Spyros G Lambrou - Academia.edu (original) (raw)

Papers by Spyros G Lambrou

Research paper thumbnail of Effects of balloon mitral valvuloplasty on left atrial function in mitral stenosis as assessed by pressure–area relation

Journal of the American College of Cardiology, Jul 1, 1998

Objectives. This study sought to investigate the changes induced on the pressure-area relation of... more Objectives. This study sought to investigate the changes induced on the pressure-area relation of the left atrium in patients with mitral stenosis after percutaneous balloon mitral valvuloplasty. Background. Left atrial (LA) function is influenced by changes in LA afterload. The latter is increased in mitral stenosis as a result of increased resistance to blood flow imposed by the stenotic mitral valve. Methods. We studied the effects of acute alterations of LA afterload induced by retrograde nontransseptal balloon mitral valvuloplasty (RNBMV) on LA function in patients with mitral stenosis. LA pressure-area relations were obtained in 15 patients with mitral stenosis (8 with sinus rhythm, 7 with atrial fibrillation) before and after valvuloplasty, as well as in 15 normal subjects. LA pressure was recorded by a catheter-tipped micromanometer introduced retrogradely into the left atrium while LA area was recorded simultaneously using acoustic quantification. The areas of the A and V loops of the pressure-area relation as well as the LA chamber stiffness constant were calculated. Results. Balloon valvuloplasty resulted in a significant increase in mitral valve area (p < 0.001) and a substantial reduction of the mean transmitral pressure gradient (p < 0.001) and mean LA pressure (p < 0.001). The area of the A loop in patients with sinus rhythm and the area of the V loop in those with atrial fibrillation increased significantly after completion of the procedure (p < 0.001). Furthermore, LA stiffness decreased in both groups. Conclusions. After RNBMV, there is a significant increase in LA pump function in patients with sinus rhythm, a significant increase in LA reservoir function in patients with atrial fibrillation and a significant reduction in LA stiffness in all patients. Marked alterations of the configuration of the LA pressure-area relation occur immediately after successful RNBMV in patients with mitral stenosis.

Research paper thumbnail of Retrograde nontransseptal balloon mitral valvuloplasty: immediate results and intermediate long-term outcome in 441 cases—a multicenter experience

Journal of the American College of Cardiology, Oct 1, 1998

Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for... more Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for the treatment of symptomatic mitral stenosis, avoids transseptal catheterization. Until recently, the self-positioning lnoue balloon catheter, unlike all other commercially available balloon catheters, had not been employed in this nontransseptal technique due to the short length of its catheter shaft. To employ a self-positioning balloon in retrograde nontransseptal balloon mitral valvuloplasty, we modified the lnoue device by extension of the catheter shaft. After retrograde nontransseptal left atrial catheterization using a steerable cardiac catheter, the modified lnoue balloon catheter was inserted through the femoral artery and advanced to the mitral valve retrogradely. Valvuloplasty was performed in 20 patients, with a successful result achieved in all. The modified lnoue balloon catheter was easy to use in retrograde nontransseptal balloon mitral valvuloplasty and showed excellent stability during inflation. Mean mitral valve area increased from 1 .O 2 0.29 to 2.23 f 0.64 cm2 (P<O.OOl) and mean transmitral gradient decreased from 11.4 & 6 to 4.3 f 2.1 mm Hg (P<O.OOl). No major or minor complications were observed. Retrograde nontransseptal balloon mitral valvuloplasty using a modified lnoue balloon catheter is a feasible and effective technique for the treatment of symtomatic mitral stenosis. It appears to combine the advantages of avoiding transseptal catheterization with the advantages of this balloon's special configuration.

Research paper thumbnail of Haemodynamic determinants of carotid artery distensibility in patients with essential hypertension

Research paper thumbnail of 1.P.345 Smoking and HDL-cholesterol in a population of young male adults; study of 1954 Greek army recruits

Atherosclerosis, Oct 1, 1997

Research paper thumbnail of Microalbuminuria is Associated with Excess Impairment of Thoracic Aortic Mechanics in Essential Hypertension

Journal of Hypertension, Jun 1, 2000

Research paper thumbnail of Comparison of Frequency of Left Atrial Thrombus in Patients With Mechanical Prosthetic Cardiac Valves and Stroke Versus Transient Ischemic Attacks

The American Journal of Cardiology, 1997

Transesophageal echocardiography performed in a group of 36 patients who had a first cerebral emb... more Transesophageal echocardiography performed in a group of 36 patients who had a first cerebral embolic event after implantation of a mechanical cardiac valvular prosthesis revealed that stroke is associated with the presence of left atrial thrombi more frequently than transient ischemic attacks. Intracardiac embolic sources other than thrombi are possibly related more often to the latter type of cerebral embolism in this patient population.

Research paper thumbnail of Retrograde nontransseptal balloon mitral valvuloplasty by the brachial artery approach

Catheterization and Cardiovascular Interventions, 2000

Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for... more Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for the treatment of symptomatic mitral stenosis, avoids transseptal catheterization. Until recently, the self-positioning lnoue balloon catheter, unlike all other commercially available balloon catheters, had not been employed in this nontransseptal technique due to the short length of its catheter shaft. To employ a self-positioning balloon in retrograde nontransseptal balloon mitral valvuloplasty, we modified the lnoue device by extension of the catheter shaft. After retrograde nontransseptal left atrial catheterization using a steerable cardiac catheter, the modified lnoue balloon catheter was inserted through the femoral artery and advanced to the mitral valve retrogradely. Valvuloplasty was performed in 20 patients, with a successful result achieved in all. The modified lnoue balloon catheter was easy to use in retrograde nontransseptal balloon mitral valvuloplasty and showed excellent stability during inflation. Mean mitral valve area increased from 1 .O 2 0.29 to 2.23 f 0.64 cm2 (P<O.OOl) and mean transmitral gradient decreased from 11.4 & 6 to 4.3 f 2.1 mm Hg (P<O.OOl). No major or minor complications were observed. Retrograde nontransseptal balloon mitral valvuloplasty using a modified lnoue balloon catheter is a feasible and effective technique for the treatment of symtomatic mitral stenosis. It appears to combine the advantages of avoiding transseptal catheterization with the advantages of this balloon's special configuration.

Research paper thumbnail of Left atrial enlargment is related with unfavorable left ventricular geometric pattern in untreated essential hypertensive subjects

American Journal of Hypertension

4 weeks and 6 months treatment, and the clinical blood pressure was observed at same time. Contro... more 4 weeks and 6 months treatment, and the clinical blood pressure was observed at same time. Control group was included 36 patients with essential hypertension who did not like to receipt antihypertensive drugs. After treatment of Valsartan for 4 weeks, decreasing values of clinical systolic blood pressure and clinical diastolic blood pressure were 16.68Ϯ2.69 mmHg and 11.67Ϯ3.39 mmHg respectively. There were no changes in diameter of left atrium and left ventricle, and the end systolic and diastolic volume of left ventricle. The thickness of ventricular septum and posterior wall, Left ventricular mass and left ventricular mass index decreased significantly after 4 weeks and 6 months therapy of Valsartan PϽ0.05, 0.01 respectively). Blood pressure and left ventricular wall had no any changes in control group during 6 months. Valsartan can inverse left ventricular hypertrophy in patients with essential hypertension, the effects began at 4 weeks after Valsartan treatment.

Research paper thumbnail of Echocardiographic and Electrocardiographic Prognostic Factors of Heart Failure in Young Patients with 3-Thalassemia Major: A 10-Year (1995-2004) Follow-up

Research paper thumbnail of 2701 Diurnal variation of short-term outcome of acute myocardial infarction according to timing of thrombolysis administration: Insights from the Assent-2 study

Research paper thumbnail of Application of retrograde non-transseptal catheterization in the study of left atrial mechanics

European Heart Journal Supplements, 2000

Research paper thumbnail of Absence of relationship between a blunted nocturnal blood pressure fall and left atrial dimensions in essential hypertensive subjects

American Journal of Hypertension, 2003

Unfortunately, is not unusual to make decisions about the management of hypertension without perf... more Unfortunately, is not unusual to make decisions about the management of hypertension without performing a correct BP measurement in clinical practice, which may lead to an underestimation of the control of hypertension due to the alert reaction. The aims of this study were as follows: 1. To compare the percentage of treated hypertensive patients who were controlled when BP was measured by using the usual conditions of clinical practice (CP), or by using the standard recommendations (SR) of current guidelines (OMS/ ISH and BSH) in GPЈs office. 2. To estimate the time required to perform BP measurements when using a CP or SR methodology. A crosssectional, descriptive and observational study was carried out in 198 treated hypertensive patients, over 18 years old, consecutively attended in GPЈoffice in a health area of Madrid (Spain). Four BP measurements were recorded: 1. the last BP recorded in the clinical history of the patient (CH); 2. the BP measured following a usual CP the day of the visit; 3. the average of three measurements (M3) following standard recomendations (SR); and 4. the average of the two last (M2) following standard recomendations (SR). Control was defined whenever BP Ͻ 140/90 mmHg. Significance was set at pϽ 0.05. The time (in minutes) required to obtain BP values was measured with both CP and SR methodologies. Mean age of participants was 67.85G 12.3 years old, 54% of them women. The percentage of control according to the last BP recorded in clinical hystory (CH) was 17.2 %; when using CP it was 16.2 %, with SR (M3) 39.8%, and with SR (M2) 42.9%. CP or CH vs M3 or M2 Ͻ 0.00. The average time required to measure BP by means of CP was 3 minutes, whereas with SR it was 11.34 minutes. In conclusion, it is very important to use a correct methodology to measure BP, since despite it is time consuming, it may spare the need to reinforce treatment (i.e. increasing dose or adding a new drug) in almost 30% of patients.

Research paper thumbnail of 620 Myocardial contrast echocardiography accurately predicts functional recovery early after acute myocardial infarction in elderly people

European Journal of Echocardiography, 2003

Background: The ability of myocardial contrast echocardiography (MCE) to predict contractile rese... more Background: The ability of myocardial contrast echocardiography (MCE) to predict contractile reserve after acute myocardial infarction (AMI) is still controversial. Given the possible reversibility of no-reflow after 30 days, we tested whether MCE predictive value depends on the timing of the test. Methods: 32 patients presenting with their first AMI and successfully recanalized IRA by either rt-PA (n=18) or primary angioplasty (n=14) underwent MCE at 24 hours and 30 days after symptom onset. MCE was performed by intermittent Harmonic Power Doppler and i.v. PESDA. Regional wall motion was evaluated by 2D echo 24 hours and 3 months later. Results: 24 hours after AMI, 231 myocardial segments were defined as a-kinetic or hypo-kinetic. Contractile recovery was observed in 105 segments, 101 perfused at 24 hours MCE and all 105 at 30 days MCE. Among the 126 dysfunctioning segments that did non show any contractile improvement, 28 were perfused at 24 hours, and 70 at 30 days. Within 46 dysfunctioning segments non perfused at 24 hours, perfusion was restored at 30 days but contraction improved in only 4 segments (9%). Dignostic potential and predictive value of MCE 24 hours and 30 days MCE in the evaluation of contractile recovery of post-AMI dysfunctioning myocardium are shown in the table.

Research paper thumbnail of intermediate long-term outcome in 441 cases—a multicenter experience Retrograde nontransseptal balloon mitral valvuloplasty: immediate results and

Research paper thumbnail of Embolic stroke after "cured" prosthetic aortic valve endocarditis

Cardiology in review

The authors report on the case of a patient with infective endocarditis of a prosthetic valve in ... more The authors report on the case of a patient with infective endocarditis of a prosthetic valve in the aortic position, after receiving percutaneous transluminal coronary angioplasty. Transesophageal echocardiography provided valuable information about the existence and size of vegetations at the time of initial diagnosis and during followup. Despite successful treatment resulting in good control of the infection and a significant reduction of vegetation size, the patient still suffered a major cerebral embolic event early after hospital discharge.

Research paper thumbnail of Evolution of thoracic aorta atheroscielerosis in patients with heterozygous familial hypercholesterolemia after statin therapy

Journal of the American College of Cardiology, 1998

vs 701, IP =, 0.02), systolic hyperten=ion (53% vs 42~, p = 003), dmbetes (171 w B%, p == 0,002),... more vs 701, IP =, 0.02), systolic hyperten=ion (53% vs 42~, p = 003), dmbetes (171 w B%, p == 0,002), no m~ular exemise (79% v~ f101, p ,~ 0,001) and tngly~rlO~ (187 ~ 77 vs 158 ± 69 mg/~, p ,~ 0.001). The m~ttv~ nsk (RR) ol pmgmsston w~s simdm ~ both g(~lers

Research paper thumbnail of Culprit coronary lesion location correlates closely with aortic root mechanics early after acute myocardial infarction

Journal of the American College of Cardiology, 2003

Research paper thumbnail of Long-term (9-Year) Follow-up of Patients Undergoing Retrograde Nontransseptal Balloon Mitral Valvuloplasty

Journal of the American College of Cardiology, 1998

Research paper thumbnail of Smoking and HDL-Cholesterol in a Population of Young Male Adults; Study of 1954 Greek Army Recruits

Journal of the American College of Cardiology, 1998

B,sOk0m~ Hen~t failure con now bo tmaled eft, t~t it can be d~ff~. ~no~ In ~al~ls_ ~ _~m,Fr~toma~... more B,sOk0m~ Hen~t failure con now bo tmaled eft, t~t it can be d~ff~. ~no~ In ~al~ls_ ~ _~m,Fr~toma~ kffl ventm~lar (LV)impaJmlnt, ~m,W~Y Me~q_~.b.-We. am ~men~ 7QO0 pa,ent= aged 4~ ~nd above tram Ihe O0m~unily in WeS! ~ ~ 011Ert0~nd: 4000 randondy imlecled aged

Research paper thumbnail of Left atrial pressure-volume relation in humans: A new method based on direct nontransseptal left atrial catheterization and echocardiography

Journal of the American College of Cardiology, 1996

Few details are known about the behavior of activation fronts (AFs) during ventdcutar fibrillatio... more Few details are known about the behavior of activation fronts (AFs) during ventdcutar fibrillation 0/F). Therefore, we developed computerized methods to quantitate (I) the number of AFs per s, (ll) the number of AFs passing each epicardial site per s, (Ill) the conduction velocity of the AFs in m/s, (IV) the number of AFs that fragment into 2 AFs per s bec_+ause of block, and (V) the number of AFs that collide and coalesce into a single AF per s. Unipolar potentials were recorded fr~.m a 504 (21X24) electrode plaque (2 mm interelectrode spacing) cove:L~0-,= 20 cm2 of the anterior RV and LV in 5 pigs. In each animal, six episodes of VF were induced by premature stimutalion (1-12 rnA). Segments of VF it s) starting 0, 10, 20, 30 and 40 s pest-induction were analyzed. 0,-1' 10-11' 20-21' 30-3V 40,-41'

Research paper thumbnail of Effects of balloon mitral valvuloplasty on left atrial function in mitral stenosis as assessed by pressure–area relation

Journal of the American College of Cardiology, Jul 1, 1998

Objectives. This study sought to investigate the changes induced on the pressure-area relation of... more Objectives. This study sought to investigate the changes induced on the pressure-area relation of the left atrium in patients with mitral stenosis after percutaneous balloon mitral valvuloplasty. Background. Left atrial (LA) function is influenced by changes in LA afterload. The latter is increased in mitral stenosis as a result of increased resistance to blood flow imposed by the stenotic mitral valve. Methods. We studied the effects of acute alterations of LA afterload induced by retrograde nontransseptal balloon mitral valvuloplasty (RNBMV) on LA function in patients with mitral stenosis. LA pressure-area relations were obtained in 15 patients with mitral stenosis (8 with sinus rhythm, 7 with atrial fibrillation) before and after valvuloplasty, as well as in 15 normal subjects. LA pressure was recorded by a catheter-tipped micromanometer introduced retrogradely into the left atrium while LA area was recorded simultaneously using acoustic quantification. The areas of the A and V loops of the pressure-area relation as well as the LA chamber stiffness constant were calculated. Results. Balloon valvuloplasty resulted in a significant increase in mitral valve area (p < 0.001) and a substantial reduction of the mean transmitral pressure gradient (p < 0.001) and mean LA pressure (p < 0.001). The area of the A loop in patients with sinus rhythm and the area of the V loop in those with atrial fibrillation increased significantly after completion of the procedure (p < 0.001). Furthermore, LA stiffness decreased in both groups. Conclusions. After RNBMV, there is a significant increase in LA pump function in patients with sinus rhythm, a significant increase in LA reservoir function in patients with atrial fibrillation and a significant reduction in LA stiffness in all patients. Marked alterations of the configuration of the LA pressure-area relation occur immediately after successful RNBMV in patients with mitral stenosis.

Research paper thumbnail of Retrograde nontransseptal balloon mitral valvuloplasty: immediate results and intermediate long-term outcome in 441 cases—a multicenter experience

Journal of the American College of Cardiology, Oct 1, 1998

Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for... more Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for the treatment of symptomatic mitral stenosis, avoids transseptal catheterization. Until recently, the self-positioning lnoue balloon catheter, unlike all other commercially available balloon catheters, had not been employed in this nontransseptal technique due to the short length of its catheter shaft. To employ a self-positioning balloon in retrograde nontransseptal balloon mitral valvuloplasty, we modified the lnoue device by extension of the catheter shaft. After retrograde nontransseptal left atrial catheterization using a steerable cardiac catheter, the modified lnoue balloon catheter was inserted through the femoral artery and advanced to the mitral valve retrogradely. Valvuloplasty was performed in 20 patients, with a successful result achieved in all. The modified lnoue balloon catheter was easy to use in retrograde nontransseptal balloon mitral valvuloplasty and showed excellent stability during inflation. Mean mitral valve area increased from 1 .O 2 0.29 to 2.23 f 0.64 cm2 (P<O.OOl) and mean transmitral gradient decreased from 11.4 & 6 to 4.3 f 2.1 mm Hg (P<O.OOl). No major or minor complications were observed. Retrograde nontransseptal balloon mitral valvuloplasty using a modified lnoue balloon catheter is a feasible and effective technique for the treatment of symtomatic mitral stenosis. It appears to combine the advantages of avoiding transseptal catheterization with the advantages of this balloon's special configuration.

Research paper thumbnail of Haemodynamic determinants of carotid artery distensibility in patients with essential hypertension

Research paper thumbnail of 1.P.345 Smoking and HDL-cholesterol in a population of young male adults; study of 1954 Greek army recruits

Atherosclerosis, Oct 1, 1997

Research paper thumbnail of Microalbuminuria is Associated with Excess Impairment of Thoracic Aortic Mechanics in Essential Hypertension

Journal of Hypertension, Jun 1, 2000

Research paper thumbnail of Comparison of Frequency of Left Atrial Thrombus in Patients With Mechanical Prosthetic Cardiac Valves and Stroke Versus Transient Ischemic Attacks

The American Journal of Cardiology, 1997

Transesophageal echocardiography performed in a group of 36 patients who had a first cerebral emb... more Transesophageal echocardiography performed in a group of 36 patients who had a first cerebral embolic event after implantation of a mechanical cardiac valvular prosthesis revealed that stroke is associated with the presence of left atrial thrombi more frequently than transient ischemic attacks. Intracardiac embolic sources other than thrombi are possibly related more often to the latter type of cerebral embolism in this patient population.

Research paper thumbnail of Retrograde nontransseptal balloon mitral valvuloplasty by the brachial artery approach

Catheterization and Cardiovascular Interventions, 2000

Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for... more Retrograde nontransseptal balloon mitral valvuloplasty, a method developed in our institution for the treatment of symptomatic mitral stenosis, avoids transseptal catheterization. Until recently, the self-positioning lnoue balloon catheter, unlike all other commercially available balloon catheters, had not been employed in this nontransseptal technique due to the short length of its catheter shaft. To employ a self-positioning balloon in retrograde nontransseptal balloon mitral valvuloplasty, we modified the lnoue device by extension of the catheter shaft. After retrograde nontransseptal left atrial catheterization using a steerable cardiac catheter, the modified lnoue balloon catheter was inserted through the femoral artery and advanced to the mitral valve retrogradely. Valvuloplasty was performed in 20 patients, with a successful result achieved in all. The modified lnoue balloon catheter was easy to use in retrograde nontransseptal balloon mitral valvuloplasty and showed excellent stability during inflation. Mean mitral valve area increased from 1 .O 2 0.29 to 2.23 f 0.64 cm2 (P<O.OOl) and mean transmitral gradient decreased from 11.4 & 6 to 4.3 f 2.1 mm Hg (P<O.OOl). No major or minor complications were observed. Retrograde nontransseptal balloon mitral valvuloplasty using a modified lnoue balloon catheter is a feasible and effective technique for the treatment of symtomatic mitral stenosis. It appears to combine the advantages of avoiding transseptal catheterization with the advantages of this balloon's special configuration.

Research paper thumbnail of Left atrial enlargment is related with unfavorable left ventricular geometric pattern in untreated essential hypertensive subjects

American Journal of Hypertension

4 weeks and 6 months treatment, and the clinical blood pressure was observed at same time. Contro... more 4 weeks and 6 months treatment, and the clinical blood pressure was observed at same time. Control group was included 36 patients with essential hypertension who did not like to receipt antihypertensive drugs. After treatment of Valsartan for 4 weeks, decreasing values of clinical systolic blood pressure and clinical diastolic blood pressure were 16.68Ϯ2.69 mmHg and 11.67Ϯ3.39 mmHg respectively. There were no changes in diameter of left atrium and left ventricle, and the end systolic and diastolic volume of left ventricle. The thickness of ventricular septum and posterior wall, Left ventricular mass and left ventricular mass index decreased significantly after 4 weeks and 6 months therapy of Valsartan PϽ0.05, 0.01 respectively). Blood pressure and left ventricular wall had no any changes in control group during 6 months. Valsartan can inverse left ventricular hypertrophy in patients with essential hypertension, the effects began at 4 weeks after Valsartan treatment.

Research paper thumbnail of Echocardiographic and Electrocardiographic Prognostic Factors of Heart Failure in Young Patients with 3-Thalassemia Major: A 10-Year (1995-2004) Follow-up

Research paper thumbnail of 2701 Diurnal variation of short-term outcome of acute myocardial infarction according to timing of thrombolysis administration: Insights from the Assent-2 study

Research paper thumbnail of Application of retrograde non-transseptal catheterization in the study of left atrial mechanics

European Heart Journal Supplements, 2000

Research paper thumbnail of Absence of relationship between a blunted nocturnal blood pressure fall and left atrial dimensions in essential hypertensive subjects

American Journal of Hypertension, 2003

Unfortunately, is not unusual to make decisions about the management of hypertension without perf... more Unfortunately, is not unusual to make decisions about the management of hypertension without performing a correct BP measurement in clinical practice, which may lead to an underestimation of the control of hypertension due to the alert reaction. The aims of this study were as follows: 1. To compare the percentage of treated hypertensive patients who were controlled when BP was measured by using the usual conditions of clinical practice (CP), or by using the standard recommendations (SR) of current guidelines (OMS/ ISH and BSH) in GPЈs office. 2. To estimate the time required to perform BP measurements when using a CP or SR methodology. A crosssectional, descriptive and observational study was carried out in 198 treated hypertensive patients, over 18 years old, consecutively attended in GPЈoffice in a health area of Madrid (Spain). Four BP measurements were recorded: 1. the last BP recorded in the clinical history of the patient (CH); 2. the BP measured following a usual CP the day of the visit; 3. the average of three measurements (M3) following standard recomendations (SR); and 4. the average of the two last (M2) following standard recomendations (SR). Control was defined whenever BP Ͻ 140/90 mmHg. Significance was set at pϽ 0.05. The time (in minutes) required to obtain BP values was measured with both CP and SR methodologies. Mean age of participants was 67.85G 12.3 years old, 54% of them women. The percentage of control according to the last BP recorded in clinical hystory (CH) was 17.2 %; when using CP it was 16.2 %, with SR (M3) 39.8%, and with SR (M2) 42.9%. CP or CH vs M3 or M2 Ͻ 0.00. The average time required to measure BP by means of CP was 3 minutes, whereas with SR it was 11.34 minutes. In conclusion, it is very important to use a correct methodology to measure BP, since despite it is time consuming, it may spare the need to reinforce treatment (i.e. increasing dose or adding a new drug) in almost 30% of patients.

Research paper thumbnail of 620 Myocardial contrast echocardiography accurately predicts functional recovery early after acute myocardial infarction in elderly people

European Journal of Echocardiography, 2003

Background: The ability of myocardial contrast echocardiography (MCE) to predict contractile rese... more Background: The ability of myocardial contrast echocardiography (MCE) to predict contractile reserve after acute myocardial infarction (AMI) is still controversial. Given the possible reversibility of no-reflow after 30 days, we tested whether MCE predictive value depends on the timing of the test. Methods: 32 patients presenting with their first AMI and successfully recanalized IRA by either rt-PA (n=18) or primary angioplasty (n=14) underwent MCE at 24 hours and 30 days after symptom onset. MCE was performed by intermittent Harmonic Power Doppler and i.v. PESDA. Regional wall motion was evaluated by 2D echo 24 hours and 3 months later. Results: 24 hours after AMI, 231 myocardial segments were defined as a-kinetic or hypo-kinetic. Contractile recovery was observed in 105 segments, 101 perfused at 24 hours MCE and all 105 at 30 days MCE. Among the 126 dysfunctioning segments that did non show any contractile improvement, 28 were perfused at 24 hours, and 70 at 30 days. Within 46 dysfunctioning segments non perfused at 24 hours, perfusion was restored at 30 days but contraction improved in only 4 segments (9%). Dignostic potential and predictive value of MCE 24 hours and 30 days MCE in the evaluation of contractile recovery of post-AMI dysfunctioning myocardium are shown in the table.

Research paper thumbnail of intermediate long-term outcome in 441 cases—a multicenter experience Retrograde nontransseptal balloon mitral valvuloplasty: immediate results and

Research paper thumbnail of Embolic stroke after "cured" prosthetic aortic valve endocarditis

Cardiology in review

The authors report on the case of a patient with infective endocarditis of a prosthetic valve in ... more The authors report on the case of a patient with infective endocarditis of a prosthetic valve in the aortic position, after receiving percutaneous transluminal coronary angioplasty. Transesophageal echocardiography provided valuable information about the existence and size of vegetations at the time of initial diagnosis and during followup. Despite successful treatment resulting in good control of the infection and a significant reduction of vegetation size, the patient still suffered a major cerebral embolic event early after hospital discharge.

Research paper thumbnail of Evolution of thoracic aorta atheroscielerosis in patients with heterozygous familial hypercholesterolemia after statin therapy

Journal of the American College of Cardiology, 1998

vs 701, IP =, 0.02), systolic hyperten=ion (53% vs 42~, p = 003), dmbetes (171 w B%, p == 0,002),... more vs 701, IP =, 0.02), systolic hyperten=ion (53% vs 42~, p = 003), dmbetes (171 w B%, p == 0,002), no m~ular exemise (79% v~ f101, p ,~ 0,001) and tngly~rlO~ (187 ~ 77 vs 158 ± 69 mg/~, p ,~ 0.001). The m~ttv~ nsk (RR) ol pmgmsston w~s simdm ~ both g(~lers

Research paper thumbnail of Culprit coronary lesion location correlates closely with aortic root mechanics early after acute myocardial infarction

Journal of the American College of Cardiology, 2003

Research paper thumbnail of Long-term (9-Year) Follow-up of Patients Undergoing Retrograde Nontransseptal Balloon Mitral Valvuloplasty

Journal of the American College of Cardiology, 1998

Research paper thumbnail of Smoking and HDL-Cholesterol in a Population of Young Male Adults; Study of 1954 Greek Army Recruits

Journal of the American College of Cardiology, 1998

B,sOk0m~ Hen~t failure con now bo tmaled eft, t~t it can be d~ff~. ~no~ In ~al~ls_ ~ _~m,Fr~toma~... more B,sOk0m~ Hen~t failure con now bo tmaled eft, t~t it can be d~ff~. ~no~ In ~al~ls_ ~ _~m,Fr~toma~ kffl ventm~lar (LV)impaJmlnt, ~m,W~Y Me~q_~.b.-We. am ~men~ 7QO0 pa,ent= aged 4~ ~nd above tram Ihe O0m~unily in WeS! ~ ~ 011Ert0~nd: 4000 randondy imlecled aged

Research paper thumbnail of Left atrial pressure-volume relation in humans: A new method based on direct nontransseptal left atrial catheterization and echocardiography

Journal of the American College of Cardiology, 1996

Few details are known about the behavior of activation fronts (AFs) during ventdcutar fibrillatio... more Few details are known about the behavior of activation fronts (AFs) during ventdcutar fibrillation 0/F). Therefore, we developed computerized methods to quantitate (I) the number of AFs per s, (ll) the number of AFs passing each epicardial site per s, (Ill) the conduction velocity of the AFs in m/s, (IV) the number of AFs that fragment into 2 AFs per s bec_+ause of block, and (V) the number of AFs that collide and coalesce into a single AF per s. Unipolar potentials were recorded fr~.m a 504 (21X24) electrode plaque (2 mm interelectrode spacing) cove:L~0-,= 20 cm2 of the anterior RV and LV in 5 pigs. In each animal, six episodes of VF were induced by premature stimutalion (1-12 rnA). Segments of VF it s) starting 0, 10, 20, 30 and 40 s pest-induction were analyzed. 0,-1' 10-11' 20-21' 30-3V 40,-41'