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de Juan Bagudá J, de Frutos F, López-Vilella R, Couto Mallón D, Guzman-Bofarull J, Blazquez-Bermejo Z, Cobo-Belaustegui M, Mitroi C, Pastor-Pérez FJ, Moliner-Abós C, Rangel-Sousa D, Díaz-Molina B, Tobar-Ruiz J, Salterain Gonzalez N, García-Pinilla JM, García-Cosío Carmena MD, Crespo-Leiro MG, Dobarro D, Almenar L, Delgado-Jiménez JF, Paredes-Galán E, González-Vílchez F, González-Costello J. Repetitive ambulatory levosimendan as a bridge to heart transplantation. Rev Esp Cardiol (Engl Ed) 2024; 77:290-301. [PMID: 37516313 DOI: 10.1016/j.rec.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/07/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION AND OBJECTIVES Repetitive ambulatory doses of levosimendan are an option as a bridge to heart transplantation (HT), but evidence regarding the safety and efficacy of this treatment is scarce. The objective of the LEVO-T Registry is to describe the profile of patients on the HT list receiving levosimendan, prescription patterns, and clinical outcomes compared with patients not on levosimendan. METHODS We retrospectively reviewed all patients listed for elective HT from 2015 to 2020 from 14 centers in Spain. RESULTS A total of 1015 consecutive patients were included, of whom 238 patients (23.4%) received levosimendan. Patients treated with levosimendan had more heart failure (HF) admissions in the previous year and a worse clinical profile. The most frequent prescription pattern were fixed doses triggered by the patients' clinical needs. Nonfatal ventricular arrhythmias occurred in 2 patients (0.8%). No differences in HF hospitalizations were found between patients who started levosimendan in the first 30 days after listing and those who did not (33.6% vs 34.5%; P=.848). Among those who did not, 102 patients (32.9%) crossed over to levosimendan after an HF admission. These patients had a rate of 0.57 HF admissions per month before starting levosimendan and 0.21 afterwards. Propensity score matching analysis showed no differences in survival at 1 year after listing between patients receiving levosimendan and those who did not (HR, 1.03; 95%CI, 0.36-2.97; P=.958) or in survival after HT (HR, 0.97; 95%CI, 0.60-1.56; P=.958). CONCLUSIONS Repetitive levosimendan in an ambulatory setting as a bridge to heart transplantation is commonly used, is safe, and may reduce HF hospitalizations.
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Affiliation(s)
- Javier de Juan Bagudá
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Spain.
| | - Fernando de Frutos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardíaca Avanzada y Trasplante, Servicio de Cardiología, Hospital Universitari de Bellvitge. BIOHEART-Cardiovascular diseases group; Cardiovascular, Respiratory and Systemic Diseases and cellular aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Raquel López-Vilella
- Unidad de Insuficiencia Cardíaca y Trasplante, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - David Couto Mallón
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | | | | | - Manuel Cobo-Belaustegui
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Cristina Mitroi
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Madrid, Spain
| | | | - Carlos Moliner-Abós
- Servicio de Cardiología, Instituto Investigación Biomédica (IIB) SANT PAU, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Diego Rangel-Sousa
- Unidad de Insuficiencia Cardíaca y Trasplante Cardíaco, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Beatriz Díaz-Molina
- Servicio de Cardiología, Área Gestión Clínica (AGC) del Corazón, Hospital Universitario Central de Asturias, Asturias, Spain
| | - Javier Tobar-Ruiz
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - José Manuel García-Pinilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain
| | - María Dolores García-Cosío Carmena
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - María Generosa Crespo-Leiro
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Grupo de Investigación Cardiovascular (GRINCAR), Universidad de A Coruña (UDC), A Coruña, Spain
| | - David Dobarro
- Unidad de Insuficiencia Cardiaca e Hipertensión Pulmonar, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Luis Almenar
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardíaca y Trasplante, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Juan F Delgado-Jiménez
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Francisco González-Vílchez
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - José González-Costello
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardíaca Avanzada y Trasplante, Servicio de Cardiología, Hospital Universitari de Bellvitge. BIOHEART-Cardiovascular diseases group; Cardiovascular, Respiratory and Systemic Diseases and cellular aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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García JCLA, Marco I, Martín JG, López-Medrano F, Eixerés-Esteve A, Pérez PC, Bagudá JDJ, López-Jiménez EA, Arribas F, Delgado-Jiménez JF, Carmena MDGC. Evolution of the impact of the COVID-19 pandemic on heart transplant recipients: Decreasing risk, improving perspective. Transpl Infect Dis 2024; 26:e14250. [PMID: 38375958 DOI: 10.1111/tid.14250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND AND METHODS Heart transplant recipients (HTr) have a higher probability of suffer from severe coronavirus disease-2019 (COVID-19) in comparison to general population, but their risk has changed over the course of the pandemic in relation to various factors. We conducted a prospective study including all HTr at risk of COVID-19 in a tertiary center between February 2020 and October 2022. The aim was to analyze how the prognosis (incidence of pneumonia and mortality) of COVID-19 in HTr has evolved over time, contextualizing variants, vaccination, and other treatments. RESULTS Of 308 HTr included, 124 got the infection (39.2%). COVID and non-COVID HTr had similar baseline characteristics. COVID-19 patients with pneumonia had a poorer prognosis than those with less severe presentations, with a higher rate of hospitalization (93.3 vs. 14.1%, p < .001) and death (41.0 vs. 1.2%, p < .001). Multivariate analysis identified age ≥60 years (odds ratio [OR] 3.65, 95% confidence interval [CI] 1.16-11.49, p = .027), and chronic kidney disease ≥3a (OR 4.95, 95% CI 1.39-17.54, p = .014) as predictors of pneumonia. Two-dose vaccination (OR 0.20, CI 95% 0.05-0.72, p = .02) and early remdesivir administration (OR 0.17, CI 0.03-0.90, p = .037) were protective factors. Over the course of the pandemic considering three periods in the follow-up (prevaccination February-December 2020, postvaccination January-December 2021, and post early remdesivir indication January-October 2022), we observed a reduction in pneumonia incidence from 62% to 19% (p < .001); and mortality (from 23% to 4%, p < .001). CONCLUSIONS The prognosis of COVID-19 in HTr has improved over time, likely due to vaccination and early administration of remdesivir.
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Affiliation(s)
- Juan Carlos López-Azor García
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Irene Marco
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Javier González Martín
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
| | - Francisco López-Medrano
- Department of Medicine, Universidad Complutense Madrid, Madrid, Spain
- Unit of Infectious Diseases, Instituto de Investigación del Hospital 12 de Octubre (imas12), University Hospital 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC; CB21/13/00009), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Pedro Caravaca Pérez
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
| | - Javier de Juan Bagudá
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Elena Ana López-Jiménez
- Clinical Biochemistry Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Fernando Arribas
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
| | - Juan Francisco Delgado-Jiménez
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
- Department of Medicine, Universidad Complutense Madrid, Madrid, Spain
| | - María Dolores García-Cosío Carmena
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain
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Cabezón-Villalba G, Barge-Caballero E, González-Vílchez F, Castel-Lavilla MÁ, Gómez-Bueno M, Almenar-Bonet L, González-Costello J, Lambert-Rodríguez JL, Martínez-Sellés M, de la Fuente-Galán L, Mirabet-Pérez S, García-Cosío Carmena MD, Hervás-Sotomayor D, Rangel-Sousa D, Blasco-Peiró T, Garrido-Bravo IP, Rábago Juan-Aracil G, Muñiz J, Crespo-Leiro MG. Use of a surgically implanted, nondischargeable, extracorporeal continuous flow circulatory support system as a bridge to heart transplant. Rev Esp Cardiol (Engl Ed) 2024; 77:39-49. [PMID: 37217134 DOI: 10.1016/j.rec.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION AND OBJECTIVES We aimed to describe the clinical outcomes of the use of the CentriMag acute circulatory support system as a bridge to emergency heart transplantation (HTx). METHODS We conducted a descriptive analysis of the clinical outcomes of consecutive HTx candidates included in a multicenter retrospective registry who were treated with the CentriMag device, configured either for left ventricular support (LVS) or biventricular support (BVS). All patients were listed for high-priority HTx. The study assessed the period 2010 to 2020 and involved 16 transplant centers around Spain. We excluded patients treated with isolated right ventricular support or venoarterial extracorporeal membrane oxygenation without LVS. The primary endpoint was 1-year post-HTx survival. RESULTS The study population comprised 213 emergency HTx candidates bridged on CentriMag LVS and 145 on CentriMag BVS. Overall, 303 (84.6%) patients received a transplant and 53 (14.8%) died without having an organ donor during the index hospitalization. Median time on the device was 15 days, with 66 (18.6%) patients being supported for> 30 days. One-year posttransplant survival was 77.6%. Univariable and multivariable analyses showed no statistically significant differences in pre- or post-HTx survival in patients managed with BVS vs LVS. Patients managed with BVS had higher rates of bleeding, need for transfusion, hemolysis and renal failure than patients managed with LVS, while the latter group showed a higher incidence of ischemic stroke. CONCLUSIONS In a setting of candidate prioritization with short waiting list times, bridging to HTx with the CentriMag system was feasible and resulted in acceptable on-support and posttransplant outcomes.
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Affiliation(s)
| | - Eduardo Barge-Caballero
- Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | | | - María Ángeles Castel-Lavilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Manuel Gómez-Bueno
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Luis Almenar-Bonet
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Politécnico La Fe, Valencia, Spain
| | - José González-Costello
- Servicio de Cardiología, Hospital Universitari de Bellvitge, Institut d́Investigació Biomédica de Bellvitge (IDIBELL), ĹHospitalet de Llobregat, Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | - Manuel Martínez-Sellés
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Hospital General Universitario Gregorio Marañón, Universidad Europea de Madrid, Universidad Complutense, Madrid, Spain
| | - Luis de la Fuente-Galán
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Sonia Mirabet-Pérez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - María Dolores García-Cosío Carmena
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Doce de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | | | - Diego Rangel-Sousa
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Teresa Blasco-Peiró
- Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Iris P Garrido-Bravo
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | | | - Javier Muñiz
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Ciencias de la Salud, Universidade de A Coruña, A Coruña, Spain
| | - María G Crespo-Leiro
- Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cirugía Cardiaca, Hospital Clínica Universidad de Navarra, Pamplona, Navarra, Spain
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Marco I, López-Azor García JC, González Martín J, Severo Sánchez A, García-Cosío Carmena MD, Mancebo Sierra E, de Juan Bagudá J, Castrodeza Calvo J, Hernández Pérez FJ, Delgado JF. De Novo Donor-Specific Antibodies after Heart Transplantation: A Comprehensive Guide for Clinicians. J Clin Med 2023; 12:7474. [PMID: 38068526 PMCID: PMC10707043 DOI: 10.3390/jcm12237474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 04/12/2024] Open
Abstract
Antibodies directed against donor-specific human leukocyte antigens (HLAs) can be detected de novo after heart transplantation and play a key role in long-term survival. De novo donor-specific antibodies (dnDSAs) have been associated with cardiac allograft vasculopathy, antibody-mediated rejection, and mortality. Advances in detection methods and international guideline recommendations have encouraged the adoption of screening protocols among heart transplant units. However, there is still a lack of consensus about the correct course of action after dnDSA detection. Treatment is usually started when antibody-mediated rejection is present; however, some dnDSAs appear years before graft failure is detected, and at this point, damage may be irreversible. In particular, class II, anti-HLA-DQ, complement binding, and persistent dnDSAs have been associated with worse outcomes. Growing evidence points towards a more aggressive management of dnDSA. For that purpose, better diagnostic tools are needed in order to identify subclinical graft injury. Cardiac magnetic resonance, strain techniques, or coronary physiology parameters could provide valuable information to identify patients at risk. Treatment of dnDSA usually involves plasmapheresis, intravenous immunoglobulin, immunoadsorption, and ritxumab, but the benefit of these therapies is still controversial. Future efforts should focus on establishing effective treatment protocols in order to improve long-term survival of heart transplant recipients.
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Affiliation(s)
- Irene Marco
- Cardiology Department, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Juan Carlos López-Azor García
- Cardiology Department, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain; (J.C.L.-A.G.); (F.J.H.P.)
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain; (J.G.M.); (M.D.G.-C.C.); (J.d.J.B.); (J.C.C.)
- School of Medicine, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Javier González Martín
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain; (J.G.M.); (M.D.G.-C.C.); (J.d.J.B.); (J.C.C.)
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Andrea Severo Sánchez
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - María Dolores García-Cosío Carmena
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain; (J.G.M.); (M.D.G.-C.C.); (J.d.J.B.); (J.C.C.)
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Esther Mancebo Sierra
- Immunology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Javier de Juan Bagudá
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain; (J.G.M.); (M.D.G.-C.C.); (J.d.J.B.); (J.C.C.)
- School of Medicine, Universidad Europea de Madrid, 28670 Madrid, Spain
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
| | - Javier Castrodeza Calvo
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain; (J.G.M.); (M.D.G.-C.C.); (J.d.J.B.); (J.C.C.)
- Cardiology Department, Hospital Universitario Gregorio Marañón, 28007 Madrid, Spain
| | | | - Juan Francisco Delgado
- Centro Nacional de Investigaciones Biomédicas en Red de Enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain; (J.G.M.); (M.D.G.-C.C.); (J.d.J.B.); (J.C.C.)
- Cardiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain;
- School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Enríquez-Vázquez D, Barge-Caballero E, González-Vílchez F, Almenar-Bonet L, García-Cosío Carmena MD, González-Costello J, Gómez-Bueno M, Castel-Lavilla MÁ, Díaz-Molina B, Martínez-Sellés M, Mirabet-Pérez S, De la Fuente-Galán L, Hervás-Sotomayor D, Rangel-Sousa D, Garrido-Bravo IP, Blasco-Peiró T, Juan-Aracil GR, Muñiz J, Crespo-Leiro MG. Sex, Temporary Mechanical Circulatory Support, and Heart Transplantation: Insights From a Multi-Institutional Spanish Registry. JACC Heart Fail 2023; 11:1763-1766. [PMID: 37715770 DOI: 10.1016/j.jchf.2023.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/25/2023] [Indexed: 09/18/2023]
Affiliation(s)
- Daniel Enríquez-Vázquez
- Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Eduardo Barge-Caballero
- Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
| | | | - Luis Almenar-Bonet
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Universitario Politécnico La Fe, Valencia, Spain
| | - María Dolores García-Cosío Carmena
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Universitario Doce de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid, Spain
| | - José González-Costello
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Universitari de Bellvitge, Institut d'investigació Biomédica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat (Barcelona), Spain
| | - Manuel Gómez-Bueno
- Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Hospital Universitario Puerta de Hierro, Majadahonda (Madrid), Spain
| | - María Ángeles Castel-Lavilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Manuel Martínez-Sellés
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital General Universitario Gregorio Marañón, Universidad Europea, Universidad Complutense, Madrid, Spain
| | - Sonia Mirabet-Pérez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Luis De la Fuente-Galán
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Iris P Garrido-Bravo
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | - Javier Muñiz
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Universidade de A Coruña, A Coruña, Spain
| | - María G Crespo-Leiro
- Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Clínica Universidad de Navarra, Pamplona, Spain
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6
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Gómez-Bueno M, Pérez de la Sota E, Forteza Gil A, Ortiz-Berbel D, Castrodeza J, García-Cosío Carmena MD, Barge-Caballero E, Rangel Sousa D, Díaz Molina B, Manrique Antón R, Almenar-Bonet L, Uribarri González A, Barrio-Rodríguez A, Castel Lavilla MÁ, López-López L, Dobarro Pérez D, Pastor Pérez F, Burgos-Palacios V, Álvarez-García J, Garrido-Jiménez JM, González-Fernández Ó, Codina P, López-Granados A, Grau-Sepulveda A, González-Costello J. Durable ventricular assist device in Spain (2007-2020). First report of the REGALAD registry. Rev Esp Cardiol (Engl Ed) 2023; 76:227-237. [PMID: 36055642 DOI: 10.1016/j.rec.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the clinical characteristics, outcomes and complications of all consecutive patients implanted with a long-term mechanical circulatory support device in Spain between 2007 and 2020. METHODS Analysis of the Spanish Registry of durable ventricular assist devices (REGALAD) including data form Spanish centers with a mechanical circulatory support program. RESULTS During the study period, 263 ventricular assist devices were implanted in 22 hospitals. The implanted device was an isolated continuous-flow left ventricular assist device in 182 patients (69%), a pulsatile-flow device (58 isolated left ventricular and 21 biventricular) in 79 (30%), and a total artificial heart in 2 patients (1%). The strategy of the implant was as bridge to heart transplant in 78 patients (30%), bridge to candidacy in 110 (42%), bridge to recovery in 3 (1%) and destination therapy in 72 patients (27%). Overall survival at 6, 12 and 24 months was 79%, 74% and 69%, respectively, and was better in continuous-flow left ventricular assist devices (84%, 80%, and 75%). The main adverse events related to this therapy were infections (37% of patients), bleeding (35%), neurological (29%), and device malfunction (17%). CONCLUSIONS Durable ventricular assist devices have emerged in Spain in the last few years as a useful therapy for patients with advanced heart failure. As in other international registries, the current trend is to use continuous-flow intracorporeal left ventricular devices, which are associated with better results. Adverse events continue to be frequent and severe.
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Affiliation(s)
- Manuel Gómez-Bueno
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana (IDIPHISA), Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | | | - Alberto Forteza Gil
- Servicio de Cirugía Cardiaca, Hospital Universitario Puerta de Hierro-Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana (IDIPHISA), Majadahonda, Madrid, Spain
| | - Daniel Ortiz-Berbel
- Servicio de Cirugía Cardiaca, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Javier Castrodeza
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - María Dolores García-Cosío Carmena
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital 12 de Octubre, Instituto de Investigación Sanitaria (imas12), Madrid, Spain
| | - Eduardo Barge-Caballero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - Diego Rangel Sousa
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Beatriz Díaz Molina
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Rebeca Manrique Antón
- Servicio de Cirugía Cardiaca, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Luis Almenar-Bonet
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - María Ángeles Castel Lavilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura López-López
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - David Dobarro Pérez
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Francisco Pastor Pérez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Virginia Burgos-Palacios
- Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Jesús Álvarez-García
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | - Pau Codina
- Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - Andrés Grau-Sepulveda
- Servicio de Cardiología, Hospital Universitario Son Espases, Palma, Balearic Islands, Spain
| | - José González-Costello
- Servicio de Cardiología, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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7
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Gómez-Bueno M, Pérez de la Sota E, Forteza Gil A, Ortiz-Berbel D, Castrodeza J, García-Cosío Carmena MD, Barge-Caballero E, Rangel Sousa D, Díaz Molina B, Manrique Antón R, Almenar-Bonet L, Uribarri González A, Barrio-Rodríguez A, Castel Lavilla MÁ, López-López L, Dobarro Pérez D, Pastor Pérez F, Burgos-Palacios V, Álvarez-García J, Garrido-Jiménez JM, González-Fernández Ó, Codina P, López-Granados A, Grau-Sepulveda A, González-Costello J. Asistencia ventricular de larga duración en España (2007-2020). I informe del registro REGALAD. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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González-Trevilla AA, Maneiro Melón NM, García Tejada J, Velázquez Martín MT, García-Cosío Carmena MD, Sarnago Cebada F. Migraci�n de pr�tesis a�rtica transcat�ter en insuficiencia a�rtica por asistencia ventricular. RECIC 2022. [DOI: 10.24875/recic.m20000134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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9
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López-Azor JC, de la Torre N, García-Cosío Carmena MD, Caravaca Pérez P, Munera C, MarcoClement I, Cózar León R, Álvarez-García J, Pachón M, Ynsaurriaga FA, Salguero Bodes R, Delgado Jiménez JF, de Juan Bagudá J. Clinical Utility of HeartLogic, a Multiparametric Telemonitoring System, in Heart Failure. Card Fail Rev 2022; 8:e13. [PMID: 35516795 PMCID: PMC9062709 DOI: 10.15420/cfr.2021.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/08/2022] [Indexed: 01/09/2023] Open
Abstract
Telemonitoring through multiple variables measured on cardiac devices has the potential to improve the follow-up of patients with heart failure. The HeartLogic algorithm (Boston Scientific), implemented in some implantable cardiac defibrillators and cardiac resynchronisation therapy, allows monitoring of the nocturnal heart rate, respiratory movements, thoracic impedance, physical activity and the intensity of heart tones, with the aim of predicting major clinical events. Although HeartLogic has demonstrated high sensitivity for the detection of heart failure decompensations, its effects on hospitalisation and mortality in randomised clinical trials has not yet been corroborated. This review details how the HeartLogic algorithm works, compiles available evidence from clinical studies, and discusses its application in daily clinical practice.
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Affiliation(s)
- Juan Carlos López-Azor
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
| | | | - María Dolores García-Cosío Carmena
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
| | - Pedro Caravaca Pérez
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
| | - Catalina Munera
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
| | - Irene MarcoClement
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
| | - Rocío Cózar León
- Cardiology Service, University Hospital Virgen MacarenaSeville, Spain
| | - Jesús Álvarez-García
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
- Cardiology Service, University Hospital Ramón y CajalMadrid, Spain
| | - Marta Pachón
- Cardiology Service, Unidad de Arritmias, Hospital Universitario de ToledoToledo, Spain
| | - Fernando Arribas Ynsaurriaga
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
| | - Rafael Salguero Bodes
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
| | - Juan Francisco Delgado Jiménez
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
- Faculty of Medicine, Complutense UniversityMadrid, Spain
| | - Javier de Juan Bagudá
- Cardiology Service, Hospital Universitario 12 de OctubreMadrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV)Madrid, Spain
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10
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González NT, Carmena MDGC, Moyano MF, Zafra AB, Guntín SV, Bermejo ZB, Pérez PC, Fernández LM, Bagudá JDJ, Jiménez JFD. Organ Donation: With Great Power Comes Great Responsibility. Transplant Proc 2021; 53:2646-2649. [PMID: 34635369 DOI: 10.1016/j.transproceed.2021.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022]
Abstract
Spain is a world leader in donation and transplantation. This model has been exported to other countries with favorable results. The objective of this study was to compare the actual donation intention rate with the effective donation figures, and analyze the main reasons why families decline organ donation. To estimate the current donation intention, we conducted 1065 surveys in March 2019, and to calculate effective donation figures in our hospital, we analyzed 1158 interviews conducted with relatives of potential organ donors between 1996 and 2018. Regarding the surveys to estimate donation intention, the mean (standard deviation) age was 51.6 (17-91) years. A total of 58% were women, 26% were health care professionals, and 5.1% were transplant recipients; 89.4% would donate their organs. In the multivariate analysis, having expressed the desire to donate to their family was independently related to the intention to donate (odds ratio, 3.4; 95% confidence interval, 2.2-5.2; P < .001). Regarding the interviews with relatives of potential donors, 79.4% were finally effective donors. The belief that the possible donor would have rejected the organ donation stands out among the causes of decline. However, only one-half of those surveyed expressed the wish to be a donor to their relatives. In the temporal evolution, a greater acceptance of donation is observed in the first period with a reduction over the last years (P > .001). It is our responsibility to improve transplantation rates because our model has shown to save lives and it is a role model for other nations, promoting information activities that encourage greater discussion of organ donation within families.
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Affiliation(s)
- Nerea Torres González
- Cardiology Department, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz, Santa Cruz de Tenerife, Spain.
| | - María Dolores García-Cosío Carmena
- Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Mercedes Ferrón Moyano
- Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain
| | - Ana Benito Zafra
- Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain
| | | | - Zorba Blázquez Bermejo
- Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Pedro Caravaca Pérez
- Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Morán Fernández
- Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier de Juan Bagudá
- Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan F Delgado Jiménez
- Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Imas12, Instituto de investigación del Hospital 12 de Octubre, Hospital 12 de Octubre, Madrid, Spain; CIBERCV, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Medicine Department, Universidad Complutense de Madrid, Madrid, Spain
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11
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Caravaca Pérez P, Nuche J, Morán Fernández L, Lora D, Blázquez-Bermejo Z, López-Azor JC, de Juan Bagudá J, García-Cosío Carmena MD, Escribano Subías P, Salguero-Bodes R, Arribas Ynsaurriaga F, Delgado JF. Potential Role of Natriuretic Response to Furosemide Stress Test During Acute Heart Failure. Circ Heart Fail 2021; 14:e008166. [PMID: 34129364 DOI: 10.1161/circheartfailure.120.008166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Poor natriuresis has been associated with a poorer response to diuretic treatment and worse prognosis in acute heart failure. Recommendations on how and when to measure urinary sodium (UNa) are lacking. We aim to evaluate UNa quantification after a furosemide stress test (FST) capacity to predict appropriate decongestion during acute heart failure hospitalization. METHODS Patients underwent an FST on day-1 of admission, and UNa was measured 2 hours after, dividing patients into low or high UNa based on the sample median value. A semiquantitative composite congestive score (CCS; 0-9) and NT pro-BNP (N-terminal pro-B-type natriuretic peptide) quantification were assessed before the FST and at day 5 after the FST. RESULTS Median UNa after FST in the 65 patients included was 113 (97-122) mmol/L. At day 5, a lower proportion of patients with a low UNa reached a 30% decrease in NT-proBNP levels (21 [66%] for low UNa versus 31 [94%] for high UNa; P=0.005) and an appropriate grade of decongestion (CCS<3) (20 [62%] for low UNa versus 32 [97%] for high UNa; P<0.001). A UNa>83 mmol/L 2 hours after FST had a 96% sensitivity to predict an NT-proBNP reduction ≥30% and 95% to predict a CCS<3 at day 5. Low UNa patients presented a lower cumulative diuresis and weight loss and presented more often with prolonged hospitalization, worsening heart failure, and readmission because of acute heart failure or death at 6 months. CONCLUSIONS Low natriuresis after an FST identified patients at a higher risk of an inadequate diuretic response and an inappropriate decongestion. FST-guided diuretic treatment might help to improve decongestion, shorten hospitalizations, and to reduce adverse outcomes.
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Affiliation(s)
- Pedro Caravaca Pérez
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Jorge Nuche
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (J.N.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Laura Morán Fernández
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - David Lora
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Zorba Blázquez-Bermejo
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Juan Carlos López-Azor
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Javier de Juan Bagudá
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - María Dolores García-Cosío Carmena
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Pilar Escribano Subías
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Rafael Salguero-Bodes
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Fernando Arribas Ynsaurriaga
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.)
| | - Juan F Delgado
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain (P.C.P., J.N., L.M.F., Z.B.-B., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Centro de Investigaciones Biomédicas En Red de enfermedades CardioVasculares (CIBERCV), Spain (P.C.P., J.N., L.M.F., J.C.L.-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (P.C.P., J.N., L.M.F., D.L., Z.B.-B., J.C.L-A., J.d.J.B., M.D.G.-C.C., P.E.S., R.S.-B., F.A.Y., J.F.D.).,Facultad de Medicina, Universidad Complutense de Madrid, Spain (P.E.S., R.S.-B., F.A.Y., J.F.D.)
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de Juan Bagudá J, Fontenla A, García-Cosío Carmena MD, Salguero Bodes R, Delgado Jiménez JF, Arribas Ynsaurriaga F. First experience in Spain of cardiac contractility modulation. A new alternative for patients with heart failure. Rev Esp Cardiol (Engl Ed) 2020; 73:855-857. [PMID: 32386962 DOI: 10.1016/j.rec.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/25/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Javier de Juan Bagudá
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, CIBERCV, Madrid, Spain.
| | - Adolfo Fontenla
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain
| | - María Dolores García-Cosío Carmena
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, CIBERCV, Madrid, Spain
| | - Rafael Salguero Bodes
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, CIBERCV, Madrid, Spain
| | - Juan F Delgado Jiménez
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, CIBERCV, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Fernando Arribas Ynsaurriaga
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, CIBERCV, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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de Juan Bagudá J, Fontenla A, García-Cosío Carmena MD, Salguero Bodes R, Delgado Jiménez JF, Arribas Ynsaurriaga F. Primera experiencia en España de la modulación de la contractilidad cardiaca. Una nueva alternativa para los pacientes con insuficiencia cardiaca. Rev Esp Cardiol (Engl Ed) 2020. [DOI: 10.1016/j.recesp.2020.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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14
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Ponz de Antonio I, de Juan Bagudá JS, Rodríguez Chaverri A, García-Cosío Carmena MD, Arribas Ynsaurriaga F, Delgado Jiménez JF. Levosimendan as bridge to transplant in patients with advanced heart failure. Rev Esp Cardiol (Engl Ed) 2020; 73:422-424. [PMID: 32061565 DOI: 10.1016/j.rec.2019.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Inés Ponz de Antonio
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Javier S de Juan Bagudá
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
| | - Adriana Rodríguez Chaverri
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain
| | - María Dolores García-Cosío Carmena
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Fernando Arribas Ynsaurriaga
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan F Delgado Jiménez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Ponz de Antonio I, de Juan Bagudá JS, Rodríguez Chaverri A, García-Cosío Carmena MD, Arribas Ynsaurriaga F, Delgado Jiménez JF. Levosimendán como terapia puente a trasplante cardiaco en pacientes con insuficiencia cardiaca avanzada. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Avellana P, Segovia J, Sufrate E, Gómez-Bueno M, García-Cosío Carmena MD, García-Pavía P, Gutiérrez Landaluce C, Pérez Pereira E, Alonso-Pulpón L. Efectos a largo plazo (5 años) de bosentán en pacientes con hipertensión arterial pulmonar. Rev Esp Cardiol 2011; 64:667-73. [DOI: 10.1016/j.recesp.2011.04.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 04/25/2011] [Indexed: 11/29/2022]
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