Revista espanola de cardiologia最新文献

{"title":"Comentarios a la guía ESC 2024 sobre el diagnóstico y el tratamiento de los síndromes coronarios crónicos","authors":"Grupo de Trabajo de la SEC sobre la guía ESC 2024 sobre el diagnóstico y el tratamiento de los síndromes coronarios crónicos y el Comité de Guías de la SEC","doi":"10.1016/j.recesp.2024.10.009","DOIUrl":"10.1016/j.recesp.2024.10.009","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 170-175"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descarga precoz y evolución clínica en pacientes con miocarditis fulminante sometidos a ECMO-VA: resultados de un estudio retrospectivo multicéntrico","authors":"Minjung Bak ,&nbsp;Junho Hyun ,&nbsp;Hyukjin Park ,&nbsp;Hyung Yoon Kim ,&nbsp;Seonhwa Lee ,&nbsp;In-Cheol Kim ,&nbsp;So Ree Kim ,&nbsp;Mi-Na Kim ,&nbsp;Kyung-Hee Kim ,&nbsp;Jeong Hoon Yang","doi":"10.1016/j.recesp.2024.06.005","DOIUrl":"10.1016/j.recesp.2024.06.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides effective cardiocirculatory support in patients with fulminant myocarditis, the most effective timing of venting is uncertain. We aimed to investigate the benefit of early venting among patients who underwent VA-ECMO for fulminant myocarditis.</div></div><div><h3>Methods</h3><div>Among 841 patients with acute myocarditis from 7 hospitals in the Republic of Korea, 217 patients with fulminant myocarditis who underwent VA-ECMO were included in this analysis. The patients were categorized into 2 groups: an early unloading group that underwent venting within 24<!--> <!-->hours of ECMO insertion, and the no or delayed unloading group. The primary outcome was a composite of death, cardiac replacement, or cardiovascular rehospitalization.</div></div><div><h3>Results</h3><div>Among 217 patients, 56 underwent early venting, 54 underwent delayed venting, and 107 did not undergo venting. On spline curves in 110 patients who underwent venting, rapid deterioration was observed as the timing of venting was delayed. The incidence of the primary outcome was lower in the early venting group than in the no or delayed unloading group (37.5% vs 58.4%; HR, 0.491; 95%CI, 0.279-0.863; <em>P</em> <!-->=<!--> <!-->.014). Among patients not experiencing the primary outcome within 6 months, clinical outcomes were similar after 6 months (<em>P</em> <!-->=<!--> <!-->.375).</div></div><div><h3>Conclusions</h3><div>Early left heart unloading within 24<!--> <!-->hours of ECMO insertion is associated with a lower risk of a composite of death, cardiac replacement therapy, and cardiovascular rehospitalization in patients with fulminant myocarditis undergoing VA-ECMO. Registered at ClinicalTrials.gov (NCT05933902).</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 176-184"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trombo intraventricular gigante con múltiples embolismos: ¿anticoagulación o cirugía?","authors":"Diana Ladera Santos ,&nbsp;Ignacio Gallo Fernández ,&nbsp;Manuel Anguita Sánchez","doi":"10.1016/j.recesp.2024.08.008","DOIUrl":"10.1016/j.recesp.2024.08.008","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 282-283"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervención dirigida por catéter en la embolia aguda de pulmón. Posicionamiento SEC-Asociación de Cardiología Intervencionista/SEC-Asociación de Cardiopatía Isquémica y Cuidados Agudos Cardiovasculares/SEC-GT Hipertensión Pulmonar","authors":"Pablo Salinas ,&nbsp;Ana Belén Cid Álvarez ,&nbsp;Pablo Jorge Pérez ,&nbsp;María Eugenia Vázquez-Álvarez ,&nbsp;Alfonso Jurado-Román ,&nbsp;Miriam Juárez ,&nbsp;Miguel Corbí-Pascual ,&nbsp;Maite Velázquez Martín ,&nbsp;Jesús Jiménez-Mazuecos ,&nbsp;Sandra Ofelia Rosillo Rodríguez ,&nbsp;Valeriano Ruiz Quevedo ,&nbsp;María Lázaro ,&nbsp;Ana Viana-Tejedor ,&nbsp;Javier Martín Moreiras ,&nbsp;Roberto Martín-Asenjo","doi":"10.1016/j.recesp.2024.09.006","DOIUrl":"10.1016/j.recesp.2024.09.006","url":null,"abstract":"<div><div>Pulmonary embolism (PE) is the leading cause of hospital death and the third most frequent cause of cardiovascular mortality. Traditionally, treatment options have included anticoagulation, thrombolysis, or surgery; however, catheter-directed interventions (CDI), including catheter-directed thrombolysis and aspiration thrombectomy, have been developed for patients with intermediate- or high-risk PE. These techniques can rapidly improve right ventricular function, hemodynamic status, and mortality in some patients, although there is a lack of evidence from randomized controlled trials. This document, prepared by the Interventional Cardiology Association, the Association of Ischemic Heart Disease and Acute Cardiovascular Care, and the Working Group on Pulmonary Hypertension of the Spanish Society of Cardiology (SEC), reviews the current recommendations and available evidence on the management of PE. It emphasizes the importance of rapid response teams, risk stratification, and early patient monitoring in identifying candidates for reperfusion. Based on existing clinical evidence on CDI, the document discusses various clinical scenarios and provides guidance on patient selection, particularly in situations of uncertainty due to insufficient evidence. Lastly, it describes periprocedural support, highlighting the necessary multidisciplinary approach to improve outcomes and reduce morbidity and mortality in patients with PE.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 239-251"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vía transapical para reemplazo percutáneo de válvula mitral por valvulopatía: una experiencia ibérica","authors":"Eva Gutiérrez-Ortiz ,&nbsp;Javier Cobiella ,&nbsp;Christian Muñoz-Guijosa ,&nbsp;Rui C. Teles ,&nbsp;Rodrigo Estévez-Loureiro ,&nbsp;Vanessa Moñivas ,&nbsp;Ander Regueiro ,&nbsp;Sara Blasco-Turrión ,&nbsp;Patricia Mahía ,&nbsp;Danela Figuereo Beltre ,&nbsp;Pedro Freitas ,&nbsp;Miguel Piñón ,&nbsp;Ignacio J. Amat-Santos ,&nbsp;Ignasi Julià Amill ,&nbsp;Tiago Nolasco ,&nbsp;Daniel Pereda ,&nbsp;Carlos Martín López ,&nbsp;Luis Nombela-Franco","doi":"10.1016/j.recesp.2024.07.009","DOIUrl":"10.1016/j.recesp.2024.07.009","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Transcatheter mitral valve replacement (TMVR) is an emerging treatment alternative for mitral valve (MV) disease in patients who were ineligible for surgical intervention or edge-to-edge repair. This study aimed to assess the short- and mid-term outcomes of this procedure.</div></div><div><h3>Methods</h3><div>We conducted a prospective registry to include the initial experience with symptomatic, consecutive patients who underwent TMVR using the transapical Tendyne system at 7 centers in the Iberian Peninsula. Baseline clinical and imaging data, periprocedural information, and follow-up assessments were collected at 1 month and 1 year.</div></div><div><h3>Results</h3><div>A total of 40 patients (mean age 78.5 years [76-82], 47,5% males) underwent TMVR. The majority had significant surgical risk, comorbidities, and advanced functional class. All patients had significant mitral regurgitation (MR), except for 2 with severe stenosis. Previous MV intervention and off-label indication for the procedure were present in 4 (10.0%) and 8 (20.0%) patients, respectively. Technical success was recorded in 100%, device success in 95.0%, and procedural success in 85.0% at 30-day. All-cause mortality was 2.5% and 17.5% at the 1-month and 1-year follow-up, respectively. MR reduction (≤ 1) and functional class improvement (NYHA I-II) were observed at 1 year in 93.9% and 87.9% of survivors, respectively.</div></div><div><h3>Conclusions</h3><div>Treatment with TMVR produced enduring resolution of MV disease and notable functional enhancement at 1 year of follow-up. The procedure demonstrated a satisfactory early safety profile, although 1-year mortality remained relatively high in this high-risk population.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 229-238"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Un marcapaso o un marcapasos?","authors":"Fernando A. Navarro","doi":"10.1016/j.recesp.2024.09.001","DOIUrl":"10.1016/j.recesp.2024.09.001","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Page 163"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinación aislada de sodio urinario en pacientes ambulatorios con insuficiencia cardiaca","authors":"Miguel Lorenzo ,&nbsp;Rafael de la Espriella ,&nbsp;Gema Miñana ,&nbsp;Gonzalo Núñez ,&nbsp;Arturo Carratalá ,&nbsp;Enrique Rodríguez ,&nbsp;Enrique Santas ,&nbsp;Neus Valls ,&nbsp;Sandra Villar ,&nbsp;Víctor Donoso ,&nbsp;Antoni Bayés-Genís ,&nbsp;Juan Sanchis ,&nbsp;Julio Núñez","doi":"10.1016/j.recesp.2024.07.003","DOIUrl":"10.1016/j.recesp.2024.07.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Spot determination of urinary sodium (UNa+) has emerged as a useful tool for monitoring diuretic response in patients with acute heart failure (AHF). However, the evidence in outpatients is scarce. We aimed to examine the relationship between spot UNa+ levels and the risk of mortality and worsening heart failure (WHF) events in individuals with chronic HF.</div></div><div><h3>Methods</h3><div>This observational and ambispective study included 1145 outpatients with chronic HF followed in a single center specialized HF clinic. UNa+ assessment was carried out 1-5 days before each visit. The endpoints of the study were the association between UNa+ and risk of <em>a)</em> long-term death and <em>b)</em> AHF-hospitalization and total WHF events (including AHF-hospitalization, emergency department visits or parenteral loop-diuretic administration in HF clinic), assessed by multivariate Cox and negative binomial regressions.</div></div><div><h3>Results</h3><div>The mean<!--> <!-->±<!--> <!-->standard deviation of age was 73<!--> <!-->±<!--> <!-->11 years, 670 (58.5%) were men, 902 (78.8%) were on stable NYHA class II, and 595 (52%) had LFEF ≥<!--> <!-->50%. The median (interquartile range) UNa+ was 72 (51-94) mmol/L. Over a median follow-up of 2.63 (1.70-3.36) years, there were 293 (25.6%) deaths and 382 WHF events (244 AHF-admissions) in 233 (20.3%) patients. After multivariate adjustment, baseline UNa+ was inverse and linearly associated with the risk of total WHF (IRR, 1.07; 95%CI, 1.02-1.12; <em>P</em> <!-->=<!--> <!-->.007) and AHF-admissions (IRR, 1.08; 95%CI, 1.02-1.14; <em>P</em> <!-->=<!--> <!-->.012) and borderline associated with all-cause mortality (HR, 1.04; 95%CI, 0.99-1.09; <em>P</em> <!-->=<!--> <!-->.068).</div></div><div><h3>Conclusions</h3><div>In outpatients with chronic HF, lower UNa+ was associated with a higher risk of recurrent WHF events.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 185-195"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacto de la natriuresis en el empeoramiento de la función renal durante un episodio de insuficiencia cardiaca aguda","authors":"Pedro Caravaca Pérez ,&nbsp;Ignacio Fernández-Herrero ,&nbsp;José Jesús Broseta ,&nbsp;Nikein Ibarra-Márquez ,&nbsp;Zorba Blázquez-Bermejo ,&nbsp;Juan Carlos López-Azor ,&nbsp;César Del Castillo Gordillo ,&nbsp;Marta Cobo Marcos ,&nbsp;Javier de Juan Bagudá ,&nbsp;María Dolores García Cosío ,&nbsp;Ana García-Álvarez ,&nbsp;Marta Farrero ,&nbsp;Juan F. Delgado","doi":"10.1016/j.recesp.2024.07.011","DOIUrl":"10.1016/j.recesp.2024.07.011","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Worsening renal function (WRF) is a frequent complication in acute heart failure (AHF) with a controversial prognostic value. We aimed to study the usefulness of natriuresis to evaluate WRF.</div></div><div><h3>Methods</h3><div>We conducted an observational, prospective, multicenter study of patients with AHF who underwent a furosemide stress test. The patients were classified according to whether WRF was present or absent and according to the median natriuretic response. The main endpoint was the combination of mortality, rehospitalization due to HF, and heart transplant at 6 months of follow-up.</div></div><div><h3>Results</h3><div>One hundred and fifty-six patients were enrolled, and WRF occurred in 60 (38.5%). The patients were divided into 4 groups: <em>a)</em> 47 (30.1%) no WRF/low UNa (UNa ≤ 109 mEq/L); <em>b)</em> 49 (31.4%) no WRF/high UNa (UNa &gt;<!--> <!-->109 mEq/L); <em>c)</em> 31 (19.9%) WRF/low UNa and <em>d)</em> 29 (18.6%) WRF/high UNa. The parameters of the WRF/low UNa group showed higher clinical severity and worse diuretic and decongestive response. The development of WRF was associated with a higher risk of the combined event (HR, 1.88; 95%CI, 1.01-3.50; <em>P</em> <!-->=<!--> <!-->.046). When stratified by natriuretic response, WRF was associated with an increased risk of adverse events in patients with low natriuresis (HR, 2.28; 95%CI, 1.15-4.53; <em>P</em> <!-->=<!--> <!-->.019), but not in those with high natriuresis (HR, 1.18; 95%CI, 0.26-5.29; <em>P</em> <!-->=<!--> <!-->.826).</div></div><div><h3>Conclusions</h3><div>Natriuresis could be a useful biomarker for interpreting and prognosticating WRF in AHF. WRF is associated with a higher risk of adverse events only in the context of low natriuresis.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 196-205"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibidores del cotransportador 2 de sodio-glucosa, agonistas del receptor de péptido 1 similar al glucagón y mortalidad por cáncer. Registro de la práctica real","authors":"David García-Vega ,&nbsp;Sergio Cinza-Sanjurjo ,&nbsp;Carlos Tilves-Bellas ,&nbsp;Sonia Eiras ,&nbsp;José R. González-Juanatey","doi":"10.1016/j.recesp.2024.07.004","DOIUrl":"10.1016/j.recesp.2024.07.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1ra) reduce cardiovascular events through different mechanisms, but their association with cancer remains unclear. The aim of this study was to compare the effect of combined treatment (SGLT2i and GLP1ra) and monotherapy (SGLT2i or GLP1ra) on hospitalization and/or death from cancer in a general population and a subgroup of patients with cardiovascular disease (CVD).</div></div><div><h3>Methods</h3><div>We conducted a nonconcurrent observational prospective study of patients prescribed SGLT2i, GLP1ra, or both. Multinomial propensity scores were performed in the entire population and in a subgroup of patients with CVD. A multivariate Cox regression analysis was used to determine the hazard ratio (HR) for age, sex, risk factors, and treatment for each outcome.</div></div><div><h3>Results</h3><div>We included 14 709 patients (11366 with SGLT2i, 1016 with GLP1ra, and 2327 with both treatments) from treatment initiation. Diabetes was present in 97% of the patients. The subgroup with CVD included 4957 (33.7%) patients. After a median of 33 months of follow-up, the risk of adverse cancer events was similar between patients with and without CVD (3.4% or 3.7%, respectively). The main risk factors for cancer mortality were male sex and age. Combined treatment and its duration reduced the risk of cancer mortality compared with monotherapy with SGLT2i or GLP1ra in the overall population (HR, 0.2216; 95%<span>C</span>I, 0.1106-0.4659; <em>P</em> <!-->&lt;<!--> <!-->.001; and HR, 0.1928; 95%CI, 0.071-0.5219; <em>P</em> <!-->=<!--> <!-->.001, respectively) and in the subgroup of patients with CVD (HR, 0.2879; 95%CI, 0.0878-0.994; <em>P</em> <!-->&lt;<!--> <!-->.049; and HR, 0.1329; 95%CI, 0.024-0.6768; <em>P</em> <!-->=<!--> <!-->.014, respectively).</div></div><div><h3>Conclusions</h3><div>Initiation of combined therapy (SGLT2i and GLP1ra) vs monotherapy with SGLT2i or GLP1ra was associated with a lower risk of cancer mortality, mostly in diabetic patients with or without CVD. Although clinical trials are needed, these results might be explained by the complementary mechanisms of these drugs, including their antiproliferative, anti-inflammatory, and metabolic effects. Future clinical trials and mechanistic studies will clarify the possible role of these drugs in carcinogenesis.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 218-228"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143507969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planos transgástricos: complemento en la evaluación de la orejuela izquierda","authors":"Lucía Fernández Gassó ,&nbsp;Esther Pérez David ,&nbsp;Raúl Moreno","doi":"10.1016/j.recesp.2024.10.015","DOIUrl":"10.1016/j.recesp.2024.10.015","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 284-285"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}