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Biography
Fotios Barkas
Nationality: Greek (+30) 6936636376 (+30) 2651099846 Date of birth: 16/10/1986 Email addresses: fotisbarkas@windowslive.com; f.barkas@ic.ac.uk; f.barkas@uoi.gr Facebook: https://www.facebook.com/fotis.barkas.3 Twitter: https://twitter.com/fotisbarkas LinkedIn: www.linkedin.com/in/fotisbarkas Home address: Aoou 21, 45221 Ioannina (Greece) Consultant in Internal Medicine University Hospital
  • 854
  • 17 Nov 2022
Topic Review
microRNAs in Acute Coronary Syndromes
microRNAs (miRs) are endogenous non-coding single-stranded RNAs of approximately 20 nucleotides in length that negatively regulate post-transcriptional gene functions. Acute coronary syndromes (ACS) is a result of the interplay between coronary artery in situ thrombus formation, vulnerable plaque features such as a lipid or a necrotic core, myocardial necrosis followed by fibrosis. 
  • 854
  • 29 Nov 2022
Topic Review
Molecular Determinants of Chronic Venous Disease
Chronic Venous Disease (CVD) refers to several pathological and hemodynamic alterations of the veins of lower limbs causing a wide range of symptoms and signs with a high prevalence in the general population and with disabling consequences in the most severe forms. The etiology and pathophysiology of CVD is complex and multifactorial, involving genetic, proteomic, and cellular mechanisms that result in changes to the venous structure and functions. Expressions of several genes associated with angiogenesis, vascular development, and the regulation of veins are responsible for the susceptibility to CVD. Evidence shows that several extracellular matrix alterations (ECM) could be identified and in some cases pharmacologically targeted. 
  • 853
  • 07 Feb 2023
Topic Review
Treatment of IgA Nephropathy
IgA nephropathy remains the most common primary glomerular disease worldwide. It affects children and adults of all ages, and is a leading cause of end-stage kidney disease, making it a considerable public health issue in many countries.
  • 852
  • 21 Jun 2021
Topic Review
Exosomes in Ischemic Heart Disease
Exosomes are a subgroup of extracellular vesicles that can be secreted by virtually all types of cells, including cardiomyocytes, cardiac fibroblasts, endothelial cells, and stem and progenitor cells.
  • 851
  • 01 Jul 2021
Topic Review
High-Density Lipoproteins-Based Nanomedicine in Cardiovascular Disease
High-density lipoproteins (HDL) are complex endogenous nanoparticles involved in important functions such as reverse cholesterol transport and immunomodulatory activities, ensuring metabolic homeostasis and vascular health. The ability of HDL to interact with a plethora of immune cells and structural cells places it in the centre of numerous disease pathophysiologies. With a better understanding of the properties of synthetic and reconstituted HDL formulations and an increase in preclinical research, several HDL based nanoformulations have been tested in clinical trials.
  • 849
  • 09 Jun 2023
Topic Review
Pathophysiology of Cardiotoxic Cancer Therapies
Cardiotoxicity is a well-recognized late effect among childhood cancer survivors. With various pediatric cancers becoming increasingly curable, it is imperative to understand the disease burdens that survivors may face in the future.
  • 847
  • 26 Oct 2021
Topic Review
Obstructive Sleep Apnea and Atrial Fibrillation
Atrial fibrillation (AF) is the most common arrhythmia, increasing with age and comorbidities. Obstructive sleep apnea (OSA) is a chronic sleep disorder more common in older men. It has been shown that OSA is linked to AF. Nonetheless, the prevalence of OSA in patients with AF remains unknown because OSA is significantly underdiagnosed. 
  • 847
  • 24 Mar 2022
Topic Review
Artificial Intelligence in Identifying Disease States
Echocardiography is an integral part of the diagnosis and management of cardiovascular disease. The use and application of artificial intelligence (AI) is a rapidly expanding field in medicine to improve consistency and reduce interobserver variability. AI can be successfully applied to echocardiography in addressing variance during image acquisition and interpretation. Furthermore, AI and machine learning can aid in the diagnosis and management of cardiovascular disease. In the realm of echocardiography, accurate interpretation is largely dependent on the subjective knowledge of the operator. Echocardiography is burdened by the high dependence on the level of experience of the operator, to a greater extent than other imaging modalities like computed tomography, nuclear imaging, and magnetic resonance imaging. AI technologies offer new opportunities for echocardiography to produce accurate, automated, and more consistent interpretations. 
  • 846
  • 01 Mar 2023
Topic Review
Redo-TAVR
Within the last two decades, transcatheter aortic valve replacement (TAVR) has transformed the treatment strategy for symptomatic severe aortic stenosis (AS), representing a less invasive alternative to traditional open-chest surgery. With time, advances in device features, imaging planning, and implantation techniques have contributed to an improvement in safety as well as a reduction in procedural complications. This has led to the expansion of TAVR to lower-risk patients, where TAVR has shown favorable outcomes compared to surgical aortic valve replacement (SAVR). As TAVR expands to younger and lower-risk patients with longer life expectancies, the need for reintervention for failing transcatheter heart valves is expected to increase. Redo-TAVR has gained increasing relevance in the lifetime management of AS as one of the treatment strategies available for structural valve dysfunction (SVD).
  • 846
  • 28 Jul 2023
Topic Review
Interplay of Angiotensin Peptides, Vasopressin, and Insulin
In each vascular bed, the blood flow depends on perfusion pressure, the rheologic properties of the blood, the structural and functional properties of the vascular wall, and the action of vasoconstrictory and vasodilatory factors produced locally or inflowing from the systemic circulation. The fundamental role of the heart in the maintenance of blood circulation requires the particularly precise regulation of the coronary blood flow (CBF). Rhythmic contractions of the heart exert direct mechanical effects on the coronary vessels that are associated with the production of metabolic factors in the cardiac myocytes and the smooth muscle cells of coronary vessels. 
  • 845
  • 29 Jan 2024
Topic Review
Cisd2 in Cardiac Ageing
CISD2 is an evolutionally conserved protein that is mainly located in the mitochondria, ER, and MAMs. The expression level of Cisd2 decreases during natural ageing in many tissues and organs, including the heart, skeletal muscles, liver, brain, and skin.
  • 844
  • 29 Dec 2020
Topic Review
Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease
Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a valuable tool in cardiovascular disease because of the difficulty associated with comprehending cardiovascular anatomy and pathology on 2D flat screens. Additionally, the added value of using 3D-printed models is especially apparent in congenital heart disease (CHD), due to its wide spectrum of anomalies and its complexity. 
  • 844
  • 15 Mar 2023
Topic Review
Management of Postoperative Chylothorax after Paediatric Cardiac Surgery
Chylothorax refers to the accumulation of lymphatic fluid in the pleural space. Its presence in the neonatal and pediatric population has been associated with numerous conditions, mainly chest trauma, thoracic surgery, extracorporeal membrane oxygenation and primary or metastatic malignancy, particularly lymphoma.
  • 843
  • 12 May 2022
Topic Review
Therapies for Atrial Fibrillation
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world, with an estimated prevalence of 2 to 4%. It is defined as supraventricular tachyarrhythmia with uncoordinated atrial electrical activation, which results in chaotic and irregular activation of atrial pacemaker cells and thus ineffective mechanical contraction of the atrial chambers.
  • 842
  • 11 Jan 2023
Topic Review
Classification and Hemodynamic Definitions of Pulmonary Hypertension
Pulmonary hypertension (PH) refers to a pathologic elevation of the mean pulmonary artery pressure (mPAP) and is associated with increased morbidity and mortality in a wide range of medical conditions. These conditions are classified according to similarities in pathophysiology and management in addition to their invasive hemodynamic profiles. The 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension present the newest clinical classification system and includes significant updates to the hemodynamic definitions. Pulmonary hypertension is now hemodynamically defined as an mPAP > 20 mmHg, reduced from the previous threshold of ≥25 mmHg, due to important insights from both normative and prognostic data. Pulmonary vascular resistance has been extended into the definition of pre-capillary pulmonary hypertension, with an updated threshold of >2 Wood Units (WU), to help differentiate pulmonary vascular disease from other causes of increased mPAP. Exercise pulmonary hypertension has been reintroduced into the hemodynamic definitions and is defined by an mPAP/cardiac output slope of >3 mmHg/L/min between rest and exercise. While these new hemodynamic thresholds will have a significant impact on the diagnosis of pulmonary hypertension, no evidence-based treatments are available for patients with mPAP between 21–24 mmHg and/or PVR between 2–3 WU or with exercise PH. 
  • 842
  • 21 Mar 2024
Topic Review
Renin–Angiotensin–Aldosterone System and Immunomodulation
The renin–angiotensin system (RAS) has long been considered the pinnacle of homeostasis in cardiovascular physiology. Its main function involves regulation of blood pressure, via direct and indirect means, through electrolyte balance, and trophic and vasomotor functions. While historically associated with these basic functions, the role of inflammation in cardiovascular diseases has been more and more described, and a critical role of RAS in inflammation regulation has been suggested.
  • 841
  • 05 Aug 2021
Topic Review
Fibrinolysis for Patients with COVID-19
An impaired fibrinolytic process has been demonstrated in patients infected with SARS-CoV-2, including those in severe or critical condition. Disruption of fibrinolysis leads to fibrin deposition, which exacerbates inflammation and fibrosis and damages the pulmonary surfactant. Numerous authors point out the different course of coagulopathy in patients with COVID-19. It is reported that they may have a state of secondary hyperfibrinolysis, which may explain, at least in part, the increased incidence of venous thromboembolism, even among those patients already receiving appropriate anticoagulant treatment. This raises the question of whether current guidelines for the prevention and treatment of embolic–thrombotic complications, among patients with severe COVID-19, are sufficient. Some studies show evidence of clinical improvement in patients who have received fibrinolytic therapy, beyond the current indications for its implementation. 
  • 841
  • 07 Nov 2022
Topic Review
Sirtuins in Cardiovascular Diseases
Adverse cardiovascular disease (CVD) outcomes, such as sudden cardiac death, acute myocardial infarction, and stroke, are often catastrophic. Statins are frequently used to attenuate the risk of CVD-associated morbidity and mortality through their impact on lipids and they may also have anti-inflammatory and other plaque-stabilization effects via different signaling pathways. Different statins, including atorvastatin, rosuvastatin, pravastatin, pitavastatin, and simvastatin, are administered to manage circulatory lipid levels. In addition, statins are potent inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase via modulating sirtuins (SIRTs).
  • 841
  • 20 Mar 2023
Topic Review
Metabolic Approaches for Treatment of Dilated Cardiomyopathy
In dilated cardiomyopathy (DCM), where the heart muscle becomes stretched and thin, heart failure (HF) occurs, and the cardiomyocytes suffer from an energetic inefficiency caused by an abnormal cardiac metabolism. Although underappreciated as a potential therapeutic target, the optimal metabolic milieu of a failing heart is still largely unknown and subject to debate. Because glucose naturally has a lower P/O ratio (the ATP yield per oxygen atom), the previous studies using this strategy to increase glucose oxidation have produced some intriguing findings. In reality, the vast majority of small-scale pilot trials using trimetazidine, ranolazine, perhexiline, and etomoxir have demonstrated enhanced left ventricular (LV) function and, in some circumstances, myocardial energetics in chronic ischemic and non-ischemic HF with a reduced ejection fraction (EF).
  • 840
  • 26 Jul 2023
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