Imperial College London

ProfessorPetrosNihoyannopoulos

Faculty of MedicineNational Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 3313 8156p.nihoyannopoulos

 
 
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Location

 

Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

669 results found

Nel S, Nihoyannopoulos P, Libhaber E, Essop MR, dos Santos CF, Matioda H, Waterworth C, Grinter S, Meel R, Peters Fet al., 2020, Echocardiographic Indices of the Left and Right Heart in a Normal Black African Population, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 33, Pages: 358-367, ISSN: 0894-7317

Journal article

Kyung S, Goldberg A, Feinstein S, Wilson S, Mulvagh S, Nihoyannopoulos Pet al., 2020, The 34th Annual Advances in Contrast Ultrasound International Bubble Conference, Chicago 2019: synopsis and take-home messages, ECHO RESEARCH AND PRACTICE, Vol: 7, Pages: M1-M5, ISSN: 2055-0464

Journal article

Celutkiene J, Lainscak M, Anderson L, Gayat E, Grapsa J, Harjola V-P, Manka R, Nihoyannopoulos P, Filardi PP, Vrettou R, Anker SD, Filippatos G, Mebazaa A, Metra M, Piepoli M, Ruschitzka F, Luis Zamorano J, Rosano G, Seferovic Pet al., 2020, Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 22, Pages: 181-195, ISSN: 1388-9842

Journal article

Alfarih M, Leu C, Moon J, Hughes A, Nihoyannopoulos P, Captur Get al., 2019, Echocardiographic Assessment of Left Ventricular Function in Patients with Aortic Stenosis and the short-term effects after intervention, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 507-507, ISSN: 0195-668X

Conference paper

Vrettos A, Al Saikhan L, Matiti L, Plymen C, Low B, Nihoyannopoulos Pet al., 2019, Left atrial strain parameters predict clinical outcomes in patients with HFmrEF and HFpEF, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 1423-1423, ISSN: 0195-668X

Conference paper

Augustine DX, Coates-Bradshaw LD, Willis J, Harkness A, Ring L, Grapsa J, Coghlan G, Kaye N, Oxborough D, Robinson S, Sandoval J, Rana BS, Siva A, Nihoyannopoulos P, Howard LS, Fox K, Bhattacharyya S, Sharma V, Steeds RP, Mathew Tet al., 2019, Echocardiographic assessment of pulmonary hypertension: a guideline protocol from the British Society of Echocardiography (vol 5, pg G11, 2018), ECHO RESEARCH AND PRACTICE, Vol: 6, Pages: X1-X1, ISSN: 2055-0464

Journal article

Triposkiadis F, Butler J, Abboud FM, Armstrong PW, Adamopoulos S, Atherton JJ, Backs J, Bauersachs J, Burkhoff D, Bonow RO, Chopra VK, de Boer RA, de Windt L, Hamdani N, Hasenfuss G, Heymans S, Hulot J-S, Konstam M, Lee RT, Linke WA, Lunde IG, Lyon AR, Maack C, Mann DL, Mebazaa A, Mentz RJ, Nihoyannopoulos P, Papp Z, Parissis J, Pedrazzini T, Rosano G, Rouleau J, Seferovic PM, Shah AM, Starling RC, Tocchetti CG, Trochu J-N, Thum T, Zannad F, Brutsaert DL, Segers VF, De Keulenaer GWet al., 2019, The continuous heart failure spectrum: moving beyond an ejection fraction classification, European Heart Journal, Vol: 40, Pages: 2155-2163, ISSN: 1522-9645

Randomized clinical trials initially used heart failure (HF) patients with low left ventricular ejection fraction (LVEF) to select study populations with high risk to enhance statistical power. However, this use of LVEF in clinical trials has led to oversimplification of the scientific view of a complex syndrome. Descriptive terms such as 'HFrEF' (HF with reduced LVEF), 'HFpEF' (HF with preserved LVEF), and more recently 'HFmrEF' (HF with mid-range LVEF), assigned on arbitrary LVEF cut-off points, have gradually arisen as separate diseases, implying distinct pathophysiologies. In this article, based on pathophysiological reasoning, we challenge the paradigm of classifying HF according to LVEF. Instead, we propose that HF is a heterogeneous syndrome in which disease progression is associated with a dynamic evolution of functional and structural changes leading to unique disease trajectories creating a spectrum of phenotypes with overlapping and distinct characteristics. Moreover, we argue that by recognizing the spectral nature of the disease a novel stratification will arise from new technologies and scientific insights that will shape the design of future trials based on deeper understanding beyond the LVEF construct alone.

Journal article

Steeds RP, Wheeler R, Bhattacharyya S, Reiken J, Nihoyannopoulos P, Senior R, Monaghan MJ, Sharma Vet al., 2019, Stress echocardiography in coronary artery disease: a practical guideline from the British Society of Echocardiography, ECHO RESEARCH AND PRACTICE, Vol: 6, Pages: G17-G33, ISSN: 2055-0464

Journal article

Papazoglou S-M, Jaffer U, Aslam M, Trikas A, Pantos C, Toutouzas K, Nihoyannopoulos P, Stefanadis CH, Tousoulis D, Standfield Net al., 2019, Do NT-proBNP levels depend on the diameter of abdominal aorta in patients with chronic HFpEF and AAA?, European Heart failure meeting, Publisher: WILEY, Pages: 51-52, ISSN: 1388-9842

Conference paper

Vrettos A, Al Saikhan L, Plymen C, Chilcott J, Matiti L, Nihoyannopoulos Pet al., 2019, Left atrial function in HFpEF and HFmrEF patients; relation to pulmonary artery systolic pressure, European Heart Failure meeting, Publisher: WILEY, Pages: 227-228, ISSN: 1388-9842

Conference paper

Papazoglou S-MS-M, Jaffer U, Aslam M, Richter D, Trikas A, Pantos C, Toutouzas K, Nihoyannopoulos P, Standfield NJ, Tousoulis Det al., 2019, Does PSV in ICA independently predict plasma levels of NT-proBNP in patients with HFrEF diabetic cardiomyopathy and ipsilateral carotid artery disease?, European Heart Failure meeting, Publisher: WILEY, Pages: 205-206, ISSN: 1388-9842

Conference paper

Keramida K, Farmakis D, Bingcang J, Sulemane S, Sutherland S, Bingcang RA, Ramachandran K, Tzavara C, Charalampopoulos G, Filippiadis D, Kouris N, Nihoyannopoulos Pet al., 2019, Longitudinal changes of right ventricular deformation mechanics during trastuzumab therapy in breast cancer patients, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 21, Pages: 529-535, ISSN: 1388-9842

Journal article

Ikonomidis I, Aboyans V, Blacher J, Brodmann M, Brutsaert DL, Chirinos JA, De Carlo M, Delgado V, Lancellotti P, Lekakis J, Mohty D, Nihoyannopoulos P, Parissis J, Rizzoni D, Ruschitzka F, Seferovic P, Stabile E, Tousoulis D, Vinereanu D, Vlachopoulos C, Vlastos D, Xaplanteris P, Zimlichman R, Metra Met al., 2019, The role of ventricular-arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 21, Pages: 402-424, ISSN: 1388-9842

Journal article

Grapsa I, Tan T, Nunes MDC, O'Regan D, Durighel G, Howard LSGE, Gibbs SJR, Nihoyannopoulos Pet al., 2019, IMPACT OF ADVERSE RIGHT VENTRICULAR REMODELING ON MORTALITY IN IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION, 68th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 1912-1912, ISSN: 0735-1097

Conference paper

Al Saikhan L, Hughes AD, Chung W-S, Alsharqi M, Nihoyannopoulos Pet al., 2019, Left atrial function in heart failure with mid-range ejection fraction differs from that of heart failure with preserved ejection fraction: a 2D speckle-tracking echocardiographic study, EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging, Vol: 20, Pages: 279-290, ISSN: 2047-2412

Aims: Heart failure (HF) with mid-range ejection fraction (HFmrEF) shares similar diagnostic criteria to HF with preserved ejection fraction (HFpEF). Whether left atrial (LA) function differs between HFmrEF and HFpEF is unknown. We, therefore, used 2D-speckle-tracking echocardiography (2D-STE) to assess LA phasic function in patients with HFpEF and HFmrEF. Methods and results: Consecutive outpatients diagnosed with HF according to current European recommendations were prospectively enrolled. There were 110 HFpEF and 61 HFmrEF patients with sinus rhythm, and 37 controls matched by age. LA phasic function was analysed using 2D-STE. Peak-atrial longitudinal strain (PALS), peak-atrial contraction strain (PACS), and PALS-PACS were measured reflecting LA reservoir, pump, and conduit function, respectively. Among HF groups, most of left ventricular (LV) diastolic function measures, and LA volume were similar. Both HF groups had abnormal LA phasic function compared with controls. HFmrEF patients had worse LA phasic function than HFpEF patients even among patients with LA enlargement. Among patients with normal LA size, LA reservoir, and pump function remained worse in HFmrEF. Differences in LA phasic function between HF groups remained significant after adjustment for confounders. Global PALS and PACS were inversely correlated with brain natriuretic peptide, LA volume, E/A, E/e', pulmonary artery systolic pressure, and diastolic dysfunction grade in both HF groups. Conclusion: LA phasic function was worse in HFmrEF patients compared with those with HFpEF regardless of LA size, and independent of potential confounders. These differences could be attributed to intrinsic LA myocardial dysfunction perhaps in relation to altered LV function.

Journal article

Rana BS, Robinson S, Francis R, Toshner M, Swaans MJ, Agarwal S, de Silva R, Rana AA, Nihoyannopoulos Pet al., 2019, Tricuspid regurgitation and the right ventricle in risk stratification and timing of intervention, ECHO RESEARCH AND PRACTICE, Vol: 6, Pages: R25-R39, ISSN: 2055-0464

Journal article

Katsi V, Georgiopoulos G, Magkas N, Oikonomou D, Virdis A, Nihoyannopoulos P, Toutouzas K, Tousoulis Det al., 2019, The Role of Arterial Hypertension in Mitral Valve Regurgitation., Curr Hypertens Rep, Vol: 21, Pages: 20-20

PURPOSE OF REVIEW: To review medical literature for evidence of association between hypertension and mitral regurgitation (MR) and summarize potential favorable effects of antihypertensive drugs on MR natural history and treatment. RECENT FINDINGS: Hypertension and MR are common diseases affecting a large proportion of the general population. Contemporary evidence suggests that hypertension may worsen the progression and prognosis of MR through augmented mechanical stress and increased regurgitation volume. Renin-angiotensin axis inhibitors, beta-blockers, and vasodilators have been tested in order to prevent or decrease primary or secondary MR. Although antihypertensive agents may improve hemodynamic parameters and left ventricular remodeling in primary MR, there is no strong evidence of benefit on clinical outcomes. On the other hand, a beneficial effect of these drugs on secondary MR is better established. Moreover, there are no studies evaluating a possible benefit of lower blood pressure targets in MR. Randomized controlled trials are warranted to elucidate the precise role of antihypertensive therapy on treatment of MR.

Journal article

Skalis G, Katsi V, Miliou A, Georgiopoulos G, Papazachou O, Vamvakou G, Nihoyannopoulos P, Tousoulis D, Makris Tet al., 2019, MicroRNAs in Preeclampsia., Microrna, Vol: 8, Pages: 28-35

Preeclampsia (PE) continues to represent a worldwide problem and challenge for both clinicians and laboratory-based doctors. Despite many efforts, the knowledge acquired regarding its pathogenesis and pathophysiology does not allow us to treat it efficiently. It is not possible to arrest its progressive nature, and the available therapies are limited to symptomatic treatment. Furthermore, both the diagnosis and prognosis are frequently uncertain, whilst the ability to predict its occurrence is very limited. MicroRNAs are small non-coding RNAs discovered two decades ago, and present great interest given their ability to regulate almost every aspect of the cell function. A lot of evidence regarding the role of miRNAs in pre-eclampsia has been accumulated in the last 10 years. Differentially expressed miRNAs are characteristic of both mild and severe PE. In many cases they target signaling pathway-related genes that result in altered processes which are directly involved in PE. Immune system, angiogenesis and trophoblast proliferation and invasion, all fundamental aspects of placentation, are controlled in various degrees by miRNAs which are up- or downregulated. Finally, miRNAs represent a potential therapeutic target and a diagnostic tool.

Journal article

Katsi V, Georgiopoulos G, Oikonomou D, Aggeli C, Grassos C, Papadopoulos DP, Thomopoulos C, Marketou M, Dimitriadis K, Toutouzas K, Nihoyannopoulos P, Tsioufis C, Tousoulis Det al., 2019, Aortic Stenosis, Aortic Regurgitation and Arterial Hypertension., Curr Vasc Pharmacol, Vol: 17, Pages: 180-190

BACKGROUND: Hypertension (HT) is an important risk factor for cardiovascular disease and might precipitate pathology of the aortic valve. OBJECTIVE: To investigate the association of HT with aortic dysfunction (including both aortic regurgitation and stenosis) and the impact of antihypertensive treatment on the natural course of underlying aortic disease. METHODS: We performed a systematic review of the literature for all relevant articles assessing the correlation between HT and phenotype of aortic disease. RESULTS: Co-existence of HT with aortic stenosis and aortic regurgitation is highly prevalent in hypertensive patients and predicts a worse prognosis. Certain antihypertensive agents may improve haemodynamic parameters (aortic jet velocity, aortic regurgitation volume) and remodeling of the left ventricle, but there is no strong evidence of benefit regarding clinical outcomes. Renin-angiotensin system inhibitors, among other vasodilators, are well-tolerated in aortic stenosis. CONCLUSION: Several lines of evidence support a detrimental association between HT and aortic valve disease. Therefore, HT should be promptly treated in aortic valvulopathy. Despite conventional wisdom, specific vasodilators can be used with caution in aortic stenosis.

Journal article

Nihoyannopoulos P, Kisslo J, 2018, Echocardiography - Second Edition 2018, Publisher: Springer, ISBN: 978-3-319-71617-6

Book

Celutkiene J, Plymen CM, Flachskampf FA, de Boer RA, Grapsa J, Manka R, Anderson L, Garbi M, Barberis V, Filardi PP, Gargiulo P, Luis Zamorano J, Lainscak M, Seferovic P, Ruschitzka F, Rosano GMC, Nihoyannopoulos Pet al., 2018, Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 20, Pages: 1615-1633, ISSN: 1388-9842

Journal article

Keramida K, Lazaros G, Nihoyannopoulos P, 2018, Right ventricular involvement in hypertrophic cardiomyopathy: Patterns and implications, HELLENIC JOURNAL OF CARDIOLOGY, Vol: 61, Pages: 3-8, ISSN: 1109-9666

Journal article

Augustine DX, Coates-Bradshaw LD, Willis J, Harkness A, Ring L, Grapsa J, Coghlan G, Kaye N, Oxborough D, Robinson S, Sandoval J, Rana BS, Siva A, Nihoyannopoulos P, Howard LS, Fox K, Bhattacharyya S, Sharma V, Steeds RP, Mathew T, British Society of Echocardiography Education Committeeet al., 2018, Echocardiographic assessment of pulmonary hypertension: a guideline protocol from the British Society of Echocardiography, Echo Research and Practice, Vol: 5, Pages: G11-G24, ISSN: 2055-0464

Pulmonary hypertension is defined as a mean arterial pressure of ≥25 mmHg as confirmed on right heart catheterisation. Traditionally, the pulmonary arterial systolic pressure has been estimated on echo by utilising the simplified Bernoulli equation from the peak tricuspid regurgitant velocity and adding this to an estimate of right atrial pressure. Previous studies have demonstrated a correlation between this estimate of pulmonary arterial systolic pressure and that obtained from invasive measurement across a cohort of patients. However, for an individual patient significant overestimation and underestimation can occur and the levels of agreement between the two is poor. Recent guidance has suggested that echocardiographic assessment of pulmonary hypertension should be limited to determining the probability of pulmonary hypertension being present rather than estimating the pulmonary artery pressure. In those patients in whom the presence of pulmonary hypertension requires confirmation, this should be done with right heart catheterisation when indicated. This guideline protocol from the British Society of Echocardiography aims to outline a practical approach to assessing the probability of pulmonary hypertension using echocardiography and should be used in conjunction with the previously published minimum dataset for a standard transthoracic echocardiogram.

Journal article

Al Saikhan L, Nihoyannopoulos P, 2018, Left atrial function in heart failure with mid-range ejection fraction differs from that of heart failure with preserved ejection fraction: a two-dimensional speckle tracking echocardiographic study, European-Society-of-Cardiology Congress, Publisher: OXFORD UNIV PRESS, Pages: 377-378, ISSN: 0195-668X

Conference paper

Flachskampf FA, Nihoyannopoulos P, 2018, Our obsession with normal values, Echo Research and Practice, Vol: 5, ISSN: 2055-0464

Normal values provide the background for interpretation of quantitative imaging data and thus are essential information for daily routine. Nevertheless, the ways how normal values are obtained, presented, and interpreted, often do not receive the attention they deserve. We review the concepts of normalcy, the implications of typical normal ranges including the types of distribution of normal data, the possibilities to index for confounding biological factors like body surface area, and the limitations of the very concept of normal values, demonstrating that there are no easy statistical solutions for difficult clinical problems.

Journal article

Rehman MB, Garcia R, Christiaens L, Larrieu-Ardilouze E, Howard LS, Nihoyannopoulos Pet al., 2018, Power of resting echocardiographic measurements to classify pulmonary hypertension patients according to European society of cardiology exercise testing risk stratification cut-offs, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 257, Pages: 291-297, ISSN: 0167-5273

Journal article

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer Pet al., 2018, ESC guidelines for the diagnosis and treatment of acute and chronic heart failure (vol 37, pg 2129, 2016), EUROPEAN HEART JOURNAL, Vol: 39, ISSN: 0195-668X

Journal article

Panoulas VF, Keramida K, Boletti O, Papafaklis MI, Flessas D, Petropoulou M, Nihoyannopoulos Pet al., 2018, Association between fractional flow reserve, instantaneous wave-free ratio and dobutamine stress echocardiography in patients with stable coronary artery disease, EUROINTERVENTION, Vol: 13, Pages: 1959-1966, ISSN: 1774-024X

Journal article

Nihoyannopoulos P, Elliott P, 2018, The Cardiomyopathies, Echocardiography, Second Edition, Pages: 577-617, ISBN: 9783319716152

Cardiomyopathies are a diverse group of conditions characterised by structural and functional abnormalities of the heart muscle that are unexplained by coronary artery disease, hypertension or valve disease. They are grouped into morphological and functional phenotypes, each of which can be caused by genetic and non-genetic mechanisms. Most genetic cardiomyopathies are monogenic disorders (i.e. the genetic mutation is sufficient to cause disease), but they can appear sporadic when a mutation has arisen de novo. Non-familial or non-genetic cardiomyopathies are subdivided into idiopathic (no identifiable cause) and acquired disorders in which ventricular dysfunction is a complication of a disorder unrelated to a primary disturbance of cardiomyocyte function. Examples of the latter include cardiac amyloidosis, haemochromatosis and myocarditis. By convention, left ventricular dysfunction caused by coronary artery disease, hypertension, valve disease and congenital heart disease is excluded from the term cardiomyopathy, although they can coexist.

Book chapter

Panoulas VF, Francis DP, Ruparelia N, Malik IS, Chukwuemeka A, Sen S, Anderson J, Nihoyannopoulos P, Sutaria N, Hannan EL, Samadashvili Z, D'Errigo P, Schymik G, Mehran R, Chieffo A, Latib A, Presbitero P, Mehilli J, Petronio AS, Morice M-C, Tamburino C, Thyregod HGH, Leon M, Colombo A, Mikhail GWet al., 2018, Female-specific survival advantage from transcatheter aortic valve implantation over surgical aortic valve replacement: Meta-analysis of the gender subgroups of randomised controlled trials including 3758 patients, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 250, Pages: 66-72, ISSN: 0167-5273

Journal article

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