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

{"title":"Spanish founder variant in MYBPC3: implications of diagnostic criteria, clinical phenotype, and prognosis.","authors":"Angel Júdez-Serrano, Jesús Wagih-Gómez, Serena Munteanu, Natalia Sonicheva-Paterson, Connie Bezzina, Iacopo Olivotto, Roberto Barriales-Villa, William J McKenna, María Sabater-Molina, Juan R Gimeno","doi":"10.1016/j.rec.2026.08.009","DOIUrl":"https://doi.org/10.1016/j.rec.2026.08.009","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>MYBPC3 is the most frequently mutated gene in hypertrophic cardiomyopathy (HCM). This study presents the clinical phenotype of a founder variant in MYBPC3, p.Arg891Alafs*160, present in 47 families from southern Spain, and compares it with other described founder truncating variants in MYBPC3.</p><p><strong>Methods: </strong>We studied 259 relatives of 47 index cases with HCM carrying the p.Arg891Alafs*160 variant. Clinical evaluation, including recently proposed diagnostic criteria, pedigree analysis and genotyping in relation to outcomes, were performed.</p><p><strong>Results: </strong>A total of 159 carriers of p.Arg891Alafs*160 (age, 48.8 ± 19.6 years; 40.3% female) were identified, of whom 90 (57.0%, 30.0% female) had HCM. The mean age of affected individuals was 57.1 ± 15.0 years, mean maximal left ventricular hypertrophy (LVH) was 19.0 ± 5.7 mm, and 20 (22.5%) had left ventricular obstruction. Age, sex and body surface area correction altered the proportion of men and women with HCM. There were 8 adverse cardiac events: 1 sudden death, 1 resuscitated cardiac arrest, 2 implantable cardioverter-defibrillator discharges, 2 transplants, and 2 heart failure deaths. Disease penetrance increased with age, and men developed disease 8.0 years earlier than women. This variant had a lower annual sudden death rate than other MYBPC3 truncating variants.</p><p><strong>Conclusions: </strong>MYBPC3 p.Arg891Alafs*160 is a founder truncating variant associated with HCM. Affected carriers present with incomplete penetrance, moderate LVH, and disease onset in middle age. Implementation of age, sex and body surface area-normalized LVH cutoffs for the diagnosis of HCM has an impact on the proportion of affected females.</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":"149008971","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 implantable cardioverter-defibrillator registry. 22nd official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2025).","authors":"Javier Jiménez-Candil, Vicente Bertomeu González, Eduardo Arana Rueda, Joaquín Osca Asensi, David Calvo","doi":"10.1016/j.rec.2026.06.019","DOIUrl":"https://doi.org/10.1016/j.rec.2026.06.019","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>This article presents data on implantable cardioverter-defibrillator (ICD) implantation in Spain in 2025.</p><p><strong>Methods: </strong>The registry is based on data submitted by participating centers after device implantation to the Spanish Society of Cardiology Heart Rhythm Association registry through CardioDispositivos, the online platform of the national registry. Additional data sources included: a) data provided by device manufacturers and distributors; b) local databases submitted by implanting centers; and c) the ICD Technical Report. Implantation rates were calculated using population data from the Spanish National Institute of Statistics.</p><p><strong>Results: </strong>In 2025, 200 hospitals participated in the registry. A total of 8637 devices were reported, compared with 9076 reported by Eucomed (European Confederation of Medical Suppliers Associations). The overall implantation rate was 182 implants per million inhabitants (the second highest in the history of the registry), with substantial variation among the autonomous communities. Only 18% of ICD implantations were performed in women.</p><p><strong>Conclusions: </strong>The registry data for 2025 reflect virtually all ICD implantations performed in Spain. The number of implantations remained close to the highest levels recorded to date, although marked differences persisted among the autonomous communities.</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":"149009047","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 pacemaker registry. 23rd official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2025).","authors":"Rocío Cózar-León, Francisco Javier García-Fernández, Josep Navarro-Manchón, Adolfo Fontenla, Manuel Molina-Lerma, David Calvo","doi":"10.1016/j.rec.2026.07.008","DOIUrl":"10.1016/j.rec.2026.07.008","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>This report presents data on cardiac pacing system implantation in Spain in 2025.</p><p><strong>Methods: </strong>The registry is based on information provided by implanting centers to the Heart Rhythm Association of the Spanish Society of Cardiology following device implantation, through the national online registry platform, CardioDispositivos. Additional sources of information included: a) data provided by device manufacturers and distributors; b) the European pacemaker patient identification card; and c local databases submitted by implanting centers.</p><p><strong>Results: </strong>A total of 136 hospitals participated in the registry, 8 more than in 2024, and 26 130 devices were reported (1% fewer than in 2024). These accounted for 53% of all device implantations billed in Spain, with considerable geographical variation. The number of cardiac resynchronization therapy devices remained stable, whereas implantation of leadless pacemakers increased markedly (+ 62%). The most frequent indication was atrioventricular block, and the most commonly used pacing mode was DDD/R. Left bundle branch area pacing was reported in 27.3% of implants, and the axillary venous approach was used more often than the subclavian approach. Remote monitoring continued to increase overall, although its use declined for leadless pacemakers and cardiac resynchronization defibrillators.</p><p><strong>Conclusions: </strong>Participation in the Spanish pacemaker registry has stabilized, with data reported for 53% of implanted devices. The continued uptake of emerging therapies, such as conduction system pacing and leadless pacemaker implantation, is particularly noteworthy. Substantial geographical variation persists across all pacing modalities.</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":"149009053","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 kidney function in a large contemporary ambulatory heart failure cohort.","authors":"Marta Cobo Marcos, Rafael de la Espriella, Jara Gayán Ordás, Pau Llàcer, Isabel Zegrí-Reiriz, Aleix Fort, Inés Ponz de Antonio, Ana Méndez, Zorba Blázquez-Bermejo, Pedro Caravaca Pérez, Jorge Rubio Gracia, Alejandro Recio-Mayoral, José Manuel García Pinilla, Esther Montero Hernández, Almudena Castro, María José Soler, José Luis Górriz, Ramón Bascompte Claret, Paula Fluvià-Brugués, Luis Manzano, Julio Núñez","doi":"10.1016/j.rec.2026.08.002","DOIUrl":"10.1016/j.rec.2026.08.002","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Kidney dysfunction is common in chronic heart failure (CHF), but its prognostic significance in contemporary populations remains uncertain. We evaluated 1-year outcomes according to kidney function stage and the prognostic role of the estimated glomerular filtration rate (eGFR).</p><p><strong>Methods: </strong>We analyzed 1105 patients with CHF enrolled in the CARDIOREN Registry (13 centers, 2021-2022). Kidney function was categorized according to CKD-EPI eGFR (≥ 60, 30-59,<30mL/min/1.73 m²). The primary endpoint was the composite of all-cause death or worsening heart failure at 1 year; all-cause mortality was analyzed separately. Associations were assessed using multivariable Cox regression models with fractional polynomial modeling.</p><p><strong>Results: </strong>Median age was 75 years, 63% of patients were men, and 38% had heart failure with preserved ejection fraction. Overall, 59% had eGFR <60mL/min/1.73 m². At 1 year, the composite endpoint occurred in 24% of patients, and all-cause mortality occurred in 13%. Event rates increased progressively with worsening kidney function categories for the primary endpoint (11%, 31%, and 38%; P <.001) and for all-cause mortality (4%, 16%, and 26%; P <.001). In multivariable analysis, N-terminal pro-B-type natriuretic peptide, hemoglobin, and furosemide-equivalent dose were independently associated with both outcomes. Hemoglobin showed a U-shaped association, with higher risk at both low and high concentrations. CA125 was independently associated with all-cause mortality. eGFR was not independently associated with the composite endpoint but remained independently associated with all-cause mortality, showing a nonlinear inverse relationship.</p><p><strong>Conclusions: </strong>In this contemporary CHF population, worse kidney function identified patients with a more adverse clinical profile and poorer outcomes, although these associations were attenuated after adjustment for congestion markers and disease severity.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814390","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 an extravascular congestion score and its interaction with SGLT2 inhibitor therapy in patients hospitalized for acute heart failure.","authors":"Pau Llàcer, Esteban Pérez Pisón, François Croset, Alberto Pérez Nieva, Jorge Campos, Marina García Melero, Carlos Pérez, Marina Vergara, Paul Cevallos Castro, Juan Esteban Oyuela Rodríguez, María Pumares, Cristina Fernández, Martín Fabregate, Beatriz Del Hoyo, Julio Núñez, Luis Manzano","doi":"10.1016/j.rec.2026.08.008","DOIUrl":"10.1016/j.rec.2026.08.008","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Congestion is the main driver of hospitalization and adverse outcomes in acute heart failure (AHF), with tissue-predominant volume expansion frequently persisting despite loop diuretic therapy. We evaluated whether an extravascular congestion score (ECS) identifies high-risk patients and modifies the prognostic effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i).</p><p><strong>Methods: </strong>We prospectively studied 821 patients hospitalized for AHF. ECS at discharge was defined as the sum of 3 variables: antigen carbohydrate 125> 35 U/mL, peripheral edema, and pleural effusion (range 0-3). The primary endpoint was a composite of all-cause mortality or heart failure rehospitalization at 1 year. Multivariable Cox models assessed associations between ECS and outcomes and tested the interaction with SGLT2i use at discharge.</p><p><strong>Results: </strong>During follow-up, the primary endpoint occurred in 436 patients (53.5%). Higher ECS was associated with a stepwise increase in risk. Compared with ECS 0, adjusted HRs were 1.72 (95%CI, 1.04-2.85; P=.034) for ECS 1 and 2.39 (95%CI, 1.29-4.43; P=.006) for ECS 2. A significant interaction was observed between ECS and SGLT2i use (P for interaction=.029). SGLT2i use was not associated with improved outcomes in ECS 0 (HR, 1.21; P=.462) but was associated with numerically lower risk in ECS 1 (HR, 0.76; P=.065), and with a marked risk reduction in ECS 2 (HR, 0.45; P=.003).</p><p><strong>Conclusions: </strong>ECS identifies AHF patients at high risk due to residual tissue congestion. The association between SGLT2i use and improved outcomes was more pronounced with increasing extravascular congestion burden.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913673","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 differences in preoperative cardiac damage in patients with primary mitral regurgitation: impact on surgical outcomes.","authors":"Lucía Barriales, Fabián Islas, Manuel Carnero, Patricia Landín, Jorge García-Onrubia, Daniel Pérez-Camargo, Lourdes Montero, María Rivadeneira, Sandra Gil-Abizanda, Eduardo Pozo, J Alberto de Agustín, Carmen Olmos","doi":"10.1016/j.rec.2026.08.007","DOIUrl":"10.1016/j.rec.2026.08.007","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Prior evidence suggests that women have worse outcomes after surgery for mitral regurgitation (MR). We aimed to examine sex-related differences in preoperative cardiac damage among patients with severe primary MR and to assess the impact of these differences on surgical outcomes.</p><p><strong>Methods: </strong>We performed a retrospective analysis of a prospective cohort of patients undergoing surgery for primary MR at a tertiary hospital (2014-2022). Baseline clinical and echocardiographic data and 1-year outcomes (all-cause mortality and heart failure [HF] hospitalizations) were compared by sex.</p><p><strong>Results: </strong>A total of 349 patients were included; 154 (44%) were female. Women were older, had a higher comorbidity burden and were more frequently symptomatic at the time of surgery. Compared with men, women had significantly more advanced (right-sided) cardiac damage before surgery (54.5% vs 36.5%; P=.017), greater impairment of left ventricular global longitudinal strain and left atrial reservoir strain, and worse right ventricular-pulmonary arterial coupling. Mitral valve repair was more common in men, whereas women more often required concomitant tricuspid valve repair. At 1 year, the incidence of HF hospitalizations was higher in women (7% vs 1%; HR, 2.41; 95%CI, 1.14-6.30), and there was a nonsignificant trend toward higher all-cause mortality (11% vs 6.2%; HR, 1.72; 95%CI, 0.79-3.76).</p><p><strong>Conclusions: </strong>Women with primary MR were more often symptomatic at the time of surgery, presented with more advanced biventricular and left atrial dysfunction preoperatively, and had higher HF hospitalization rates after surgery. New strategies are needed to ensure equitable management and outcomes between sexes.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913622","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.","authors":"Andrés Carrillo López, Pablo Ruiz de Gopegui Miguelena, Javier Miguelena Hycka","doi":"10.1016/j.rec.2026.06.017","DOIUrl":"10.1016/j.rec.2026.06.017","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913583","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":"First partial heart transplant in Spain.","authors":"Juan-Miguel Gil-Jaurena, Ramón Pérez-Caballero, Ana Pita, Carlos Pardo, Nuria Gil-Villanueva, Manuela Camino","doi":"10.1016/j.rec.2026.06.016","DOIUrl":"10.1016/j.rec.2026.06.016","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913556","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":"Current indications for cardiac magnetic resonance and cardiac computed tomography: a position statement from the Cardiovascular Imaging Association of the Spanish Society of Cardiology.","authors":"José Antonio Parada-Barcia, Álvaro Rodríguez-Pérez, Rocío Eiros-Bachiller, Marinela Chaparro-Muñoz, José Rodríguez-Palomares, Covadonga Fernández-Golfin, Manuel Barreiro-Pérez","doi":"10.1016/j.rec.2026.06.015","DOIUrl":"10.1016/j.rec.2026.06.015","url":null,"abstract":"<p><p>Cardiac magnetic resonance and cardiac computed tomography have become essential imaging modalities in the evaluation of patients with a wide spectrum of cardiovascular diseases, providing valuable anatomical and functional information for clinical decision-making, prognostic stratification, and therapeutic planning. Their indications and clinical applications have expanded considerably in recent years; however, accessibility and implementation remain uneven among health care settings. To facilitate and promote access to these techniques, the Cardiovascular Imaging Association of the Spanish Society of Cardiology has prepared this position statement, which brings together, in a structured format, the main recommendations of the European Society of Cardiology regarding their use. The document promotes the implementation of these modalities through specialized training for health care professionals, the use of well-established indications, and the prioritization of applications with high clinical impact in cardiovascular medicine.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913567","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":"Prescription of medical therapy and postdischarge outcomes in patients hospitalized with HFrEF: insights from the ICARUS registry.","authors":"Luis E Echeverría, Lyda Z Rojas, Angie Yarlady Serrano-García, Daniel Botero, Karen Andrea García-Rueda, Ángela Torres-Bustamante, Diana Ivonne Cañón-Gómez, Juan Sebastián Salcedo, Alexandra Hurtado-Ortiz, Jaime A Rodríguez, Sergio A Gómez-Ochoa","doi":"10.1016/j.rec.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.rec.2026.08.006","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Guidelines recommend early initiation of the 4 pillars of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF), but real-world evidence on quadruple therapy (QT) at discharge remains limited in Latin America.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of consecutive patients with HFrEF discharged from a tertiary cardiovascular center in Colombia (2022-2026). Patients were classified as receiving QT, defined as all 4 GDMT pillars, or incomplete therapy (IT, 0-3 pillars). Propensity-score optimal full matching was performed using 26 covariates. The primary endpoint was 30-day death or readmission. The robustness of the mortality findings was assessed using the primary estimator and 4 sensitivity analyses.</p><p><strong>Results: </strong>Among 3839 patients (median age, 68.2 years; 71.2% male), 2758 (71.8%) were discharged on QT. The 30-day composite endpoint occurred in 751 patients (19.6%). QT was associated with a lower risk of death or readmission (RR, 0.71; 95%CI, 0.58-0.88; P = .001). Mortality showed a consistent direction of association (RR, 0.61; 95%CI, 0.37-1.01; P = .052), with the 95%CI excluding unity in all 4 sensitivity analyses. Readmission was lower with QT (cause-specific HR, 0.73; 95%CI, 0.56-0.95; P = .017). Findings in the Chagas subgroup (n = 614) were directionally consistent with those in the overall cohort, with no significant treatment-by-subgroup interaction.</p><p><strong>Conclusions: </strong>In this Latin American HFrEF cohort, QT at discharge was associated with a lower risk of 30-day death or readmission. The magnitude of the mortality association may partly reflect residual confounding rather than a pharmacological effect. These findings support the feasibility of QT prescription in a tertiary care setting in a low- and middle-income country.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875851","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}