Revista española de cardiología (English ed.)最新文献

{"title":"Risk factors for early reintervention in patients with cryopreserved homografts in the pulmonary position.","authors":"Alessia Callegari, Mattia Bernardinetti, Margaux Bernardini, Nicolas Garcelon, Neil Derridj, Damien Bonnet, Regis Gaudin, Olivier Raisky, Sophie Malekzadeh-Milani","doi":"10.1016/j.rec.2026.05.004","DOIUrl":"10.1016/j.rec.2026.05.004","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Cryopreserved homograft implantation in the pulmonary position is a common surgical approach for pulmonary valve replacement, although it carries a risk of early failure requiring reintervention. This study aimed to identify clinical, anatomical, surgical, graft, and postoperative factors associated with early failure, defined as reintervention (percutaneous or surgical) within 3 years.</p><p><strong>Methods: </strong>In this retrospective cohort study (2017-2024), we included 136 patients (median weight 45.0 [IQR: 25.25-60.00] kg; age 14.11 [8.31-18.09] years) who received a homograft in the pulmonary position. Time-to-event analyses were performed to identify factors associated with early failure, including multivariable Cox proportional hazards regression.</p><p><strong>Results: </strong>The most frequent underlying conditions were tetralogy of Fallot in 44.0% and common arterial trunk in 16.9%. The median homograft size was 22 [19-24] mm, and 15 (11%) were aortic homografts. The median follow-up was 4.15 [1.61-5.00] years. Eighteen patients (13.2%) required reintervention at a median of 1.29 [0.72-1.93] years. Reasons for reintervention included postimplantation due to stenosis (n=8), stenosis and infective endocarditis (n=1), and stenosis and regurgitation (n=9). Interventions included percutaneous pulmonary valve implantation (n=5), homograft dilatation (n=3), stenting (n=3), and surgical replacement or heterograft implantation (n=7). Univariate analysis identified significant associations with fever, fever without documented infection, pericardial/mediastinal collection necessitating reintervention, and elevated RVOT velocity on echo (> 2.1 m/s) at discharge. On multivariable Cox regression analysis, fever without documented infection remained independently associated with earlier reintervention (HR, 4.42; 95%CI, 1.34-14.52; P=.014).</p><p><strong>Conclusions: </strong>Early reintervention is associated with postoperative inflammatory markers and immediate suboptimal homograft function. These findings support and refine previous observations on early homograft dysfunction and may help identify patients who warrant closer postoperative surveillance.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158508","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":"Clinical value of ECG-derived markers for risk stratification in sudden cardiac arrest due to Chagas cardiomyopathy.","authors":"Ángela Hernández, João Paulo Madeiro, Roberto C Pedrosa, Pablo Laguna, Julia Ramírez","doi":"10.1016/j.rec.2026.05.005","DOIUrl":"10.1016/j.rec.2026.05.005","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Sudden cardiac arrest (SCA) is a significant complication in the spectrum of Chagas cardiomyopathy (CC) among infected individuals. Although the Rassi score (RS) is the most established tool for predicting mortality, a nonnegligible proportion of low- or intermediate-risk CC patients still experience SCA. This study aimed to evaluate whether electrocardiogram (ECG)-derived ventricular repolarization indices, when combined with the RS, improve SCA risk stratification in low- or intermediate-risk CC patients.</p><p><strong>Methods: </strong>We analyzed 24-hour ECGs from 144 chronic CC patients to derive QT (Δα^QT), T-peak-to-end (Δα^Tpe), T-wave morphology (TMR), and T-peak-to-end morphology (TpeMR) restitution indices. Cox regression models, adjusted for RS, assessed the independent predictive value of each index for SCA. A combined risk model was developed by combining the strongest predictors with RS.</p><p><strong>Results: </strong>Δα^Tpe showed the strongest association with SCA (P <.001) and remained an independent predictor alongside RS and hypertension (HR, 13.6; P=.020). The combined risk model improved sensitivity, balanced accuracy, and negative predictive value for identifying high-risk patients compared with RS alone, although it showed a reduction in specificity and positive predictive value. Moreover, the combined risk model maintained overall discrimination (HR, 23.1 vs RS alone HR, 17.8; both P <.001), providing complementary prognostic information.</p><p><strong>Conclusions: </strong>Δα^Tpe was independently associated with SCA risk in CC. Its combination with the RS improved the identification of high-risk patients but was less effective at detecting low-risk individuals, suggesting a complementary rather than superior role to the RS.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158553","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":"Carbohydrate antigen 125 trajectories during the transitional phase predict short-term outcomes after admission for acute heart failure.","authors":"Rafael de la Espriella, Enrique Santas, Gema Miñana, Miguel Lorenzo, Gonzalo Núñez, Anna Mollar, Enrique Rodríguez, Antoni Bayés-Genís, Marat Fudim, Mark C Petrie, Kieran F Docherty, Vicent Bodí, Juan Sanchis, Eduardo Núñez, Julio Núñez","doi":"10.1016/j.rec.2026.05.003","DOIUrl":"10.1016/j.rec.2026.05.003","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The early postdischarge period after acute heart failure (AHF) hospitalization is marked by high rates of rehospitalization and death, largely driven by residual congestion. Carbohydrate antigen 125 (CA125) is a congestion-sensitive biomarker, yet the prognostic value of its longitudinal trajectory after AHF remains poorly characterized. We aimed to determine whether serial CA125 measurements during the first 6 months postdischarge predict heart failure (HF) rehospitalization and all-cause mortality.</p><p><strong>Methods: </strong>This single-center cohort study included 3980 consecutive AHF patients (October 2008-February 2023) with 6975 serial CA125 measurements (median follow-up, 161.5 days). Log-transformed CA125 trajectories were modeled using spline-fitted joint models linking longitudinal biomarker evolution with recurrent HF rehospitalizations (joint frailty model) and all-cause mortality (Weibull hazard), with adjustment for established clinical covariates.</p><p><strong>Results: </strong>During follow-up, 814 rehospitalizations occurred in 549 patients (20.5%) and there were 604 deaths (15.2%). CA125 displayed a biphasic trajectory: an early postdischarge peak around day 10, a steep decline within the first month, and a gradual reduction thereafter (P <.001). In joint modeling, each log-unit increase in CA125 was associated with a 27% higher risk of recurrent HF rehospitalization (HR, 1.27; 95%CI, 1.17-1.37; P <.001), an association that remained constant over time. The association with mortality was time-dependent (P for interaction <.001), strongest within the first 60 days (HR, ∼1.70), and nonsignificant thereafter.</p><p><strong>Conclusions: </strong>In patients with AHF, serial CA125 measurements display a distinct postdischarge trajectory and independently predict recurrent HF rehospitalizations and early mortality. These findings support the integration of CA125 monitoring into postdischarge management to guide risk stratification and decongestive therapy.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158384","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":"Mental health in adults with congenital heart disease: an overlooked component of specialized follow-up care.","authors":"Agustín Carlos Martín-García, María García de Pedro, Ana Martín-García, Leyre Álvarez-Rodríguez, Beatriz Plata-Izquierdo, Pedro Luis Sánchez-Fernández","doi":"10.1016/j.rec.2026.04.007","DOIUrl":"10.1016/j.rec.2026.04.007","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057420","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":"Growing with the patient: toward a lifespan risk score for pediatric pulmonary hypertension.","authors":"Raquel Luna-López, Ana García-Álvarez","doi":"10.1016/j.rec.2026.05.002","DOIUrl":"10.1016/j.rec.2026.05.002","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057512","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":"Severe myocardial involvement in oculoleptomeningeal hereditary transthyretin amyloidosis.","authors":"Chen-Wen Wang, Chun-Yan Ma, Yong-Huai Wang","doi":"10.1016/j.rec.2026.05.001","DOIUrl":"10.1016/j.rec.2026.05.001","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006985","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":"Serum chloride and the response to hydrochlorothiazide in patients with acute heart failure: a post-hoc analysis from the CLOROTIC trial.","authors":"David García-Escrivá, José Pérez-Silvestre, Julio Núñez, Jesús Casado, José Luís Morales-Rull, Marta Sánchez-Marteles, Alicia Conde-Martel, Pau Llàcer, Prado Salamanca-Bautista, Miguel Ángel Plasín, José Manuel Cerqueiro, Paloma Gil, Luís Manzano, Francesc Formiga, Joan Carles Trullàs","doi":"10.1016/j.rec.2026.04.006","DOIUrl":"10.1016/j.rec.2026.04.006","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Hypochloremia is associated with worse prognosis and diuretic resistance in acute heart failure (AHF). This study investigated whether serum chloride is associated with the efficacy and safety of hydrochlorothiazide in patients with AHF.</p><p><strong>Methods: </strong>This post-hoc analysis included all 230 patients from the CLOROTIC (Safety and efficacy of the combination of loop with thiazide-type diuretics in patients with decompensated heart failure) trial, randomized to oral hydrochlorothiazide or placebo in addition to intravenous furosemide. The impact of baseline serum chloride on the treatment effect of hydrochlorothiazide on the main trial endpoints was assessed.</p><p><strong>Results: </strong>At baseline, hypochloremia (< 96 mmol/L) and hyperchloremia (> 106 mmol/L) were observed in 17% and 9% of patients, respectively. The effect of hydrochlorothiazide was more pronounced in patients with hypo- or normochloremia than in those with hyperchloremia for several efficacy endpoints (weight loss at 72 or 96hours, 24-hour diuresis, and diuresis per milligram of furosemide); only weight loss at 72hours showed a significant interaction (P = .02). However, when baseline chloride was modeled as a continuous variable, no significant interaction was observed with primary or secondary efficacy endpoints. Similarly, no significant interaction was found between serum chloride and the effect of hydrochlorothiazide on mortality or rehospitalization. Regarding safety endpoints, baseline hypochloremia was significantly associated with an increased risk of hypokalemia (potassium< 3.5 mmol/L) in patients allocated to hydrochlorothiazide (P = .029), with no significant interaction between hydrochlorothiazide and baseline chloride for the other safety outcomes.</p><p><strong>Conclusions: </strong>In patients with AHF, the addition of hydrochlorothiazide to loop diuretics enhances decongestion regardless of the baseline serum chloride. (ClinicalTrials.gov: NCT01647932; EudraCT Number: 2013-001852-36).</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976216","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":"Hypertrophic cardiomyopathy in a patient with diabetes and congenital hearing loss.","authors":"Sara Ruiz-Magaña, José Antonio Fernández-Sánchez, Víctor Manuel López-Espinosa","doi":"10.1016/j.rec.2026.03.012","DOIUrl":"10.1016/j.rec.2026.03.012","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934186","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":"Efficacy and clinical safety of TricValve bicaval implantation in patients with cardiac implantable electronic devices.","authors":"Luis Manuel Domínguez-Rodríguez, Luis Nombela-Franco, Roman Pfister, Martin Swaans, Rishi Puri, Ángel Sánchez-Recalde","doi":"10.1016/j.rec.2026.04.003","DOIUrl":"10.1016/j.rec.2026.04.003","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869882","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":"Use of a Y-introducer needle to increase the safety profile of pericardiocentesis.","authors":"Karthikeyan Balakrishnan, Rajeshwari Lingala, Avinash Anantharaj","doi":"10.1016/j.rec.2026.04.004","DOIUrl":"10.1016/j.rec.2026.04.004","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869874","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}