Revista espanola de cardiologia最新文献

{"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}

{"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":"Sarcoma sinovial causante de obstrucción del tracto de salida del VD","authors":"Leizhi Ku ,&nbsp;Youping Chen ,&nbsp;Xiaojing Ma","doi":"10.1016/j.recesp.2024.12.001","DOIUrl":"10.1016/j.recesp.2024.12.001","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 7","pages":"Pages 663-664"},"PeriodicalIF":5.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481506","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":"Implante de desfibrilador en la miocardiopatía chagásica crónica: la puntuación de Rassi de riesgo de muerte para la toma de decisiones","authors":"Juan Carlos Carrion-Arias ,&nbsp;Christina Grüne de Souza e Silva ,&nbsp;Basílio de Bragança Pereira ,&nbsp;Emília Matos do Nascimento ,&nbsp;Roberto Coury Pedrosa","doi":"10.1016/j.recesp.2024.11.002","DOIUrl":"10.1016/j.recesp.2024.11.002","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 5","pages":"Pages 485-486"},"PeriodicalIF":5.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879373","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":"Juan Cosín Aguilar","authors":"Enrique Asín Cardiel","doi":"10.1016/j.recesp.2025.02.006","DOIUrl":"10.1016/j.recesp.2025.02.006","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 6","pages":"Pages 577-578"},"PeriodicalIF":5.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134687","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":"Seguridad precoz tras TAVI según los criterios VARC-3: incidencia, predictores e impacto clínico","authors":"Ariana Gonzálvez-García ,&nbsp;Pedro Cepas-Guillén ,&nbsp;Julien Ternacle ,&nbsp;Marina Urena ,&nbsp;Alberto Alperi ,&nbsp;Asim N. Cheema ,&nbsp;Gabriela Veiga-Fernández ,&nbsp;Luis Nombela-Franco ,&nbsp;Victoria Vilalta ,&nbsp;Giovanni Esposito ,&nbsp;Francisco Campelo-Parada ,&nbsp;Ciro Idolfi ,&nbsp;María del Trigo ,&nbsp;Antonio Muñoz-García ,&nbsp;Nicolás Maneiro ,&nbsp;Luis Asmarats ,&nbsp;Ander Regueiro ,&nbsp;David del Val ,&nbsp;Vicenç Serra ,&nbsp;Vincent Auffret ,&nbsp;Josep Rodés-Cabau","doi":"10.1016/j.recesp.2024.12.005","DOIUrl":"10.1016/j.recesp.2024.12.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The Valve Academic Research Consortium (VARC)-3 definition of the early safety (ES) composite endpoint after transcatheter aortic valve replacement (TAVR) lacks clinical validation. The aim of this study was to determine the incidence, predictors, and clinical impact of ES after TAVR as defined by VARC-3 criteria.</div></div><div><h3>Methods</h3><div>We performed a multicenter study including 10 078 patients with severe aortic stenosis undergoing transarterial TAVR. According to VARC-3 criteria, ES at 30 days was defined as freedom from all-cause mortality, stroke, VARC type 2-4 bleeding, major vascular, access-related, or cardiac structural complications, acute kidney injury stages 3-4, moderate or severe aortic regurgitation, new permanent pacemaker implantation, and surgery or intervention related to the device. Baseline, procedural, and follow-up data were prospectively collected in a dedicated database.</div></div><div><h3>Results</h3><div>ES was achieved in 6598 patients (65.5%). The main factors associated with a lack of ES were the occurrence of type 2-4 bleeding (18.9%), and new pacemaker implantation (13.6%). Advanced age, peripheral artery disease, chronic kidney disease, and balloon postdilation were associated with an increased risk of no-ES (<em>P</em> <!-->&lt;<!--> <!-->.01 for all). Failure to achieve ES was associated with higher all-cause mortality up to 1-year after TAVR (HR, 3.17; 95%CI, 2.76-3.65; <em>P</em> <!-->&lt;<!--> <em>.</em>001).</div></div><div><h3>Conclusions</h3><div>VARC-3 ES was not achieved in up to one-third of contemporary TAVR patients, which was associated with worse mid-term outcomes. The factors associated with increased risk were advanced age, baseline comorbidities, and some procedural features (postdilation). These findings highlight the importance of continued efforts to minimize the risk of TAVR-related procedural complications.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 7","pages":"Pages 618-627"},"PeriodicalIF":5.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481499","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":"Comentarios a la guía ESC 2024 sobre el diagnóstico y tratamiento de la fibrilación auricular","authors":"Grupo de Trabajo de la SEC para la guía ESC 2024 sobre el diagnóstico y tratamiento de la fibrilación auricular y Comité de Guías de la SEC","doi":"10.1016/j.recesp.2024.10.011","DOIUrl":"10.1016/j.recesp.2024.10.011","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 4","pages":"Pages 291-295"},"PeriodicalIF":5.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706254","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 calcificación valvular aórtica en el TAVI. ¿Debemos dar la vuelta a los conceptos previos?","authors":"Alberto Alperi ,&nbsp;Raquel del Valle ,&nbsp;Pablo Avanzas","doi":"10.1016/j.recesp.2024.12.009","DOIUrl":"10.1016/j.recesp.2024.12.009","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 6","pages":"Pages 519-520"},"PeriodicalIF":5.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134693","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}