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

{"title":"Exercise-induced ventricular ectopy with RBBB morphology suggests underlying myocardial fibrosis in inherited left ventricular cardiomyopathy.","authors":"Elena Sola-García, Francisco J Bermúdez-Jiménez, Carlos Gómez-Navarro, José Ángel Urbano-Moral, Eva Cabrera-Borrego, Luis Tercedor-Sánchez, Pablo Javier Sánchez-Millán, Rosa Macías-Ruíz, Juan Jiménez-Jáimez","doi":"10.1016/j.rec.2026.08.005","DOIUrl":"10.1016/j.rec.2026.08.005","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Inherited left ventricular cardiomyopathies (iLVC) are genetic disorders characterized by myocardial remodeling and fibrosis, predisposing patients to ventricular arrhythmias. The prevalence of exercise-induced right bundle branch block-pattern ventricular ectopy (EI-RBBB-VE) and its relationship with myocardial fibrosis in iLVC remain poorly characterized. We aimed to assess the prevalence and characteristics of EI-RBBB-VE in iLVC and its association with myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR).</p><p><strong>Methods: </strong>In this multicenter, cross-sectional study, 77 patients with genetically characterized iLVC underwent CMR and treadmill exercise testing. The presence, morphology, and timing of EI-RBBB-VE were assessed.</p><p><strong>Results: </strong>EI-RBBB-VE was present in 48.1% of patients and was significantly more frequent in those with LGE (LGE(+)) than in those without LGE (LGE(-)) (61.0% vs 33.3%; P=.015). Patients with LGE exhibited a lower arrhythmic threshold, with earlier ectopy onset (median 36 [IQR, 7-174] vs 117 [85-414] seconds; P=.008) and ectopy occurring at a lower percentage of predicted maximal heart rate (52% vs 67%; P=.022). The prevalence of LGE did not differ between low- and high-burden ectopy groups (62.5% vs 66.7%; P=1.0). On multivariable analysis, EI-RBBB-VE was independently associated with myocardial fibrosis (OR, 3.92; 95%CI, 1.28-12; P=.017), whereas resting Holter ectopic burden and genotype positivity were not.</p><p><strong>Conclusions: </strong>EI-RBBB-VE is common in iLVC and is independently associated with myocardial fibrosis on CMR. Earlier exercise-induced ectopy also identifies patients with fibrosis, supporting exercise testing as an accessible tool for detecting an underlying fibrotic substrate beyond resting ECG, Holter monitoring, and genotype.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851467","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":"Early changes in pulmonary arterial systolic pressure after transcatheter edge-to-edge mitral valve repair and their association with outcomes.","authors":"Gaspard Suc, MyLien Nguyen, Caroline Chong-Nguyen, Mustafa Habib, Jorge Nuche, Manuel Giráldez, Fernando Sarnago-Cebada, Isaac Pascual, Iria Silva, Jean-Michel Paradis, Josep Rodés-Cabau, Grégory Ducrocq, Jules Mesnier, Bernard Iung, Fabien Praz, Marina Urena","doi":"10.1016/j.rec.2026.08.004","DOIUrl":"10.1016/j.rec.2026.08.004","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Transcatheter edge-to-edge repair (TEER) is a treatment for high-surgical-risk patients with severe mitral regurgitation. While pulmonary hypertension (PH) predicts poor outcomes after mitral surgery, its impact after TEER remains uncertain. The aim of this study was to assess early changes in systolic pulmonary arterial pressure (sPAP) after TEER and their association with outcomes.</p><p><strong>Methods: </strong>This multicenter, retrospective cohort study included 378 patients undergoing TEER between 2012 and 2023. sPAP was measured by transthoracic echocardiography before the procedure and on day 1. PH was defined as sPAP> 50 mmHg pre-TEER and> 40 mmHg post-TEER. Patients were classified into 4 groups: no PH (no PH before or after TEER), new PH (normal baseline sPAP with postprocedural PH), normalized PH (baseline PH with normalization after TEER), and persistent PH (PH before and after TEER). The primary endpoint was a composite of all-cause mortality, heart failure hospitalization, or mitral valve reintervention at 2 years.</p><p><strong>Results: </strong>Median age was 80 [interquartile range, 74-85] years, and 43% were women; 39% had baseline PH. Post-TEER, 24% developed new PH and 27% had persistent PH, resulting in residual PH in 51% of patients. Predictors of residual PH included age (aOR, 1.03/y), chronic lung disease (aOR, 2.20), baseline sPAP> 50 mmHg (aOR, 3.44), and higher postprocedural transmitral gradient (aOR, 1.18/mmHg), while primary mitral regurgitation was protective (aOR, 0.48). Unlike baseline PH, residual PH was independently associated with the primary endpoint (aHR, 2.26).</p><p><strong>Conclusions: </strong>Residual PH is common after TEER and is independently associated with adverse outcomes. Early postprocedural sPAP assessment may refine risk prognostication.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841497","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":"When every second counts: outcomes and predictors of survival in acute total occlusion of the left main coronary artery.","authors":"Michał Chyrchel, Anna Stanaszek, Natalia Zabawa, Jan Roczniak, Artur Dziewierz, Stanisław Bartuś","doi":"10.1016/j.rec.2026.08.003","DOIUrl":"10.1016/j.rec.2026.08.003","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814435","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":"Prevalent and incident heart failure hospitalization in patients with significant tricuspid regurgitation: insights from a competing risk analysis.","authors":"Jorge Segovia-Reyes, Paloma Márquez-Camas, Jesús Carmona-Carmona, Diego Félix Arroyo Moñino, Marinela Chaparro-Muñoz, Matías Soler-González, Manuel García Del Río, Teodora Egido de la Iglesia, Mora Murri, José Raúl López Salguero, David Couto-Mallón, Miguel Romero-Cuevas, Nelsa González Aguado, Arancha Díaz Expósito, Francesco Costa, Gemma Sánchez-Espín, Francisco Javier Pavón-Morón, Jorge Rodríguez-Capitán, Manuel Jiménez-Navarro","doi":"10.1016/j.rec.2026.07.006","DOIUrl":"10.1016/j.rec.2026.07.006","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Tricuspid regurgitation (TR) is closely linked to heart failure (HF). However, the burden and predictors of HF hospitalization at diagnosis and during follow-up have not been fully characterized, particularly after accounting for the competing risk of death.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter cohort study including 757 patients with significant TR. Prevalent HF was defined as HF hospitalization at the time of diagnosis. Among patients without prevalent HF, the cumulative incidence of first HF hospitalization was assessed using competing risk analysis, with all-cause mortality treated as a competing event. Multivariable models were used to identify independent predictors.</p><p><strong>Results: </strong>At diagnosis, 260 patients (34.4%) were hospitalized for HF. Male sex, right-sided HF, left ventricular systolic dysfunction, and TR etiologies related to ventricular dysfunction or pulmonary hypertension were independently associated with prevalent HF. Among patients without prevalent HF (n=497), the cumulative incidence of HF hospitalization was 16.4% at 1 year and 44.3% at 7 years. Independent predictors of incident HF included prior HF hospitalization (sHR, 2.08; 95%CI, 1.50-2.87), NYHA functional class III-IV (sHR, 1.70; 95%CI, 1.24-2.35), and higher pulmonary artery systolic pressure (sHR, 1.01; 95%CI, 1.00-1.02). Tricuspid valve surgery was associated with a lower risk of HF hospitalization (sHR, 0.56; 95%CI, 0.33-0.96).</p><p><strong>Conclusions: </strong>HF hospitalization is common in patients with significant TR, both at diagnosis and during follow-up. HF hospitalization at the time of diagnosis identifies an advanced clinical phenotype, while incident hospitalization remains frequent after accounting for the competing risk of death.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799054","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":"In-person and remote volunteering in cardiology: the SECoopera program experience.","authors":"Jordi Bañeras, Sofía Cuenca, Sonia Mirabet, Sandra Roncero, Eduard Ródenas-Alesina, Marta Farrero","doi":"10.1016/j.rec.2026.05.012","DOIUrl":"10.1016/j.rec.2026.05.012","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707845","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":"Is population-based cardiovascular screening feasible in primary care? Results from the PreveCardio program.","authors":"Christian Bengoa Terrero, Jesús Flores Soler, José Enrique Villares Rodríguez, Tania Blanco Maestro, Carlos Vergara Uzcategui, Marian Bas Villalobos, María Del Rosario Azcutia Gómez, José Ignacio Ten Morón, Carla Peinado Escobar, Cristina Fernández Pérez, Elena Melero Cabadas, Julián Pérez-Villacastín, Almudena Quintana Morgado, Isidre Vilacosta","doi":"10.1016/j.rec.2026.07.005","DOIUrl":"10.1016/j.rec.2026.07.005","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Cardiovascular diseases are the leading cause of mortality in Spain, yet there is no systematic population-based cardiovascular screening program. This study evaluated the feasibility of a nurse-led, single-visit cardiovascular screening program in primary care (PreveCardio), and identified the prevalence of modifiable cardiovascular risk factors, their associated socioeconomic factors, and the translation of pilot findings into regional health policy.</p><p><strong>Methods: </strong>We conducted a cross-sectional study across 42 primary care centers in a Spanish region (January-March 2023). A random sample of 8491 individuals aged 50 to 75 years was invited to participate. Trained nurses performed a single 30-minute visit with point-of-care measurements (blood pressure, lipid profile, HbA1c) and validated questionnaires. Multivariable logistic regression models were fitted with Benjamini-Hochberg correction.</p><p><strong>Results: </strong>A total of 3545 individuals participated (41.8%; mean age 61.2±7.3 years; 56.7% women). The completeness of clinical data exceeded 99%. Elevated blood pressure was identified in 40.4%, obesity in 29.5%, nonoptimal low-density lipoprotein cholesterol in 48.7%, prediabetes in 30.7%, and active smoking in 19.5%. Smoking showed the steepest socioeconomic gradient (aOR, 3.25; 95%CI, 2.09-5.03). The direct cost per participant was €11.75.</p><p><strong>Conclusions: </strong>A nurse-led, single-visit cardiovascular screening program is operationally feasible in Spanish primary care, revealing a high burden of modifiable cardiovascular risk factors and significant socioeconomic disparities. Smoking showed the steepest income-associated gradient. This pilot study led to the approval of the first systematic cardiovascular screening program in a Spanish autonomous community.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680162","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.","authors":"Manuel Martínez-Sellés","doi":"10.1016/j.rec.2026.08.001","DOIUrl":"10.1016/j.rec.2026.08.001","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702213","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":"Evaluation of risk factor-weighted and coronary artery calcium score-weighted clinical likelihoods as gatekeepers before advanced ischemia testing","authors":"Simon M. Frey,&nbsp;Igor G. Schneider,&nbsp;Ann-Sophie Otto,&nbsp;Florian M. Geiser,&nbsp;Fiona Nafaa,&nbsp;Gabrielle Huré,&nbsp;Jinju Elavathingal,&nbsp;Karolina Sobolewska,&nbsp;Klara Rumora,&nbsp;Damian Wild,&nbsp;Philip Haaf,&nbsp;Felix Mahfoud,&nbsp;Christian E. Mueller,&nbsp;Michael J. Zellweger","doi":"10.1016/j.rec.2025.12.017","DOIUrl":"10.1016/j.rec.2025.12.017","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Gatekeeper strategies using risk factor-weighted clinical likelihood (RF-CL), alone or combined with coronary artery calcium score-weighted clinical likelihood (CACS-CL), may reduce the number of normal scans, radiation exposure, and health care costs.</div></div><div><h3>Methods</h3><div>Three diagnostic algorithms based on RF-CL and CACS-CL were evaluated in 1792 patients (mean age 65<!--> <!-->± 11 years; 43% female) referred for rubidium-82 (⁸²Rb) positron emission tomography (PET). Algorithm 1 deferred testing if RF-CL ≤ 5%. Algorithm 2 reclassified patients with RF-CL &gt;<!--> <!-->5%-15% using CACS-CL and deferred testing if either RF-CL or CACS-CL was ≤ 5%. Algorithm 3 deferred testing if CACS-CL ≤ 5%. Missed diagnoses, normal scans, radiation exposure, and costs were compared with the current reference standard (CACS<!--> <!-->+<!--> <!-->PET). Endpoints were defined as small ischemia (summed difference score [SDS] ≥ 2) and relevant ischemia (≥ 10% of the myocardium).</div></div><div><h3>Results</h3><div>Median RF-CL and CACS-CL were 11% [6-19] and 12% [3-28], respectively. Algorithm 1 reduced radiation exposure and costs by 22.0% while maintaining high gatekeeper performance (sensitivity/negative predictive value [NPV]: 92.7%/98.2%). Algorithm 2 deferred the largest proportion of patients (36.4%) but missed small ischemia in 2.0%. Algorithm 3 demonstrated the best overall gatekeeper performance, reducing radiation exposure by 28.7% and costs by 29.7% without compromising diagnostic accuracy (sensitivity/NPV: 93.2%/98.4% for small ischemia and 97.0%/99.7% for relevant ischemia).</div></div><div><h3>Conclusions</h3><div>Refining RF-CL in all patients and deferring testing when CACS-CL ≤ 5% provided the most effective gatekeeper strategy in patients with suspected chronic coronary syndromes.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 8","pages":"Pages 658-666"},"PeriodicalIF":4.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991138","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":"Selection of standards for measuring patient-reported outcomes in cardiology departments of the Spanish National Health System (PROMCAR 1)","authors":"Luis Rodríguez Padial,&nbsp;Andrés Íñiguez Romo,&nbsp;José Luis Bernal Sobrino,&nbsp;Ángel Cequier Fillat,&nbsp;María Teresa San Saturnino,&nbsp;Concepción Cruzado Álvarez,&nbsp;Rocío García Orta,&nbsp;Rafael Hidalgo Urbano,&nbsp;Francisco Javier Elola Somoza,&nbsp;Nicolás Rosillo Ramírez,&nbsp;Josebe Goirigolzarri Artaza,&nbsp;Ignacio Fernández Lozano,&nbsp;on behalf of the PROMCAR project committees and working groups","doi":"10.1016/j.rec.2026.02.013","DOIUrl":"10.1016/j.rec.2026.02.013","url":null,"abstract":"<div><div>The PROMCAR project, promoted by the Spanish Society of Cardiology and the Spanish Heart Foundation, aims to improve the health and experience of patients treated in cardiology departments within the Spanish National Health System. Its scope includes the use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). The PROMCAR project was structured in 3 phases. This study addressed the first phase: the selection of questionnaires. Under the scientific direction of the steering committee, working groups were established to select a generic PROM and specific PROMs for 5 clinical conditions, as well as PREMs. Key decisions were made using an adapted consensus development conference methodology. Four previously validated questionnaires available in Spanish-language versions were unanimously selected. Recommendations were also formulated regarding the identification of target populations and the administration of the questionnaires. The selected questionnaires constitute a reference standard for implementation across cardiology departments within the Spanish National Health System, as well as for the development of a digital data analytics platform to support clinical decision-making and benchmarking to improve quality of care.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 8","pages":"Pages 713-720"},"PeriodicalIF":4.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176790","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":"Computed tomography versus cardiac magnetic resonance for myocardial late enhancement quantification","authors":"Cristina García-Sebastián,&nbsp;Juan Manuel Monteagudo Ruiz,&nbsp;Sonia Antoñana Ugalde,&nbsp;Javier Moreno,&nbsp;José Luis Zamorano,&nbsp;Covadonga Fernández-Golfín","doi":"10.1016/j.rec.2025.12.015","DOIUrl":"10.1016/j.rec.2025.12.015","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 8","pages":"Pages 726-729"},"PeriodicalIF":4.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805387","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}