Scholars@Duke
Christos Kyriakopoulos

Scholarly Works

Adipocyte Enhancer Binding Protein 1 (AEBP1) Inhibition as a Potential Anti-Fibrotic Therapy in Heart Failure.

Journal article Res Sq · May 26, 2026 Persistent activation of cardiac fibroblasts into myofibroblasts drives excessive extracellular matrix deposition, leading to maladaptive myocardial fibrosis, adverse remodeling and heart failure (HF) progression. Adipocyte enhancer binding protein 1 (AEBP ... Full text Link to item Cite

The Effect of Vericiguat on Endothelial Function in Patients With Heart Failure With Reduced Ejection Fraction: A Pilot Randomized Study.

Journal article The American journal of cardiology · May 2026 Vericiguat is a soluble guanylate cyclase stimulator previously shown to improve cardiovascular outcomes in patients with heart failure with reduced ejection fraction (HFrEF). However, the underlying mechanisms remain incompletely understood. To evaluate t ... Full text Cite

Integrative Clinical–Molecular Modeling Identifies LRRN4CL as a Determinant of Structural and Functional Myocardial Improvement

Preprint · April 26, 2026 ABSTRACTBackgroundMechanical ventricular unloading and systemic circulatory support with left ventricular assist devices (LVADs) enab ... Full text Cite

Determining the individualized probability of myocardial recovery: The multicenter RecoverHeart calculator.

Journal article J Heart Lung Transplant · April 17, 2026 BACKGROUND: Recent reports from UNOS and INTERMACS highlight that left ventricular assist devices (LVADs) remain underutilized as a bridge-to-recovery (BTR) strategy, despite data from registries and other studies demonstrating that a meaningful subset of ... Full text Link to item Cite

Systemic Manifestations and Mortality Risk in Transthyretin V142I Variant Carriers: A Million Veteran Program Analysis.

Journal article JACC. CardioOncology · February 2026 BackgroundThe most common pathogenic transthyretin variant underlying variant transthyretin amyloidosis in the United States is c.424G>A, p.Val142Ile (V142I). In affected individuals, disease manifests predominantly as heart failure (HF) and cardi ... Full text Cite

The Role of Sphingolipids in Myocardial Recovery Mediated by Mechanical Unloading and Circulatory Support.

Journal article JACC. Basic to translational science · January 2026 Myocardial recovery after left ventricular assist device (LVAD) support is a critical phenomenon that allows advanced heart failure patients to retain their native heart. We quantified targeted sphingolipids in serum and cardiac tissue of patients who exhi ... Full text Cite

Factors associated with native heart survival and intermediate-term outcomes in acute myocardial infarction-related cardiogenic shock.

Journal article European heart journal open · January 2026 AimsCardiogenic shock (CS) is the leading cause of in-hospital mortality in patients suffering acute myocardial infarction (AMI). Despite advances in their management, short- and long-term mortality remain unacceptably high. We assessed short and ... Full text Cite

CPT1a Expression Is a Critical Cardioprotective Response to Pathological Stress That Enables Rescue by Gene Transfer.

Journal article Circulation research · January 2026 BackgroundCPT1 (carnitine palmitoyltransferase 1) is a rate-limiting enzyme for long-chain fatty acid oxidation. In adult hearts, CPT1b predominates, while CPT1a is coexpressed at lower levels. Pathological stress on the heart induces CPT1a expres ... Full text Cite

Association of Kidney Function With Myocardial Recovery and Adverse Events Following Left Ventricular Assist Device Circulatory Support.

Journal article Journal of the American Heart Association · December 2025 BackgroundWhether preleft ventricular assist device (LVAD) kidney function relates to myocardial recovery and LVAD-related adverse events remains uncertain. We evaluated the association of baseline estimated glomerular filtration rate (eGFR) with ... Full text Cite

Expression profiles of histone H4K20 methylation and its associated enzymes in mouse cardiac disease and human heart failure.

Journal article Epigenetics · December 2025 Histone H4K20 methylation is critical in regulating the cell cycle, DNA damage response, and gene repression in proliferating cells. However, its role in the heart remains poorly understood. Our previous work revealed that histone H4K20 tri-methylation is ... Full text Cite

Application of the Updated Cardiogenic Shock Working Group SCAI Classification for Cardiogenic Shock: A Single-Centre Analysis.

Journal article The Canadian journal of cardiology · October 2025 BackgroundIn 2019, the Society for Cardiovascular Angiography and Interventions (SCAI) proposed an algorithm to assess cardiogenic shock (CS) severity, known as SCAI classification. In 2022, the Cardiogenic Shock Working Group (CSWG) modified the ... Full text Cite

Left Atrial Reverse Remodeling in Patients Supported With Durable Left Ventricular Assist Devices and Clinical Implications.

Journal article Circulation. Heart failure · July 2025 BackgroundThe left atrium (LA) maintains a dynamic interaction with the left ventricle (LV). LA forward and reverse remodeling affect prognosis in patients with chronic heart failure. We examined LA reverse remodeling in patients supported with LV ... Full text Cite

Direct procurement with machine perfusion and normothermic regional perfusion in donation after circulatory death heart transplantation.

Journal article The Journal of thoracic and cardiovascular surgery · July 2025 BackgroundDonation after circulatory death (DCD) heart transplants have increased in the United States with direct procurement with machine perfusion (DPP) and thoracoabdominal normothermic regional perfusion (TA-NRP) techniques. There remains a p ... Full text Cite

Advanced Markers for Hemodynamic Monitoring in Cardiogenic Shock and End-Stage Heart Failure: A Mini Review.

Journal article Heart failure reviews · May 2025 Right heart catheterization (RHC) provides critical hemodynamic insights by measuring atrial, ventricular, and pulmonary artery pressures, as well as cardiac output (CO). Although the use of RHC has decreased, its application has been linked to improved ou ... Full text Cite

Integration of Patient Reported Quality-of-life Data into Risk Assessment in Heart Failure.

Journal article Journal of cardiac failure · May 2025 BackgroundOptimal management of outpatients with heart failure (HF) requires serially updating the estimates of their risk for adverse clinical outcomes to guide treatment. Patient-reported outcomes (PROs) are becoming increasingly used in clinica ... Full text Cite

Peroxisome proliferator-activated receptor gamma ( PPARG )-mediated myocardial salvage in acute myocardial infarction managed with left ventricular unloading and coronary reperfusion.

Preprint · February 15, 2025 Ischemic heart disease and acute myocardial infarction (AMI) is a leading cause of morbidity and mortality. Improvements have been made in coronary interventions to restore blood flow, but ischemia/reperfusion (I/R) injury significantly impacts clinical ou ... Full text Link to item Cite

Informing Management of Patients Developing Cardiogenic Shock at a Spoke and Being Transferred to a Hub.

Journal article Journal of the American Heart Association · February 2025 BackgroundMultidisciplinary teams and regionalized care systems have been suggested to improve cardiogenic shock (CS) outcomes. We sought to identify clinical factors associated with successful outcomes for patients developing CS at an outside hea ... Full text Cite

A Latent Cardiomyocyte Regeneration Potential in Human Heart Disease.

Journal article Circulation · January 2025 BackgroundCardiomyocytes in the adult human heart show a regenerative capacity, with an annual renewal rate of ≈0.5%. Whether this regenerative capacity of human cardiomyocytes is employed in heart failure has been controversial.MethodsWe ... Full text Cite

Cardiac Reverse Remodeling Mediated by HeartMate 3 Left Ventricular Assist Device: Comparison to Older Generation Devices.

Journal article ASAIO journal (American Society for Artificial Internal Organs : 1992) · December 2024 Currently, the fully magnetically levitated left ventricular assist device (LVAD) HeartMate 3 (HM3) is the only commercially available device for advanced heart failure (HF) patients. However, the left ventricular (LV) functional and structural changes fol ... Full text Cite

Cost-Effectiveness of a Shock Team Approach in Refractory Cardiogenic Shock.

Journal article Circulation. Heart failure · November 2024 BackgroundMultidisciplinary Shock Teams have improved clinical outcomes for cardiogenic shock, but their implementation costs have not been studied. This study's objective was to compare costs between patients treated with and without a Shock Team ... Full text Cite

Increased CPT1a expression is a critical cardioprotective response to pathological stress that suppresses gene programs for remodeling and enables rescue by gene transfer

Preprint · October 2, 2024 Text AbstractBackgroundCarnitine palmitoyl transferase 1 (CPT1) is a rate-limiting enzyme for long chain fatty acid oxidation (FAO) i ... Full text Cite

Pathophysiologic Vasodilation in Cardiogenic Shock and Its Impact on Mortality.

Journal article Circulation. Heart failure · September 2024 BackgroundCardiogenic shock (CS) mortality remains near 40%. In addition to inadequate cardiac output, patients with severe CS may exhibit vasodilation. We aimed to examine the prevalence and consequences of vasodilation in CS.MethodsWe a ... Full text Cite

Clinical Characteristics and Outcomes of Patients Suffering Acute Decompensated Heart Failure Complicated by Cardiogenic Shock.

Journal article Circulation. Heart failure · September 2024 BackgroundCardiogenic shock (CS) can stem from multiple causes and portends poor prognosis. Prior studies have focused on acute myocardial infarction-CS; however, acute decompensated heart failure (ADHF)-CS accounts for most cases. We studied pati ... Full text Cite

Impact of Diabetes and Glycemia on Cardiac Improvement and Adverse Events Following Mechanical Circulatory Support.

Journal article Journal of the American Heart Association · July 2024 BackgroundType 2 diabetes is prevalent in cardiovascular disease and contributes to excess morbidity and mortality. We sought to investigate the effect of glycemia on functional cardiac improvement, morbidity, and mortality in durable left ventric ... Full text Cite

Bridge-to-transplant temporary mechanical circulatory support and risk of allosensitization.

Journal article Clinical transplantation · May 2024 IntroductionSince the 2018 change in the US adult heart allocation policy, more patients are bridged-to-transplant on temporary mechanical circulatory support (tMCS). Previous studies indicate that durable left ventricular assist devices (LVAD) ma ... Full text Cite

Hospital Readmissions in Patients Supported with Durable Centrifugal-Flow Left Ventricular Assist Devices.

Journal article Journal of clinical medicine · May 2024 Background: Centrifugal-flow left ventricular assist devices (CF-LVADs) have improved morbidity and mortality for their recipients. Hospital readmissions remain common, negatively impacting quality of life and survival. We sought to identify risk fa ... Full text Cite

Integrating molecular and clinical variables to predict myocardial recovery.

Preprint · April 20, 2024 Mechanical unloading and circulatory support with left ventricular assist devices (LVADs) mediate significant myocardial improvement in a subset of advanced heart failure (HF) patients. The clinical and biological phenomena associated with cardiac recovery ... Full text Link to item Cite

Artificial intelligence predictive analytics in heart failure: results of the pilot phase of a pragmatic randomized clinical trial.

Journal article Journal of the American Medical Informatics Association : JAMIA · April 2024 ObjectivesWe conducted an implementation planning process during the pilot phase of a pragmatic trial, which tests an intervention guided by artificial intelligence (AI) analytics sourced from noninvasive monitoring data in heart failure patients ... Full text Cite

Machine Learning Multicenter Risk Model to Predict Right Ventricular Failure After Mechanical Circulatory Support: The STOP-RVF Score.

Journal article JAMA cardiology · March 2024 ImportanceThe existing models predicting right ventricular failure (RVF) after durable left ventricular assist device (LVAD) support might be limited, partly due to lack of external validation, marginal predictive power, and absence of intraoperat ... Full text Cite

Mitochondria possess a large, non-selective ionic current that is enhanced during cardiac injury.

Preprint · November 16, 2023 Mitochondrial ion channels are essential for energy production and cell survival. To avoid depleting the electrochemical gradient used for ATP synthesis, channels so far described in the mitochondrial inner membrane open only briefly, are highly ion-select ... Full text Link to item Cite

Left ventricular functional improvement appears to contribute to lower rates of device thrombosis in patients on durable mechanical circulatory support.

Journal article The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · July 2023 By unloading the failing heart, left ventricular (LV) assist devices (LVADs) provide a favorable environment for reversing adverse structural and functional cardiac changes. Prior reports have suggested that an improved native LV function might contribute ... Full text Cite

Distinct Transcriptomic and Proteomic Profile Specifies Patients Who Have Heart Failure With Potential of Myocardial Recovery on Mechanical Unloading and Circulatory Support.

Journal article Circulation · January 2023 BackgroundExtensive evidence from single-center studies indicates that a subset of patients with chronic advanced heart failure (HF) undergoing left ventricular assist device (LVAD) support show significantly improved heart function and reverse st ... Full text Cite

Myocardial Recovery During LVAD Support

Book section · January 1, 2023 Heart failure (HF) is characterized by a pathologic process known as remodeling that involves progressive enlargement of the ventricle, reduction in contractility, and an increase in intracardiac pressures. Patients with chronic advanced HF supported with ... Full text Cite

Baseline QRS duration associates with cardiac recovery in patients with continuous-flow left ventricular assist device implantation.

Journal article American heart journal plus : cardiology research and practice · October 2022 ObjectiveIn chronic heart failure (HF) patients supported with continuous-flow left ventricular assist device (CF-LVAD), we aimed to assess the clinical association of pre-LVAD QRS duration (QRSd) with post-LVAD cardiac recovery, and its correlati ... Full text Cite

Does cardiac recovery favorably impact adverse events and outcomes of LVAD patients?

Journal article The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · August 2022 Full text Cite

LVAD as a Bridge to Remission from Advanced Heart Failure: Current Data and Opportunities for Improvement.

Journal article Journal of clinical medicine · June 2022 Left ventricular assist devices (LVADs) are an established treatment modality for advanced heart failure (HF). It has been shown that through volume and pressure unloading they can lead to significant functional and structural cardiac improvement, allowing ... Full text Cite

FGF21 (Fibroblast Growth Factor 21) Defines a Potential Cardiohepatic Signaling Circuit in End-Stage Heart Failure.

Journal article Circulation. Heart failure · March 2022 BackgroundExtrinsic control of cardiomyocyte metabolism is poorly understood in heart failure (HF). FGF21 (Fibroblast growth factor 21), a hormonal regulator of metabolism produced mainly in the liver and adipose tissue, is a prime candidate for s ... Full text Cite

Predicting mortality in cardiogenic shock secondary to ACS requiring short-term mechanical circulatory support: The ACS-MCS score.

Journal article Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · December 2021 ObjectiveTo identify predictors of 30-day all-cause mortality for patients with cardiogenic shock secondary to acute coronary syndrome (ACS-CS) who require short-term mechanical circulatory support (ST-MCS).BackgroundACS-CS mortality is h ... Full text Cite

Implantable cardioverter defibrillators in left ventricular assist device patients: Α systematic review and meta-analysis.

Journal article The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · October 2021 Implantable cardioverter-defibrillators (ICDs) remain the standard of care in advanced heart failure with reduced ejection fraction patients for the prevention of sudden cardiac death. However, current guidelines remain conflicting with respect to the use ... Full text Cite

Circulating and Myocardial Cytokines Predict Cardiac Structural and Functional Improvement in Patients With Heart Failure Undergoing Mechanical Circulatory Support.

Journal article Journal of the American Heart Association · October 2021 Background Recent prospective multicenter data from patients with advanced heart failure demonstrated that left ventricular assist device (LVAD) support combined with standard heart failure medications, induced significant cardiac structural and functional ... Full text Cite

Remodeling of t-system and proteins underlying excitation-contraction coupling in aging versus failing human heart.

Journal article NPJ aging and mechanisms of disease · May 2021 It is well established that the aging heart progressively remodels towards a senescent phenotype, but alterations of cellular microstructure and their differences to chronic heart failure (HF) associated remodeling remain ill-defined. Here, we show that th ... Full text Cite

Framework to Classify Reverse Cardiac Remodeling With Mechanical Circulatory Support: The Utah-Inova Stages.

Journal article Circulation. Heart failure · May 2021 BackgroundVariable definitions and an incomplete understanding of the gradient of reverse cardiac remodeling following continuous flow left ventricular assist device (LVAD) implantation has limited the field of myocardial plasticity. We evaluated ... Full text Cite

Etiology-Specific Remodeling in Ventricular Tissue of Heart Failure Patients and Its Implications for Computational Modeling of Electrical Conduction.

Journal article Frontiers in physiology · January 2021 With an estimated 64.3 million cases worldwide, heart failure (HF) imposes an enormous burden on healthcare systems. Sudden death from arrhythmia is the major cause of mortality in HF patients. Computational modeling of the failing heart provides insights ... Full text Cite