Cardiocore最新文献

{"title":"Valor pronóstico del ratio tiempo de aceleración/tiempo de eyección en la estenosis valvular aórtica","authors":"Sergio Gamaza-Chulián ,&nbsp;Dolores Ruiz-Fernández ,&nbsp;Enrique Díaz-Retamino ,&nbsp;Santiago Camacho-Freire ,&nbsp;Alberto Giráldez-Valpuesta ,&nbsp;Bárbara Serrano-Muñoz ,&nbsp;Enrique Otero-Chulián","doi":"10.1016/j.carcor.2017.12.002","DOIUrl":"10.1016/j.carcor.2017.12.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Guidelines underline the importance of assessment of aortic flow waveform morphology to estimate aortic stenosis (AS) severity. Our aim was to evaluate acceleration time/ejection time ratio (AT/ET) as prognostic value in this disease.</p></div><div><h3>Methods</h3><p>Between January 2013 and July 2016, patients with severe AS (aortic valve area &lt;<!--> <!-->1<!--> <!-->cm²) who came to our echocardiography laboratory were included. We analyzed in the aortic flow in continuos Doppler wave the time between the onset and the peak velocity (acceleration time), and total ejection time, and then acceleration time/ejection time ratio was calculated. The primary end-point was a combined one of cardiovascular death or aortic valve replacement.</p></div><div><h3>Results</h3><p>One hundred and ninety-seven patients with severe AS were included (55% women, mean age 76<!--> <!-->±<!--> <!-->8<!--> <!-->years). Complete follow-up was achieved in 190 patients (96%): during a mean follow-up of 223<!--> <!-->±<!--> <!-->156<!--> <!-->days, 110 patients (58%) reached the primary endpoint; 70 patients (37%) were surgically operated, 8 patients (4%) percutaneous replacement, 33 patients (17%) suffered from cardiovascular death. Patients with AT/ET higher than 0.35 had more cardiovascular events (66% vs. 41%, <em>P</em> <!-->=<!--> <!-->.008). There was a non-significant trend to lower free-events survival by Kaplan-Meier method in patients with AT/ET higher than 0.35 (284<!--> <!-->±<!--> <!-->25 vs. 350<!--> <!-->±<!--> <!-->32<!--> <!-->days, <em>P</em> <!-->=<!--> <!-->.07). In multivariate analysis by Cox regression, only aortic valve area (<em>P</em> <!-->=<!--> <!-->.03), atrial fibrillation (<em>P</em> <!-->=<!--> <!-->.02), symptomatic status (<em>P</em> <!-->&lt;<!--> <!-->.001) and AT/ET (<em>P</em> <!-->=<!--> <!-->.04) were independent predictors of combined end-point.</p></div><div><h3>Conclusion</h3><p>AT/ET ratio could help to identify patients with more severe AS. Higher values of AT/ET ratio were associated with higher incidence of aortic valve replacement and/or cardiovascular death.</p></div>","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 4","pages":"Pages 152-158"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.carcor.2017.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85253051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problemas ligados al sobresensado de onda T en un DAI: los extremos se juntan","authors":"Pablo Bastos Amador,&nbsp;Rocío Cózar León,&nbsp;Ernesto Díaz Infante","doi":"10.1016/j.carcor.2018.09.003","DOIUrl":"10.1016/j.carcor.2018.09.003","url":null,"abstract":"<div><p>We describe the case of a 72-year-old patient with an ICD in primary prevention due to ischemic dilated myocardiopathy with T-wave oversensing in relation to the development of right bundle branch block, which caused inappropriate therapies of the device, and subsequently inhibition of pacing due to the oversensing after the appearance of complete AV block. We highlight the importance of this situation and the knowledge of each of the programmability options or algorithms offered by each manufacturer to deal with this phenomenon.</p></div>","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 4","pages":"Pages e48-e50"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120192980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terapia génica en insuficiencia cardiaca","authors":"Manuel Lobo González","doi":"10.1016/j.carcor.2017.08.004","DOIUrl":"10.1016/j.carcor.2017.08.004","url":null,"abstract":"<div><p>Patients with heart failure still have a reduced life expectancy, poor quality of life and frequent hospital admissions, although specific care units, new drugs and devices have been developed in the last years. For that reason, novel strategies are needed to treat the growing population of heart failure patients. Better understanding of many of the basic molecular mechanisms involved in the heart failure disease has allowed the development of gene therapy models using different vectors, including viral vectors specifically directed to these molecular targets. In spite of the promising results from animal studies, the clinical translation by randomized clinical trials has been unsuccessful. This review briefly reviews the principles underlying gene transfer therapy and its application in the field of heart failure, as well as the recent trials carried out in patients with heart failure.</p></div>","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 3","pages":"Pages 128-132"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.carcor.2017.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81374453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sangre autóloga a reinfundir con el recuperador celular a pacientes cardíacos en respuesta a las transfusiones sanguíneas","authors":"Manuel Luque Oliveros ,&nbsp;María A. Domínguez Baños ,&nbsp;Margarita Gutiérrez Plata","doi":"10.1016/j.carcor.2018.05.002","DOIUrl":"10.1016/j.carcor.2018.05.002","url":null,"abstract":"<div><h3>Introduction and objetives</h3><p>The cell saver is an alternative to blood transfusions according to the existing evidence. However, there is no evidence to determine the time of reinfusion of red blood cells in line with transfusions. Our objective was to analyze the evidence on the effectiveness of the cell saver to reduce blood transfusions.</p></div><div><h3>Methods</h3><p>Randomized clinical trial with 91 patients in a non-exposed group (reinfusion of autologous blood with the cell saver was performed at the end of surgery) and 80 patients exposed group (reinfusion of autologous blood was performed continuously during surgery). Variables were collected at three moments (preoperative, intraoperative and postoperative).</p></div><div><h3>Results</h3><p>Both haemoglobin and haematocrit were lower in the unexposed group when compared to the exposed group, both during after surgery (p=.011 and.018, respectively), and blood transfusions were higher in the unexposed group both during, and after surgery (p=.001).</p></div><div><h3>Conclusions</h3><p>In order to reduce the transfusion rate of cardiac patients as much as possible, the optimal time to reinfuse autologous blood from the cell saver should be during the surgery, according to a continuous reinfusion protocol.</p></div>","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 3","pages":"Pages 122-127"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.carcor.2018.05.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91514563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dolor torácico no coronario. Papel del electrocardiograma en el diagnóstico diferencial de la pericarditis aguda y la repolarización precoz","authors":"Bárbara M. Serrano-Muñoz,&nbsp;Sergio Gamaza-Chulián,&nbsp;Rocío Carmona-García,&nbsp;Enrique Díaz-Retamino,&nbsp;Alberto Giráldez-Valpuesta,&nbsp;Dolores Ruiz-Fernández,&nbsp;Dolores Cañadas-Pruaño,&nbsp;Enrique Otero-Chulián","doi":"10.1016/j.carcor.2018.03.003","DOIUrl":"10.1016/j.carcor.2018.03.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Electrocardiogram plays a fundamental role in the differential diagnosis of chest pain. It is sometimes difficult to differentiate these 2 entities: acute pericarditis and early repolarization. The aim of this study was to establish electrocardiographic characteristic to allow their differentiation.</p></div><div><h3>Method</h3><p>We included retrospectively a sample of patients who were hospitalized due to a non ischemic chest pain who showed ST segment elevation on the electrocardiogram between January 2010-December 2015. The patients were classified according to the electrocardiographic evolution and presence/absence of other pericarditis criteria in 2 groups: acute pericarditis and chest pain with a pattern of early repolarization.</p></div><div><h3>Results</h3><p>The study included 93 patients (76 patients with acute pericarditis and 17 patients with early repolarization) and they had a mean age of 35<!--> <!-->±<!--> <!-->15 years, whom 80% were male. The patients with acute pericarditis showed higher ST segment elevation and a bigger ST/T ratio in V5 and V6, being the result statistically significant (<em>P</em> <!-->&lt;<!--> <!-->.001). ST/T ratio in V5 with a cut-off point of 0.19 appears to be the most discriminative parameter in a significant way.</p></div><div><h3>Conclusions</h3><p>ST segment elevation and fundamentally ST/T ratio in V5 and V6 are useful for the differential diagnostic between acute pericarditis and early repolarization.</p></div>","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 3","pages":"Pages 110-115"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.carcor.2018.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90468041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abordaje diagnóstico no invasivo y estratificación del riesgo de la cardiopatía isquémica estable","authors":"María Martín ,&nbsp;Pablo Flórez ,&nbsp;César Morís","doi":"10.1016/j.carcor.2018.01.002","DOIUrl":"10.1016/j.carcor.2018.01.002","url":null,"abstract":"","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 3","pages":"Pages 93-96"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.carcor.2018.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74604198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disección aórtica en mujer joven embarazada. Importancia del manejo multidisciplinar","authors":"Ainhoa Robles-Mezcua,&nbsp;Ana Guijarro-Contreras,&nbsp;Nasiba Abdeselam-Mohamed,&nbsp;Manolo Jiménez-Navarro","doi":"10.1016/j.carcor.2017.09.001","DOIUrl":"10.1016/j.carcor.2017.09.001","url":null,"abstract":"<div><p>We present the case of a 29-year-old pregnant woman that consults in the emergency department because of a stabbing chest pain episode with the diagnosis of type A aortic dissection and with a successful final result for the mother and the newborn due to the multidisciplinary approach finished. Subsequent follow-up was performed in our specialized clinics, being diagnosed the patient of Marfan syndrome. We want to highlight the need and importance of multidisciplinary management of patients with this syndrome, both in diagnosis and in treatment and follow-up.</p></div>","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 3","pages":"Pages e4-e6"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.carcor.2017.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85604314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constricción pericárdica. Una presentación atípica","authors":"Francisco José Caro Fernández, Guillermo Isasti Aizpurua, Ana Manovel Sánchez, Mariola García Lizana, Antonio Gómez Menchero, Jessica Roa Garrido, Jose Luis Gómez Reyes","doi":"10.1016/j.carcor.2017.10.002","DOIUrl":"https://doi.org/10.1016/j.carcor.2017.10.002","url":null,"abstract":"","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"310 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79963606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abordaje terapéutico de la cardiopatía isquémica estable: tratamiento médico versus revascularización coronaria","authors":"Alberto Alperi ,&nbsp;Pablo Avanzas ,&nbsp;Isaac Pascual ,&nbsp;César Morís","doi":"10.1016/j.carcor.2018.04.003","DOIUrl":"10.1016/j.carcor.2018.04.003","url":null,"abstract":"","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 3","pages":"Pages 106-109"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.carcor.2018.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81843717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacto de la etiología de la regurgitación mitral en la mortalidad tardía de pacientes tratados con MitraClip®","authors":"Rafael Campos Arjona,&nbsp;Fernando Carrasco Chinchilla,&nbsp;Alberto López Blázquez,&nbsp;Juan Horacio Alonso Briales,&nbsp;Antonio Jesús Muñoz García,&nbsp;Antonio Domínguez Franco,&nbsp;Manuel Jiménez Navarro,&nbsp;Jose María Hernández García,&nbsp;Eduardo de Teresa Galván","doi":"10.1016/j.carcor.2018.03.002","DOIUrl":"10.1016/j.carcor.2018.03.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Mitral regurgitation is the second most common cause of valvular heart disease, and even though it involves so bad prognosis, almost a half of patients are rejected from surgical treatment. For this cohort of patients, it has treated with MitraClip^® with promising outcomes in both functional and degenerative etiology of mitral regurgitation.</p></div><div><h3>Material and methods</h3><p>Retrosprective observational study about features and outcomes of 72 patients underwent MitraClip^® implantation from November 2011 to October 2016.</p></div><div><h3>Results</h3><p>Mitral regurgitation etiology was functional (61.1%), degenerative (26.4%) or mixed (12.5%). The functional etiology was associated with lower age (67.9<!--> <!-->±<!--> <!-->8.74 vs 74.6<!--> <!-->±<!--> <!-->13.06 years old, <em>P</em> <!-->=<!--> <!-->.21) and lower left ventricular ejection fraction (34<!--> <!-->±<!--> <!-->8.5% vs 57<!--> <!-->±<!--> <!-->15%; <em>P</em> <!-->&lt;<!--> <!-->.001). The median EuroSCORE-II was 3.84 (Q1-Q3 quartile: 2.21-8.10). There was no differences about the number of clips used (1.55<!--> <!-->±<!--> <!-->0.68 functional and 1.64<!--> <!-->±<!--> <!-->0.55 degenerative, <em>P</em> <!-->=<!--> <!-->.53) or the number of days in hospitalary admission after intervention (3.36 functional vs 3.7 degenerative; p<!--> <!-->=<!--> <!-->.56). Regurgitation reduction was partial (more than grade 2) in 4.5% of functional etiology and 14.3% of degenerative etiology (<em>P</em> <!-->=<!--> <!-->.145). No cases of in-hospital mortality or during the first month after discharge were reported. During an average follow up of 24 months it was reported 9 deaths (20.45%) in functional etiology and 2 deaths (7.14%) in degenerative/mixed etiology (<em>P</em> <!-->=<!--> <!-->.13).</p></div><div><h3>Conclusion</h3><p>MitraClip® treatment is safe and effective in patients with both functional and degenerative etiology of mitral regugitation, even though the last one seems to be associated with a lower late mortality rate.</p></div>","PeriodicalId":100216,"journal":{"name":"Cardiocore","volume":"53 3","pages":"Pages 116-121"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91316397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}