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

{"title":"SYNTAX score for assessing coronary artery disease burden and complexity: past, present, and future.","authors":"Zixiang Ye, Jiaxi Cheng, Joost Daemen, Roberto Diletti, Luca Testa, José M de la Torre-Hernández, Shengnan Liu, Haoyu Wang, Enmin Xie, Adrian P Banning, Kefei Dou, Ernest Spitzer","doi":"10.1016/j.rec.2026.06.010","DOIUrl":"10.1016/j.rec.2026.06.010","url":null,"abstract":"<p><p>The anatomical synergy between percutaneous coronary intervention with TAXUS and cardiac surgery (SYNTAX) score remains a cornerstone for quantifying coronary artery disease complexity and guiding decisions between percutaneous coronary intervention and coronary artery bypass grafting. Developed from the SYNTAX trial in 2009, the score uses a standard methodological approach to systematically define coronary lesion attributes and yields an overall score that allows stratification of coronary complexity. A commonly accepted stratification divides patients into low (≤ 22), intermediate (23-32), and high (≥ 33) SYNTAX score, with higher categories associated with an increased risk of adverse cardiovascular events. This review article traces the history, evolution, and integration of the SYNTAX score in ESC and ACC/AHA guidelines. We also discuss its role in clinical trials and its contribution to Heart Team deliberations in patients with complex coronary artery disease. Patient benefits include adding precision for treatment selection with a historical potential to lower mortality in high-score cases by favoring coronary artery bypass grafting. Artificial intelligence and advanced imaging, such as coronary computed tomography angiography, are advancing automated, noninvasive SYNTAX score computation with superior accuracy. Future directions involve artificial intelligence-hybrid models for real-time, personalized assessments. This review article evaluates the enduring impact of the SYNTAX score and its evolving role in precision medicine.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425171","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":"Worsening renal function in acute heart failure: a hemoconcentration-conditioned interpretation with ranges of benefit, safety, and harm.","authors":"Agustín Fernández-Cisnal, Rafael de la Espriella, Pedro López-Ayala, Gemma Donaire, Gema Miñana, Enrique Santas, César Romero Menor, Miguel Lorenzo, Marta Cobo-Marcos, Pau Llàcer, José Luis Górriz, Jan Biegus, Julio Núñez","doi":"10.1016/j.rec.2026.06.008","DOIUrl":"10.1016/j.rec.2026.06.008","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Creatinine increases during acute heart failure treatment may occur in the setting of hemoconcentration and decongestion, but the ranges of creatinine increase associated with lower risk, safety, or harm remain poorly defined.</p><p><strong>Methods: </strong>We studied 2043 consecutive hospitalizations for acute heart failure between 2014 and 2021. The main exposures were the maximum in-hospital increase in creatinine (ΔCr) and hemoglobin change (ΔHb). Models used restricted cubic splines for ΔCr, continuous ΔHb, and their interaction. Mortality and composite endpoints were analyzed with Cox models; first all-cause and heart failure rehospitalization were analyzed using Fine-Gray models. The primary ΔHb contrast was the observed interquartile range reporting contrast (+1.3g/dL), rather than a subgroup cutoff.</p><p><strong>Results: </strong>The median age was 77 [69-83] years and 57.6% of hospitalizations involved male patients. In the context of hemoconcentration, ΔCr ranges associated with lower risk were identified for mortality (0.10-0.18mg/dL), first all-cause rehospitalization (0.06-0.25mg/dL), first heart failure rehospitalization (0.00-0.32mg/dL), and the composite of death or first all-cause rehospitalization (0.10-0.23mg/dL). Harm thresholds were observed above 0.61, 0.98, and 0.91mg/dL, respectively; no harm threshold was identified for heart failure rehospitalization.</p><p><strong>Conclusions: </strong>Among patients hospitalized with acute heart failure who achieved hemoconcentration, small creatinine increases were associated with lower risk, whereas larger increases were associated with a loss of benefit and, for some endpoints, harm. These findings support a continuous, context-dependent interpretation of worsening renal function during decongestive therapy.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406261","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":"Infective endocarditis involving a right atrial false tendon.","authors":"Renata Forcada Barreda, Iñaki Villanueva Benito, Itziar Solla Ruiz","doi":"10.1016/j.rec.2026.05.008","DOIUrl":"10.1016/j.rec.2026.05.008","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406216","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":"LVAD-associated cardiac tamponade: an atypical echocardiographic image.","authors":"Mario José Recio Ibarz, Ana Marcén Miravete, Diana Cristina Batin","doi":"10.1016/j.rec.2026.06.009","DOIUrl":"10.1016/j.rec.2026.06.009","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406265","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":"Dissecting septal aneurysm as a complication of a coronary artery fistula","authors":"Leizhi Ku ,&nbsp;Di Zhou ,&nbsp;Xiaojing Ma","doi":"10.1016/j.rec.2025.10.008","DOIUrl":"10.1016/j.rec.2025.10.008","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 651-652"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148357687","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":"Pulmonary artery growth and antegrade flow in staged single-ventricle palliation: one size may fit only some","authors":"Antonio J. Cartón Sánchez,&nbsp;María Luz Polo López,&nbsp;Enrique José Balbacid Domingo","doi":"10.1016/j.rec.2025.12.019","DOIUrl":"10.1016/j.rec.2025.12.019","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 590-592"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999089","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":"Design of the Spanish registry of structural and coronary interventions indicated in centenarians: observation and inclusion (REDIRECCION registry)","authors":"Manuel Martínez-Sellés,&nbsp;J. Ángel Pérez Rivera,&nbsp;Javier Martín Moreiras,&nbsp;Carolina Robles,&nbsp;María Teresa Vidán,&nbsp;Ana Belén Cid Álvarez","doi":"10.1016/j.rec.2025.11.016","DOIUrl":"10.1016/j.rec.2025.11.016","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 645-647"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041693","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 implications of coronary microvascular dysfunction in STEMI with and without metabolic syndrome","authors":"Qian Guo,&nbsp;Yingying Guo,&nbsp;Shutian Shi,&nbsp;Hui Wang,&nbsp;Bin Que,&nbsp;Lei Xu,&nbsp;Hongtao Liu,&nbsp;Shaoping Nie,&nbsp;Deyong Long,&nbsp;Xiao Wang","doi":"10.1016/j.rec.2025.12.007","DOIUrl":"10.1016/j.rec.2025.12.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Metabolic syndrome (MetS) is associated with coronary microvascular dysfunction (CMD), both of which increase the risk of cardiovascular events after ST-segment elevation myocardial infarction (STEMI). However, the prognostic significance of CMD in STEMI patients with MetS remains unclear. This study aimed to evaluate the effects of CMD, assessed by the angiography-derived index of microcirculatory resistance, on cardiovascular outcomes in STEMI patients with and without MetS.</div></div><div><h3>Methods</h3><div>STEMI patients undergoing primary percutaneous coronary intervention were prospectively enrolled at 4 centers. MetS was defined as the presence of at least 3 out of 5 cardiometabolic abnormalities. CMD was defined as an angiography-derived index of microcirculatory resistance<!--> <!-->&gt; 40 U.</div></div><div><h3>Results</h3><div>Among 497 included patients, 316 (63.8%) patients had MetS. During 2.8 years follow-up, the cumulative incidence of adverse outcomes was significantly higher in the CMD group than in the non-CMD group among patients with MetS (30.3% vs 18.4%; <em>P</em> <!-->=<!--> <!-->.034), but not among those without MetS (12.6% vs 13.0%; <em>P</em> <!-->=<!--> <!-->.937). Both the presence of CMD and the angiography-derived index of microcirculatory resistance as a continuous variable predicted adverse outcomes in patients with MetS, but not in those without MetS. CMD was also significantly associated with left ventricular dysfunction (OR, 3.909; 95%CI, 1.330-11.489; <em>P</em> <!-->=<!--> <!-->.013) and lack of left ventricular ejection fraction recovery (OR, 3.367; 95%CI, 1.099-10.318; <em>P</em> <!-->=<!--> <!-->.034) at follow-up, independently of baseline function.</div></div><div><h3>Conclusions</h3><div>CMD assessed by the angiography-derived index of microcirculatory resistance independently predicts adverse outcomes and lack of left ventricular functional recovery in STEMI patients with MetS, but not in those without MetS.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 606-617"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783177","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":"Transcatheter closure of ostium secundum atrial septal defects: echocardiogram predictors of device embolization","authors":"Grégoire Albenque,&nbsp;Estibaliz Valdeolmillos,&nbsp;Marine Cachanado,&nbsp;Jérôme Petit,&nbsp;Clément Batteux,&nbsp;Sébastien Hascoët","doi":"10.1016/j.rec.2025.11.015","DOIUrl":"10.1016/j.rec.2025.11.015","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 640-643"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640861","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":"Left atrioventricular coupling index and atrial fibrillation and stroke in hypertrophic cardiomyopathy: a CMR study","authors":"Martina De Raffele,&nbsp;Guillem Casas,&nbsp;Victoria Delgado,&nbsp;Germán Cediel,&nbsp;Andrea Faggiano,&nbsp;Francisco González-Santorum,&nbsp;Leydimar Adel Anmad-Shihadeh,&nbsp;Arnau Subira-Ingla,&nbsp;Gladys Juncà,&nbsp;Gizem Kasa,&nbsp;Cristina Conte,&nbsp;Jerremy Weerts,&nbsp;Matteo Bertini,&nbsp;José F. Rodríguez-Palomares,&nbsp;Albert Teis","doi":"10.1016/j.rec.2026.01.001","DOIUrl":"10.1016/j.rec.2026.01.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Left atrial remodeling is common in hypertrophic cardiomyopathy (HCM) and is associated with atrial fibrillation (AF) and thromboembolic events. However, currently available AF risk prediction models perform poorly in patients with HCM. The left atrioventricular coupling index (LACI) is a novel imaging marker that integrates left atrial size and left ventricular filling properties and has emerged as a potential indicator of atrial remodeling and AF risk. This study aimed to evaluate the association between LACI and new-onset AF, transient ischemic attack, or ischemic stroke in patients with HCM.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 287 patients with HCM without a prior history of AF, transient ischemic attack, or ischemic stroke who underwent cardiac magnetic resonance imaging between 2014 and 2022. Left atrial and left ventricular volumes were measured, and LACI was calculated as the ratio of minimum left atrial volume to left ventricular end-diastolic volume. Patients were categorized into tertiles according to LACI. Left atrial strain analysis was performed. Cox proportional hazards models assessed the association between LACI and a composite endpoint including AF, transient ischemic attack, or ischemic stroke.</div></div><div><h3>Results</h3><div>During a median follow-up of 60 months, 51 patients (17.9%) reached the composite endpoint. Patients in the highest LACI tertile (≥ 36%) had a significantly higher risk of AF or thromboembolic events (adjusted HR, 2.88; 95%CI, 1.27–6.51; <em>P</em> &lt;<!--> <!-->.001). Left atrial booster strain was also independently associated with adverse outcomes.</div></div><div><h3>Conclusions</h3><div>LACI and left atrial booster strain are independently associated with new-onset AF and thromboembolic events in patients with HCM.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 631-639"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935466","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}