ProfessorPetrosNihoyannopoulos

Antoniadi K, Thomaidis N, Nihoyannopoulos P, Toutouzas K, Gikas E, Kelaidi C, Polychronopoulou Set al., 2023, Prognostic Factors for Cardiotoxicity among Children with Cancer: Definition, Causes, and Diagnosis with Omics Technologies, Diagnostics, Vol: 13

Improvements in the treatment of childhood cancer have considerably enhanced survival rates over the last decades to over 80% as of today. However, this great achievement has been accompanied by the occurrence of several early and long-term treatment-related complications major of which is cardiotoxicity. This article reviews the contemporary definition of cardiotoxicity, older and newer chemotherapeutic agents that are mainly involved in cardiotoxicity, routine process diagnoses, and methods using omics technology for early and preventive diagnosis. Chemotherapeutic agents and radiation therapies have been implicated as a cause of cardiotoxicity. In response, the area of cardio-oncology has developed into a crucial element of oncologic patient care, committed to the early diagnosis and treatment of adverse cardiac events. However, routine diagnosis and the monitoring of cardiotoxicity rely on electrocardiography and echocardiography. For the early detection of cardiotoxicity, in recent years, major studies have been conducted using biomarkers such as troponin, N-terminal pro b-natriuretic peptide, etc. Despite the refinements in diagnostics, severe limitations still exist due to the increase in the above-mentioned biomarkers only after significant cardiac damage has occurred. Lately, the research has expanded by introducing new technologies and finding new markers using the omics approach. These new markers could be used not only for early detection but also for the early prevention of cardiotoxicity. Omics science, which includes genomics, transcriptomics, proteomics, and metabolomics, offers new opportunities for biomarker discovery in cardiotoxicity and may provide an understanding of the mechanisms of cardiotoxicity beyond traditional technologies.

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Sachpekidis V, Papadopoulou S-L, Kantartzi V, Styliadis I, Nihoyannopoulos Pet al., 2022, A Novel Handheld Echocardiography Device with Continuous-Wave Doppler Capability: Implications for the Evaluation of Aortic Stenosis Severity, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 35, Pages: 1273-1280, ISSN: 0894-7317

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• Citations: 4

Sachpekidis V, Papadopoulou SL, Kantartzi V, Styliadis I, Nihoyannopoulos Pet al., 2022, Use of a novel handheld ultrasound device with continuous-wave doppler capability for the assessment of valvular heart disease, Publisher: OXFORD UNIV PRESS, Pages: 1-1, ISSN: 0195-668X

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Porter TR, Feinstein SB, Senior R, Mulvagh SL, Nihoyannopoulos P, Strom JB, Mathias W, Gorman B, Rabischoffsky A, Main ML, Appis Aet al., 2022, CEUS cardiac exam protocols International Contrast Ultrasound Society (ICUS) recommendations, ECHO RESEARCH AND PRACTICE, Vol: 9, ISSN: 2055-0464

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Dunleavy M, Goldberg A, Feinstein S, Wilson S, Mulvagh S, Nihoyannopoulos Pet al., 2022, The 35th annual advances in contrast ultrasound international bubble conference, Chicago 2021: synopsis and take-home messages., Echo Res Pract, Vol: 9, ISSN: 2055-0464

The 35th Annual Advances in Contrast Ultrasound International Bubble Conference convened in Chicago, IL, USA, on September 30th to October 1st, 2021. It featured a range of novel research from animal studies to clinical applications in multiple organ systems, demonstrating the utility of contrast enhanced ultrasound (CEUS). A multidisciplinary group of experts on the use of CEUS, including physicians, basic scientists, engineers, and industry partners, convened to discuss cutting edge research and new applications for CEUS. The conference demonstrated the wide range of CEUS uses and potential uses, including cardiac risk stratification, sonothrombolysis, peripheral vascular reperfusion, liver and renal mass evaluation, lymphatic evaluation, sentinel node identification, and CEUS use in pediatrics. The International Contrast Ultrasound Society uses this information to continue advocating for the safe and appropriate use of CEUS.

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Klettas D, Georgiopoulos G, Rizvi Q, Oikonomou D, Magkas N, Bhuva AN, Manisty C, Captur G, Aimo A, Nihoyannopoulos Pet al., 2022, Echocardiographic and Cardiac Magnetic Resonance Imaging-Derived Strains in Relation to Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 171, Pages: 132-139, ISSN: 0002-9149

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• Citations: 3

Bazoukis G, Thomopoulos C, Tse G, Tsioufis K, Nihoyannopoulos Pet al., 2022, Global longitudinal strain predicts responders after cardiac resynchronization therapy-a systematic review and meta-analysis, HEART FAILURE REVIEWS, Vol: 27, Pages: 827-836, ISSN: 1382-4147

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Papadopoulou S-L, Sachpekidis V, Kantartzi V, Styliadis I, Nihoyannopoulos Pet al., 2022, Clinical validation of an artificial intelligence-assisted algorithm for automated quantification of left ventricular ejection fraction in real time by a novel handheld ultrasound device., Eur Heart J Digit Health, Vol: 3, Pages: 29-37

AIMS: We sought to evaluate the reliability and diagnostic accuracy of a novel handheld ultrasound device (HUD) with artificial intelligence (AI) assisted algorithm to automatically calculate ejection fraction (autoEF) in a real-world patient population. METHODS AND RESULTS: We studied 100 consecutive patients (57 ± 15 years old, 61% male), including 38 with abnormal left ventricular (LV) function [LV ejection fraction (LVEF) < 50%]. The autoEF results acquired using the HUD were independently compared with manually traced biplane Simpson's rule measurements on cart-based systems to assess method agreement using intra-class correlation coefficient (ICC), linear regression analysis, and Bland-Altman analysis. The diagnostic accuracy for the detection of LVEF <50% was also calculated. Test-retest reliability of measured EF by the HUD was assessed by calculating the ICC and the minimal detectable change (MDC). The ICC, linear regression analysis, and Bland-Altman analysis revealed good agreement between autoEF and reference manual EF (ICC = 0.85; r = 0.87, P < 0.001; mean bias -1.42% with limits of agreement 14.5%, respectively). Detection of abnormal LV function (EF < 50%) by autoEF algorithm was feasible with sensitivity 90% (95% CI 75-97%), specificity 87% (95% CI 76-94%), PPV 81% (95% CI 66-91%), NPV 93% (95% CI 83-98%), and a total diagnostic accuracy of 88%. Test-retest reliability was excellent (ICC = 0.91, P < 0.001; r = 0.91, P < 0.001; mean difference ± SD: 0.54% ± 5.27%, P = 0.308) and MDC for LVEF measurement by autoEF was calculated at 4.38%. CONCLUSION: Use of a novel HUD with AI-enabled capabilities provided similar LVEF results with those derived by manual biplane Simpson's method on cart-based systems and shows clinical potentia

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Fragoulis C, Dimitriadis K, Siafi E, Iliakis P, Kasiakogias A, Kalos T, Leontsinis I, Andrikou I, Konstantinidis D, Nihoyannopoulos P, Tsivgoulis G, Thomopoulos C, Tousoulis D, Muiesan ML, Tsioufis KPet al., 2022, Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry., Eur J Prev Cardiol, Vol: 29, Pages: 194-201

AIMS: Currently there are scarce epidemiological data regarding prevalence, clinical phenotype, and therapy of hypertensive urgencies (HU) and emergencies (HE). The aim of this article was to record the prevalence, clinical characteristics, and management of patients with HU and HE assessed in an emergency department (ED) of a tertiary hospital. METHODS AND RESULTS: The population consisted of patients presenting with HE and HU in the ED (acute increase in systolic blood pressure (BP) ≥ 180 mmHg and/or diastolic BP ≥120 mmHg with and without acute target organ damage, respectively). Of the 38 589 patients assessed in the ED during a 12-month period, 353 (0.91%) had HU and HE. There were 256 (72.5%) cases presented as HU and 97 (27.5%) as HE. Primary causes for both HU and HE were stress/anxiety (44.9%), increased salt intake (33.9%), and non-adherence to medication (16.2%). Patients with HU reported mainly dizziness/headache (46.8%) and chest pain (27.4%), whereas those with HE presented dyspnoea (67%), chest pain (30.2%), dizziness/headache (10.3%), and neurological disorders (8.2%). In HE, the underlying associated conditions were pulmonary oedema (58%), acute coronary syndrome (22.6%), and neurological disorders/stroke (7.2%). All HE cases were hospitalized and received intensive healthcare, including dialysis. CONCLUSION: This 1-year single-centre registry demonstrates a reasonable prevalence of HU and HE contributing to the high volume of visits to the ED. Stress, increased salt intake and non-adherence were main triggers of HE and HU. Dizziness and headache were the prevalent symptoms of HU patients while heart failure was the most common underlying disease in patients with HE.

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Filippou C, Tatakis F, Polyzos D, Manta E, Thomopoulos C, Nihoyannopoulos P, Tousoulis D, Tsioufis Ket al., 2022, Overview of salt restriction in the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet for blood pressure reduction., Rev Cardiovasc Med, Vol: 23, ISSN: 1530-6550

Despite considerable advances in pharmacological treatments, hypertension remains a major cause of premature morbidity and mortality worldwide since elevated blood pressure (BP) adversely influences cardiovascular and renal outcomes. Accordingly, the current hypertension guidelines recommend the adoption of dietary modifications in all subjects with suboptimal BP levels. These modifications include salt intake reduction and a healthy diet, such as the Dietary Approaches to Stop Hypertension (DASH) diet or the Mediterranean diet (MedDiet), independently of the underlying antihypertensive drug treatment. However, dietary modifications for BP reduction in adults with prehypertension or hypertension are usually examined as stand-alone interventions and, to a lesser extent, in combination with other dietary changes. The purpose of the present review was to summarize the evidence regarding the BP effect of salt restriction in the context of the DASH diet and the MedDiet. We also summarize the literature regarding the effects of these dietary modifications when they are applied as the only intervention for BP reduction in adults with and without hypertension and the potent physiological mechanisms underlying their beneficial effects on BP levels. Available data of randomized controlled trials (RCTs) provided evidence about the significant BP-lowering effect of each one of these dietary strategies, especially among subjects with hypertension since they modulate various physiological mechanisms controlling BP. Salt reduction by 2.3 g per day in the DASH diet produces less than half of the effect on systolic blood pressure (SBP)/diastolic blood pressure (DBP) (-3.0/-1.6 mmHg) as it does without the DASH diet (-6.7/-3.5 mmHg). Although their combined effect is not fully additive, low sodium intake and the DASH diet produce higher SBP/DBP reduction (-8.9/-4.5 mmHg) than each of these dietary regimens alone. It is yet unsettled whether this finding is also true for salt reductio

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Captur G, Manisty CH, Raman B, Marchi A, Wong TC, Ariga R, Bhuva A, Ormondroyd E, Lobascio I, Camaioni C, Loizos S, Bonsu-Ofori J, Turer A, Zaha VG, Augutsto JB, Davies RH, Taylor AJ, Nasis A, Al-Mallah MH, Valentin S, de Arenaza DP, Patel V, Westwood M, Petersen SE, Li C, Tang L, Nakamori S, Nezafat R, Kwong RY, Ho CY, Fraser AG, Watkins H, Elliott PM, Neubauer S, Lloyd G, Olivotto I, Nihoyannopoulos P, Moon JCet al., 2021, Maximal Wall Thickness Measurement in Hypertrophic Cardiomyopathy Biomarker Variability and its Impact on Clinical Care, JACC-CARDIOVASCULAR IMAGING, Vol: 14, Pages: 2123-2134, ISSN: 1936-878X

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• Citations: 10

Sanna GD, Canonico ME, Santoro C, Esposito R, Masia SL, Galderisi M, Parodi G, Nihoyannopoulos Pet al., 2021, Echocardiographic Longitudinal Strain Analysis in Heart Failure: Real Usefulness for Clinical Management Beyond Diagnostic Value and Prognostic Correlations? A Comprehensive Review, CURRENT HEART FAILURE REPORTS, Vol: 18, Pages: 290-303, ISSN: 1546-9530

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• Citations: 11

Naderi H, Robinson S, Swaans MJ, Bual N, Cheung W-S, Reid L, Shun-Shin M, Asaria P, Pabari P, Cole G, Kanaganayagam GS, Sutaria N, Bellamy M, Fox K, Nihoyannopoulos P, Petraco R, Al-Lamee R, Nijjer SS, Sen S, Ruparelia N, Baker C, Mikhail G, Malik I, Khamis R, Varnava A, Francis D, Mayet J, Rana Bet al., 2021, Adapting the role of handheld echocardiography during the COVID-19 pandemic: A practical guide, PERFUSION-UK, Vol: 36, Pages: 547-558, ISSN: 0267-6591

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Kadoglou NPE, Papadopoulos CH, Papadopoulos KG, Karagiannis S, Karabinos I, Loizos S, Theodosis-Georgilas A, Aggeli K, Keramida K, Klettas D, Kounas S, Makavos G, Ninios I, Ntalas I, Ikonomidis I, Sahpekidis V, Stefanidis A, Zaglavara T, Athanasopoulos G, Karatasakis G, Kyrzopoulos S, Kouris N, Patrianakos A, Paraskevaidis I, Rallidis L, Savvatis K, Tsiapras D, Nihoyannopoulos Pet al., 2021, Updated knowledge and practical implementations of stress echocardiography in ischemic and non-ischemic cardiac diseases: An expert consensus of the Working Group of Echocardiography of the Hellenic Society of Cardiology, HELLENIC JOURNAL OF CARDIOLOGY, Vol: 64, Pages: 30-57, ISSN: 1109-9666

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• Citations: 7

Schleberger R, Rillig A, Kirchhof P, Metzner A, Reissmann Bet al., 2021, [Update atrial fibrillation: the 2020 ESC guidelines and recent data on early rhythm control]., Herzschrittmacherther Elektrophysiol, Vol: 32, Pages: 257-263

Atrial fibrillation (AF) can be a significant burden for patients as well as the health care system. Every third 55-year-old will develop AF. Despite improvements of disease management, a significant risk for cardiovascular events remains. The current AF guidelines of the European Society of Cardiology focus on an integrative therapy approach. The new algorithm "CC to ABC" comprises recommendations for diagnosis ("confirm" and "characterise") and treatment ("avoid stroke", "better symptom control", "comorbidities") of AF. Direct oral anticoagulants administered according to the CHA2DS2-VASc score remain the corner stones of stroke prevention. Besides the concept of heart rate control, rhythm control therapy like antiarrhythmic drugs or catheter ablation is recommended to relieve symptoms and in certain patient groups for the improvement of prognosis. Therapy of comorbidities and reduction of risk factors like hypertension, diabetes mellitus, obesity and obstructive sleep apnoea should be part of any comprehensive treatment approach. The results of the randomized, prospective EAST-AFNET 4 trial were published in August 2020. The trial shows that an early rhythm control therapy can lead to a reduction of cardiovascular mortality and incidence of stroke additionally to guideline-based AF management. Given the safety profile and potential positive effects of antiarrhythmic drugs and catheter ablation, early initiation of rhythm control therapy should be considered in every patient during the first months after diagnosis of AF.

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Narodden S, 2021, Shockwave for the abrogation of heart failure in myocardial ischaemia-reperfusion injury

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Filippou CD, Thomopoulos CG, Kouremeti MM, Sotiropoulou LI, Nihoyannopoulos PI, Tousoulis DM, Tsioufis CPet al., 2021, Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled trials., Clin Nutr, Vol: 40, Pages: 3191-3200

BACKGROUND & AIMS: It is unclear whether the Mediterranean diet (MedDiet) has a favorable effect on blood pressure (BP) levels because among randomized controlled trials (RCTs) investigating the MedDiet-mediated BP reduction significant methodological and clinical differences are observed. The purpose of this study was to comprehensively assess the MedDiet BP-effect compared to the usual diet or another dietary intervention (e.g. low-fat diet) in adults with and without hypertension, accounting for methodological and clinical confounders. METHODS: We systematically searched Medline and the Cochrane Collaboration Library databases and identified 35 RCTs (13,943 participants). Random-effects model was used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted. RESULTS: Compared to the usual diet and all other active intervention diets the MedDiet reduced SBP and DBP (difference in means: -1.5 mm Hg; 95% CI: -2.8, -0.1; P = 0.035, and -0.9 mm Hg; 95% CI: -1.5, -0.3; P = 0.002, respectively). Compared only to the usual diet the MedDiet reduced SBP and DBP, while compared to all other active intervention diets or only to the low-fat diet the MedDiet did not reduce SBP and DBP. The MedDiet reduced DBP levels to a higher extent in trials with mean baseline SBP ≥130 mm Hg, while both SBP and DBP were reduced more in trials with a mean follow-up period ≥16 weeks. The quality of evidence was rated as moderate for both outcomes according to the grading of recommendations, assessment, development and evaluation (GRADE) approach. CONCLUSIONS: The adoption of the MedDiet was accompanied by a relatively small, but yet significant BP reduction, while higher baseline SBP levels and longer follow-up duration enhanced the BP-lowering effect of the intervention. This meta-analysis was registered in the Inter

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Mikhail G, Khawaja SA, Mohan P, Jabbour R, Bampouri T, Bowsher G, Hassan AMM, Huq F, Baghdasaryan L, Wang B, Sethi A, Sen S, Petraco R, Ruparelia N, Nijjer S, Malik IS, Foale R, Bellamy M, Kooner J, Rana BS, Cole G, Sutaria N, Kanaganayagam G, Nihoyannopoulos P, Fox K, Plymen CM, Pabari P, Howard L, Davies R, Hajoi G, Lo Giudice F, Kanagaratnam P, Anderson J, Chukwuemeka A, Khamis R, Varnava A, Baker CSR, Francis D, Asaria P, Al-Lamee Ret al., 2021, COVID-19 and its impact on the cardiovascular system, Open Heart, Vol: 8, Pages: 1-9, ISSN: 2053-3624

Objectives: The clinical impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has varied across countries with varying cardiovascular manifestations. We review the cardiac presentations, in-hospital outcomes and development of cardiovascular complications in the initial cohort of SARS-CoV-2 positive patients at Imperial College Healthcare NHS Trust, United Kingdom.Methods: We retrospectively analysed 498 COVID-19 positive adult admissions to our institute from 7th March to 7th April 2020. Patient data was collected for baseline demographics, co-morbidities and in-hospital outcomes, especially relating to cardiovascular intervention.Results:Mean age was 67.4±16.1 years and 62.2%(n=310) were male. 64.1%(n=319) of our cohort had underlying cardiovascular disease (CVD) with 53.4%(n=266) having hypertension. 43.2%(n=215) developed acute myocardial injury. Mortality was significantly increased in those patients with myocardial injury (47.4% vs 18.4%,p<0.001). Only 4 COVID-19 patients had invasive coronary angiography,2 underwent percutaneous coronary intervention and 1 required a permanent pacemaker implantation. 7.0%(n=35) of patients had an inpatient echocardiogram. Acute myocardial injury (OR 2.39,1.31-4.40,p=0.005) and history of hypertension (OR 1.88 ,1.01-3.55,p=0.049) approximately doubled the odds of in-hospital mortality in patients admitted with COVID-19 after other variables had been controlled for.Conclusion:Hypertension, pre-existing CVD and acute myocardial injury were associated with increased in-hospital mortality in our cohort of COVID-19 patients. However, only a low number of patients required invasive cardiac intervention.

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Panoulas VF, Chandrasekhar J, Busi G, Ruparelia N, Zhang Z, Mehilli J, Sartori S, Lefevre T, Presbitero P, Capranzano P, Tchetche D, Iadanza A, Sardella G, Van Mieghem NM, Meliga E, Dumonteil N, Fraccaro C, Trabattoni D, Sharma S, Ferrer-Gracia M-C, Naber CK, Kievit PC, Snyder C, Sutaria N, Sen S, Malik IS, Morice M-C, Nihoyannopoulos P, Petronio AS, Mehran R, Chieffo A, Mikhail GWet al., 2021, Prevalence, predictors, and outcomes of patient prosthesis mismatch in women undergoingTAVIfor severe aortic stenosis: Insights from theWIN-TAVIregistry, CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol: 97, Pages: 516-526, ISSN: 1522-1946

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• Citations: 11

Cambronero-Cortinas E, Moratalla-Haro P, Nihoyannopoulos P, 2021, Uncommon cardiac involvement of hypereosinophylic syndrome, Revista Espanola de Cardiologia, Vol: 74, ISSN: 0300-8932

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Celutkiene J, Pudil R, Lopez-Fernandez T, Grapsa J, Nihoyannopoulos P, Bergler-Klein J, Cohen-Solal A, Farmakis D, Tocchetti CG, von Haehling S, Barberis V, Flachskampf FA, Ceponlene J, Haegler-Laube E, Suter T, Lapinskas T, Prasad S, de Boer RA, Wechalekar K, Anker MS, Iakobishvili Z, Bucciarelli-Ducci C, Schulz-Menger J, Cosyns B, Gaemperli O, Belenkov Y, Hulot J-S, Galderisi M, Lancellotti P, Bax J, Marwick TH, Chioncel O, Jaarsma T, Mullens W, Piepoli M, Thum T, Heymans S, Mueller C, Moura B, Ruschitzka F, Zamorano JL, Rosano G, Coats AJS, Asteggiano R, Seferovic P, Edvardsen T, Lyon ARet al., 2021, Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC) (vol 22, pg 1504, 2020), EUROPEAN JOURNAL OF HEART FAILURE, Vol: 23, Pages: 345-345, ISSN: 1388-9842

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• Citations: 1

Ramlakhan KP, Tobler D, Greutmann M, Schwerzmann M, Baris L, Yetman AT, Nihoyannopoulos P, Manga P, Boersma E, Maggioni AP, Johnson MR, Hall R, Roos-Hesselink JWet al., 2021, Pregnancy outcomes in women with aortic coarctation, HEART, Vol: 107, Pages: 290-298, ISSN: 1355-6037

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• Citations: 9

Cambronero-Cortinas E, Moratalla-Haro P, Nihoyannopoulos P, 2021, Uncommon cardiac involvement of hypereosinophylic syndrome, REVISTA ESPANOLA DE CARDIOLOGIA, Vol: 74, Pages: 183-183, ISSN: 1885-5857

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Sachpekidis V, Adamopoulos C, Datsios A, Mosialos L, Stamatiadis N, Gogos C, Poulianitis V, Galanos O, Stratilati S, Styliadis I, Nihoyannopoulos Pet al., 2021, A tricky case of cardiogenic shock: Diagnostic challenges in the COVID-19 era, CLINICAL CASE REPORTS, Vol: 9, Pages: 420-424, ISSN: 2050-0904

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• Citations: 1

Ricci P, Ostenfeld E, Flick C, West C, Babu-Narayan S, Nihoyannopoulos P, Li Wet al., 2020, Assessment of biventricular function using advanced echocardiography in patients with Ebstein's anomaly pre and post-tricuspid valve surgery, Euroecho 2020, Publisher: OXFORD UNIV PRESS, Pages: 147-147, ISSN: 0195-668X

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Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, Chrysochoou CA, Nihoyannopoulos PI, Tousoulis DMet al., 2020, Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials., Adv Nutr, Vol: 11, Pages: 1150-1160

The Dietary Approaches to Stop Hypertension (DASH) diet is recognized as an effective dietary intervention to reduce blood pressure (BP). However, among randomized controlled trials (RCTs) investigating the DASH diet-mediated BP reduction, there are significant methodological and clinical differences. The purpose of this study was to comprehensively assess the DASH diet effect on BP in adults with and without hypertension, accounting for underlying methodological and clinical confounders. We systematically searched Medline and the Cochrane Collaboration Library databases and identified 30 RCTs (n = 5545 participants) that investigated the BP effects of the DASH diet compared with a control diet in hypertensive and nonhypertensive adults. Both random-effects and fixed-effect models were used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted. Compared with a control diet, the DASH diet reduced both SBP and DBP (difference in means: -3.2 mm Hg; 95% CI: -4.2, -2.3 mm Hg; P < 0.001, and -2.5 mm Hg; 95% CI: -3.5, -1.5 mm Hg; P < 0.001, respectively). Hypertension status did not modify the effect on BP reduction. The DASH diet compared with a control diet reduced SBP levels to a higher extent in trials with sodium intake >2400 mg/d than in trials with sodium intake ≤2400 mg/d, whereas both SBP and DBP were reduced more in trials with mean age <50 y than in trials of older participants. The quality of evidence was rated as moderate for both outcomes according to the Grading of Recommendations, Assessment, Development, and Evaluation approach. The adoption of the DASH diet was accompanied by significant BP reduction in adults with and without hypertension, although higher daily sodium intake and younger age enhanced the BP-lowering effect of the intervention. This meta-analysis was registered at www.crd.york.ac.uk/pro

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Tsampasian V, Panoulas V, Jabbour RJ, Ruparelia N, Malik IS, Hadjiloizou N, Frame A, Sen S, Sutaria N, Mikhail GW, Nihoyannopoulos Pet al., 2020, Left ventricular speckle tracking echocardiographic evaluation before and after TAVI, ECHO RESEARCH AND PRACTICE, Vol: 7, Pages: 29-38, ISSN: 2055-0464

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• Citations: 2

Celutkiene J, Pudil R, Lopez-Fernandez T, Grapsa J, Nihoyannopoulos P, Bergler-Klein J, Cohen-Solal A, Farmakis D, Tocchetti CG, von Haehling S, Barberis V, Flachskampf FA, Ceponiene I, Haegler-Laube E, Suter T, Lapinskas T, Prasad S, de Boer RA, Wechalekar K, Anker MS, Iakobishvili Z, Bucciarelli-Ducci C, Schulz-Menger J, Cosyns B, Gaemperli O, Belenkov Y, Hulot J-S, Galderisi M, Lancellotti P, Bax J, Marwick TH, Chioncel O, Jaarsma T, Mullens W, Piepoli M, Thum T, Heymans S, Mueller C, Moura B, Ruschitzka F, Zamorano JL, Rosano G, Coats AJS, Asteggiano R, Seferovic P, Edvardsen T, Lyon ARet al., 2020, Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC), EUROPEAN JOURNAL OF HEART FAILURE, Vol: 22, Pages: 1504-1524, ISSN: 1388-9842

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• Citations: 183

Garcia-Gonzalez C, Georgiopoulos G, Azim SA, Macaya F, Kametas N, Nihoyannopoulos P, Nicolaides KH, Charakida Met al., 2020, Maternal Cardiac Assessment at 35 to 37 Weeks Improves Prediction of Development of Preeclampsia, HYPERTENSION, Vol: 76, Pages: 514-522, ISSN: 0194-911X

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• Citations: 13

Grapsa J, Tan TC, Nunes MCP, O'Regan DP, Durighel G, Howard LSGE, Gibbs JSR, Nihoyannopoulos Pet al., 2020, Prognostic impact of right ventricular mass change in patients with idiopathic pulmonary arterial hypertension, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 304, Pages: 172-174, ISSN: 0167-5273

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• Citations: 5