High prevalence and diminished awareness of overweight and obesity in a mediterranean population. An alarming call for action.

Introduction: The epidemic proportions of overweight, obesity and diabetes in most European countries stress the need for the implementation of an effective action plan for the prevention of cardiovascular (CV) disease. This ques-tionnaire study was designed to evaluate the viewpoint of the general population regarding the relative significance of CV risk factors in the cumulative risk of CV disease.

Methods: All participants answered a questionnaire regarding the self-reported presence of CV disease risk factors and the perceived notion of having excess weight.

Depression in patients with hypertrophic cardiomyopathy: is there any relation with the risk factors for sudden death?

Objectives: The aim of this study was to investigate whether depressive symptoms are related to the risk factors for sudden death in patients with hypertrophic cardiomyopathy (HCM).

Design: 121 patients diagnosed as having HCM were assessed for depressive symptomatology using the Beck Depression Inventory and the Center for Epidemiological Studies Depression Scale (CES-D) and followed up for a period of 2 years. For the interview, the authors used the Structured Clinical Interview for DSM-III/DSM-III-R.

Eleven-year prevalence trends of obesity in Greek children: first evidence that prevalence of obesity is leveling off.

We examined 11-year (1997-2007) trends in underweight, overweight, and obesity in Greek children. Population data derived from a yearly, school-based health survey carried out between 1997 and 2007 in >80% of all Greek schools. Height and weight measurements from 651,582 children, aged 8-9 years (boys: 51.

Estrogen-induced improvement in coronary flow responses during atrial pacing in relation to endothelin-1 levels in postmenopausal women without coronary disease.

Background: The cardioprotective role of hormonal replacement therapy remains in doubt, but interest is increasing in the vascular effects of estrogens especially in coronary circulation.

Methods: Coronary blood flow (CBF) was measured in 24 postmenopausal women (age 55+/-3 years), whose coronary arteries appeared angiographically normal, during incremental atrial pacing (AP) before and 20 minutes after intracoronary administration of either 75 ng/mL 17-beta estradiol (treated group, n=18) or 0.9% saline (controls, n=6).

Association of the 894G>T polymorphism in the endothelial nitric oxide synthase gene with risk of acute myocardial infarction.

Background: This study was designed to investigate the association of the 894G>T polymorphism in the eNOS gene with risk of acute myocardial infarction (AMI), extent of coronary artery disease (CAD) on coronary angiography, and in-hospital mortality after AMI.

Methods: We studied 1602 consecutive patients who were enrolled in the GEMIG study. The control group was comprised by 727 individuals, who were randomly selected from the general adult population.

Depressive symptomatology and the prevalence of cardiovascular risk factors among older men and women from Cyprus; the MEDIS (Mediterranean Islands Elderly) epidemiological study.

Aims: The purpose of this paper is to explore the link between symptoms of depression and the prevalence of cardiovascular risk factors in older adults.

Methods: During 2005, 136 older men and 164 women from various parts of Cyprus agreed to participate in the study. The sampling was random and multistage (according to age-sex distribution of the referent population).

Long-term primary cultures of human adult atrial cardiac myocytes: cell viability, structural properties and BNP secretion in vitro.

Background: Human adult cardiomyocytes (CM) have been used in short-term cultures for in vitro studies of the adult myocardium. However, little information is available regarding human adult CMs cultured for long term (>2 weeks).

Methods: Human adult CMs were isolated from atrial specimens of 43 patients undergoing cardiopulmonary bypass surgery.

Severe mitral regurgitation due to perforation of the mitral anterior leaflet.

We present a case of a 75-year-old male with a worsening dyspnea during the last month. Transthoracic echocardiography revealed a severe mitral regurgitation. Transesophageal echocardiography was evident of a 6 mm defect of the mitral anterior leaflet at the region of the anteromedial A1 and medial A2 scallops probably due to perforation, which caused a significant regurgitant jet as documented by the presence of a convergence flow over the 'hole'.

Long-term fish intake is associated with better lipid profile, arterial blood pressure, and blood glucose levels in elderly people from Mediterranean islands (MEDIS epidemiological study).

Background: A study to evaluate the link between long-term fish intake and health status in a sample of elderly adults was undertaken.

Material/methods: Three hundred men and women from Cyprus, 142 from Mitilini, and 100 from Samothraki islands (aged 65 to 100 years) were enrolled in this study during 2005-2006. Dietary habits (including fish consumption) were assessed through a food frequency questionnaire.

Acute improvement of aortic mechanics following hemodialysis in patients with chronic renal failure.

Background: Evidence suggests that distensibility of the aorta is decreased in patients with end-stage renal failure, while the underlying mechanisms are unclear.

Hypothesis: The purpose of the study was to evaluate the distensibility of the aorta in patients at the end stage of chronic renal failure before and after hemodialysis (HD).

Methods: The diameter of the ascending aorta and distensibility were assessed in 48 patients on HD (31 men, 17 women, aged 45+/-14 years) and in 27 normal subjects (17 men, 10 women, aged 44+/-14 years).

Efficacy of antithrombotic therapy in chronic heart failure: the HELAS study.

Background: It is not clear if long-term antithrombotic treatment has a beneficial effect on the incidence of thromboembolism in chronic heart failure (CHF). The HELAS study (Heart failure Long-term Antithrombotic Study) is a multicentre, randomised, double-blind, placebo-controlled trial to evaluate antithrombotic treatment in patients with CHF.

Methods: 197HF patients (EF <35%) were enrolled.

Relation of microalbuminuria to adiponectin and augmented C-reactive protein levels in men with essential hypertension.

Microalbuminuria, and recently, hypoadiponectinemia, have been associated with progression of atherosclerotic disease and increased cardiovascular risk. We examined the possible associations of urinary albumin excretion, expressed as the ratio of albumin to creatinine (ACR), with plasma adiponectin and high-sensitivity C-reactive protein (hs-CRP) levels in men who had essential hypertension. The study population consisted of 108 men who did not have diabetes and were newly diagnosed with stage I to II essential hypertension (age 44.

Fish consumption and the risk of developing acute coronary syndromes: the CARDIO2000 study.

Objective: The aim of this work was to investigate the association between fish consumption and the development of non-fatal acute coronary syndromes (ACS), in a Mediterranean population.

Methods: During 2000-2001, we randomly and stratified selected, from all Greek regions, 848 hospitalised patients (695 males, 58+/-10 years old and 153 females, 65+/-9 years old) who had a first event of ACS and 1078 paired, by region-sex-age, controls without any clinical symptoms or signs of coronary heart disease.

Results: On multivariate logistic regression analysis and, after controlling for several potential confounders, we found that fish consumption less than 150 g/week was associated with 38% lower odds of developing ACS as compared to no consumption (odds ratio=0.

Younger age potentiates post myocardial infarction survival disadvantage of women.

Background: Female patients with acute myocardial infarction (MI) exhibit higher unadjusted in-hospital mortality rates compared to male patients. However, contradictory evidence exists on whether this survival disadvantage disappears after adjustment for age and other prognostic factors. This study, based on a countrywide survey of consecutive unselected patients with acute MI, examined whether female gender is an independent predictor of poor short-term outcome and less intensive in-hospital treatment.

Comparison of the effects of ramipril versus telmisartan in reducing serum levels of high-sensitivity C-reactive protein and oxidized low-density lipoprotein cholesterol in patients with type 2 diabetes mellitus.

The effect of ramipril (an angiotensin [AT]-converting enzyme inhibitor), telmisartan (an AT-II type 1 receptor blocker), or their combination on inflammation and lipid peroxidation was assessed in 37 patients with type 2 diabetes who were free of coronary artery disease. All regimens were associated with a significant reduction of C-reactive protein and oxidized low-density lipoprotein cholesterol serum levels (p <0.001).

Nondipping status does not attenuate the conjugated estrogen-induced improvement in aortic stiffness in postmenopausal women with untreated hypertension.

Background: Whether the blunted nocturnal blood pressure (BP) fall alters the potential beneficial effects of estrogen replacement therapy (ERT) on arterial elastic properties in hypertensive postmenopausal women has not been clarified. The aim of this study was to determine the potential beneficial effects of ERT on arterial elastic properties and to investigate whether a blunted nocturnal BP fall could unfavorably modify the estrogen-induced alterations of large-artery stiffness in postmenopausal women with untreated essential hypertension.

Methods: A total of 66 postmenopausal women with untreated essential hypertension underwent carotid-femoral pulse wave velocity (PWV) measurements at baseline and after 12 weeks of ERT with 0.

Lack of association between common polymorphisms in genes of the renin-angiotensin system and mortality after myocardial infarction.

The insertion/deletion (I/D) polymorphism in the ACE gene and the A1166C polymorphism in the AT1R gene have been associated with left ventricular remodelling and prognosis after acute myocardial infarction (AMI). We investigated whether these genetic variants associate with impaired left ventricular ejection fraction (LVEF) and increased risk for in-hospital mortality after AMI. Consecutive AMI patients were recruited on admission and were genotyped for the above-mentioned polymorphisms.

Perforated aneurysm on the posterior leaflet of the mitral valve.

We present a case of a 71-year-old homeless diabetic man who was hospitalized due to bilateral cellulitis of the lower limbs. Because of severe calcific aortic stenosis, he had undergone valve replacement by a bioprosthesis 3 years earlier. Except from the two preadmission days, he reported no fever, malaise, or weight loss at any time after surgery.

The paradoxical association of common polymorphisms of the renin-angiotensin system genes with risk of myocardial infarction.

Background: The insertion/deletion polymorphism of the angiotensin-converting enzyme (ACE) and the A1166C polymorphism of the angiotensin-II AT1 receptor (AT1R) have been extensively investigated as possible risk factors for myocardial infarction (MI).

Design And Methods: Genetic association, case-control study, specifically designed to investigate the association of the above-mentioned polymorphisms with risk of MI in a homogeneous, low coronary risk, Caucasian population. The study population consisted of 1603 consecutive patients with acute MI who were recruited from nine clinics, located in three cities, and 699 unrelated adults who were randomly selected from the city catalogues.

Detection of increased temperature of the culprit lesion after recent myocardial infarction: the favorable effect of statins.

Background: Increased thermal heterogeneity has been demonstrated in atherosclerotic plaques, with the higher temperature recorded in acute myocardial infarction (MI). Dietary or treatment interventions reduce heat production. The purpose of the present study was to investigate whether increased plaque temperature is maintained for a prolonged period after MI and the role of statin administration.

Exercise-induced left bundle branch block accompanied by chest pain. Correlation with coronary artery disease.

A case of a 25-year-old woman with familiar hypercholesterolemia, who was admitted complaining for chest pain on exertion, is presented. She underwent a treadmill stress test and during the exercise left bundle branch block with concomitant chest pain in low heart rate (105/min) was demonstrated. After these findings TL-201 scintigraphy with dipyridamole infusion was performed: Chest pain and left bundle branch block appeared again during the test, and the stress TL-201 tomographic images showed reversible defect in the anterior wall.

An integrated assessment of family history on the risk of developing acute coronary syndromes (CARDIO2000 study).

Objective: In this work we assessed a risk score for developing a first event of acute coronary syndrome (ACS) based on the family history of the cardiovascular risk factors.

Methods And Results: The studied population consisted of 848 randomly selected middle-aged patients with first event of ACS and 1078 sex-age-region matched controls admitted to the same hospitals for minor operations and without any clinical suspicion of cardiovascular disease in their life. A Family History Score (FHS) was developed based on the presence of coronary heart disease, hypertension, hypercholesterolaemia and diabetes mellitus, among first-degree relatives of the participants after adjusting for the family size.

The cooling effect of coronary blood flow on heart: a new approach.

We tested the hypothesis that blood flow through the coronary arteries may have a cooling effect on heart. The difference (?T) of blood temperature between coronary sinus and right atrium was calculated, during and after acute complete occlusion of blood flow in left coronary artery by balloon dilatation and confirmed by a Doppler guidewire. Coronary sinus blood temperature increased during interruption of coronary blood flow with balloon dilatation.

Forty-year follow-up of coronary heart disease mortality and its predictors: the Corfu cohort of the seven countries study.

The authors examined the effect of several risk factors in relation to coronary heart disease (CHD) mortality in the Corfu cohort of the Seven Countries Study. The population studied in this analysis consisted of 529 rural men (age 40-59 years) enrolled in 1961. Multivariate analysis was performed with CHD death as the end point; age, blood pressure, heart rate, serum total cholesterol, smoking, physical activity, body mass index, skinfold thickness, vital capacity, and forced expiratory volume were the predictors.