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Ymittos Athens, Greece

Manolis A.J.,Asklepeion General Hospital | Rosei E.A.,University of Brescia | Coca A.,University of Barcelona | Cifkova R.,Institute of Clinical and Experimental Medicine | And 9 more authors.
Journal of Hypertension | Year: 2012

Hypertension is the most common cardiovascular disorder and atrial fibrillation is the most common clinically significant arrhythmia. Both these conditions frequently coexist and their prevalence increases rapidly with aging. There are different risk factors and clinical conditions predisposing to the development of atrial fibrillation, but due its high prevalence, hypertension is still the main risk factor for the development of atrial fibrillation. Several pathophysiologic mechanisms (such as structural changes, neurohormonal activation, fibrosis, atherosclerosis, etc.) have been advocated to explain the onset of atrial fibrillation. The presence of atrial fibrillation per se increases the risk of stroke but its coexistence with high blood pressure leads to an abrupt increase of cardiovascular complications. Different risk models are available for the risk stratification and the prevention of thromboembolism in patients with atrial fibrillation. In all of them hypertension is present and is an important risk factor. Antihypertensive treatment may contribute to reduce this risk, and it seems some classes are superior to others in the prevention of new-onset atrial fibrillation and prevention of stroke. Antithrombotic treatment with warfarin is effective in the prevention of thromboembolic events, although quite recently, new classes of anticoagulants that do not require international normalized ratio monitoring have been introduced with promising results. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Lovic D.,Clinic for Internal Disease Intermedica | Manolis A.J.,Asklepeion General Hospital | Lovic B.,Clinic for Internal Disease Intermedica | Stojanov V.,University of Belgrade | And 3 more authors.
Current Vascular Pharmacology | Year: 2014

The prevalence of resistant hypertension and existing limitations in antihypertensive drug therapy renders the interventional management of hypertension an attractive alternative. Carotid baroreceptors have been traditionally thought to be implicated only in short-term blood pressure regulation; however recent evidence suggests that the baroreceptors might play an important role even in the long-term blood pressure regulation. Electrical baroreflex stimulation appears safe and effective and might represent a useful adjunct to medical therapy in patients with resistant hypertension. This review endeavors to summarize the complex pathophysiology of blood pressure regulation, to describe the baroreflex circuit, its anatomy and physiology, to present previous data refuting a role for the baroreceptors in the long-term control of blood pressure and recent animal and human data suggesting an effective role of carotid baroreceptor activation in long-lasting blood pressure reduction. In this paper we attempt to critically evaluate existing information in this area and provide the scientific basis for carotid baroreceptor stimulation in the management of resistant hypertension. © 2014 Bentham Science Publishers.

Tsioufis K.,National and Kapodistrian University of Athens | Andrikopoulos G.,Henry Dunant Hospital | Manolis A.,Asklepeion General Hospital
Angiology | Year: 2014

Trimetazidine (TMZ) is a metabolic agent used in cardiology for more than 40 years. Several studies assessed the cardioprotective effects of TMZ in patients with chronic coronary heart disease (CHD) as well as in patients with heart failure (HF). In light of the inclusion of TMZ in the current guidelines on the management of stable CHD, we reviewed the published literature on TMZ, focusing mainly its effects on patients with stable angina and HF. According to the published literature, there is sufficient evidence to support the addition of this agent in the treatment of symptomatic patients with stable angina. © The Author(s) 2014.

Papaspiliopoulos A.,Asklep eion General Hospital | Papaparaskeva K.,Konstantopouleio General Hospital | Papadopoulou E.,National Technical University of Athens | Feroussis J.,Asklepeion General Hospital | And 2 more authors.
Journal of Investigative Surgery | Year: 2010

Objective: There is still controversy about the effect of anabolic steroid on connective tissue. This study examines the hypothesis that the local use of nandrolone decanoate, an anabolic steroid on rotator cuff, facilitates the healing process when used in combination with surgical repair. Methods: Forty-eight male rabbits were divided in four groups with anabolic steroids (Nandrolone Decanoate 10 mg/kg) and immobilization as variables. The groups were the following: first group, nonsteroid use-immobilization (NSI); second group, nonsteroid use-nonimmobilization (NSNI); third group, steroid use-immobilization (SI); fourth group steroid use-nonimmobilization (SNI). Every rabbit underwent a rotator cuff incision and reconstruction. Fifteen days later the tendons were sent for biomechanical and histological evaluation. Results: Groups that did not receive anabolic steroids showed better healing and more tendon strength in comparison to groups that received anabolic steroids. Microscopic examination of specimens from the groups without the use of anabolic steroid showed extensive fibroblastic activity whereas the specimens from those groups with anabolic steroid use showed focal fibroblastic reaction and inflammation. Immobilization provided better results in the groups with anabolic steroid use but it did not influence healing in groups without steroids. Conclusions: The effect of local nandrolone decanoate use on a rotator cuff tear is detrimental, acting as a healing inhibitor. © 2010 Informa Healthcare USA, Inc.

Stack A.,University of Limerick | Manolis A.J.,Asklepeion General Hospital | Ritz E.,Nierenzentrum
Current Medical Research and Opinion | Year: 2015

A bulk of evidence now exists that links gout with adverse cardiovascular (CV) outcomes. However, continuing doubt remains as to whether hyperuricemia can be truly considered an independent major CV risk factor. In fact, many gouty patients who develop major CV and renal events also possess several traditional CV risk factors, the presence of which can potentially confound any relationship between gout and adverse CV events.This paper reviews the available evidence to determine whether sufficient proof exists from biological, epidemiological and clinical trial studies to support a causal relationship between gout and major CV and renal events.This review is based on a PubMed/Embase database search for articles on hyperuricemia and its impact on cardiovascular and renal function. © 2015 © 2015 Taylor & Francis.

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