Coronary Atherosclerosis: Pathophysiologic Basis for Diagnosis and Management.

Coronary atherosclerosis is a long lasting and continuously evolving disease with multiple clinical manifestations ranging from asymptomatic to stable angina, acute coronary syndrome (ACS), heart failure (HF) and sudden cardiac death (SCD). Genetic and environmental factors contribute to the development and progression of coronary atherosclerosis. In this review, current knowledge related to the diagnosis and management of coronary atherosclerosis based on pathophysiologic mechanisms will be discussed.

Association Between rs2200733 Polymorphism on Chromosome 4q25 and Atrial Fibrillation in a Greek Population.

Introduction: Atrial fibrillation (AF) is a common arrhythmia with evidence of genetic susceptibility. The rs2200733 single-nucleotide polymorphism (SNP) in a non-coding region on chromosome 4q25 has been associated with AF. The purpose of this case-control study was to examine the possible association of the rs2200733 polymorphism with AF in the Greek population.

The shortcomings of clinical practice guidelines.

Accumulation of medical knowledge related to diagnosis and management over the last 5-6 decades has altered the course of diseases, improved clinical outcomes and increased survival. Thus, it has become difficult for the practicing physician to evaluate the long-term effects of a particular therapy on survival of an individual patient. Further, the approach by each physician to an individual patient with the same disease is not always uniform.

The effect of continuous positive airway pressure therapy on blood pressure and arterial stiffness in hypertensive patients with obstructive sleep apnea.

Aim: We aimed to evaluate the effect of continuous positive airway pressure (CPAP) therapy on blood pressure (BP) and arterial stiffness in hypertensive patients with obstructive sleep apnea (OSA).

Patients And Methods: We studied 38 hypertensive patients who suffered from severe OSA. Ambulatory BP measurement was performed at baseline and after at least 3 months of uninterrupted CPAP therapy.

Right atrial and ventricular adaptations to training in male Caucasian athletes: an echocardiographic study.

Background: The aim of this study was to investigate the systolic and diastolic properties of the right cardiac chambers (the right ventricle and right atrium) among different subsets of athletes to unveil potential variations in right ventricular and right atrial remodeling secondary to different training modes.

Methods: A cohort of Caucasian male top-level athletes (n = 108; 80 endurance athletes [EAs], mean age, 31.2 ± 10.

Comparison of the diagnostic accuracy of ischemia-modified albumin and echocardiography in patients with acute chest pain.

Background: Several imaging tests and biomarkers have been proposed for the identification of patients with unstable angina among those presenting to the emergency department with acute chest pain. Preliminary data suggest that ischemia-modified albumin (IMA) may represent a potentially useful biomarker in these patients.

Objective: To compare IMA and echocardiography in excluding unstable angina in patients with acute chest pain.

Efficacy of various "classic" echocardiographic and laboratory indices in distinguishing the "gray zone" between athlete's heart and hypertrophic cardiomyopathy: a pilot study.

Left ventricular hypertrophy (LVH) with intraventricular septum thickness (IVST) between 1.2 and 1.5 cm in athletes represents a "gray zone" between physiologic adaptation and mild hypertrophic cardiomyopathy (HCM).

Brugada syndrome masked by ibutilide treatment in a patient with atrial flutter.

We present a case of Brugada syndrome in a young patient whose typical ECG pattern was 'masked' after ibutilide was administered for atrial flutter cardioversion. Ibutilide, a class III antiarrhythmic agent used for the treatment of atrial fibrillation and flutter, prolongs the action potential duration plateau phase by augmenting the slow component of the inward Na(+) current and by blocking the rapid component of the delayed rectifier potassium current. Insights into the pathophysiology of Brugada syndrome and this first-reported action of ibutilide are supplied, providing a plausible scientific basis for the masking effect of ibutilide.

Comparison of effectiveness of ranolazine plus amiodarone versus amiodarone alone for conversion of recent-onset atrial fibrillation.

Ranolazine, an antianginal agent with antiarrhythmic properties, prevents atrial fibrillation (AF) in patients with acute coronary syndrome. In experimental models, the combination of ranolazine and amiodarone has marked synergistic effects that potently suppress AF. Currently, the clinical effect of the ranolazine-amiodarone combination for the conversion of AF is unknown.

Sinus nodal response to adenosine relates to the severity of sinus node dysfunction.

Aims: It is unknown as to whether the result of adenosine testing for the diagnosis of sinus node dysfunction (SND) depends on the clinical presentation. We investigated whether syncope or presyncope are associated with a more pronounced sinus nodal inhibition by adenosine in SND.

Methods And Results: We studied 46 patients with SND, 33 with syncope or presyncope and 13 without such history.

A case of exhaustion of implantable cardioverter defibrillator therapies due to inappropriate programming.

Strategically chosen tachycardia detection and therapy options targeting non-sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) can efficiently reduce the morbidity related to implantable cardioverter defibrillator (ICD) therapy. We report a case of a 60-year-old woman with ischemic cardiomyopathy who underwent ICD implantation due to frequent episodes of non-sustained VT. In this case, the inappropriate setting for VF detection in addition to the limited flexibility in device programming for tachycardia confirmation led to the rapid exhaustion of all available shock therapies.

Beneficial effect of ischemic preconditioning on post-infarction left ventricular remodeling and global left ventricular function.

Background: Preinfarction angina (PA) is a clinical analogue of ischemic preconditioning that improves postinfarct prognosis. Data concerning the association of PA with post infarction left ventricular (LV) remodeling and LV diastolic function are limited. We aimed to evaluate this association in patients with acute myocardial infarction (AMI) in the modern clinical era of widespread use of revascularization and antiremodeling medical treatment.

Aortic stiffness in patients undergoing hemodialysis is positively related to antigen presenting cell-dependent T-lymphocyte reactivity.

Background: Aortic stiffness is increased in patients undergoing hemodialysis (HD), and it is associated with an increased cardiovascular mortality. Among others, aortic stiffness has been correlated with serum markers of inflammation, indicating a role of the immune system in its pathogenesis. The aim of this study was to evaluate the impact of antigen-presenting cell-dependent T-lymphocyte reactivity on aortic stiffness in HD patients.