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

{"title":"Design of the Spanish registry of structural and coronary interventions indicated in centenarians: observation and inclusion (REDIRECCION registry)","authors":"Manuel Martínez-Sellés, J. Ángel Pérez Rivera, Javier Martín Moreiras, Carolina Robles, María Teresa Vidán, 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}

{"title":"Pulmonary artery growth in Fontan: what is the most effective strategy?","authors":"Neil Derridj,&nbsp;Manon Hily,&nbsp;Olivier Raisky,&nbsp;Regis Gaudin,&nbsp;Mathilde Méot,&nbsp;Lucile Houyel,&nbsp;Sophie Malekzadeh Milani,&nbsp;Damien Bonnet","doi":"10.1016/j.rec.2025.12.005","DOIUrl":"10.1016/j.rec.2025.12.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To model the growth of pulmonary artery (PA) branches in children with a functionally univentricular heart between the Glenn procedure and total cavopulmonary connection (TCPC) and to assess whether anterograde pulmonary blood flow (APBF) promotes growth and influences morbidity and mortality.</div></div><div><h3>Methods</h3><div>Patients with a functionally univentricular heart who underwent cardiac catheterization prior to Glenn and TCPC between 2004 and 2024 were included. Growth was assessed by comparing pre-Glenn and pre-TCPC cross-sectional areas. PA growth was modeled using linear regression.</div></div><div><h3>Results</h3><div>A total of 180 children with a median follow-up of 8.8 years were included: 64 (35.6%) had maintained APBF. PA growth was linear over time (fractional polynomials; <em>P</em> <!-->=<!--> <!-->.20), with an estimated β<!--> <!-->=<!--> <!-->11.6<!--> <!-->mm/y; 95%CI, 5.8-17.4 mm²/y. Maintaining APBF was independently associated with increased PA growth (β<!--> <!-->=<!--> <!-->50.9<!--> <!-->mm; 95%CI, 25.3-76.5 mm²; <em>P</em> &lt;<!--> <!-->.01), independent of TCPC timing. The multivariable model explained 21% of the variance in PA branch growth. Nine-year survival did not differ significantly between the APBF and non-APBF groups: 86.7% (95%CI, 71.9-93.9) vs 73.4% (95%CI, 61.3-82.3), respectively (<em>P</em> <!-->=<!--> <!-->.21). Morbidity outcomes, including length of hospital stay, hemodynamic contraindications to fenestration closure, and Fontan failure rates, were similar between groups.</div></div><div><h3>Conclusions</h3><div>PA growth between the Glenn procedure and TCPC is substantial and can be considered linear, suggesting that delaying TCPC optimizes growth potential. Maintaining APBF accelerates PA growth without increasing morbidity or mortality. Due to considerable interindividual variability, these findings are most meaningful at a group level and should be interpreted with caution when applied to individual patients.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 582-589"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710054","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":"Predictors of poor prognosis in a large cohort of patients with hereditary cardiac transthyretin amyloidosis","authors":"Tomás Ripoll-Vera,&nbsp;Fernando de Frutos,&nbsp;José González-Costello,&nbsp;Ana José Manovel-Sánchez,&nbsp;Esther Zorio-Grima,&nbsp;M. Teresa Bosch-Rovira,&nbsp;José Manuel García-Pinilla,&nbsp;María Robledo-Iñarritu,&nbsp;Javier Limeres-Freire,&nbsp;Ana García-Álvarez,&nbsp;María Gallego-Delgado,&nbsp;María Ángeles Espinosa-Castro,&nbsp;José López-Aguilera,&nbsp;Rosa Macías-Ruiz,&nbsp;María Valverde-Gómez,&nbsp;Xabier Arana-Achaga,&nbsp;Ana Isabel Rodríguez-Serrano,&nbsp;Edgardo Alania-Torres,&nbsp;José Ángel Urbano-Moral,&nbsp;José M. Larrañaga-Moreira,&nbsp;Jorge Álvarez-Rubio","doi":"10.1016/j.rec.2025.12.016","DOIUrl":"10.1016/j.rec.2025.12.016","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Hereditary transthyretin amyloidosis (hATTR) is a rare, multisystemic, autosomal dominant disease. Cardiac involvement worsens prognosis. We aimed to characterize Spanish patients with hATTR cardiac amyloidosis (hATTR-CA) and to identify predictors of poor prognosis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, multicenter study in 39 Spanish hospitals, including adults with genetically confirmed hATTR and cardiac involvement (January 2000-September 2022). Independent predictors of poor prognosis (death, heart transplantation, heart failure, or cardiovascular hospitalization) were identified using multivariate logistic regression. Data were also collected on clinical and genetic characteristics, management patterns, and event-free survival.</div></div><div><h3>Results</h3><div>A total of 442 patients were included (67.6% male; median age at diagnosis, 65 years). Fifteen <em>TTR</em> variants were identified, with p.Val30Met being the most frequent (64.9%). The most common extracardiac manifestation was neuropathy (64.6%). At baseline, most patients were in New York Heart Association class I-II, with progressive worsening during follow-up. Overall, 48.9% of patients were hospitalized, and 21.9% died; 25.3% of deaths were heart failure-related. Five-year event-free survival was 80.2% from symptom onset and 66.9% from diagnosis. Disease-specific treatments (tafamidis, patisiran, inotersen, or liver transplant) were associated with improved survival (<em>P</em> &lt;<!--> <!-->.001). In an exploratory analysis stratified by diagnosis before vs after 2018, event-free survival did not differ significantly (HR, 1.04; 95%CI, 0.63-1.72; <em>P</em> <!-->=<!--> <!-->.88). Independent predictors of poor prognosis included New York Heart Association class II-IV, lower left ventricular ejection fraction, elevated N-terminal pro-B-type natriuretic peptide, and the presence of neurological involvement.</div></div><div><h3>Conclusions</h3><div>This national cohort—the largest reported to date—highlights the clinical and genetic heterogeneity of hATTR -CA in Spain. Early diagnosis and disease-specific therapies are essential to improving prognosis.</div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 618-630"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834887","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":"Influence of sex on surgery of acute type A aortic dissection: mid-term survival and cardiovascular events","authors":"Yolanda Carrascal,&nbsp;Javier Gómez-Pilar,&nbsp;Rocío Bernal,&nbsp;Irene Velasco,&nbsp;Bárbara Segura-Méndez","doi":"10.1016/j.rec.2025.12.013","DOIUrl":"10.1016/j.rec.2025.12.013","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 647-650"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800813","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 stratification of patients with nonobstructive coronary artery disease managed according to invasive coronary function testing","authors":"Eva Rumiz,&nbsp;Georgina Fuertes,&nbsp;Ainhoa Pérez,&nbsp;Guillem Llopis,&nbsp;Luis Cerdán,&nbsp;Pablo Vadillo,&nbsp;Alberto Carrión,&nbsp;Isabel Ezpeleta,&nbsp;Cristina Buisán,&nbsp;Sonia Cardona,&nbsp;Ernesto Valero,&nbsp;Javier Escaned,&nbsp;Julio Núñez","doi":"10.1016/j.rec.2025.11.012","DOIUrl":"10.1016/j.rec.2025.11.012","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Angina or myocardial ischemia with nonobstructive coronary artery disease (ANOCA/INOCA) is associated with an elevated risk of adverse outcomes. This study aimed to evaluate the prognosis of patients with ANOCA/INOCA who received tailored therapy according to their endotype, as defined by invasive coronary function testing (CFT).</div></div><div><h3>Methods</h3><div>This prospective, multicenter observational study included ANOCA/INOCA patients who underwent an invasive CFT. The primary outcome was a composite of total episodes of myocardial infarction, emergency department visits for chest pain, or hospital admissions for angina or heart failure that occurred during a long-term follow-up. Negative binomial regression was used to assess the association between endotypes and total events, with risk estimates expressed as incidence rate ratios (IRR).</div></div><div><h3>Results</h3><div>From January 2020 to November 2023, a total of 308 patients were enrolled. Patients were stratified into 4 endotypes: microvascular dysfunction (n<!--> <!-->=<!--> <!-->141), epicardial spasm (n<!--> <!-->=<!--> <!-->66), microvascular spasm (n<!--> <!-->=<!--> <!-->26), or negative-CFT (n<!--> <!-->=<!--> <!-->75). At a median follow-up of 1.8 years, the incidence rates of the composite outcome per 100 patient-years were 35.3, 12.9, 31.0, and 10.2 in microvascular dysfunction, epicardial spasm, microvascular spasm, and negative-CFT endotypes, respectively (<em>P</em> &lt;<!--> <!-->.001). After multivariable adjustment, microvascular dysfunction emerged as the only independent predictor of the composite outcome (IRR, 3.24; 95%CI, 1.12-9.05; <em>P</em> <!-->=<!--> <!-->.029).</div></div><div><h3>Conclusions</h3><div>Despite tailored medical therapy, ANOCA/INOCA endotype classification revealed significant prognostic differences, with microvascular dysfunction being the endotype associated with the highest burden of recurrent events<strong>.</strong></div></div>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 593-602"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640881","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":"Diffusely positive instantaneous wave-free ratio in the left anterior descending artery: long-term prognosis with medical therapy","authors":"Jorge Perea-Armijo,&nbsp;Adriana Resúa-Collazo,&nbsp;Javier Herrera-Flores,&nbsp;Javier Suárez de Lezo,&nbsp;Soledad Ojeda,&nbsp;Manuel Pan-Álvarez","doi":"10.1016/j.rec.2025.11.017","DOIUrl":"10.1016/j.rec.2025.11.017","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 643-645"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087523","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":"Does that which does not kill us make us stronger?","authors":"Héctor M. García-García,&nbsp;Pablo Rubio,&nbsp;Mauro Echavarría-Pinto","doi":"10.1016/j.rec.2025.12.020","DOIUrl":"10.1016/j.rec.2025.12.020","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":"79 7","pages":"Pages 603-605"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044423","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}