Publications by authors named "Maria Marketou"

Article Synopsis
  • Hypovitaminosis D is linked to the development of atherosclerosis and is more common in women, but its specific effects on coronary artery disease (CAD) severity between genders are not well understood.
  • A study involving 1,484 patients with acute myocardial infarction found that women had significantly lower vitamin D levels and a higher prevalence of severe CAD when experiencing hypovitaminosis D compared to those without it.
  • Furthermore, women with both hypovitaminosis D and diabetes mellitus faced over three times the risk of severe CAD compared to those without either condition.
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The 2021 European Society of Cardiology guideline on diagnosis and treatment of acute and chronic heart failure (HF) and the 2023 Focused Update include recommendations on the pharmacotherapy for patients with New York Heart Association (NYHA) class II-IV HF with reduced ejection fraction. However, multinational data from the EVOLUTION HF study found substantial prescribing inertia of guideline-directed medical therapy (GDMT) in clinical practice. The cause was multifactorial and included limitations in organizational resources.

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The main purpose of this project was to capture experts' opinion on hyperkalaemia management and form best practice recommendations for cardiorenal patients in Greece. A steering committee of nephrologists and cardiologists developed 37 statements. An online questionnaire completed by 32 experts in cardiorenal management in Greece.

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Awareness and early identification of hypertension is crucial in reducing the burden of cardiovascular disease (CVD). Artificial intelligence-based analysis of 12-lead electrocardiograms (ECGs) can already detect arrhythmias and hypertension. We performed an observational two-center study in order to develop a machine learning algorithm to proactively detect arterial hypertension from single-lead ECGs.

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Hypertrophic cardiomyopathy (HCM) is a heart muscle disease associated with an increased risk for sudden cardiac death (SCD). Cytokeratin 18-based proteins, such as M30 and M65 antigens, are known cell-death biomarkers. M30 antigen is released from cells during apoptosis, and M65 antigen is released during cell death from any cause, such as apoptosis or necrosis.

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Background: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European research consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis, and linkage to specialty care for European PC settings. Based on the lessons from this project, the latest research evidence, and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral, and management of MASLD in PC.

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Introduction: The aim of this prospective study was to evaluate the impact of hemodialysis (HD) on myocardial injury, of both right and left ventricle function as well as their association with venous oxygen saturation (ScvO2) alterations.

Material And Methods: We included in the study stable consecutive patients with end-stage renal disease (ESRD) undergoing regular HD. Right and left ventricular speckle-tracking echocardiographies were performed in all patients.

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The concept of "type 3 diabetes" has emerged to define alterations in glucose metabolism that predispose individuals to the development of Alzheimer's disease (AD). Novel evidence suggests that changes in the insulin/insulin-like growth factor 1 (IGF-1)/growth hormone (GH) axis, which are characteristic of Diabetes Mellitus, are one of the major factors contributing to excessive amyloid-beta (Aβ) production and neurodegenerative processes in AD. Moreover, molecular findings suggest that insulin resistance and dysregulated IGF-1 signaling promote atherosclerosis via endothelial dysfunction and a pro-inflammatory state.

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Cardiac remodeling and ventricular pacing represent intertwined phenomena with profound implications for cardiovascular health and therapeutic interventions. This review explores the intricate relationship between cardiac remodeling and ventricular pacing, spanning from the molecular underpinnings to biomechanical alterations. Beginning with an examination of genetic predispositions and cellular signaling pathways, we delve into the mechanisms driving myocardial structural changes and electrical remodeling in response to pacing stimuli.

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Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed.

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Article Synopsis
  • The study aimed to assess the impact of the COVID-19 pandemic on hypertension awareness and treatment in Greece, analyzing data collected in 2019 and 2022 during the May Measurement Month (MMM) initiative.
  • Data from over 12,000 adults revealed consistent hypertension prevalence rates (around 41-43%) before and after the pandemic, but an increase in undiagnosed cases was observed, rising from 21.3% to 27.5%.
  • The findings suggest that while the overall prevalence of hypertension remained stable, there is a pressing need for improved national strategies to detect and manage hypertension effectively in Greece, especially post-pandemic.
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Hypertension is often linked with metabolic risk factors that share common pathophysiological pathways. Despite wide-spread availability of multiple drug classes, optimal blood pressure (BP) control remains challenging. Increased central sympathetic outflow is frequently neglected as a critical regulator of both circulatory and metabolic pathways and often remains unopposed therapeutically.

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Article Synopsis
  • - A 2023 survey by the European Society of Hypertension assessed the management of chronic kidney disease (CKD) patients with hypertension across 88 centers in 27 countries, finding that only 28% had preexisting CKD, and 30% exhibited resistant hypertension.
  • - The survey indicated inconsistent rates of recent kidney function tests and varying usage of important medications, showing higher rates of certain drugs when nephrologists were involved in the care team.
  • - Overall, the study highlighted significant gaps in CKD screening and treatment prior to referral for specialized care, suggesting that tailored initiatives could enhance management for patients with hypertension and CKD.
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Objective: Trimethylamine N-oxide (TMAO) has been associated with atherosclerosis and poor outcome. We evaluated the prognostic impact of intra-hospital TMAO variation on patient outcome.

Methods And Results: Blood samples from 149 patients with acute myocardial infarction (AMI) were taken on admission and discharge.

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Hypertensive disorders in pregnancy (HDP), remain the leading cause of adverse maternal, fetal, and neonatal outcomes. Epidemiological factors, comorbidities, assisted reproduction techniques, placental disorders, and genetic predisposition determine the burden of the disease. The pathophysiological substrate and the clinical presentation of HDP are multifarious.

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The heart beats are due to the synchronized contraction of cardiomyocytes triggered by a periodic sequence of electrical signals called action potentials, which originate in the sinoatrial node and spread through the heart's electrical system. A large body of work is devoted to modeling the propagation of the action potential and to reproducing reliably its shape and duration. Connection of computational modeling of cells to macroscopic phenomenological curves such as the electrocardiogram has been also intense, due to its clinical importance in analyzing cardiovascular diseases.

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Background And Aims: Vitamin D deficiency is a common cardiovascular risk factor associated with the development of atherosclerosis. We evaluated changes in 25(OH)D concentrations in 1510 patients with acute myocardial infarction (AMI) over a long observation period, including the COVID-19 pandemic.

Methods And Results: Patients were separated into four groups according to the year of enrolment, group 1 (2009-2010), group 2 (2014-2016), group 3 (2017-2019), and group 4 (2020-2022).

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Article Synopsis
  • Cardiac magnetic resonance (CMR) imaging plays a crucial role in evaluating and managing cardiomyopathies, particularly dilated cardiomyopathy (DCM).
  • It provides a non-invasive way to analyze heart tissue, enabling early diagnosis and tailored treatment plans for patients.
  • The article reviews how CMR techniques, including late gadolinium enhancement and advanced quantitative mapping, aid in diagnosing DCM, assessing risks, and improving prognosis beyond traditional measures like ejection fraction.
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Objective: The purpose of this study was to evaluate the contribution of single photon emission computed tomography/computed tomography (SPECT/CT) standardized uptake value (SUV) metrics in classifying patients with suspected transthyretin cardiac amyloidosis (ATTR-CA) among the different Perugini grades.

Subjects And Methods: One hundred four patients suspected of ATTR-CA underwent planar scintigraphy with bone seeking tracer (Tc pyrophosphate-PYP). Patients were classified according to the Perugini scale, the H/CL, H/Bone and H/Bkg ratios.

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Background: Heart failure with preserved ejection fraction (HFpEF) is a major health issue with high morbidity and mortality. The epidemiology and the factors that cause HFpEF have not been fully clarified, while accurate predictive biomarkers are lacking. Our aim was to determine whether levels of microRNA-21 (miR-21) in peripheral blood monocytes, which play a critical role in many pathophysiological pathways of hypertensive heart disease, can predict the occurrence of HFpEF in older hypertensives, as well as the associated mortality and morbidity.

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Objective: The clinical importance of following up on the ascending aortic diameter lies in the fundamental presumption that wall pathology eventually manifests as a change in shape. However, the diameter describes the vessel locally, and the 55 mm criterion fails to prevent most dissections. We hypothesized that geometric changes across the ascending aorta are not necessarily imprinted on its diameter; i.

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Arterial hypertension is a major cause of cardiovascular morbidity and mortality and the most common cause of comorbidity in heart failure (HF) with preserved ejection fraction (HFpEF). As an adjunct to medication, healthy lifestyle modifications with emphasis on regular exercise are strongly recommended by both the hypertension and the HF guidelines of the European Society of Cardiology. Several long-term studies have shown that exercise is associated with a reduction in all-cause mortality, a favorable cardiac and metabolic risk profile, mental health, and other non-cardiovascular benefits, as well as an improvement in overall quality of life.

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Article Synopsis
  • Breast cancer is a leading cause of cancer-related deaths in women and traditional radiotherapy can unintentionally harm the heart and lead to cardiovascular issues, especially in left-sided cases.
  • Recent advancements in radiotherapy techniques aim to minimize heart exposure to harmful doses and reduce the risk of heart disease post-treatment.
  • The review focuses on current strategies that protect the heart during radiation treatment for breast cancer, emphasizing the importance of technology, patient positioning, and various treatment factors in achieving safer outcomes.
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Cardiovascular disease (CVD) is a process whose pathogenetic mechanisms start very early in life. Recently, the importance of visceral adipose tissue (VAT) has been highlighted in the development of CVD. VAT does not always depend on body mass index (BMI) and has been implicated in unfavorable metabolic activity and cardiovascular adverse events.

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