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

{"title":"Effect of low-flow, very low-gradient aortic stenosis on survival and objective functional recovery after TAVI.","authors":"José M de la Torre-Hernández, Gabriela Veiga, Rigoberto Hernández, Nicolás Maneiro Melón, Leire Andraka, Miguel Artaiz, Sergio García-Blas, Ignacio J Amat Santos, Antonio J Muñoz-García, Joaquín Sánchez Gila, Manuel López Pérez, Francisco Ten, Guillermo Galeote, María Cruz Ferrer, Juan Francisco Oteo Domínguez, Luisa Salido, Cristobal Urbano-Carrillo, Tamara García Camarero, Lluis Asmarats, Bruno García Del Blanco, Raquel Del Valle, Luis Nombela, Juan M Ruiz-Nodar, Enrique Gutiérrez, Víctor Fradejas-Sastre, Ander Regueiro, Carlos Cuellas, Valeriano Ruiz Quevedo, Jessica Roa, Soledad Ojeda, Pilar Jiménez Quevedo","doi":"10.1016/j.rec.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.rec.2026.09.002","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>It is unclear how the magnitude of reductions in baseline mean aortic gradient and flow affects clinical outcomes after TAVI. This study aimed to assess the prognostic impact of low-flow very low-gradient (LF-VLG) aortic stenosis on survival and objective functional recovery after TAVI.</p><p><strong>Methods: </strong>Data from the Spanish TAVI Registry were analyzed. Three groups were included: high-gradient (≥ 40 mmHg), low-flow low-gradient (LF-LG) (20-39 mmHg) and LF-VLG (≤ 20 mmHg). A prospective single-center substudy was conducted to evaluate objective functional recovery after TAVI.</p><p><strong>Results: </strong>A total of 17 836 patients were included. Two-year survival was 82% in the high-gradient group (n = 12 800), 79% in the LF-LG group (n = 4126), and 73.2% in the LF-VLG group (n = 495) (P < .0001). In patients with LF-VLG, coronary artery disease and atrial fibrillation, but not ejection fraction, independently predicted mortality. In a cohort of 465 patients, objective improvement was observed in 88% of patients in the high-gradient group, 70% in the LF-LG group, and 57% in the LF-VLG group (P < .0001).</p><p><strong>Conclusions: </strong>Patients with LF-VLG aortic stenosis show reduced but acceptable 2-year survival regardless of ejection fraction and limited functional recovery at 6 months after TAVI. Coronary artery disease and atrial fibrillation were independent predictors of mortality.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116053","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":"Single-operator implantation of the new generation VitaFlow Liberty valve for efficient transcatheter aortic valve implantation: the SINGLE-TAVI study","authors":"Filippo Pensotti,&nbsp;Julio Ruiz Ruiz,&nbsp;Bin Wang,&nbsp;Matias Stejfman,&nbsp;Mario García-Gómez,&nbsp;Ignacio J. Amat-Santos","doi":"10.1016/j.rec.2026.02.010","DOIUrl":"10.1016/j.rec.2026.02.010","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 10","pages":"Pages 868-872"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436114","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":"Spontaneous resolution of an asymptomatic idiopathic coronary artery aneurysm","authors":"Ana Carolina Menezes Borsoi,&nbsp;Cristiane Zambolim,&nbsp;Thiago L. Scudeler","doi":"10.1016/j.rec.2026.01.002","DOIUrl":"10.1016/j.rec.2026.01.002","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 10","pages":"Pages 875-876"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044440","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":"Sex and incident heart failure following acute coronary syndrome. Response.","authors":"Mireia Andrés Villarreal, Emili Vela, Marc Llagostera, Josep Comín-Colet","doi":"10.1016/j.rec.2026.07.009","DOIUrl":"10.1016/j.rec.2026.07.009","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116019","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":"Heart transplantation for cardiac amyloidosis: selection, timing, and challenges in the modern era.","authors":"Daniel Enríquez-Vázquez, Gonzalo Barge-Caballero, María G Crespo-Leiro","doi":"10.1016/j.rec.2026.07.010","DOIUrl":"10.1016/j.rec.2026.07.010","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116091","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":"Percutaneous left atrial appendage occlusion versus oral anticoagulation in patients with atrial fibrillation: a systematic review and meta-analysis.","authors":"Maddalena Immobile Molaro, Cajetan Reichardt, Fiorenzo Simonetti, Doruntina Lahu, Gjin Ndrepepa, Tobias Lenz, Costanza Pellegrini, Moritz von Scheidt, Tobias Rheude, Felix Voll, Héctor Alfonso Álvarez Covarrubias, Teresa Trenkwalder, Hendrik B Sager, Heribert Schunkert, Michael Joner, Adnan Kastrati, Salvatore Cassese, Erion Xhepa","doi":"10.1016/j.rec.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.rec.2026.09.001","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Percutaneous left atrial appendage occlusion (LAAO) has emerged as an alternative to oral anticoagulants (OACs) in patients with atrial fibrillation (AF). However, up-to-date comparisons are lacking. We performed a systematic review and meta-analysis of randomized clinical trials comparing percutaneous LAAO with OACs (either a vitamin K antagonist or a direct oral anticoagulant) in patients with AF.</p><p><strong>Methods: </strong>MEDLINE and EMBASE were searched from inception through March 29, 2026. The primary outcome was all-cause death. Coprimary outcomes were stroke and any bleeding. Secondary outcomes included a composite of ischemic events, systemic embolism, cardiovascular death, ischemic stroke, hemorrhagic stroke, and nonprocedural bleeding. Random-effects meta-analyses were performed using IRRs with 95%CIs. Subgroup and meta-regression analyses were conducted.</p><p><strong>Results: </strong>Seven randomized trials including 7353 patients were analyzed. There were no significant differences between LAAO and OAC in terms of all-cause death (IRR, 0.95; 95%CI, 0.81-1.10), stroke (IRR, 1.00; 95%CI, 0.72-1.39), or any bleeding (IRR, 0.84; 95%CI, 0.64-1.08). LAAO reduced nonprocedural bleeding (IRR, 0.56; 95%CI, 0.45-0.71), but was associated with a numerically higher risk of ischemic stroke (IRR, 1.28; 95%CI, 1.00-1.66). There was a significant interaction between LAAO and the type of OAC regimen in terms of all-cause death (P_interaction = .02).</p><p><strong>Conclusions: </strong>In patients with AF eligible for OACs, there were no significant differences in clinical efficacy between LAAO and OAC, whereas LAAO was associated with a significant reduction in nonprocedural bleeding events. The observed trend toward an increased risk of ischemic stroke requires further investigation.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116032","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":"Prognostic impact of obesity in patients with type A acute aortic syndrome.","authors":"Inés Ramos González-Cristóbal, Carlos Ferrera, Raquel Frías García-Lago, Isaac Martínez, Luis Maroto, Isidre Vilacosta","doi":"10.1016/j.rec.2026.06.014","DOIUrl":"10.1016/j.rec.2026.06.014","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814420","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":"Multiorgan failure and urgent heart transplantation: considerations on its prognostic interpretation. Response.","authors":"Raquel López-Vilella, Francisco González-Vílchez, José González-Costello, Luis Almenar Bonet","doi":"10.1016/j.rec.2026.08.010","DOIUrl":"10.1016/j.rec.2026.08.010","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041140","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":"Gray zone NT-proBNP values and long-term outcomes in emergency department patients without prior heart failure.","authors":"Germán Cediel, María Victoria Rivera-Moreno, Gilmar Pugnet, Ramón Armengol-Naranjo, Juan René Delgado-Cornejo, Jaime Andrés Alba-Rodríguez, Óscar M Peiró, Isabel Serrano-Rodríguez, Ana Carrasquer, José Luis Ferreiro","doi":"10.1016/j.rec.2026.08.011","DOIUrl":"10.1016/j.rec.2026.08.011","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The clinical significance of gray zone N-terminal pro-B-type natriuretic peptide (NT-proBNP) values in the emergency department (ED) remains poorly defined in patients without prior heart failure (HF). We aimed to determine whether, among ED patients without prior HF who did not meet age-adjusted rule-in criteria, gray zone NT-proBNP values were associated with worse long-term outcomes compared with rule-out values.</p><p><strong>Methods: </strong>This retrospective, observational study included consecutive patients presenting to a tertiary care ED between March and August 2022 who underwent NT-proBNP testing. Patients with prior HF or NT-proBNP values above age-adjusted rule-in thresholds were excluded. First HF hospitalization and all-cause mortality were analyzed as 2 separate, independent outcomes.</p><p><strong>Results: </strong>A total of 454 patients were included, of whom 228 (50.2%) had gray zone NT-proBNP values and 226 (49.8%) had rule-out values. During a median follow-up of 2.7 years, patients with gray zone values had significantly higher rates of first HF hospitalization (24.1% vs 2.2%) and mortality (36.4% vs 5.3%). After multivariable adjustment, gray zone NT-proBNP values were associated with first HF hospitalization (subdistribution hazard ratio [HR], 6.53; 95%CI, 2.38-17.89; P <.001) and all-cause mortality (HR, 4.59; 95%CI, 2.35-8.94; P <.001).</p><p><strong>Conclusions: </strong>In ED patients without prior HF, gray zone NT-proBNP values were associated with higher long-term risks of HF hospitalization and all-cause mortality compared with rule-out values. Prospective studies are needed to determine whether structured evaluation of this population improves clinical outcomes.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040903","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":"Spanish heart transplant registry. 37th official report of the Heart Failure Association of the Spanish Society of Cardiology.","authors":"Francisco González-Vílchez, Raquel López-Vilella, Manuel Gómez-Bueno, María G Crespo-Leiro, Manuel Cobo-Belaustegui, Manuel Crespín-Crespín, Carlos Ortiz-Bautista, Andrea Severo-Sánchez, Laura Triguero-Llonch, Elena García-Romero","doi":"10.1016/j.rec.2026.06.018","DOIUrl":"10.1016/j.rec.2026.06.018","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The Spanish Heart Transplant Registry is updated annually with data on all heart transplants (HTs) performed in Spain. This report includes data through 2025. In particular, it analyzes the main characteristics of HTs performed over the past decade (2016-2025).</p><p><strong>Methods: </strong>We performed a descriptive analysis of recipient and donor characteristics, surgical procedures, and follow-up events, as well as their temporal trends since 2016. Data were collected prospectively using a standardized electronic data collection form.</p><p><strong>Results: </strong>In 2025, 390 HTs were performed, the highest annual number recorded in the registry, with 7% performed in pediatric recipients. Since 2016, significant trends have been observed toward lower rates of respiratory disease, previous cardiac surgery, mechanical ventilation, and serum bilirubin levels before HT, together with increased use of extracorporeal membrane oxygenation as pretransplant support. Donors were younger, and ischemic times were shorter. The use of controlled donation after circulatory death increased markedly, accounting for 35% of all HTs performed in 2025. Survival improved (85.5% at 1 year among patients transplanted in 2022-2024), and early mortality (within 30 days) declined to 7.5% in 2025 despite a significant increase in the incidence of severe primary graft dysfunction.</p><p><strong>Conclusions: </strong>HT activity has increased over the past 5 years, largely driven by the growing use of controlled donation after circulatory death. The improvements in early and mid-term survival are confirmed.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009019","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}