., Prosser, J., Muir, L., Barber, K., Cleland, J. G. F., Cook, J., Chapichadze, Z., Christos, I. S. A., Tsiavou, N., Chrysohoou, C., Manginas, A., Terrovitis, J., Kanakakis, J., Vavuranakis, M., Drakos, S., Farmakis, T., Samara, C., Papakosta, C., Bourantas, C., Michalis, L. K., Christos, M., Foussas, S., Adamopoulou, E., Vardas, P. E., Marketou, M., Alotti, N., Basa, A. M., Vigh, A., Preda, I., Csoti, E., Keltai, M., Kerkovits, G., Hendler, A., Blatt, A., Yakov, B., Beyar, R., Shefer, A., Halon, D., Bentzvi, M., Avramovitch, N., Bakst, A., Saba, K., Cafri, C., Grosbard, A., Sheva, B., Margolis, B., Suleiman, K., Banai, S., Meerkin, D., Mosseri, M., Guita, P., Jabara, R., Jafari, J., Shitrit, D. B., Ghasan, Salameh, Brezins, M., van den Akker-Berman, L., Guetta, V., Hashomer, T., Rozenman, Y., Biagini, A., Berti, S., Ferrero, M., Colombo, A., Roccaforte, R., Milici, C., Scarpino, L., Salvi, A., Desideri, A., Sabbadin, D., Veneto, C., Galassi, A., Giuffrida, G., Rognoni, A., Vassanelli, C., Paffoni, P., Cioppa, A., Rubino, P., de Carlo, M., Petronio, A. S., Naccarella, F., Saia, F., Marzocchi, A., Maranga, S. S., Presbitero, P., Valsecchi, F., Piscione, F., Esposito, G., Santini, N. M., Tubaro, M., Erglis, A., Narbute, I., Kavoliuniene, A., Zaliunas, R., Navickas, R., Luckute, D., Subkovas, E., Wagner, D., Vermeer, F., Lousberg, A., Fransen, H., Breeman, A., Tebbe, H., De Boer, M. J., van der Wal, M., Vos, J., Leenders, C. M., Veerhoek, M. J., Jansen, C., Bijl, M., Koppelaar, C., den Linden, V., Brons, R., Widdershofen, J. W. M. G., Broers, H., Kontny, F., Jonzon, M., Wodniecki, J., Tomasik, A., Trusz-Gluza, M., Nowak, S., Ruzyllo, W., Deptuch, T., Marques, J., Matias, F., Madeira, H., Oliveira, J., Sargento, L., Ionac, A., Dragulescu, I. S., Mut-Vitcu, B., Maximov, D., Dorobantu, M., Apetrei, E., Niculescu, R., Petrescu, V., Bucsa, A., Deleanu, D., Bucharest, Benedek, I. S., Hintea, T., Aronov, D., Tikhomirova, E., Kranjec, I., Prokselj, K., Kanic, V., Sepetoglu, A., Aytekin, S., Aytekin, V., Catakoglu, A. B., Parlar, H., Tufekcioglu, S., Ozyedek, Z., Baltali, M., Kiziltan, D., Vukovic, M., and Neskovic, A. N.

Subjects
Male, medicine.medical_specialty, Epidemiology, medicine.medical_treatment, Health Status, Coronary Artery Disease, Revascularization, Coronary artery disease, Cohort Studies, Risk Factors, Surveys and Questionnaires, medicine, Myocardial Revascularization, Surveys and Questionnaire, Humans, Prospective Studies, Prospective cohort study, Aged, business.industry, Risk Factor, Mortality rate, Confounding, Middle Aged, medicine.disease, Surgery, Europe, Prospective Studie, Treatment Outcome, Emergency medicine, Population study, Female, Cohort Studie, Cardiology and Cardiovascular Medicine, business, Human, Cohort study
Abstract

Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures. Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients. Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p

Published
2006

16. Patients enrolled in coronary intervention trials are not representative of patients in clinical practice: results from the Euro Heart Survey on Coronary Revascularization

Author

Hordijk-Trion M., Lenzen M., Wijns W., De Jaegere P., Simoons M. L., Scholte Op Reimer W. J. M., Bertrand M. E., Mercado N., Boersma E., Maier W., Meier B., Moris C., Piscione F., Sechtem U., Sergeant P., Stahle E., Vos J., Widimsky P., Unger F., Manini M., Bramley C., Laforest V., Taylor C., Del Gaiso S., Huber K., De Backer G., Sirakova V., Cerbak R., Thayssen P., Lehto S., Blanc J. -J., Delahaye F., Kobulia B., Zeymer U., Cokkinos D., Karlocai K., Graham I., Shelley E., Behar S., Maggioni A., Grabauskiene V., Deckers J., Asmussen I., Stepinska J., Goncalves L., Mareev V., Riecansky I., Kenda M. F., Alonso A., Lopez-Sendon J. L., Rosengren A., Buser P., Okay T., Sychov O., Fox K., Wood D., Crijns H., McGregor K., Mulder B., Priori S., Ryden L., Tavazzi L., Vahanian A., Vardas P., Sarkisyan K., Glogar H. D., Frick M., Pachinger O., Zwick R., Vrints C., Van Hertbruggen E., Vercammen M., Sysmans T., Schroeder E., Domange J., De Pril H., De Vriese J., Van Hecke T., Legrand V., Gillon M. -F., Richardy M., Doneux P., Petrov I., Jorgova J., Starcevic B., Eeckhout E., Berger A., Prudent V., Camenzind E., Masson N., Zambartas C., Kleanthous H., Stellova B., Aschermann M., Simek S., Kautzner J., Karmazin V., Svab P., Indrak J., Branny M., Hladilova K., Kala P., Cappelen H., Jensen L. O., Gitt A., Gehrke K., am Rhein L., Erbel R., Gutersohn A., Eggebrecht H., Al Khani M., Rosenberger A., Vogelsberg H., Klepzig H., Schmidt A., Silber S., Mau B., Leuner C., Czyborra K., Reuschling C., Muno E., Nauheim B., Kleber F., Rux S., Saad A., Elabady M., Beiras A. C., Fernandez J. S., del Arno F. N., Romo A. I., Fernandez J. M. C., Mayoreal A. R., Rebanal F. J. R., de la Borbolla M. G., Chaparro M., Brotons C., Miralda C. P., Vila i Perez S. I., Aviles F. F., de la Fuente Galan L., Vinuela P. T., de Torres F. M., Mora J., Rodriguez I. S., Bustamante I. P., Fernandez P. L. S., Torrent J. L. D., Gil J. L. D., Perpinan J., Motilla V. P., Juango M. S. A., Berjon-Reyero J., Moreno R. M., Guerrero J. C. F., Savolainen K., Syvanne M., Cohen-Solal A., Oboa A. -S., Bassand J. P., Espinosa D. P., Jouet V., Cedex B., Montalescot G., Gallois V., Daubert J. C., Clerc J. M., Machecourt J., Cottin Y., Walker D., Holland F., Prosser J., Muir L., Barber K., Cleland J. G. F., Cook J., Chapichadze Z., Christos I. S. A., Tsiavou N., Chrysohoou C., Manginas A., Terrovitis J., Kanakakis J., Vavuranakis M., Drakos S., Farmakis T., Samara C., Papakosta C., Bourantas C., Michalis L. K., Christos M., Foussas S., Adamopoulou E., Marketou M., Alotti N., Basa A. M., Vigh A., Preda I., Csoti E., Keltai M., Kerkovits G., Hendler A., Blatt A., Yakov B., Beyar R., Shefer A., Halon D., Bentzvi M., Avramovitch N., Bakst A., Saba K., Cafri C., Grosbard A., Sheva B., Margolis B., Suleiman K., Banai S., Meerkin D., Mosseri M., Guita P., Jabara R., Jafari J., Shitrit D. B., Ghasan D., Salameh D., Brezins M., van den Akker-Berman L., Guetta V., Hashomer T., Rozenman Y., Biagini A., Berti S., Ferrero M., Colombo A., Roccaforte R., Milici C., Scarpino L., Salvi A., Desideri A., Sabbadin D., Veneto C., Galassi A., Giuffrida G., Rognoni A., Vassanelli C., Paffoni P., Cioppa A., Rubino P., de Carlo M., Petronio A. S., Naccarella F., Saia F., Marzocchi A., Maranga S. S., Presbitero P., Valsecchi F., Esposito G., Santini N. M., Tubaro M., Erglis A., Narbute I., Kavoliuniene A., Zaliunas R., Navickas R., Luckute D., Subkovas E., Wagner D., Vermeer F., Lousberg A., Fransen H., Breeman A., Tebbe H., De Boer M. J., van der Wal M., Leenders C. M., Veerhoek M. J., Jansen C., Bijl M., Koppelaar C., den Linden V., Brons R., Widdershofen J. W. M. G., Broers H., Kontny F., Jonzon M., Wodniecki J., Tomasik A., Trusz-Gluza M., Nowak S., Ruzyllo W., Deptuch T., Marques J., Matias F., Madeira H., Oliveira J., Sargento L., Ionac A., Dragulescu I. S., Mut-Vitcu B., Maximov D., Dorobantu M., Apetrei E., Niculescu R., Petrescu V., Bucsa A., Deleanu D., Bucharest, Benedek I. S., Hintea T., Aronov D., Tikhomirova E., Kranjec I., Prokselj K., Kanic V., Sepetoglu A., Aytekin S., Aytekin V., Catakoglu A. B., Parlar H., Tufekcioglu S., Ozyedek Z., Baltali M., Kiziltan, Vukovic M., Neskovic A. N., Cardiology, Hordijk-Trion, M., Lenzen, M., Wijns, W., De Jaegere, P., Simoons, M. L., Scholte Op Reimer, W. J. M., Bertrand, M. E., Mercado, N., Boersma, E., Maier, W., Meier, B., Moris, C., Piscione, F., Sechtem, U., Sergeant, P., Stahle, E., Vos, J., Widimsky, P., Unger, F., Manini, M., Bramley, C., Laforest, V., Taylor, C., Del Gaiso, S., Huber, K., De Backer, G., Sirakova, V., Cerbak, R., Thayssen, P., Lehto, S., Blanc, J. -J., Delahaye, F., Kobulia, B., Zeymer, U., Cokkinos, D., Karlocai, K., Graham, I., Shelley, E., Behar, S., Maggioni, A., Grabauskiene, V., Deckers, J., Asmussen, I., Stepinska, J., Goncalves, L., Mareev, V., Riecansky, I., Kenda, M. F., Alonso, A., Lopez-Sendon, J. L., Rosengren, A., Buser, P., Okay, T., Sychov, O., Fox, K., Wood, D., Crijns, H., Mcgregor, K., Mulder, B., Priori, S., Ryden, L., Tavazzi, L., Vahanian, A., Vardas, P., Sarkisyan, K., Glogar, H. D., Frick, M., Pachinger, O., Zwick, R., Vrints, C., Van Hertbruggen, E., Vercammen, M., Sysmans, T., Schroeder, E., Domange, J., De Pril, H., De Vriese, J., Van Hecke, T., Legrand, V., Gillon, M. -F., Richardy, M., Doneux, P., Petrov, I., Jorgova, J., Starcevic, B., Eeckhout, E., Berger, A., Prudent, V., Camenzind, E., Masson, N., Zambartas, C., Kleanthous, H., Stellova, B., Aschermann, M., Simek, S., Kautzner, J., Karmazin, V., Svab, P., Indrak, J., Branny, M., Hladilova, K., Kala, P., Cappelen, H., Jensen, L. O., Gitt, A., Gehrke, K., am Rhein, L., Erbel, R., Gutersohn, A., Eggebrecht, H., Al Khani, M., Rosenberger, A., Vogelsberg, H., Klepzig, H., Schmidt, A., Silber, S., Mau, B., Leuner, C., Czyborra, K., Reuschling, C., Muno, E., Nauheim, B., Kleber, F., Rux, S., Saad, A., Elabady, M., Beiras, A. C., Fernandez, J. S., del Arno, F. N., Romo, A. I., Fernandez, J. M. C., Mayoreal, A. R., Rebanal, F. J. R., de la Borbolla, M. G., Chaparro, M., Brotons, C., Miralda, C. P., Vila i Perez, S. I., Aviles, F. F., de la Fuente Galan, L., Vinuela, P. T., de Torres, F. M., Mora, J., Rodriguez, I. S., Bustamante, I. P., Fernandez, P. L. S., Torrent, J. L. D., Gil, J. L. D., Perpinan, J., Motilla, V. P., Juango, M. S. A., Berjon-Reyero, J., Moreno, R. M., Guerrero, J. C. F., Savolainen, K., Syvanne, M., Cohen-Solal, A., Oboa, A. -S., Bassand, J. P., Espinosa, D. P., Jouet, V., Cedex, B., Montalescot, G., Gallois, V., Daubert, J. C., Clerc, J. M., Machecourt, J., Cottin, Y., Walker, D., Holland, F., Prosser, J., Muir, L., Barber, K., Cleland, J. G. F., Cook, J., Chapichadze, Z., Christos, I. S. A., Tsiavou, N., Chrysohoou, C., Manginas, A., Terrovitis, J., Kanakakis, J., Vavuranakis, M., Drakos, S., Farmakis, T., Samara, C., Papakosta, C., Bourantas, C., Michalis, L. K., Christos, M., Foussas, S., Adamopoulou, E., Marketou, M., Alotti, N., Basa, A. M., Vigh, A., Preda, I., Csoti, E., Keltai, M., Kerkovits, G., Hendler, A., Blatt, A., Yakov, B., Beyar, R., Shefer, A., Halon, D., Bentzvi, M., Avramovitch, N., Bakst, A., Saba, K., Cafri, C., Grosbard, A., Sheva, B., Margolis, B., Suleiman, K., Banai, S., Meerkin, D., Mosseri, M., Guita, P., Jabara, R., Jafari, J., Shitrit, D. B., Ghasan, D., Salameh, D., Brezins, M., van den Akker-Berman, L., Guetta, V., Hashomer, T., Rozenman, Y., Biagini, A., Berti, S., Ferrero, M., Colombo, A., Roccaforte, R., Milici, C., Scarpino, L., Salvi, A., Desideri, A., Sabbadin, D., Veneto, C., Galassi, A., Giuffrida, G., Rognoni, A., Vassanelli, C., Paffoni, P., Cioppa, A., Rubino, P., de Carlo, M., Petronio, A. S., Naccarella, F., Saia, F., Marzocchi, A., Maranga, S. S., Presbitero, P., Valsecchi, F., Esposito, G., Santini, N. M., Tubaro, M., Erglis, A., Narbute, I., Kavoliuniene, A., Zaliunas, R., Navickas, R., Luckute, D., Subkovas, E., Wagner, D., Vermeer, F., Lousberg, A., Fransen, H., Breeman, A., Tebbe, H., De Boer, M. J., van der Wal, M., Leenders, C. M., Veerhoek, M. J., Jansen, C., Bijl, M., Koppelaar, C., den Linden, V., Brons, R., Widdershofen, J. W. M. G., Broers, H., Kontny, F., Jonzon, M., Wodniecki, J., Tomasik, A., Trusz-Gluza, M., Nowak, S., Ruzyllo, W., Deptuch, T., Marques, J., Matias, F., Madeira, H., Oliveira, J., Sargento, L., Ionac, A., Dragulescu, I. S., Mut-Vitcu, B., Maximov, D., Dorobantu, M., Apetrei, E., Niculescu, R., Petrescu, V., Bucsa, A., Deleanu, D., Bucharest, Benedek, I. S., Hintea, T., Aronov, D., Tikhomirova, E., Kranjec, I., Prokselj, K., Kanic, V., Sepetoglu, A., Aytekin, S., Aytekin, V., Catakoglu, A. B., Parlar, H., Tufekcioglu, S., Ozyedek, Z., Baltali, M., Kiziltan, Vukovic, M., and Neskovic, A. N.

Subjects
Male, medicine.medical_specialty, Randomization, medicine.medical_treatment, Euro Heart Survey, Coronary Artery Disease, Revascularization, law.invention, Coronary artery disease, Randomized controlled trial, law, Internal medicine, Angioplasty, medicine, Humans, cardiovascular diseases, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, CABG, Aged, Randomized Controlled Trials as Topic, business.industry, Coronary Artery Bypa, Patient Selection, PCI, Health Survey, Middle Aged, medicine.disease, Health Surveys, Surgery, Clinical trial, Stenosis, surgical procedures, operative, Clinical Trials, Phase III as Topic, Conventional PCI, Female, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Aims: Revascularization in patients with coronary artery disease changed over the last two decades, favouring the number of patients treated by means of percutaneous coronary interventions (PCI) when compared with coronary artery bypass grafting (CABG). Many randomized controlled trials (RCTs) have been performed to compare these two competing revascularization techniques. Because of the strict enrolment criteria of RCTs in which highly selected patients are recruited, the applicability of the results may be limited in clinical practice. The current study evaluates to what extent patients in clinical practice were similar to those who participated in RCTs comparing PCI with CABG. Methods and results: Clinical characteristics and 1-year outcome of 4713 patients enrolled in the Euro Heart Survey on Coronary Revascularization were compared with 8647 patients who participated in 14 major RCTs, comparing PCI with CABG. In addition, we analysed which proportion of survey patients would have disqualified for trial participation (n = 3033, 64%), aiming at identifying differences between trial-eligible and trial-ineligible survey patients. In general, important differences were observed between trial participants and survey patients. Patients in clinical practice were older, more often had comorbid conditions, single-vessel disease, and left main stem stenosis when compared with trial participants. Almost identical differences were observed between trial-eligible and trial-ineligible survey patients. In clinical practice, PCI was the treatment of choice, even in patients who were trial-ineligible (46% PCI, 26% CABG, 28% medical). PCI remained the preferred treatment option in patients with multi-vessel disease (57% in trial-eligible and 40% in trial-ineligible patients, respectively, P < 0.001); yet, the risk profile of patients treated by PCI was better than that for patients treated either by CABG or by medical therapy. In the RCTs, there was no mortality difference between PCI and CABG. In clinical practice, however, we observed 1-year unadjusted survival benefit for PCI vs. CABG (2.9 vs. 5.4%, P < 0.001). Survival benefit was only observed in trial-ineligible patients (3.3 vs. 6.2%, P < 0.001). Conclusion: Many patients in clinical practice were not represented in RCTs. Moreover, only 36% of these patients were considered eligible for participating in a trial comparing PCI with CABG. We demonstrated that RCTs included younger patients with a better cardiovascular risk profile when compared with patients in everyday clinical practice. This study highlights the disparity between patients in clinical practice and patients in whom the studies that provide the evidence for treatment guidelines are performed. © The European Society of Cardiology 2006. All rights reserved.

Published
2006

17. EURObservational Research Programme:regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)

Author

Maggioni, A. P., Dahlstrom, U., Filippatos, G., Chioncel, O., Leiro, M. C., Drozdz, J., Fruhwald, F., Gullestad, L., Logeart, D., Fabbri, G., Urso, R., Metra, M., Parissis, J., Persson, H., Ponikowski, P., Rauchhaus, M., Voors, A. A., Nielsen, O. W., Zannad, F., Tavazzi, L., Alonso, A., Ferrari, R., Komajda, M., Wood, D., Manini, M., Taylor, C., Laroche, C., Fiorucci, E., Lucci, D., Gonzini, L., Auer, J., Oberrauner, A., Schumacher, M., Ebner, C., Hallas, A., Espersen, G., Gustafsson, F., Mattsson, N., Egstrup, K., Aagaard, S., Gohr, T., Huld, K., Knudsen, A., Refsgaard, J., Charniot, J., Juillard, A., Pon-Gabrielsen, P., Douna, F., Jondeau, G., Jourdain, P., Michel, L., Hamm, C., Lehinant, S., Rieth, A., Goeing, O., Schultheiss, H. P., Von-Schlippenbach, J., Knollmann, R., Neubuser, C., Katus, H. A., Taeger, T., Zugck, C., Fink, H., Schulz, J., Held, S., Karmann, W., Kreuzer, J., Nitsche, K., Winter, K., Fahnrich, A., Bruederlein, K., Turan, C. H., Berentelg, J., Ittel, T., Rubens, C., Hanke, M., Stoerk, S., Chrysohoou, C., Kaldara, E., Karavidas, A., Margari, R., Matzaraki, V., Nanas, J., Pozios, I., Psarogiannakopoulos, P., Pyrgakis, V., Stefanadis, C., Terrovitis, J., Trikas, A., Xydonas, S., Patrianakos, A., Vardas, P., Douras, A., Nastas, J., Ntertsas, K., Tsaknakis, T., Midi, P., Pajes, G., Moretti, L., Partemi, M., Barberini, F., Branzi, A., Gallelli, I., Grigioni, F., Ionico, T., Pasquale, F., Cas, L., Delmagro, F., Tanghetti, E., Vaccari, A., Mercuro, G., Arcuri, G. M., Marinacci, L., Severini, D., Cosmi, F., Bosi, S., Di Tano, G., Pirelli, S., Fucili, A., Minneci, C., Santoro, G. M., Correale, M., Di Biase, M., Buccolieri, M., Mandorla, S., Martinelli, S., Barbiero, M., Giordano, A., Zanelli, E., Agostoni, P., Fiorentini, C., Salvioni, E., Leuzzi, C., Modena, M. G., Reggianini, L., Cobelli, F., Opasich, C., Baldini, P., Romei, M., Pulitano, G., Ruggeri, A., Bologna, F., Piovaccari, G., Brasolin, B., Fedele, F., Merlo, M., Sinagra, G., Albanese, M. C., Miani, D., Linssen, G., Rodijk, E., Pinto, Y., Van Donk, P., Dunselman, P., Lok, D., Brouwers, F., De Jong, R. M., Boen, R., Hole, T., Rasmussen, L., Christiansen, E. M., Gjertsen, E., Lyng, J., German, M., Hogalmen, G., Skardal, R., Apelland, T., Borgen, M., Forfang, E., Baak, T., Dickstein, K., Olsen, I., Stachurski, D., Juszczyk, Z., Stankala, S., Gilewski, W., Sinkiewicz, W., Kasztelowicz, P., Gabryel, J., Kardaszewicz, P., Lazorko-Piega, M., Bellwon, J., Mosakowska, K., Rynkiewicz, A., Olczyk, S., Pagorek, M., Bartlinski, R., Borej, G., Tarchalski, J., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Bury, K., Grzegorzko, A., Mirek-Bryniarska, E., Nessler, J., Zabojszcz, M., Broncel, M., Poliwczak, A., Retwinski, A., Soska, K., Grajek, S., Straburzynska-Migaj, E., Kuzniar, J., Rzeszuto, T., Bednarczyk, G., Ruszkowski, P., Piasecka-Krysiak, E., Zambrzycki, J., Nowak, T., Szelemej, R., Balsam, P., Folga, A., Kaplon-Cieslicka, A., Kowalewski, S., Mamcarz, A., Marchel, M., Opolski, G., Welnicki, M., Jankowska, E., Nowak, J., Nowalany-Kozielska, E., Rozentryt, P., Zembala, M., Kleinrok, A., Prokop-Lewicka, G., Kudlinska, B., Radoi, M., Macarie, C., Vinereanu, D., Capalneanu, R., Giuca, A., Ionescu, D. D., Nechita, E., Datcu, M., Istrate, C., Vladoianu, M., Christodorescu, R., Salguero, R., Blanco, V. M., Lavilla, M. A., Comin-Colet, J., Cantillo, D., Bernal, J., del Prado, J. M., Pita, A., Aguero, J., Jimenez, J. F., Calvo, F., Gonzalez, R., Molina, B., Luengos, D., Lostal, C., Bonet, L., Gonzalez, P., Soriano, F., Campos, M. J., Karlstrom, P., Nyrinder, I., Olsson, B., Pettersson, T., Stenberg, A., Lindmark, K., Asserlund, B., Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC), ACS - Amsterdam Cardiovascular Sciences, Cardiology, Maggioni, Aldo P, Dahlström, Ulf, Filippatos, Gerasimo, Chioncel, Ovidiu, Leiro, Marisa Crespo, Drozdz, Jaroslaw, Fruhwald, Friedrich, Gullestad, Lar, Logeart, Damien, Fabbri, Gianna, Urso, Renato, Metra, Marco, Parissis, John, Persson, Han, Ponikowski, Piotr, Rauchhaus, Mathia, Voors, Adriaan A., Nielsen, Olav Wendelboe, Zannad, Faiez, Tavazzi, Luigi, on behalf of the Heart Failure Association of the European Society of Cardiology (HFA): [.., F. Barberini, A. Branzi, I. Gallelli, F. Grigioni, T. Ionico, F. Pasquale, and ]

Subjects
Registrie, Male, Time Factors, Peripartum cardiomyopathy, Pilot Projects, Cardiovascular Agents/therapeutic use, Acute heart failure, Chronic heart failure, Observational studies, Pharmacological treatments, Prognosis, Aged, Cardiovascular Agents, Europe, Female, Follow-Up Studies, Heart Failure, Hospital Mortality, Hospitalization, Humans, Middle Aged, Prospective Studies, Inpatients, Registries, GUIDELINES, CLINICAL CHARACTERISTICS, Medicine, Prospective cohort study, POPULATION, Hospital Mortality/trends, education.field_of_study, OUTCOMES, Ejection fraction, Mortality rate, HOSPITALIZATION, Inpatient, Cardiology and Cardiovascular Medicine, Pharmacological treatment, Human, medicine.medical_specialty, acute heart failure, chronic heart failure, observational studies, pharmacological treatments, prognosis, aged, cardiovascular agents, female, follow-up studies, heart failure, hospital mortality, hospitalization, humans, male, middle aged, pilot projects, prospective studies, time factors, inpatients, registries, cardiology and cardiovascular medicine, EUROPE, Time Factor, Prognosi, Population, DIAGNOSIS, Follow-Up Studie, Europe/epidemiology, ONE-YEAR MORTALITY, Pilot Project, education, Hospitalization/statistics & numerical data, business.industry, medicine.disease, Heart Failure/drug therapy, Observational studie, Prospective Studie, Cardiovascular Agent, Heart failure, REGISTRY, Cardiovascular agent, Emergency medicine, Physical therapy, Observational study, QUALITY-OF-CARE, business
Abstract

AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.METHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.CONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.

Published
2013

18. Peripheral muscle microcirculatory alterations in patients with pulmonary arterial hypertension: A pilot study

Author

Dimopoulos, S. Tzanis, G. Manetos, C. Tasoulis, A. Mpouchla, A. Tseliou, E. Vasileiadis, I. Diakos, N. Terrovitis, J. Nanas, S.

Abstract

Background: Pulmonary microcirculation abnormalities are the main determinants of pulmonary arterial hypertension (PAH) pathophysiology. We hypothesized that PAH patients have peripheral tissue microcirculation alterations that might benefit from hyperoxic breathing. We evaluated peripheral muscle microcirculation with near-infrared spectroscopy, before and after hyperoxic breathing. Methods: Eight PAH subjects, 8 healthy subjects (controls) matched for age, sex, and body mass index, and 16 subjects with chronic heart failure and matched for functional capacity with the PAH subjects underwent near-infrared spectroscopy. Tissue O2 saturation, defined as the hemoglobin saturation (%) in the microvasculature compartments, was measured on the thenar muscle. Then the 3-min brachial artery occlusion technique was applied before, during, and after 15 min of breathing 100% O2. We calculated the oxygen consumption rate (%/min), the reactive hyperemia time, and the time needed for tissue O2 saturation to reach its baseline value after the release of the occlusion. Results: Compared to the controls, the PAH subjects had a significantly lower resting tissue O2 saturation (65.8 ± 14.9% vs 82.1 ± 4.0%, P = .005), a trend toward a lower oxygen consumption rate (35.3 ± 9.1%/min vs 43.4 ± 19.7%/min, P = .60), and a significantly higher reactive hyperemia time (3.0 ± 0.6 min vs 2.0 ± 0.3 min, P

Published
2013

19. Hormonal imbalance in relation to exercise intolerance and ventilatory inefficiency in chronic heart failure

Author

Agapitou, V. Dimopoulos, S. Kapelios, C. Karatzanos, E. Manetos, C. Georgantas, A. Ntalianis, A. Terrovitis, J. Karga, H. Nanas, S.

Abstract

Background: Skeletal muscle wasting is associated with altered catabolic/anabolic balance and poor prognosis in patients with chronic heart failure (CHF). This study evaluated catabolic and anabolic abnormalities in relation to disease severity in CHF patients. Methods: Forty-two stable CHF patients (34 men; aged 56±12 years, body mass index, 27±5 kg/m2) receiving optimal medical treatment underwent incremental symptom-limited cardiopulmonary exercise testing on a cycle ergometer. Blood samples were drawn within 10 days to determine serum cortisol, plasma adrenocorticotropin (ACTH), and serum dehydroepiandrosterone sulfate, insulin-like growth factor 1, growth hormone, and total testosterone in men. Results: Patients with higher cortisol levels presented with impaired peak oxygen uptake (Vo2 peak: 18.3±3.9 vs 14.2±3.7 ml/kg/min, p

Published
2013

20. EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)

Author

Maggioni, A.P. Dahlström, U. Filippatos, G. Chioncel, O. Leiro, M.C. Drozdz, J. Fruhwald, F. Gullestad, L. Logeart, D. Fabbri, G. Urso, R. Metra, M. Parissis, J. Persson, H. Ponikowski, P. Rauchhaus, M. Voors, A.A. Nielsen, O.W. Zannad, F. Tavazzi, L. Alonso, A. Ferrari, R. Komajda, M. Wood, D. Manini, M. Taylor, C. Laroche, C. Fiorucci, E. Lucci, D. Gonzini, L. Auer, J. Oberrauner, A. Schumacher, M. Ebner, C. Hallas, A. Espersen, G. Gustafsson, F. Mattsson, N. Egstrup, K. Aagaard, S. Gohr, T. Huld, K. Knudsen, A. Refsgaard, J. Charniot, J. Juillard, A. Pon-Gabrielsen, P. Douna, F. Jondeau, G. Jourdain, P. Michel, L. Hamm, C. Lehinant, S. Rieth, A. Goeing, O. Schultheiss, H.P. Von-Schlippenbach, J. Knollmann, R. Neubüser, C. Katus, H.A. Taeger, T. Zugck, C. Fink, H. Schulz, J. Held, S. Karmann, W. Kreuzer, J. Nitsche, K. Winter, K. Fahnrich, A. Bruederlein, K. Turan, C.H. Berentelg, J. Ittel, T. Rubens, C. Hanke, M. Stoerk, S. Chrysohoou, C. Kaldara, E. Karavidas, A. Margari, R. Matzaraki, V. Nanas, J. Pozios, I. Psarogiannakopoulos, P. Pyrgakis, V. Stefanadis, C. Terrovitis, J. Trikas, A. Xydonas, S. Patrianakos, A. Vardas, P. Douras, A. Nastas, J. Ntertsas, K. Tsaknakis, T. Midi, P. Pajes, G. Moretti, L. Partemi, M. Barberini, F. Branzi, A. Gallelli, I. Grigioni, F. Ionico, T. Pasquale, F. Cas, L. Delmagro, F. Tanghetti, E. Vaccari, A. Mercuro, G. Arcuri, G.M. Marinacci, L. Severini, D. Cosmi, F. Bosi, S. Di Tano, G. Pirelli, S. Ferrari, R. Fucili, A. Minneci, C. Santoro, G.M. Correale, M. Di Biase, M. Buccolieri, M. Mandorla, S. Martinelli, S. Barbiero, M. Giordano, A. Zanelli, E. Agostoni, P. Fiorentini, C. Salvioni, E. Leuzzi, C. Modena, M.G. Reggianini, L. Cobelli, F. Opasich, C. Baldini, P. Romei, M. Pulitano, G. Ruggeri, A. Bologna, F. Piovaccari, G. Brasolin, B. Fedele, F. Merlo, M. Sinagra, G. Albanese, M.C. Miani, D. Linssen, G. Rodijk, E. Pinto, Y. Van Donk, P. Dunselman, P. Lok, D. Brouwers, F. De Jong, R.M. Boen, R. Hole, T. Rasmussen, L. Christiansen, E.M. Gjertsen, E. Lyng, J. German, M. Hogalmen, G. Skardal, R. Apelland, T. Borgen, M. Forfang, E. Baak, T. Dickstein, K. Olsen, I. Stachurski, D. Juszczyk, Z. Stankala, S. Gilewski, W. Sinkiewicz, W. Kasztelowicz, P. Gabryel, J. Kardaszewicz, P. Lazorko-Piega, M. Bellwon, J. Mosakowska, K. Rynkiewicz, A. Olczyk, S. Pagorek, M. Bartlinski, R. Borej, G. Tarchalski, J. Bartkowiak, R. Sosnowska-Pasiarska, B. Wozakowska-Kaplon, B. Krzeminski, A. Bury, K. Grzegorzko, A. Mirek-Bryniarska, E. Nessler, J. Zabojszcz, M. Broncel, M. Poliwczak, A. Retwinski, A. Soska, K. Grajek, S. Straburzynska-Migaj, E. Kuzniar, J. Rzeszuto, T. Bednarczyk, G. Ruszkowski, P. Piasecka-Krysiak, E. Zambrzycki, J. Nowak, T. Szelemej, R. Balsam, P. Folga, A. Kaplon-Cieslicka, A. Kowalewski, S. Mamcarz, A. Marchel, M. Opolski, G. Welnicki, M. Jankowska, E. Nowak, J. Nowalany-Kozielska, E. Rozentryt, P. Zembala, M. Kleinrok, A. Prokop-Lewicka, G. Kudlinska, B. Radoi, M. Macarie, C. Vinereanu, D. Capalneanu, R. Giuca, A. Ionescu, D.D. Nechita, E. Datcu, M. Istrate, C. Vladoianu, M. Christodorescu, R. Salguero, R. Blanco, V.M. Lavilla, M.A. Comin-Colet, J. Cantillo, D. Bernal, J. del Prado, J.M. Pita, A. Aguero, J. Jimenez, J.F. Calvo, F. Gonzalez, R. Molina, B. Luengos, D. Lostal, C. Bonet, L. Gonzalez, P. Soriano, F. Campos, M.J. Karlstrom, P. Nyrinder, I. Olsson, B. Pettersson, T. Stenberg, A. Lindmark, K. Asserlund, B. Heart Failure Association of the European Society of Cardiology (HFA)

Abstract

AimsThe ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.MethodsThe ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.ConclusionThe ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network. © 2013 The Author.

Published
2013

21. Allogeneic cardiospheres safely boost cardiac function and attenuate adverse remodeling after myocardial infarction in immunologically mismatched rat strains

Author

Tseliou, E. Pollan, S. Malliaras, K. Terrovitis, J. Sun, B. Galang, G. Marbán, L. Luthringer, D. Marbán, E.

Abstract

Objectives: We sought to characterize the immunologic profile of allogeneic cardiospheres, which are 3-dimensional, self-assembling, cardiac-derived microtissues, and to evaluate their safety and efficacy in repairing ischemic heart tissue. Background: Intramyocardial injection of autologous cardiospheres ameliorates remodeling and improves global function in infarcted myocardium. It is as yet unknown whether allogeneic cardiospheres are similarly effective without eliciting deleterious immune reactions. Methods: We expanded cardiospheres from male Wistar Kyoto rat hearts and injected them surgically in the peri-infarct zone of Wistar Kyoto (syngeneic group, n = 28) and Brown Norway female rats (allogeneic group, n = 29). Female rats from both strains (n = 37) injected with normal saline served as controls. Results: In vitro, cardiospheres expressed a low immunogenic profile and inhibited proliferation of alloreactive T cells. In vivo, cell engraftment was similar in the syngeneic and allogeneic groups 1 week and 3 weeks after transplantation. Reductions in scar size and scar collagen content and increases in viable mass in the risk region were accompanied by improvements in left ventricular function and attenuation of left ventricle remodeling that were sustained during 6 months of follow up. Transplantation of allogeneic cardiospheres increased tissue expression of the regenerative growth factors vascular endothelial growth factor, hepatocyte growth factor, and insulin-like growth factor-1, stimulating angiogenesis. Syngeneic and allogeneic cardiospheres attenuated the inflammatory response observed histologically in the peri-infarct region. Conclusions: Allogeneic cardiospheres increase viable myocardium, decrease scar, improve function, and attenuate adverse remodeling in the infarcted rat heart, without deleterious immunological sequelae. These observations lay the groundwork for developing cardiospheres as a novel off-the-shelf microtissue product for myocardial regeneration. © 2013 American College of Cardiology Foundation.

Published
2013

22. Direct comparison of different stem cell types and subpopulations reveals superior paracrine potency and myocardial repair efficacy with cardiosphere-derived cells

Author

Li, T.-S. Cheng, K. Malliaras, K. Smith, R.R. Zhang, Y. Sun, B. Matsushita, N. Blusztajn, A. Terrovitis, J. Kusuoka, H. Marbán, L. Marbán, E.

Abstract

Objectives: The goal of this study was to conduct a direct head-to-head comparison of different stem cell types in vitro for various assays of potency and in vivo for functional myocardial repair in the same mouse model of myocardial infarction. Background: Adult stem cells of diverse origins (e.g., bone marrow, fat, heart) and antigenic identity have been studied for repair of the damaged heart, but the relative utility of the various cell types remains unclear. Methods: Human cardiosphere-derived cells (CDCs), bone marrowderived mesenchymal stem cells, adipose tissuederived mesenchymal stem cells, and bone marrow mononuclear cells were compared. Results: CDCs revealed a distinctive phenotype with uniform expression of CD105, partial expression of c-kit and CD90, and negligible expression of hematopoietic markers. In vitro, CDCs showed the greatest myogenic differentiation potency, highest angiogenic potential, and relatively high production of various angiogenic and antiapoptotic-secreted factors. In vivo, injection of CDCs into the infarcted mouse hearts resulted in superior improvement of cardiac function, the highest cell engraftment and myogenic differentiation rates, and the least-abnormal heart morphology 3 weeks after treatment. CDC-treated hearts also exhibited the lowest number of apoptotic cells. The c-kit + subpopulation purified from CDCs produced lower levels of paracrine factors and inferior functional benefit when compared with unsorted CDCs. To validate the comparison of cells from various human donors, selected results were confirmed in cells of different types derived from individual rats. Conclusions: CDCs exhibited a balanced profile of paracrine factor production and, among various comparator cell types/subpopulations, provided the greatest functional benefit in experimental myocardial infarction. © 2012 American College of Cardiology Foundation.

Published
2012

23. Bone mass loss in chronic heart failure is associated with secondary hyperparathyroidism and has prognostic significance

Author

Terrovitis, J. Zotos, P. Kaldara, E. Diakos, N. Tseliou, E. Vakrou, S. Kapelios, C. Chalazonitis, A. Nanas, S. Toumanidis, S. Kontoyannis, D. Karga, E. Nanas, J.

Abstract

Aims: Chronic heart failure (CHF) is associated with increased risk of osteoporosis. We investigated the relationship between severity of CHF and bone loss, underlying pathophysiological mechanisms, and the prognostic significance of bone mass changes in heart failure. Methods and results: Total body (TB) and femoral (F) bone mineral density (BMD), and T- and Z-scores in the femur were measured in 60 men with CHF (56 ± 11 years) and 13 age-matched men free from CHF. The composite study endpoint was death, implantation of a left ventricular assist device (LVAD), or inotrope dependency during a median 2-year follow-up. Parathyroid hormone (PTH) and vitamin D were measured in all subjects. TBBMD, FBMD, T-score, and Z-score were significantly lower in men with CHF. Their PTH levels were also significantly increased (111 ± 59 vs. 39 ± 14; P < 0.001). Patients in New York Heart Association classes IIIIV compared with those in classes III demonstrated significantly lower TBBMD, FBMD, T-score, and Z-score, and higher PTH (136 ± 69 vs. 86 ± 31; P = 0.001). Increased PTH levels were correlated with reduced TBBMD (P = 0.003), FBMD (P = 0.002), and femur T-score (P = 0.001), reduced cardiac index (P = 0.01) and VO 2 peak (P < 0.0001), and increased wedge pressure (P = 0.001). Low TBBMD [hazard ratio (HR) 0.003, 95% confidence interval (CI) 0.00-0.58; P = 0.03] and Z-score (HR 0.56, 95% CI 0.35-0.90; P = 0.017) were associated with adverse outcome. Conclusions: Secondary hyperparathyroidism and reduction in bone density occur in CHF patients and are associated with disease severity. Increased bone mass loss in CHF has prognostic significance. © The Author 2012.

Published
2012

24. Chronotropic incompetence and abnormal heart rate recovery early after left ventricular assist device implantation

Author

Dimopoulos, S. Diakos, N. Tseliou, E. Tasoulis, A. Mpouchla, A. Manetos, C. Katsaros, L. Drakos, S. Terrovitis, J. Nanas, S.

Subjects
equipment and supplies
Abstract

Background: Chronotropic response to exercise and heart rate recovery immediately after exercise (HRR1) are valid prognostic markers in patients with chronic heart failure (CHF). The aim of this study was to evaluate heart rate profile during and after exercise in CHF patients early after left ventricular assist device (LVAD) implantation. Methods: We enrolled seven stable consecutive CHF patients (five males, mean age: 45 ± 16 years) after 1 month of LVAD (HeartMate II; Thoratec Corp, Pleasanton, CA, USA) implantation, seven healthy subjects, and 14 patients with advanced HF (HF control group) who performed an incremental symptom-limited cardiopulmonary exercise testing (CPET). CHF patients performed CPET at 1 and 3 months after LVAD. HRR1 was defined as the HR difference from peak to 1 minute after exercise and chronotropic response to exercise as the chronotropic reserve ([CR, %]=[peak HR-resting HR/220-age-resting HR]à - 100). Results: LVAD patients 3 months after implantation had a significantly different HR profile during exercise compared to healthy controls, with significantly lower CR (57 ± 31 vs 90 ± 14, %, P < 0.001) and HRR 1 (14 ± 6 vs 28 ± 8, bpm, P < 0.01). HR profile during exercise did not significantly change 1 and 3 months after LVAD implantation. There was no statistical difference compared to HF control group and LVAD group regarding cardiopulmonary parameters. Conclusions: LVAD patients present an impaired CR and an abnormal HRR1 after implantation, indicating significant cardiac autonomic abnormalities. These alterations seem to remain unaltered 3 months after LVAD implantation. © 2011, The Authors. Journal compilation.

Published
2011

25. Skeletal muscle microcirculatory abnormalities are associated with exercise intolerance, ventilatory inefficiency, and impaired autonomic control in heart failure

Author

Manetos, C. Dimopoulos, S. Tzanis, G. Vakrou, S. Tasoulis, A. Kapelios, C. Agapitou, V. Ntalianis, A. Terrovitis, J. Nanas, S.

Subjects
human activities
Abstract

Background: Several skeletal muscle abnormalities have been identified in patients with chronic heart failure (CHF), including endothelial dysfunction. We hypothesized that skeletal muscle microcirculation, assessed by near-infrared spectroscopy (NIRS), is impaired in CHF patients and is associated with disease severity. Methods: Eighty-three stable patients with mildmoderate CHF (72 males, mean age 54 ± 14 years, body mass index 26.7 ± 3.4 kg/m 2) and 8 healthy subjects, matched for age, gender and body mass index, underwent NIRS with the vascular occlusion technique and cardiopulmonary exercise testing (CPET) evaluation on the same day. Tissue oxygen saturation (StO 2, %), defined as the percentage of hemoglobin saturation in the microvasculature compartments, was measured in the thenar muscle by NIRS before, during and after 3-minute occlusion of the brachial artery. Measurements included StO 2, oxygen consumption rate (OCR, %/min) and reperfusion rate (RR, %/min). All subjects underwent a symptom-limited CPET on a cycle ergometer. Measurements included VO 2 at peak exercise (VO 2peak, ml/kg/min) and anaerobic threshold (VO 2AT, ml/kg/min), VE/VCO 2 slope, chronotropic reserve (CR, %) and heart rate recovery (HRR 1, bpm). Results: CHF patients had significantly lower StO 2 (75 ± 8.2 vs 80.3 ± 6, p < 0.05), lower OCR (32.3 ± 10.4 vs 37.7 ± 5.5, p < 0.05) and lower RR (10 ± 2.8 vs 15.7 ± 6.3, p < 0.05) compared with healthy controls. CHF patients with RR

Published
2011

26. The addition of strength training to aerobic interval training: Effects on muscle strength and body composition in CHF patients

Author

Bouchla, A. Karatzanos, E. Dimopoulos, S. Tasoulis, A. Agapitou, V. Diakos, N. Tseliou, E. Terrovitis, J. Nanas, S.

Abstract

Purpose: The loss of lean muscle mass and muscle strength is a common problem in chronic heart failure (CHF) patients. Endurance training is efficient in improving patient exercise capacity. This study sought to evaluate the additional effects of strength training on muscle strength and body composition in chf patients participating in an interval training program. METHODS:: Twenty consecutive, stable CHF patients participated in a rehabilitation program. Subjects were randomly assigned to aerobic (n = 10) or combined aerobic plus strength training group (n = 10). Aerobic group performed interval training on cycle ergometers. Strength training incorporated exercises for various muscle groups, including quadriceps, hamstrings, biceps brachii, and the deltoids. Both regimes were of the same duration. Body composition was evaluated by whole-body dual energy x-ray absorptiometry and quadriceps strength by the sum of the 2-repitition maximum (2-RM) test for each leg. Peak oxygen uptake ((Equation is included in full-text article.)) and peak work load (Wpeak) as well as oxygen uptake ((Equation is included in full-text article.)) and workload at anaerobic threshold (WAT) were evaluated by a symptom limited cardiopulmonary exercise testing. RESULTS:: Concerning leg lean mass, no significant within-subjects or between-groups changes were observed (P > .05). Both groups improved in 2-RM test (P < .05), while a significant difference was observed between groups (P < .05). (Equation is included in full-text article.)and (Equation is included in full-text article.)and Wpeak and WAT were equally improved between training groups (P < .05). CONCLUSIONS:: Combined aerobic interval and strength training induces a greater benefit than interval training alone on muscle strength in CHF patients. Adaptations other than hypertrophy, such as muscle fiber type alterations and/or neuromuscular adjustments, may account for these results. © 2011 Lippincott Williams & Wilkins, Inc.

Published
2011

32. No effect of stem cell mobilization with GM-CSF on infarct size and left ventricular function in experimental acute myocardial infarction

Author

Terrovitis, J Charitos, C Dolou, P Papalois, A and Eleftheriou, A Tsolakis, E Charitos, E Mponios, M and Karanastasis, G Koudoumas, D Agapitos, E Nanas, JN

Subjects
cardiovascular diseases
Abstract

Objectives:. To evaluate the effect of bone marrowpluripotent stem cell mobilization with granulocyte-monocyte colony stimulating factor (GMCSF) on infarct size and left ventricular function, in the setting of acute myocardial infarction, with a protocol easily applicable in clinical practice. Methods:. Ten pigs underwent left thoracotomy and left anterior descending coronary artery occlusion for 1 h, followed by reperfusion. After 50 min of arterial occlusion, the animals were randomly divided between treatment with placebo (Group 1) and subcutaneous GM-CSF (Group 2). The thoracotomy was closed and the animals recovered. In Group 2, GM-CSF, 20 mug/kg, was administered daily, 5 days/week, for 3 weeks. Echocardiograms were obtained at 5 and 28 days after acute myocardial infarction. At 30 days, infarct size, expressed as a percentage of the whole left ventricular mass, was measured. Results:. The white blood cell count increased from 13000 +/- 3338/mul to 28700 +/- 4916/mul (p = 0.001) in the GM-CSF-treated group. Infarct size was 7.8 +/- 6.1% in Group 1 vs 7.5 +/- 7.7% in Group 2 (ns). Similarly, no significant difference was observed between the 2 study groups in any of the echocardiographic measurements made at 28 days. Conclusions:. Subcutaneous GMCSF administered during the early post acute myocardial infarction period neither decreased infarct size nor improved left ventricular function. Other protocols for mobilization of stem cells and their concentration in the injured area should be developed to combine efficacy and clinical applicability.

Published
2004

37. Indium-111 monoclonal antimyosin cardiac scintigraphy in supspected acute myocarditis: evolution and diagnostic impact

Author

Margari, ZJ Anastasiou-Nana, MI Terrovitis, J Toumanidis, S and Agapitos, EV Lekakis, JP Nanas, JN

Abstract

Background: This study examined the evolution of the heart to lung (H/L) ratio of monoclonal antimyosin antibody (MAA) uptake in patients with suspected acute myocarditis (AM) and its time-dependent diagnostic value in conjunction with echocardiographic findings. Methods: The study included 20 patients with a short history (1.55) associated with an LVEDdless than or equal to62 mm was diagnostic of AM with a sensitivity of 67%, a specificity of 63% and a positive predictive value of 65%. Upon restudy, the H/L ratio of MAA uptake was significantly decreased in both groups, reaching almost identical levels. No difference was found in the LVEDd between the two groups. The positivity of cardiac antimyosin scintigraphy in conjunction with an LVEDdless than or equal to62 mm had a sensitivity of 45% and a specificity of 88% for the diagnosis of myocarditis. Conclusions: In patients with suspected AM a positive antimyosin scintigraphy accompanied by a non-dilated left ventricle is highly suggestive of AM, both at the early phase and 1 year after disease onset. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Published
2003

50. 10.3

Author

Terrovitis, J., primary, Abraham, M.R., additional, Engles, J., additional, Wahl, R., additional, Marban, E., additional, and Bengel, F., additional

Published
2007
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