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4. Impact of age over 70 years in the new allocation system on the outcomes of heart transplantation in the US

Author

Gemelli, Marco, primary, Doulamis, Ilias P., additional, Addonizio, Mariangela, additional, Tzani, Aspasia, additional, Rempakos, Athanasios, additional, Kampaktsis, Polydoros, additional, Guariento, Alvise, additional, Dunque, Ernesto Ruiz, additional, Asleh, Rabea, additional, Alvarez, Paulino, additional, and Briasoulis, Alexandros, additional

Published
2024
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11. FAM222A, Part of the BET-Regulated Basal Endothelial Transcriptome, Is a Novel Determinant of Endothelial Biology and Angiogenesis

Author

Tzani, Aspasia, primary, Haemmig, Stefan, additional, Cheng, Henry S., additional, Perez-Cremades, Daniel, additional, Heuschkel, Marina Augusto, additional, Jamaiyar, Anurag, additional, Singh, Sasha, additional, Aikawa, Masanori, additional, Yu, Paul, additional, Wang, Tianxi, additional, Ye, Sun, additional, Feinberg, Mark W., additional, and Plutzky, Jorge, additional

Published
2023
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17. Rejection Requiring Treatment within the First Year following Heart Transplantation: The UNOS Insight.

Author

Gemelli, Marco, Doulamis, Ilias P., Tzani, Aspasia, Rempakos, Athanasios, Kampaktsis, Polydoros, Alvarez, Paulino, Guariento, Alvise, Xanthopoulos, Andrew, Giamouzis, Grigorios, Spiliopoulos, Kyriakos, Asleh, Rabea, Ruiz Duque, Ernesto, and Briasoulis, Alexandros

Subjects
HEART transplantation, GRAFT rejection, CARDIAC surgery, HEART failure, DEATH rate
Abstract

(1) Background: Heart failure is an extremely impactful health issue from both a social and quality-of-life point of view and the rate of patients with this condition is destined to rise in the next few years. Transplantation remains the mainstay of treatment for end-stage heart failure, but a shortage of organs represents a significant problem that prolongs time spent on the waiting list. In view of this, the selection of donor and recipient must be extremely meticulous, considering all factors that could predispose to organ failure. One of the main considerations regarding heart transplants is the risk of graft rejection and the need for immunosuppression therapy to mitigate that risk. In this study, we aimed to assess the characteristics of patients who need immunosuppression treatment for rejection within one year of heart transplantation and its impact on mid-term and long-term mortality. (2) Methods: The United Network for Organ Sharing (UNOS) Registry was queried to identify patients who solely underwent a heart transplant in the US between 2000 and 2021. Patients were divided into two groups according to the need for anti-rejection treatment within one year of heart transplantation. Patients' characteristics in the two groups were assessed, and 1 year and 10 year mortality rates were compared. (3) Results: A total of 43,763 patients underwent isolated heart transplantation in the study period, and 9946 (22.7%) needed anti-rejection treatment in the first year. Patients who required treatment for rejection within one year after transplant were more frequently younger (49 ± 14 vs. 52 ± 14 years, p < 0.001), women (31% vs. 23%, p < 0.001), and had a higher CPRA value (14 ± 26 vs. 11 ± 23, p < 0.001). Also, the rate of prior cardiac surgery was more than double in this group (27% vs. 12%, p < 0.001), while prior LVAD (12% vs. 11%, p < 0.001) and IABP (10% vs. 9%, p < 0.01) were more frequent in patients who did not receive anti-rejection treatment in the first year. Finally, pre-transplantation creatinine was significantly higher in patients who did not need treatment for rejection in the first year (1.4 vs. 1.3, p < 0.01). Most patients who did not require anti-rejection treatment underwent heart transplantation during the new allocation era, while less than half of the patients who required treatment underwent transplantation after the new allocation policy implementation (65% vs. 49%, p < 0.001). Patients who needed rejection treatment in the first year had a higher risk of unadjusted 1 year (HR: 2.25; 95% CI: 1.88–2.70; p < 0.001), 5 year (HR: 1.69; 95% CI: 1.60–1.79; p < 0.001), and 10 year (HR: 1.47; 95% CI: 1.41–1.54, p < 0.001) mortality, and this was confirmed at the adjusted analysis at all three time-points. (4) Conclusions: Medical treatment of acute rejection was associated with significantly increased 1 year mortality compared to patients who did not require anti-rejection therapy. The higher risk of mortality was confirmed at a 10 year follow-up. Further studies and newer follow-up data are required to investigate the role of anti-rejection therapy in the heart transplant population. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Impaired angiogenesis in diabetic critical limb ischemia is mediated by a miR-130b-INHBA signaling axis

Author

Cheng, Henry S., primary, Pérez-Cremades, Daniel, additional, Zhuang, Rulin, additional, Jamaiyar, Anurag, additional, Wu, Winona W., additional, Chen, Jingshu, additional, Tzani, Aspasia, additional, Stone, Lauren, additional, Plutzky, Jorge, additional, Ryan, Terence E., additional, Goodney, Philip P., additional, Creager, Mark A., additional, Sabatine, Marc S., additional, Bonaca, Marc P., additional, and Feinberg, Mark W., additional

Published
2023
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20. A miRNA-CXCR4 signaling axis impairs monopoiesis and angiogenesis in diabetic critical limb ischemia

Author

Cheng, Henry S., primary, Zhuang, Rulin, additional, Pérez-Cremades, Daniel, additional, Chen, Jingshu, additional, Jamaiyar, Anurag, additional, Wu, Winona, additional, Sausen, Grasiele, additional, Tzani, Aspasia, additional, Plutzky, Jorge, additional, Henao-Mejia, Jorge, additional, Goodney, Philip P., additional, Creager, Mark A., additional, Sabatine, Marc S., additional, Bonaca, Marc P., additional, and Feinberg, Mark W., additional

Published
2023
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25. Short Leukocyte Telomere Length Precedes Clinical Expression of Atherosclerosis: The Blood-and-Muscle Model

Author

Benetos, Athanase, Toupance, Simon, Gautier, Sylvie, Labat, Carlos, Kimura, Masayuki, Rossi, Pascal M., Settembre, Nicla, Hubert, Jacques, Frimat, Luc, Bertrand, Baptiste, Boufi, Mourad, Flecher, Xavier, Sadoul, Nicolas, Eschwege, Pascal, Kessler, Michèle, Tzanetakou, Irene P., Doulamis, Ilias P., Konstantopoulos, Panagiotis, Tzani, Aspasia, Korou, Marilina, Gkogkos, Anastasios, Perreas, Konstantinos, Menenakos, Evangelos, Samanidis, Georgios, Vasiloglou-Gkanis, Michail, Kark, Jeremy D., Malikov, Serguei, Verhulst, Simon, and Aviv, Abraham

Published
2018
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27. Perivascular Fibrosis Is Mediated by a KLF10-IL-9 Signaling Axis in CD4+ T Cells

Author

Zhuang, Rulin, primary, Chen, Jingshu, additional, Cheng, Henry S., additional, Assa, Carmel, additional, Jamaiyar, Anurag, additional, Pandey, Arvind K., additional, Pérez-Cremades, Daniel, additional, Zhang, Bofang, additional, Tzani, Aspasia, additional, Khyrul Wara, Akm, additional, Plutzky, Jorge, additional, Barrera, Victor, additional, Bhetariya, Preetida, additional, Mitchell, Richard N., additional, Liu, Zhongmin, additional, and Feinberg, Mark W., additional

Published
2022
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31. Epicardial Adipocyte-derived TNF-α Modulates Local Inflammation in Patients with Advanced Coronary Artery Disease

Author

Karampetsou, Nikoleta, primary, Tzani, Aspasia, additional, Doulamis, Ilias P., additional, Bletsa, Evanthia, additional, Minia, Aggeliki, additional, Pliaka, Vaia, additional, Tsolakos, Nikos, additional, Oikonomou, Evangelos, additional, Tousoulis, Dimitris, additional, Kontzoglou, Konstantinos, additional, Alexopoulos, Leonidas G., additional, Perrea, Despoina N., additional, Patapis, Paulos, additional, and Chloroyiannis, Ioannis A., additional

Published
2022
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34. Impact of induction therapy on outcomes after heart transplantation

Author

Tzani, Aspasia Van den Eynde, Jef Doulamis, Ilias P. Kuno, Toshiki Kampaktsis, Polydoros N. Alvarez, Paulino and Briasoulis, Alexandros

Abstract

Background Approximately 50% of heart transplant (HT) programs utilize induction therapy (IT) with interleukin-2 receptor antagonists (IL2RA) or polyclonal anti-thymocyte antibodies (ATG). Methods Adult HT recipients were identified in the UNOS Registry between 2010 and 2020. We compared mortality between IT strategies with competing risk analysis. Results A total of 28 634 HT recipients were included in the study (50.1% no IT, 21.3% ATG, 27.9% IL2RA, .7% alemtuzumab, .01% OKT3). Adjusted all-cause, 30 day and 1 year mortality were lower among those treated with IT than no IT (sub-hazard ratio [SHR] .87, 95% CI .79-.96, SHR .86, .76-.97, SHR .76, .63-.93, P = .007, respectively). In propensity score matching analysis IT was associated with lower 30-day and 1-year mortality. IL2RA had higher all-cause and 1-year mortality than ATG (SHR 1.41, 95% CI 1.23-1.69 and 1.55, 95% CI 1.29-1.88, respectively). Utilization of IT was associated with significantly lower risk of treated rejection at 1 year after HT compared with no IT (relative risk ratio [RRR] .79) and similarly ATG compared with IL2RA (RRR .51). Conclusion IT was associated with lower mortality and treated rejection episodes than no IT. IL2RA is the most used IT approach but ATG has lower risk of treated rejection and mortality.

Published
2021

35. State-of-the-art machine learning algorithms for the prediction of outcomes after contemporary heart transplantation: Results from the UNOS database

Author

Kampaktsis, Polydoros N. Tzani, Aspasia Doulamis, Ilias P. and Moustakidis, Serafeim Drosou, Anastasios Diakos, Nikolaos and Drakos, Stavros G. Briasoulis, Alexandros

Abstract

Purpose We sought to develop and validate machine learning (ML) models to increase the predictive accuracy of mortality after heart transplantation (HT). Methods and results We included adult HT recipients from the United Network for Organ Sharing (UNOS) database between 2010 and 2018 using solely pre-transplant variables. The study cohort comprised 18 625 patients (53 +/- 13 years, 73% males) and was randomly split into a derivation and a validation cohort with a 3:1 ratio. At 1-year after HT, there were 2334 (12.5%) deaths. Out of a total of 134 pre-transplant variables, 39 were selected as highly predictive of 1-year mortality via feature selection algorithm and were used to train five ML models. AUC for the prediction of 1-year survival was .689, .642, .649, .637, .526 for the Adaboost, Logistic Regression, Decision Tree, Support Vector Machine, and K-nearest neighbor models, respectively, whereas the Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score had an AUC of .569. Local interpretable model-agnostic explanations (LIME) analysis was used in the best performing model to identify the relative impact of key predictors. ML models for 3- and 5-year survival as well as acute rejection were also developed in a secondary analysis and yielded AUCs of .629, .609, and .610 using 27, 31, and 91 selected variables respectively. Conclusion Machine learning models showed good predictive accuracy of outcomes after heart transplantation.

Published
2021

37. Number and Replating Capacity of Endothelial Colony‐Forming Cells are Telomere Length Dependent: Implication for Human Atherogenesis

Author

Toupance, Simon, primary, Simonici, Stéphanie, additional, Labat, Carlos, additional, Dumoulin, Chloé, additional, Lai, Tsung‐Po, additional, Lakomy, Cécile, additional, Regnault, Véronique, additional, Lacolley, Patrick, additional, Dignat George, Françoise, additional, Sabatier, Florence, additional, Aviv, Abraham, additional, Benetos, Athanase, additional, Gautier, Sylvie, additional, Watfa, Ghassan, additional, Louis, Huguette, additional, Folio, Mélanie, additional, Schmitt, Margaux, additional, Ayad, Oualid, additional, Didier, Agnes, additional, Vauthier, Sandrine, additional, François, Nelly, additional, Visvikis‐Siest, Sophie, additional, Stathopolou, Maria G., additional, Kimura, Masayuki, additional, Rossi, Pascal M., additional, Béranger, Patricia, additional, Malikov, Serguei, additional, Settembre, Nicla, additional, Hubert, Jacques, additional, Frimat, Luc, additional, Bertrand, Baptiste, additional, Boufi, Mourad, additional, Flecher, Xavier, additional, Sadoul, Nicolas, additional, Eschwege, Pascal, additional, Kessler, Michèle, additional, Tzanetakou, Irene P., additional, Doulamis, Ilias P., additional, Konstantopoulos, Panagiotis, additional, Tzani, Aspasia, additional, Korou, Marilina, additional, Gkogkos, Anastasios, additional, Perreas, Konstantinos, additional, Menenakos, Evangelos, additional, Samanidis, Georgios, additional, Vasiloglou‐Gkanis, Michail, additional, Kark, Jeremy D., additional, and Verhulst, Simon, additional

Published
2021
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40. Balloon versus self‐expandable transcatheter aortic valve implantation for bicuspid aortic valve stenosis: A meta‐analysis of observational studies

Author

Sá, Michel Pompeu B.O., primary, Simonato, Matheus, additional, Van den Eynde, Jef, additional, Cavalcanti, Luiz Rafael P., additional, Alsagheir, Ali, additional, Tzani, Aspasia, additional, Fovino, Luca Nai, additional, Kampaktsis, Polydoros N., additional, Gallo, Michele, additional, Laforgia, Pietro L., additional, Ruhparwar, Arjang, additional, Weymann, Alexander, additional, Hirji, Sameer A., additional, Kaneko, Tsuyoshi, additional, and Tang, Gilbert, additional

Published
2021
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43. Η επίδραση της Μαστίχας Χίου (Pistacia lentiscus var chia) σε πειραματικό μοντέλο αθηρωμάτωσης

Author

Tzani Aspasia

Subjects
Health Sciences, Επιστήμες Υγείας
Abstract

Σκοπός Η Μαστίχα Χίου αποτελεί ένα πολύτιμο Ελληνικό φυσικό προϊόν ευρέως γνωστό για τις αντιοξειδωτικές αλλά και τις καρδιοπροστατευτικές του ιδιότητες. Σκοπός της παρούσας μελέτης ήταν η διερεύνηση του πιθανού μοριακού μηχανισμού δράσης της σε ένα πειραματικό μοντέλο αθηροσκλήρωσης. Υλικό και μέθοδος Χρησιμοποιήθηκαν συνολικά 30 ενήλικοι αρσενικοί WT μύες και 30 διαγονιδιακοί ομόζυγοι PPARα μύες που κατανεμήθηκαν σε 3 ομάδες, αντίστοιχα: Ομάδα Ελέγχου (n=10) που έλαβε standard chow δίαιτα , Ομάδα Αθηροσκλήρωσης(n = 10) που έλαβε διατροφή υψηλής περιεκτικότητας σε λιπαρά οξέα (45%) για 12 εβδομάδες και Ομάδα Μαστίχας Χίου (n=10 )που έλαβε διατροφή υψηλής περιεκτικότητας σε λιπαρά οξέα και Μαστίχα Χίου μέσω υδατικού διαλύματος σε δοσολογία 40 mg/kg/μέρα. Πραγματοποιήθηκαν μετρήσεις του σωματικού βάρους, των λιπιδίων,των αιμοδυναμικών παραμέτρως καθώς και προφλεγμονωδών κυτοκινών στον ορό του αίματος με την χρήση πρωτεομικής μεθόδου κατά την έναρξη του πειράματος και έπειτα από 4,8 και 12 εβδομάδες.Έπειτα από ευθανασία των μυών, πραγματοποιήθηκε ιστολογική μελέτη του ήπατος. Αποτελέσματα Στο τέλος της μελέτης, η ομάδα των wild type μυών που έλαβε Μαστίχα Χίου παρουσίασεμειωμένα επίπεδα σωματικού βάρους (30 vs 34 g, p

Published
2019

44. Experimental hypogonadism: insulin resistance, biochemical changes and effect of testosterone substitution

Author

Doulamis, Ilias P., primary, Tzani, Aspasia, additional, Konstantopoulos, Panagiotis, additional, Daskalopoulou, Afroditi, additional, Spinos, Theodoros, additional, Bletsa, Evanthia, additional, Mitsopoulou, Dimitra, additional, Spinou, Marianna, additional, Brinia, Maria Evgenia, additional, Palaiopanos, Konstantinos, additional, Korou, Laskarina Maria, additional, Perrea, Despina N., additional, and Katsilambros, Nicholas L., additional

Published
2019
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45. Visceral white adipose tissue and serum proteomic alternations in metabolically healthy obese patients undergoing bariatric surgery

Author

Doulamis, Ilias P., primary, Konstantopoulos, Panagiotis, additional, Tzani, Aspasia, additional, Antoranz, Asier, additional, Minia, Angeliki, additional, Daskalopoulou, Afroditi, additional, Charalampopoulos, Anestis, additional, Alexopoulos, Leonidas, additional, Perrea, Depsina N., additional, and Menenakos, Evangelos, additional

Published
2019
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46. Surgical Treatment of Pulmonary Embolism and Chronic ThromboembolicPulmonary Hypertension

Author

Papakonstantinou, Nikolaos A., Kampaktsis, Polydoros N., Rorris, Filippos-Paschalis, Doulamis, Ilias, Tzani, Aspasia, Katsaridis, Sotirios, and Avgerinos, Dimitrios

Abstract

Venous thromboembolism clinically presents as deep venous thrombosis or acute pulmonary embolismand is globally recognized as the third most frequent acute cardiovascular syndrome after myocardial infarctionand stroke. Although pulmonary embolism does not typically cause severe pulmonary hypertension inthe acute setting, thrombus organization and fibrosis can lead to stenosis or obliteration of pulmonary arteries ina minority of patients, which in turn result in severe pulmonary hypertension and right heart failure. This diseaseis labeled chronic thromboembolic pulmonary hypertension and can occur after a single episode or multipleones of pulmonary embolism. The cornerstone of pulmonary embolism treatment is medical therapy,whereas systemic thrombolytic therapy has to be considered for patients with hemodynamic instability. Giventhe current acceptable short-term surgical mortality, the potential of first-line surgical embolectomy as an alternativeto medical thrombolysis has gained momentum as far as pulmonary embolism treatment is concerned. Incontrast to pulmonary embolism, bilateral complete pulmonary endarterectomy under short deep hypothermiccirculatory arrest intervals is the treatment of choice against chronic thromboembolic pulmonary hypertension,given patients operability. Pulmonary endarterectomy is suggested in every operable patient when the operationis offered by an experienced multidisciplinary team, including at least one experienced surgeon. Surgicalembolectomy should also be limited to large institutions since it also requires an experienced heart team. Thisreview concerns a thorough discussion regarding surgical treatment of pulmonary embolism and chronic thromboembolicpulmonary hypertension. Eligibility criteria, operation-related complications and postoperative outcomesare discussed in detail.

Published
2022
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