Publications by authors named "Vasiliki V Georgiopoulou"
Background: We conducted a pilot study to assess feasibility, on-study retention, trends in natriuretic peptide levels, quality of life, and safety of a 12-week feeding trial with 1500- versus 3000-mg daily sodium meals in high-risk patients with heart failure.
Methods: Of 196 patients with recent (≤2 weeks) hospitalization for heart failure, ejection fraction ≤40%, on optimal medical therapy, functionally independent, and able to communicate, 83 (47%) consented to participate. Of these, 27 (age, 62±11 years; 22 men; 20 white; ejection fraction, 26±8%) had 24-hour urine sodium ≥3000 mg and agreed to randomly receive either 1500-mg (N=12) or 3000-mg (N=15) sodium meals.
Background: Limited data exist on the association between circulating suppression of tumorigenicity 2 (ST2) and recurrent hospitalizations and emergency department (ED) encounters in outpatients with heart failure (HF). In addition, data on ST2 in African American patients with HF are scarce.
Methods: We evaluated 307 outpatients with HF (age, 57 ± 12 years; 64.
Background: An operational consensus definition of Stage D heart failure (HF) is currently lacking.
Methods: We evaluated 512 outpatients (median age, 63 years; 35.0% women; 45.
Article Synopsis
- This study assessed the prognostic value of INTERMACS profiles in non-inotrope-dependent heart failure patients with reduced ejection fraction (HFrEF), finding limited existing data on this topic.
- The research analyzed 3-year outcomes for 969 outpatients, categorizing them into various INTERMACS profiles based on their baseline conditions, revealing significant differences in mortality and hospitalization rates.
- Results indicated that patients classified with lower INTERMACS profiles had much higher mortality and hospitalization risks compared to stable Stage C patients, highlighting the effectiveness of these profiles for predicting outcomes in this patient group.
Article Synopsis
- Patients with heart failure and preserved ejection fraction (HFpEF) are typically older and face a high burden of other health conditions, influencing their health outcomes significantly.
- A study of 445 patients revealed a concerning number of deaths and hospitalizations over two years, with a notable percentage being related to cardiovascular issues, particularly heart failure.
- Key factors contributing to higher hospitalization rates included marital status, low albumin levels, diabetes, atrial fibrillation, and renal dysfunction, indicating that a comprehensive approach to care might be crucial for better management of these patients.
Objectives: This study sought to estimate the rate of progression to Stage D heart failure (HF) among outpatients with Stage C HF and to identify risk factors for progression.
Background: The pool of patients who may be candidates for advanced HF therapies is growing.
Methods: We estimated 3-year progression to clinically determined Stage D HF and competing mortality among 964 outpatients with Stage C heart failure with reduced ejection fraction (HFrEF), where ejection fraction is ≤40%.
Aims: Decreased arylesterase (ArylE) activity of paraoxonase-1, a HDL-associated protein with anti-inflammatory and antioxidant properties, has been associated with increased risk of cardiac events in patients with ischaemic heart failure (HF). We aim to investigate the prognostic significance of changes in serum ArylE activity over time.
Methods And Results: We examined the association between baseline and follow-up serum ArylE activity and HF outcomes (death, cardiac transplantation, or ventricular assist device implantation) in 299 patients with HF enrolled in a prospective cohort study from January 2008 to July 2009, with 145 patients having available follow-up levels at 1 year.
Introduction: Data on the association between exercise capacity and risk for heart failure (HF) in older adults are limited.
Methods: This study examined the association of exercise capacity, and its change over time, with 10-year mortality and incident HF in 2,935 participants of the Health, Aging, and Body Composition Study without HF at baseline (age, 73.6 [SD=2.
Article Synopsis
- The Patient Health Questionnaire 9 (PHQ-9) is a useful tool for assessing depression severity in heart failure (HF) patients, though there is limited data on its effects in this population.
- In a study of 308 HF outpatients, those with moderate-to-severe depressive symptoms faced significantly higher rates of hospital admissions related to HF and overall, yet less than half were receiving antidepressants.
- The findings suggest that as depressive symptoms increase, healthcare resource use rises and quality of life declines, indicating the need for interventions to address depression in HF patients for better outcomes.
Background/objectives: Cystatin-C and beta-2-microglobulin may be superior to serum creatinine, blood urea nitrogen (BUN), or estimated glomerular filtration rate (eGFR) in patients hospitalized with heart failure (HF). We compared these renal markers in ambulatory HF patients.
Methods: We prospectively evaluated the association of baseline renal markers and eGFR (by 4 different formulas) with (1) the composite of death or HF-related hospitalization and (2) rates of hospitalizations and emergency department (ED) visits in 166 outpatients with HF (57.
Article Synopsis
- Surrogate endpoints are used in about a third of cardiovascular trials, allowing for faster completion and a higher likelihood of meeting primary outcomes.
- The study analyzed 1,224 trials published from 2001 to 2012, revealing that surrogate endpoints tend to be associated with smaller trial sizes and quicker patient enrollment.
- Over time, the success rates for trials using clinical endpoints have decreased, while those for surrogate and intermediate endpoints have remained stable, highlighting the need for more research on the implications of surrogate endpoints for actual clinical outcomes.
Background: Enrollment criteria used in advanced heart failure (HF) clinical trials might identify a common set of widely accepted quantitative characteristics as the basis of a consensus definition for advanced HF, which is currently lacking.
Methods: We reviewed all clinical trials investigating interventions in patients with advanced HF as of July 31, 2015. Eligible publications (N = 134) reported original data from clinical trials explicitly defining advanced HF in adults.
Background: Vascular endothelial dysfunction may play an important role in the progression of heart failure (HF). We hypothesize that elevated levels of vascular markers, placental-like growth factor, and soluble Fms-like tyrosine kinase-1 (sFlt-1) are associated with adverse outcomes in patients with HF. We also assessed possible triggers of sFlt-1 elevation in animal HF models.
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- Clinical trials in cardiology from 2001-2012 showed a shift towards larger, more global studies, with fewer trials meeting their primary objectives.
- 27% of the trials were in North America, while multiregional trials increased from 26% to over 30%, indicating a trend towards greater international collaboration.
- Despite the increase in trial size and geographic scope, the enrollment rate per site declined, and the success rate for meeting primary endpoints fell from 69% to 57%.
Article Synopsis
- Echocardiography is recommended as an important diagnostic tool in acute heart failure (AHF), but its application is still being defined in both clinical practice and research.
- Studies suggest that echocardiographic measures can provide meaningful insights into treatment response and patient outcomes, yet there's ongoing research into the best timing and types of measures to use.
- The full potential of echocardiography in classifying AHF patients and guiding treatment decisions remains unclear, highlighting the need for further exploration in this area.
Aims: Despite improved outcomes and lower right ventricular failure (RVF) rates with continuous-flow left ventricular assist devices (LVADs), RVF still occurs in 20-40% of LVAD recipients and leads to worse clinical and patient-centred outcomes and higher utilization of healthcare resources. Preoperative quantification of RV function with echocardiography has only recently been considered for RVF prediction, and RV mechanics have not been prospectively evaluated.
Methods And Results: In this single-centre prospective cohort study, we plan to enroll a total of 120 LVAD candidates to evaluate standard and mechanics-based echocardiographic measures of RV function, obtained within 7 days of planned LVAD surgery, for prediction of (i) RVF within 90 days; (ii) quality of life (QoL) at 90 days; and (iii) RV function recovery at 90 days post-LVAD.
Background: Several clinical prediction schemes for right ventricular failure (RVF) risk after left ventricular assist device (LVAD) implantation have been developed in both the pulsatile- and continuous-flow LVAD eras. The performance of these models has not been evaluated systematically in a continuous-flow LVAD cohort.
Methods: We evaluated 6 clinical RVF prediction models (Michigan, Penn, Utah, Kormos et al, CRITT, Pittsburgh Decision Tree) in 116 patients (age 51 ± 13 years; 41.
Background: A systematic assessment of the temporal trends in heart failure (HF) clinical trials is lacking.
Methods And Results: A total of 154 phase II-IV HF trials including 162,725 patients published from 2001 to 2012 in 8 high-impact-factor journals were reviewed. The median number of participants and sites per trial were 367 (interquartile range [IQR] 133-1450) and 38 (5-101), respectively.
Device uptake and development have progressed over the last decade, but few quantitative data exist examining the overall operating characteristics and temporal trends of these clinical trials. We performed a systematic analysis of all cardiovascular device clinical trials from 2001 to 2012 published in medical and cardiovascular journals with the 8 highest impact factors. Of the 1,224 identified cardiovascular clinical trials, 299 (24.
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- - The study investigates the relationship between lung function (spirometric parameters) and outcomes in patients with stage D heart failure who are awaiting heart transplants, as previous studies indicated that impaired lung function affects those with stage C heart failure negatively.
- - Data from 187 patients revealed that lung function measurements like FEV1 and FVC did not significantly correlate with primary outcomes (death or left ventricular assist device implantation) or secondary outcomes (urgent transplantation), indicating that these parameters may not be as crucial in stage D heart failure patients.
- - Overall, unlike stage C heart failure patients, those in stage D did not show associations between lung function and post-transplant outcomes, suggesting that the two stages of heart failure may have different
Advances in medical therapies leading to improved patient outcomes are in large part related to successful conduct of clinical trials that offer critical information regarding the efficacy and safety of novel interventions. The conduct of clinical trials in the United States, however, continues to face increasing challenges with recruitment and retention. These trends are paralleled by an increasing shift toward more multinational trials where most participants are enrolled in countries outside the United States, bringing into question the generalizability of the results to the American population.
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