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16. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC

Author

McMurray, John J.V., Adamopoulos, Stamatis, Anker, Stefan D., Auricchio, Angelo, Böhm, Michael, Dickstein, Kenneth, Falk, Volkmar, Filippatos, Gerasimos, Fonseca, Cândida, Gomez-Sanchez, Miguel Angel, Jaarsma, Tiny, Køber, Lars, Lip, Gregory Y.H., Maggioni, Aldo Pietro, Parkhomenko, Alexander, Pieske, Burkert M., Popescu, Bogdan A., Rønnevik, Per K., Rutten, Frans H., Schwitter, Juerg, Seferovic, Petar, Stepinska, Janina, Trindade, Pedro T., Voors, Adriaan A., Zannad, Faiez, Zeiher, Andreas, Bax, Jeroen J., Baumgartner, Helmut, Ceconi, Claudio, Dean, Veronica, Deaton, Christi, Fagard, Robert, Funck-Brentano, Christian, Hasdai, David, Hoes, Arno, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, McDonagh, Theresa, Moulin, Cyril, Popescu, Bogdan A., Reiner, Željko, Sechtem, Udo, Sirnes, Per Anton, Tendera, Michal, Torbicki, Adam, Vahanian, Alec, Windecker, Stephan, McDonagh, Theresa, Sechtem, Udo, Bonet, Luis Almenar, Avraamides, Panayiotis, Ben Lamin, Hisham A., Brignole, Michele, Coca, Antonio, Cowburn, Peter, Dargie, Henry, Elliott, Perry, Flachskampf, Frank Arnold, Guida, Guido Francesco, Hardman, Suzanna, Iung, Bernard, Merkely, Bela, Mueller, Christian, Nanas, John N., Nielsen, Olav Wendelboe, Ørn, Stein, Parissis, John T., and Ponikowski, Piotr

Published
2012
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35. Pharmacologic inhibition of the mitochondrial Na+/Ca2+ exchanger protects against ventricular arrhythmias in a porcine model of ischemia-reperfusion

Author

Sventzouri, Stefania Nanas, Ioannis Vakrou, Styliani and Kapelios, Chris Sousonis, Vasilios Sfakianaki, Titika and Papalois, Apostolos Manolis, Antonis S. Nanas, John N. and Malliaras, Konstantinos

Abstract

Background: The mitochondrial Na+/Ca2+ exchanger (mNCX) has been implicated in the pathogenesis of arrhythmogenicity and myocardial reperfusion injury, rendering its inhibition a potential therapeutic strategy. We examined the effects of CGP-37157, a selective mNCX inhibitor, on arrhythmogenesis, infarct size (IS), and no reflow area (NRA) in a porcine model of ischemia-reperfusion. Methods: Forty pigs underwent myocardial ischemia for 60 minutes, followed by 2 hours of reperfusion. Animals were randomized to receive intracoronary infusion of 0.02 mg/kg CGP-37157 or vehicle, either before ischemia (n=17) or before reperfusion (n=17). Animals were monitored for arrhythmias. Myocardial area at risk (AR), IS, and NRA were measured by histopathology. Results: AR, NRA, and IS were comparable between groups. Administration of CGP-37157 before ischemia resulted in the following: (a) suppression of ventricular tachyarrhythmias (events/pig: 1.5 +/- 1.1 vs 3.5 +/- 1.9, p=0.014), (b) easier cardioversion of ventricular tachyarrhythmias (defibrillations required for cardioversion of each episode: 2.6 +/- 2.3 vs 6.2 +/- 2.1, p=0.006), and (c) decreased maximal depression of the J point (0.75 +/- 0.27 mm vs 1.75 +/- 0.82 mm, p=0.007), compared to controls. Administration of CGP-37157 before reperfusion expedited ST-segment resolution; complete ST-segment resolution within 30 minutes of reperfusion was observed in 7/8 CGP-37157-treated animals versus 1/9 controls (p=0.003). Conclusions: In a porcine model of myocardial infarction, intracoronary administration of CGP-37157 did not decrease IS or NRA. However, it suppressed ventricular arrhythmias, decreased depression of the J point during ischemia and expedited ST-segment resolution after reperfusion. These findings motivate further investigation of pharmacologic mNCX inhibition as a potential therapeutic strategy to suppress arrhythmias in the injured heart. (C) 2017 Hellenic Society of Cardiology. Publishing services by Elsevier B.V.

Published
2018

42. Effect of protracted dobutamine infusion on survival of patients in cardiogenic shock treated with intraaortic balloon pumping

Author

Moulopoulos, Spyridon D., Stamateolopoulos, Stamatios F., Nanas, John N., Kontoyannis, Dimitrios A., and Nanas, Serafim N.

Subjects
Intra-aortic balloon counterpulsation -- Evaluation, Mortality, Cardiogenic shock -- Patient outcomes, Dobutamine -- Dosage and administration -- Evaluation, Health, Evaluation, Patient outcomes, Dosage and administration
Abstract

The survival of subjects with postmyocardial infarction cardiogenic shock treated with intra-aortic balloon pumping (IABP) differs significantly among various reports. Differences in the criteria for IABP application and in the [...]

Published
1993

43. Arteriovenous renal replacement therapy in end-stage left-sided heart failure patients has a detrimental effect on patients with impaired right ventricular function

Author

Repasos, Evangelos Kaldara, Elisabeth Pantsios, Christos and Kapelios, Chris Nana, Emmeleia Vernadakis, Spiridon and Melexopoulou, Christina Malliaras, Konstantinos Boletis, John and Nanas, John N.

Abstract

Objective: Chronic intermittent renal replacement therapy(RRT) is an alternate method of decongestion for patients presenting with diuretic-resistant, end-stage heart failure( HF) and cardiorenal syndrome. The optimal method of vascular access has not been confirmed. This study investigated the 6-month outcomes of patients with end-stage HF after the creation of arteriovenous communications (AVC) compared with other means of RRT. Methods: We treated 40 patients with chronic, intermittent, ambulatory RRT, of whom 15 (37.5%; Group A) underwent creation of AVC, and 25 (62.5%; Group B) received intraperitoneal (n=6) or internal jugular catheters (n=19) with the goal of achieving body weight stabilization and relief from congestion. Results: The characteristics of the two groups were similar. According to Cox regression analysis, the 6-month rate of death or re-hospitalization for HF was significantly higher in Group A (73%) than in Group B (44%); hazard ratio (HR): 2.58; 95% confidence interval (CI) 1.2-6.2; P=0.02. Over a 6-month follow-up, the cumulative survival was significantly shorter (P=0.03) in Group A (13.8 +/- 10 weeks) than in Group B (20.7 +/- 7 weeks). In the 15 patients who received AVC, the only independent predictor of adverse outcome at 6 months was serum total bilirubin concentration (HR 2.5; 95% CI 1.1-5.7, p=0.02), whereas in the 25 patients who underwent other means of RRT, pulmonary vascular resistance (PVR) was identified as a risk factor for hospitalization or death at 1-year follow-up (HR 1.26; 95% CI 1.1-1.57, p=0.04). Conclusion: In patients with end-stage HF, the creation of AVC for intermittent RRT was followed by a significant increase in morbidity and mortality in comparison to the safe and effective placement of permanent central venous catheters. Patients with elevated PVR seem to comprise a group at high risk for adverse outcomes after central catheter insertion. (C) 2016 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Published
2017

47. Innate heart regeneration: endogenous cellular sources and exogenous therapeutic amplification

Author

Malliaras, Konstantinos Vakrou, Styliani Kapelios, Chris J. and Nanas, John N.

Abstract

Introduction: The -once viewed as heretical- concept of the adult mammalian heart as a dynamic organ capable of endogenous regeneration has recently gained traction. However, estimated rates of myocyte turnover vary wildly and the underlying mechanisms of cardiac plasticity remain controversial. It is still unclear whether the adult mammalian heart gives birth to new myocytes through proliferation of resident myocytes, through cardiomyogenic differentiation of endogenous progenitors or through both mechanisms.Areas covered: In this review, the authors discuss the cellular origins of postnatal mammalian cardiomyogenesis and touch upon therapeutic strategies that could potentially amplify innate cardiac regeneration.Expert opinion: The adult mammalian heart harbors a limited but detectable capacity for spontaneous endogenous regeneration. During normal aging, proliferation of pre-existing cardiomyocytes is the dominant mechanism for generation of new cardiomyocytes. Following myocardial injury, myocyte proliferation increases modestly, but differentiation of endogenous progenitor cells appears to also contribute to cardiomyogenesis (although agreement on the latter point is not universal). Since cardiomyocyte deficiency underlies almost all types of heart disease, development of therapeutic strategies that amplify endogenous regeneration to a clinically-meaningful degree is of utmost importance.

Published
2016

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