Biomedical subjects

Gregory Vyssoulis

Publications and source records attributed to Gregory Vyssoulis.

7 recordsLinked to original sources

PubMed2006

Relationship between low-grade inflammation and arterial stiffness in patients with essential hypertension.

BACKGROUND: Arterial stiffness is an independent cardiovascular risk factor in hypertensive individuals. Inflammation is associated with increased arterial stiffness and is implicated in the pathogenesis of hypertension. OBJECTIVES: To examine whether low-grade inflammation contributes to arterial stiffness and wave reflections independently of blood pressure, in patients with essential hypertension and in controls. METHODS: We studied 235 consecutive patients with uncomplicated, never-treated essential hypertension and 103 sex- and age-matched controls. The level of inflammation was evaluated with high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA). Arterial stiffness was assessed with carotid-femoral (c-f) and carotid-radial (c-r) pulse wave velocity (PWV), and wave reflections with augmentation index (AIx). RESULTS: In the hypertensive group, in multiple regression analysis, both PWVc-f and PWVc-r were independently correlated with log hsCRP (beta = 0.56, P = 0.006 and beta = 0.45, P = 0.016, respectively), whereas no correlation was found between PWV and log SAA (P = NS). No significant correlation was observed between heart-rate-corrected AIx and log hsCRP (P = NS) and log SAA (P = 0.07) in the same group. Similarly, in the control group, an independent association was observed between PWVc-f and PWVc-r with log hsCRP (beta = 0.68, P = 0.05 and beta = 0.74, P = 0.05 respectively), but not with log SAA (P = NS). Furthermore, no significant association was shown between heart-rate-corrected AIx and log hsCRP or log SAA (P = NS) in the control group. CONCLUSIONS: In hypertensive individuals, hsCRP is related to PWV, a direct marker of arterial stiffness, but not to AIx, a measure of wave reflections. Whether inflammation might act as a pathogenetic or modulating factor in arterial stiffening in chronic hypertension has to be confirmed.

Adult↗

PubMed2005

Changes in aortic root function after valve replacement in patients with aortic stenosis.

BACKGROUND: Aortic elastic properties are compromised in various states that induce functional and histological changes in the aortic wall. Aortic stenosis is frequent and often requires replacement of the stenotic valve. The purpose of this study was to examine the effect of aortic valve replacement on the aortic root function. METHODS: 31 patients, mean+/-SD age 67.2+/-9.1 years with severe aortic stenosis, who underwent aortic valve replacement with a bileaflet mechanical prosthesis, were studied. Aortic root function indices such as aortic cross-sectional compliance (CSC), aortic root distensibility (ARD), and aortic stiffness index (ASI) were calculated with the use of M-mode echocardiography in three sessions: one preoperatively (pre-op), one on day 7 postoperatively (early post-op), and one 6 months postoperatively (late post-op). RESULTS: Aortic root function deteriorated early post-op (p<0.001 for all) and returned towards pre-op levels late post-op (p=NS for all). CSC changed from 2.84+/-1.98 to 1.37+/-0.92, and 2.30+/-1.11 cm2/mmHg, ARD from 2.21+/-5.60 to 1.01+/-0.67, and 1.79+/-0.96 cm2/dyne, and ASI from 9.72+/-5.60 to 24.65+/-19.10, and 11.51+/-7.85, respectively. Correlations were found between early changes in some aortic root indices and the degree of aortic stenosis, denoting that aortic function deteriorated less in more severe cases of aortic stenosis. None of the late changes were related to aortic valve or left ventricular indices. CONCLUSIONS: Aortic valve replacement with a mechanical valve results in a significant but transient impairment of aortic distensibility.

Aged↗

PubMed2005

Cardiac hydatid cysts: echocardiographic findings.

Cardiac hydatid disease is rare. Many patients are asymptomatic, hence cardiac involvement is often discovered incidentally. Diagnosis is also difficult because of a long period between parasitic infection and the manifestation of disease. Rupture of a cardiac cyst is a serious complication. Diagnosis of cardiac hydatid cysts is often made using transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) provides details of the cysts. We present the cases of 3 patients with nonspecific symptoms of their endemic parasitic disease. The results of sonographic examinations in all patients strongly suggested the presence of cardiac hydatid cysts. One patient had a cyst in the external surface of the left ventricular apical-lateral wall visualized with TTE and TEE. Parasitic serology was negative. She underwent surgery, which confirmed a cyst located in the pericardium, and then was treated with albendazole. Another patient had a cyst in the left ventricle demonstrated by TTE and TEE and confirmed with serology. Color Doppler sonography verified that her cardiac cyst was in communication with the left ventricle. She was not a surgical candidate and was treated with albendazole. The final patient had a septated cyst in the media basilar portion of the interventricular septum demonstrated using TTE, and CT. He refused surgical treatment and albendazole was prescribed. Chest radiographs in 3 patients failed to show the cysts, and serology in 1 patient failed to indicate a hydatid cyst. Follow-up at 1-2 years revealed no recurrence in any patient. In all 3 cases, cysts could be visualized from the subcostal view via echocardiography. Imaging is critical for the early diagnosis, assessment, and follow-up of patients with this disease.

Adult↗

PubMed2005

Tissue Doppler imaging and brain natriuretic peptide levels in adults with repaired tetralogy of Fallot.

BACKGROUND: Accurate estimation of right ventricular (RV) function in patients with repaired tetralogy of Fallot (RTOF) is difficult, partly due to the presence of tricuspid regurgitation and pulmonary regurgitation and/or stenosis. The aim of the present study was to evaluate RV systolic and diastolic function of adult asymptomatic patients with RTOF by means of tissue Doppler imaging (TDI) and brain natriuretic peptide (BNP) values. METHODS: 25 adult patients with RTOF and 25 healthy controls were studied. The following echocardiographic measurements were obtained: RV diameter/left ventricular (LV) diameter (RVD/LVD) and systolic (Sa) and diastolic (Ea, Aa) velocities at the RV free wall tricuspid annulus site. Serum BNP levels were measured as well. RESULTS: Patients with RTOF demonstrated reduced TDI velocities: Sa, 8.16 +/- 1.15 versus 16.43 +/- 1.15 cm/sec (P < .001); Ea, 10.00 +/- 2.18 versus 18.99 +/- 1.00 cm/sec (P < .001); Aa, 5.64 +/- 1.77 vs. 13.69 +/- 0.86 cm/sec (P < .001). Patients with RTOF also had higher BNP levels than controls (85.0 +/- 87.0 vs 5.36 +/- 1.0 pg/mL; P < .001). The increased BNP levels in RTOF patients correlated with the RVD/LVD ratio (r = .521; P < .01). CONCLUSIONS: Our results indicate that although our cohort of patients was asymptomatic, using TDI and BNP allowed us to easily discriminate them from the healthy controls. The ability of TDI to assess ventricular function even in the presence of valvular lesions, as in RTOF patients, makes it a valuable tool in the investigation and follow-up of these patients.

Adolescent↗

PubMed2004

Successful thrombolysis of a partially obstructed bileaflet prosthetic heart valve in the mitral position.

We describe the case of a woman who presented with dyspnea of abrupt onset and who had recently undergone replacement of the mitral valve with a bileaflet mechanical prosthesis. Transthoracic echocardiographic examination with spectral Doppler recording of transvalvular blood flow revealed a velocity spectrum consistent with obstruction. Transesophageal echocardiography demonstrated partial obstruction of the prosthetic valve due to immobilization of 1 hemidisc in the closed position. This immobilization was apparently caused by a small mass whose appearance was consistent with that of a thrombus. The patient was successfully treated by intravenous administration of a thrombolytic agent. This case demonstrates the value of transesophageal echocardiography in the selection of candidates for thrombolytic treatment in cases of thrombosis of a left-sided valve prosthesis.

Aged↗

PubMedDate not supplied

Embolic stroke after "cured" prosthetic aortic valve endocarditis.

The authors report on the case of a patient with infective endocarditis of a prosthetic valve in the aortic position, after receiving percutaneous transluminal coronary angioplasty. Transesophageal echocardiography provided valuable information about the existence and size of vegetations at the time of initial diagnosis and during followup. Despite successful treatment resulting in good control of the infection and a significant reduction of vegetation size, the patient still suffered a major cerebral embolic event early after hospital discharge.

Aged↗

PubMedDate not supplied

Progressive heart failure in a patient after coronary artery bypass grafting.

A 60-year-old man suffered progressive heart failure caused by restrictive cardiomyopathy after coronary artery bypass grafting. The cardiomyopathy was due to cardiac amyloidosis coexisting with coronary artery disease. Repeated echocardiographic assessment of cardiac structure and function was crucial for diagnosis.

Coronary Artery Bypass↗