Publications by authors named "C Antoniou"

332 Publications

Multipoint left ventricular pacing as an addition to cardiac resynchronization therapy: a bridge to the holy grail?

Am J Cardiovasc Dis 2021 15;11(4):429-440. Epub 2021 Aug 15.

First Department of Cardiology, National and Kapodistrian University of Athens, Hippokrateion General Hospital Athens, Greece.

Cardiac resynchronization therapy (CRT) constitutes a cornerstone to the treatment of advanced dyssynchronous heart failure (DyssHF); moreover it represents one of the few instances that a revolutionary approach was pursued, yielding previously unfathomable benefits to patients out of realistic therapeutic options. However, as is rather extensively established, nonresponse, or even negative response, to CRT continue to plague its course, precluding favourable effects in up to 40% of recipients, for a multitude of reasons. Given the scope of the issue of nonresponse, attempts to negate it by means of altering CRT delivery mode, and, more specifically, by introducing multipoint left ventricular pacing (MPP) have been focused on. Possible reasons for divergent trial results will be presented, as well as potential criteria for predicting whether MPP activation may reap additional benefits as compared to conventional biventricular pacing (BVP). Finally, an alternative framework for approaching CRT in general will be put forward, including advancements which in the (near) future may once more revolutionise heart failure treatment.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449203PMC
August 2021

Preharvest Nutrient Deprivation Reconfigures Nitrate, Mineral, and Phytochemical Content of Microgreens.

Foods 2021 Jun 9;10(6). Epub 2021 Jun 9.

Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy.

While imparting gastronomic novelty and sensory delight, microgreens also constitute rudimentary leafy greens packed with nutrients and phytochemicals. As such, they comprise an upcoming class of functional foods. However, apart from bioactive secondary metabolites, microgreens also accumulate antinutritive agents such as nitrate, especially under conducive protected cultivation conditions. The current work examined nutrient deprivation before harvest (DBH), applied by replacing nutrient solution with osmotic water for six and twelve days, as a strategy for reducing microgreen nitrate levels in different species (lettuce, mustard, and rocket). The three species were sown on a peat-based substrate, cultivated in a controlled climate chamber, and harvested 18 days after sowing, when the first two true leaves emerged. DBH impact on major constituents of the secondary metabolome, mineral content, colorimetric, and yield traits was appraised. Nitrate and mineral content were determined through ion chromatography, phenolic composition through UHPLC-Q-Orbitrap HRMS, and carotenoid composition through HPLC-DAD. Nutrient deprivation was effective in reducing nitrate content; however, effective treatment duration differed between species and decline was more precipitous in nitrate hyperaccumulating species such as rocket. Quercetin and kaempferol glycosides were the flavonol glycosides most abundant in brassicaceous microgreens, whereas lettuce microgreens were steeped in caffeoyl quinic acid. DBH interacted with species as it increased the total phenolic content of lettuce, decreased that of rocket, but did not affect mustard. Further research to link changes in phenolic composition to the sensory and in vivo bioactive profile of microgreens is warranted. Notably, brief (≤6 days) DBH can be applied across species with moderate or no impact on the phenolic, carotenoid, and mineral composition of microgreens. Brief DBH applications also have limited impact on microgreens' yield and colorimetric traits hence on the commercial value of the product. They can therefore be applied for reducing microgreen nitrate levels without significantly impacting key secondary metabolic constituents and their potential bioactive role.
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http://dx.doi.org/10.3390/foods10061333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228507PMC
June 2021

Atrial High-Rate Episodes in Patients with Devices Without a History of Atrial Fibrillation: a Systematic Review and Meta-analysis.

Cardiovasc Drugs Ther 2021 Jun 5. Epub 2021 Jun 5.

First Department of Cardiology, University of Athens Medical School, Athens, Greece.

Purpose: Atrial high-rate episodes (AHREs) recorded with cardiac implantable electronic devices (CIEDs) have been associated with the development of clinical atrial fibrillation (AF) and increase in stroke and death risk. We sought to perform a systematic review with a meta-analysis to evaluate the prevalence of AHREs detected by CIEDs, their association with stroke risk, development of clinical AF, and mortality among patients without a documented history of AF.

Methods: We searched several databases, ClinicalTrials.gov, references of reviews, and meeting abstract books without any language restrictions up to 9 September 2020. We studied patients with CIEDs in whom AHREs were detected. Exclusion criterion was AF history. Our primary outcome was the risk of ischemic stroke in patients with AHREs.

Results: We deemed eligible eight studies for the meta-analysis enrolling a total of 4322 patients with CIED and without a documented AF history. The overall AHRE incidence ratio was estimated to be 17.56 (95% CI, 8.61 to 35.79) cases per 100 person-years. Evidence of moderate certainty suggests that patients with documented AHREs were 4.45 times (95% CI 2.87-6.91) more likely to develop clinical AF. Evidence of low confidence suggests that AHREs were associated with a 1.90-fold increased stroke risk (95% CI 1.19-3.05). AHREs were not associated with a statistically significant increased mortality risk.

Conclusion: The present systematic review and meta-analysis demonstrated that among patients without a documented history of AF, the detection of AHREs by CIEDs was associated with significant increased risk of clinical AF and stroke.

Registration Number (doi): Available in https://doi.org/10.17605/OSF.IO/ZRF6M .
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http://dx.doi.org/10.1007/s10557-021-07209-8DOI Listing
June 2021

Ontogenetic Variation in the Mineral, Phytochemical and Yield Attributes of Brassicaceous Microgreens.

Foods 2021 May 10;10(5). Epub 2021 May 10.

Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy.

Microgreens constitute novel gastronomic ingredients that combine visual, kinesthetic and bioactive qualities. The definition of the optimal developmental stage for harvesting microgreens remains fluid. Their superior phytochemical content against mature leaves underpins the current hypothesis of significant changes in compositional profile during the brief interval of ontogeny from the appearance of the first (S1) to the second true leaf (S2). Microgreens of four brassicaceous genotypes (Komatsuna, Mibuna, Mizuna and Pak Choi) grown under controlled conditions and harvested at S1 and S2 were appraised for fresh and dry yield traits. They were further analyzed for macro- and micromineral content using inductively coupled plasma optical emission spectrometry (ICP-OES), carotenoid content using high-performance liquid chromatography with a diode-array detector (HPLC-DAD), volatile organic compounds using solid-phase microextraction followed by gas chromatography-mass spectrometry (SPME-GC/MS), anthocyanins and polyphenols using liquid chromatography-high resolution-tandem mass spectrometry (LC-MS/MS) with Orbitrap technology and for chlorophyll and ascorbate concentrations, well as antioxidant capacity by spectrophotometry. Analysis of compositional profiles revealed genotype as the principal source of variation for all constituents. The response of mineral and phytochemical composition and of antioxidant capacity to the growth stage was limited and largely genotype-dependent. It is, therefore, questionable whether delaying harvest from S1 to S2 would significantly improve the bioactive value of microgreens while the cost-benefit analysis for this decision must be genotype-specific. Finally, the lower-yielding genotypes (Mizuna and Pak Choi) registered higher relative increase in fresh yield between S1 and S2, compared to the faster-growing and higher-yielding genotypes. Although the optimal harvest stage for specific genotypes must be determined considering the increase in yield against reduction in crop turnover, harvesting at S2 seems advisable for the lower-yielding genotypes.
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http://dx.doi.org/10.3390/foods10051032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151805PMC
May 2021

Effectiveness and safety of apremilast in biologic-naïve patients with moderate psoriasis treated in routine clinical practice in Greece: the APRAISAL study.

J Eur Acad Dermatol Venereol 2021 Sep 13;35(9):1838-1848. Epub 2021 Jul 13.

Clinic of Dermatology, 401 General Military Hospital of Athens, Athens, Greece.

Background: Apremilast is an oral phosphodiesterase-4 inhibitor indicated for patients with moderate-to-severe chronic plaque psoriasis and active psoriatic arthritis.

Objectives: To examine the effectiveness of apremilast on Dermatology Life Quality Index (DLQI), Psoriasis Area and Severity Index (PASI) and nail, scalp and palmoplantar involvement, when administered prior to biologics.

Methods: This 52-week real-world study included biologic-naive adults with moderate psoriasis (psoriasis-involved body surface area 10% to <20%, or PASI 10 to <20 and DLQI 10 to <20). Apremilast was initiated ≤7 days before enrolment. Data from the first 100 eligible patients who completed 24 weeks (W24) of observation (or were prematurely withdrawn) are presented in this interim analysis using the last-observation-carried-forward imputation method.

Results: Eligible patients (mean age: 49.9 years; 71.0% males; median disease duration: 8.0 years) were consecutively enrolled between April and October 2017, by 18 dermatology specialists practising in hospital outpatient settings in Greece. Baseline DLQI (median: 12.0) and PASI (median: 11.7) scores improved (P < 0.001) at all postbaseline timepoints (Weeks 6, 16 and 24; W24 median decreases: 9.0 and 9.4 points respectively). At W24, DLQI ≤5, DLQI 0 or 1, and PASI-75 response rates were 63.0%, 25.0% and 48.0% respectively. The Nail Psoriasis Severity Index score in patients with baseline nail involvement (n = 57) decreased at all postbaseline timepoints (P < 0.001; W24 median decrease: 20.0 points). At W24, 50.0% and 51.7% of patients with baseline scalp (n = 76) and palmoplantar (n = 29) involvement respectively achieved postbaseline Physician's Global Assessment (PGA) score of 0 or 1 if baseline score was ≥3, or 0 if baseline score was 1 or 2. The adverse drug reaction rate was 21.0% (serious: 2.0%).

Conclusions: These interim results indicate that through 24 weeks, apremilast improved quality of life and reduced disease severity in biologic-naive patients with moderate plaque psoriasis, while demonstrating safety consistent with the known safety profile.
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http://dx.doi.org/10.1111/jdv.17392DOI Listing
September 2021
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