Publications by authors named "Panagiotis Karyofyllis"

Background: Pulmonary arterial hypertension (PAH) is a severe complication among adult patients with congenital heart disease (ACHD). This study presents real-world data on risk stratification, pharmacotherapy and survival rates in PAH-ACHD.

Methods: Data from PAH-ACHD patients were analyzed using The Hellenic Pulmonary Hypertension Registry (HOPE), spanning eight specialized centers between 2015 and 2023.

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Haemolytic anaemia represents a risk factor for the development of pulmonary hypertension (PH), currently classified as World Health Organization group 5 PH, and data regarding appropriate therapeutic strategy are limited. A total of 28 patients, 85.7% with thalassaemia and 14.

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Background: Balloon pulmonary angioplasty (BPA) has provided an effective invasive treatment for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). The hemodynamic improvement achieved by BPA has significantly increased the long-term prognosis of these patients, mostly by reversing the negative remodeling of the right ventricle (RV).

Materials And Methods: In a cohort of 17 patients with symptomatic CTEPH hemodynamic data were collected before and after the completion of BPA sessions.

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Article Synopsis
  • Despite advancements in drug therapy for pulmonary arterial hypertension, mortality rates remain high, and specific medications for chronic thromboembolic pulmonary hypertension don't significantly improve survival.
  • The right ventricle's function is crucial for prognosis, indicating that treatments should aim at factors causing RV dysfunction rather than solely focusing on mPAP (mean pulmonary artery pressure).
  • The article argues for re-evaluating treatment strategies to prioritize mPAP reduction, as this can lead to better RV health and a potential shift from acute mortality to chronic management of pulmonary hypertension.
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Whereas younger female patients were diagnosed with idiopathic pulmonary arterial hypertension (IPAH) in 1980s, it is now frequently encountered in elderly patients with cardiovascular comorbidities (CVCs) associated with increased risk for left heart disease. We present data until November 2019 regarding specific features and clinical outcomes of IPAH population from the Hellenic Pulmonary Hypertension Registry (HOPE). Patients were divided into two groups based on the presence of ≥ or <3 CVCs, arterial hypertension, diabetes mellitus, obesity, presence of coronary artery disease, or atrial fibrillation.

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Balloon pulmonary angioplasty (BPA) is a novel and promising treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are ineligible for pulmonary endarterectomy (PEA) and for those with persistent or recurrent pulmonary hypertension after PEA. We present the results of BPA procedures in CTEPH patients included in the Greek Pulmonary Hypertension Registry, evaluating the real-life efficacy and safety. We analyzed data from 180 BPA procedures (2−17/patient, mean 8 ± 4/patient, 1248 dilated vessels, 0−18/session).

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Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a rare disease with poor prognosis if left untreated, characterized by pulmonary vascular bed obstruction due to unresolving thromboembolic material. The Hellenic pulmonary hypertension registry (HOPE) was launched in Greece in early 2015 and enrolls patients from all pulmonary hypertension subgroups in Greece. In total, 98 patients with CTEPH were enrolled from January 2015 until November 2019.

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The effect of the reportedly low ionizing radiation doses, such as those very often delivered to patients in interventional cardiology, remains ambiguous. As interventional cardiac procedures may have a significant impact on total collective effective dose, there are radiation protection concerns for patients and physicians regarding potential late health effects. Given that very low doses (<100 mSv) are expected to be delivered during these procedures, the purpose of this study was to assess the potency and suitability of current genotoxicity biomarkers to detect and quantitate biological effects essential for risk estimation in interventional cardiology.

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Pulmonary hypertension (PH) development remains a significant cardiovascular complication of haemoglobinopathies, severely affecting the morbidity and mortality of such patients. According to the 5th World Symposium on PH, PH related with chronic haemolytic anaemias is classified in group 5, mainly due to the multifactorial pathophysiology of PH in this patient population. There are no clear guidelines regarding the management of PH in patients with haemoglobinopathies; the use of specific pulmonary arterial hypertension (PAH) therapy in patients with β-thalassaemia and PH is based on data derived from other forms of PH, expert opinion and small series or case reports.

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Pulmonary arterial hypertension (PAH) is characterized by an insult in the pulmonary vasculature, with subsequent right ventricular (RV) adaptation to the increased afterload that ultimately leads to RV failure. The awareness of the importance of RV function in PAH has increased considerably because right heart failure is the predominant cause of death in PAH patients. Given its wide availability and reduced cost, echocardiography is of paramount importance in the evaluation of the right heart in PAH.

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Sickle cell disease (SCD), a haemoglobinopathy characterized by chronic haemolysis with acute exacerbations and vascular occlusion episodes, may be complicated by pulmonary hypertension. The latter may be caused by chronic thromboembolic disease of pulmonary artery branches and its management is not well-defined. Herein, we present a case of SCD complicated by chronic thromboembolic pulmonary hypertension of subsegmental pulmonary artery branches successfully treated with endothelin receptor antagonists, orally administered prostacyclin analogs and balloon pulmonary angioplasty.

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Article Synopsis
  • * While treatment options have improved, most patients were excluded from clinical trials for pulmonary arterial hypertension medications, with bosentan being the main exception.
  • * This text discusses three patients with Eisenmenger syndrome who saw health improvements after being treated with selexipag, a specific oral medication that targets certain pathways in the disease.
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  • * Balloon pulmonary angioplasty (BPA) has emerged as a new and effective treatment option for CTEPH, showing promise in centers worldwide, especially outside of Japan.
  • * There is a need for standardization of BPA techniques and more extensive research through large, international trials to compare its effectiveness against other treatments for CTEPH.
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Pulmonary arterial hypertension (PAH) is a heterogenous clinical entity with poor prognosis, despite recent major pharmacological advances. To increase awareness about the pathophysiology, epidemiology, and management of the disease, large national registries are required. The Hellenic pulmOnary hyPertension rEgistry (HOPE) was launched in early 2015 and enrolls patients from all pulmonary hypertension subgroups in Greece.

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Article Synopsis
  • * New medications, including oral therapies like phosphodiesterase type V inhibitors and intravenous epoprostenol, are available, but survival rates remain low, particularly for those on oral combination therapies.
  • * The discussion is ongoing about whether patients with intermediate risk PAH should be treated earlier with intravenous epoprostenol instead of relying solely on oral combinations.
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  • Drug-Induced Pulmonary Arterial Hypertension (PAH) is commonly associated with appetite-suppressing drugs, but Interferon-β (IFN-β) is also a potential risk factor.
  • A case study highlights a patient with Multiple Sclerosis who developed PAH while being treated with IFN-β, detailing her treatment and disease progression.
  • The article includes a review of existing research on the relationship between IFN-β and the development of PAH.
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Article Synopsis
  • Pulmonary hypertension (PH) is a serious condition that can arise from various systemic diseases, including β-Thalassaemia, which worsens patient outcomes.
  • Key mechanisms contributing to PH in these patients include haemolysis, iron overload, and a hypercoagulable state, making them more susceptible to chronic thromboembolic pulmonary hypertension (CTEPH).
  • While pulmonary endarterectomy is commonly considered the best treatment for CTEPH, balloon pulmonary angioplasty (BPA) may offer a promising alternative for thalassaemic patients who cannot undergo surgery, as illustrated by a successful case of a patient with severe PH related to chronic thromboembolic disease who improved significantly after BPA.
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Purpose Of Review: Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of precapillary pulmonary hypertension. Although pulmonary endarterectomy (PEA) is the preferred management strategy, a significant number of CTEPH patients will have an inoperable disease. As drug therapy is not expected to offer relief from the mechanical component of the disease, the novel technique of balloon pulmonary angioplasty (BPA) has provided a new therapeutic option for patients with inoperable CTEPH.

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Background: transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement for patients with severe aortic stenosis considered inoperable or at high operative risk, but the long-term outcome remains unknown.

Hypothesis: we assessed the 4-year clinical and echocardiographic outcomes of patients undergoing TAVI with the self-expanding Medtronic CoreValve prosthesis.

Methods: sixty-three patients (mean age 80 ± 6 years) with severe aortic stenosis (AS) at high risk for surgical aortic valve replacement (Logistic EuroSCORE 28.

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Background: Dual antiplatelet treatment (DAPLT) for at least 12 months is recommended after drug eluting stent (DES) implantation, but concerns regarding the extended use of this treatment persist due to increased risk of bleeding. In this study are assessed the incidence, correlates, and clinical significance of bleeding complications in diabetic patients after long-term DAPLT post DES implantation.

Methods: We studied 610 consecutive diabetic patients after DES implantation.

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