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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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Robles-Mezcua A, Ruíz-Salas A, Medina-Palomo C, Robles-Mezcua M, Díaz-Expósito A, Ortega-Jiménez MV, Gimeno-Blanes JR, Jiménez-Navarro MF, García-Pinilla JM. The Novel Variant NP_00454563.2 ( p.Glu259Glyfs*77) in Gene PKP2 Associated with Arrhythmogenic Cardiomyopathy in 8 Families from Malaga, Spain. Genes (Basel) 2023; 14:1468. [PMID: 37510372 PMCID: PMC10379208 DOI: 10.3390/genes14071468] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Arrhythmogenic cardiomyopathy (ACM) is a hereditary heart disease defined by the progressive replacement of the ventricular myocardium with fibroadipose tissue, which can act as a substrate for arrhythmias, sudden death, or even give rise to heart failure (HF). Sudden death is frequently the first manifestation of the disease, particularly among young patients. The aim of this study is to describe a new pathogenic variant in the PKP2 gene. METHODS A descriptive observational study that included eight initially non-interrelated families with a diagnosis of ACM undergoing follow-up at our HF and Familial Cardiomyopathies Unit, who were carriers of the NM_004572.3:c.775_776insG; p.(Glu259Glyfs*77) variant in the PKP2 gene. The genetic testing employed next-generation sequencing for the index cases and the Sanger method for the targeted study with family members. We compiled personal and family histories, demographic and clinical characteristics, data from the additional tests at the time of diagnosis, and arrhythmic events at diagnosis and during follow-up. RESULTS We included 47 subjects, of whom 8 were index cases (17%). Among the evaluated family members, 16 (34%) were carriers of the genetic variant, 3 of whom also had a diagnosis of ACM. The majority were women (26 patients; 55.3%), with a mean age on diagnosis of 48.9 ± 18.6 years and a median follow-up of 39 [24-59] months. Worthy of note are the high incidences of arrhythmic events as the form of presentation and in follow-up (21.5% and 20.9%, respectively), and the onset of HF in 25% of the sample. The most frequent ventricular involvements were right (four patients, 16.7%) and biventricular (four patients, 16.7%); we found no statistical differences in any of the variables analysed. CONCLUSIONS This variant is a pathogenic variant of gene PKP2 that has not previously been described and is not present in the control groups associated with ACM. It has incomplete penetrance, a highly variable phenotypic expressivity, and was identified in eight families of our geographical area in Malaga (Andalusia, Spain), suggesting a founder effect in this area and describe the clinical and risk characteristics.
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Affiliation(s)
- Ainhoa Robles-Mezcua
- Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (A.R.-S.); (C.M.-P.); (M.R.-M.); (A.D.-E.); (M.F.J.-N.); (J.M.G.-P.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
| | - Amalio Ruíz-Salas
- Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (A.R.-S.); (C.M.-P.); (M.R.-M.); (A.D.-E.); (M.F.J.-N.); (J.M.G.-P.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
| | - Carmen Medina-Palomo
- Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (A.R.-S.); (C.M.-P.); (M.R.-M.); (A.D.-E.); (M.F.J.-N.); (J.M.G.-P.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
| | - María Robles-Mezcua
- Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (A.R.-S.); (C.M.-P.); (M.R.-M.); (A.D.-E.); (M.F.J.-N.); (J.M.G.-P.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
| | - Arancha Díaz-Expósito
- Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (A.R.-S.); (C.M.-P.); (M.R.-M.); (A.D.-E.); (M.F.J.-N.); (J.M.G.-P.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
| | - María Victoria Ortega-Jiménez
- Pathological Anatomy Service, IBIMA, 29590 Málaga, Spain;
- Human Physiology, Human Histology and Physical and Sports Education Department, Universidad de Málaga, 29071 Málaga, Spain
| | - Juan Ramón Gimeno-Blanes
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
- Inherited Cardiac Disease Unit, Cardiology Department, University Hospital Virgen de la Arrixaca, El Palmar, 30120 Murcia, Spain
| | - Manuel F. Jiménez-Navarro
- Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (A.R.-S.); (C.M.-P.); (M.R.-M.); (A.D.-E.); (M.F.J.-N.); (J.M.G.-P.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
| | - José Manuel García-Pinilla
- Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; (A.R.-S.); (C.M.-P.); (M.R.-M.); (A.D.-E.); (M.F.J.-N.); (J.M.G.-P.)
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28220 Madrid, Spain;
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Esteban-Fernández A, Gómez-Otero I, López-Fernández S, Santamarta MR, Pastor-Pérez FJ, Fluvià-Brugués P, Pérez-Rivera JÁ, López López A, García-Pinilla JM, Palomas JLB, Bonet LA, Cobo-Marcos M, Mateo VM, Llergo JT, Fernández VA, Vives CG, de Juan Bagudá J, Benedicto AM, de Polavieja JIM, Solla-Ruiz I, Solé-González E, Cardona M, Olaetxea JR, Cortés CO, Dosantos VM, López AG, Amao E, Sánchez BC, Torres EA, Carrillo VG, García-Fuertes D, Ridocci-Soriano F. Influence of the medical treatment schedule in new diagnoses patients with heart failure and reduced ejection fraction. Clin Res Cardiol 2023:10.1007/s00392-023-02241-0. [PMID: 37341769 DOI: 10.1007/s00392-023-02241-0] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/30/2023] [Indexed: 06/22/2023]
Abstract
AIMS Heart failure (HF) guidelines recommend treating all patients with HF and reduced ejection fraction (HFrEF) with quadruple therapy, although they do not establish how to start it. This study aimed to evaluate the implementation of these recommendations, analyzing the efficacy and safety of the different therapeutic schedules. METHODS AND RESULTS Prospective, observational, and multicenter registry that evaluated the treatment initiated in patients with newly diagnosed HFrEF and its evolution at 3 months. Clinical and analytical data were collected, as well as adverse reactions and events during follow-up. Five hundred and thirty-three patients were included, selecting four hundred and ninety-seven, aged 65.5 ± 12.9 years (72% male). The most frequent etiologies were ischemic (25.5%) and idiopathic (21.1%), with a left ventricular ejection fraction of 28.7 ± 7.4%. Quadruple therapy was started in 314 (63.2%) patients, triple in 120 (24.1%), and double in 63 (12.7%). Follow-up was 112 days [IQI 91; 154], with 10 (2%) patients dying. At 3 months, 78.5% had quadruple therapy (p < 0.001). There were no differences in achieving maximum doses or reducing or withdrawing drugs (< 6%) depending on the starting scheme. Twenty-seven (5.7%) patients had any emergency room visits or admission for HF, less frequent in those with quadruple therapy (p = 0.02). CONCLUSION It is possible to achieve quadruple therapy in patients with newly diagnosed HFrEF early. This strategy makes it possible to reduce admissions and visits to the emergency room for HF without associating a more significant reduction or withdrawal of drugs or significant difficulty in achieving the target doses.
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Affiliation(s)
- Alberto Esteban-Fernández
- Cardiology Service, Hospital Universitario Severo Ochoa, Universidad Internacional de Valencia, Madrid, Spain.
- Valencian Internacional University, Valencia, Spain.
| | - Inés Gómez-Otero
- Cardiology Service, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia López-Fernández
- Cardiology Service, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | | | - Francisco J Pastor-Pérez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Cardiology Service, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Paula Fluvià-Brugués
- Cardiology Service, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - José-Ángel Pérez-Rivera
- Cardiology Service, Hospital Universitario de Burgos, Burgos, Spain
- Facultad de Ciencias de La Salud, Universidad Isabel I, Burgos, Spain
| | | | - José Manuel García-Pinilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Cardiology Service, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain
- Departamento de Medicina y Dermatología, Universidad de Málaga, Málaga, Spain
| | | | | | - Marta Cobo-Marcos
- Cardiology Service, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Virgilio Martínez Mateo
- Cardiology Service, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain
| | | | | | - Cristina Goena Vives
- Cardiology Service, Hospital de Mendaro, Mendaro, Gipuzkoa, Spain
- Instituto de Investigación Biodonostia, Donostia, Gipuzkoa, Spain
| | - Javier de Juan Bagudá
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Cardiology Service, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain
| | - Alba Maestro Benedicto
- Cardiology Service, Hospital de la Santa Creu I Sant Pau, IIB SANT PAU, Barcelona, Spain
| | | | - Itziar Solla-Ruiz
- Cardiology Service, Hospital Universitario de Donostia, San Sebastián, Spain
| | | | - Montserrat Cardona
- Cardiology Service, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain
| | | | | | - Victor Martínez Dosantos
- Cardiology Service, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Antonio Gámez López
- Cardiology Service, Hospital General de Valdepeñas, Valdepeñas, Ciudad Real, Spain
| | - Elvis Amao
- Cardiology Service, Hospital Verge de la Cinta, Tortosa, Tarragona, Spain
| | - Borja Casas Sánchez
- Cardiology Service, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | | | | | | | - Francisco Ridocci-Soriano
- Cardiology Service, Hospital General Universitario de Valencia, Valencia, Spain
- Departamento de Medicina, Universitat de Valencia, Valencia, Spain
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Cruzado-Álvarez C, Pérez-Cabeza AI, Robles-Mezcua A, Robles-Mezcua M, García-Pinilla JM. Analysis of the activity of the telephone nursing consultation on demand for patients with heart failure. Enferm Clin (Engl Ed) 2023; 33:137-140. [PMID: 36822471 DOI: 10.1016/j.enfcle.2022.11.003] [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: 05/18/2022] [Accepted: 11/19/2022] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Analyzing the most frequent reasons for telephone demand in the heart failure nurse's consultation and to evaluate the response resolution capacity after the call. METHOD Descriptive, retrospective study of all telephone calls recorded between June 2020 and April 2021 in a specific nursing consultation for heart failure care. The main sociodemographic and clinical variables, reason for calling and action carried out by the nurse were extracted from the electronic medical records. For its subsequent descriptive análisis. RESULTS 643 calls were analyzed, 354 (55.1%) were made by the patients. The most frequent reason for calling was to consult symptoms 45.8% (n = 162). 71.6% (n = 116) of the consultations were resolved by adjusting the pharmacological treatment by telephone, 24.7% (n = 40) required a face-to-face visit in the nurse's consultation, 22 (13.6%) needed emergency care. 5 due to worsening heart failure. The patients who consulted for symptoms had a worse functional class (p = 0.007) and had been referred from hospitalization (p = 0.023). CONCLUSIONS The telephone consultation was shown to be useful for patients with heart failure, being mainly demanded by users who present symptoms of worsening of their disease.
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Affiliation(s)
- Concepción Cruzado-Álvarez
- Enfermera, Unidad de Insuficiencia Cardiaca, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
| | - Alejandro Isidoro Pérez-Cabeza
- Facultativo Especialista de Área en Cardiología, Unidad de Insuficiencia Cardiaca, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Ainhoa Robles-Mezcua
- Facultativo Especialista de Área en Cardiología, Unidad de Insuficiencia Cardiaca, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - María Robles-Mezcua
- Enfermera, Unidad de Insuficiencia Cardiaca, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - José Manuel García-Pinilla
- Facultativo Especialista de Área en Cardiología, Unidad de Insuficiencia Cardiaca, Hospital Universitario Virgen de la Victoria, Málaga, Spain
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Cruzado-Álvarez C, Pérez-Cabeza AI, Robles-Mezcua A, Robles-Mezcua M, García-Pinilla JM. Análisis de la actividad de la consulta de enfermería telefónica a demanda para pacientes con insuficiencia cardíaca. Enfermería Clínica 2023. [DOI: 10.1016/j.enfcli.2022.11.003] [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: 01/17/2023]
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Gómez MA, Robles-Mezcua A, Becerra Muñoz VM, García-Pinilla JM. Case Report on Ambulatory pulmonary pressure monitoring: an attempt to reduce readmissions for heart failure with preserved ejection fraction. Eur Heart J Case Rep 2022; 6:ytac401. [PMID: 36285229 PMCID: PMC9581212 DOI: 10.1093/ehjcr/ytac401] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/13/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022]
Abstract
Background Despite many recent advances in heart failure (HF) therapies, there remains an unmet need in patients with HF with preserved ejection fraction (HFpEF) for adequate treatment and follow-up, with the potential to reduce associated mortality and morbidity. Increased intracardiac and intrapulmonary pressures have been shown to precede the onset of symptoms of decompensated HF by several days or even weeks, so there have been several attempts to influence the prognosis of HF by monitoring through various methods. One of these is ambulatory pulmonary pressure monitoring to guide treatment in anticipation of decompensation. Case summary We present the case of a 65-year-old woman with rheumatic valve disease and mechanical aortic and mitral prosthesis since 2003 and pacemaker since 2014, with development of severe tricuspid regurgitation in 2018 and with new valve implantation and multiple decompensations of HFpEF despite optimal medical treatment. Under follow-up in the Heart Failure Unit and after multiple unsuccessful treatment adjustments, it was decided to implant a pulmonary artery pressure monitoring device—CardioMEMS®—in order to optimize patient follow-up and treatment. The procedure was carried out without complications and early optimization of treatment was possible, resulting in a significant reduction in decompensations and admissions for HF. Discussion Ambulatory pulmonary pressure monitoring is shown to be a safe and effective option to anticipate treatment of heart failure decompensation even with preserved left ventricular ejection fraction, with a significantly positive impact on hospital readmissions and consequent benefit on morbidity and mortality.
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Affiliation(s)
- María Angullo Gómez
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga-IBIMA , España. CIBERCV
| | - Ainhoa Robles-Mezcua
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga-IBIMA , España. CIBERCV
| | - Víctor Manuel Becerra Muñoz
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga-IBIMA , España. CIBERCV
| | - José Manuel García-Pinilla
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga-IBIMA , España. CIBERCV
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Delgado-Jiménez JF, Segovia-Cubero J, Almenar-Bonet L, de Juan-Bagudá J, Lara-Padrón A, García-Pinilla JM, Bonilla-Palomas JL, López-Fernández S, Mirabet-Pérez S, Gómez-Otero I, Castro-Fernández A, Díaz-Molina B, Goirigolzarri-Artaza J, Rincón-Díaz LM, Pascual-Figal DA, Anguita-Sánchez M, Muñiz J, Crespo-Leiro MG. Prevalence, Incidence, and Outcomes of Hyperkalaemia in Patients with Chronic Heart Failure and Reduced Ejection Fraction from a Spanish Multicentre Study: SPANIK-HF Design and Baseline Characteristics. J Clin Med 2022; 11:jcm11051170. [PMID: 35268260 PMCID: PMC8910891 DOI: 10.3390/jcm11051170] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
Hyperkalaemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) as it limits the use of some prognostic-modifying drugs and has a negative impact on prognosis. The objective of the present study was to estimate the prevalence of hyperkalaemia in outpatients with HFrEF and its impact on achieving optimal medical treatment. For this purpose, a multicentre, prospective, and observational study was carried out on consecutive HFrEF patients who were monitored as outpatients in heart failure (HF) units and who, in the opinion of their doctor, received optimal medical treatment. A total of 565 HFrEF patients were included from 16 specialised HF units. The mean age was 66 ± 12 years, 78% were male, 45% had an ischemic cause, 39% had atrial fibrillation, 43% were diabetic, 42% had a glomerular filtration rate < 60 mL/min/1.7 m2, and the mean left ventricular ejection fraction was 31 ± 7%. Treatment at the study entry included: 76% on diuretics, 13% on ivabradine, 7% on digoxin, 18.9% on angiotensin-conversing enzyme inhibitors (ACEi), 11.3% on angiotensin receptors blockers (ARBs), 63.8% on angiotensin-neprilysin inhibitors (ARNi), 78.5% on mineralocorticoid receptor antagonists (MRAs), and 92.9% on beta-blockers. Potassium levels in the baseline analysis were: ≤5 mEq/L = 80.5%, 5.1−5.4 mEq/L = 13.8%, 5.5−5.9 mEq/L = 4.6%, and ≥6 mEq/L = 1.06%. Hyperkalaemia was the reason for not prescribing or reaching the target dose of an MRAs in 34.8% and 12.5% of patients, respectively. The impact of hyperkalaemia on not prescribing or dropping below the target dose in relation to ACEi, ARBs, and ARNi was significantly less. In conclusion, hyperkalaemia is a frequent problem in the management of patients with HFrEF and a limiting factor in the optimisation of medical treatment.
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Affiliation(s)
- Juan F. Delgado-Jiménez
- Instituto de Investigación y Servicio de Cardiología del Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Correspondence:
| | - Javier Segovia-Cubero
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, 28222 Madrid, Spain
| | - Luis Almenar-Bonet
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Hospital Universitario La Fe, 46026 Valencia, Spain
| | - Javier de Juan-Bagudá
- Instituto de Investigación y Servicio de Cardiología del Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
| | - Antonio Lara-Padrón
- Servicio de Cardiología, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain;
| | - José Manuel García-Pinilla
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, International Business Information Management Association, Hospital Universitario Virgen de la Victoria, 29010 Malaga, Spain
| | | | - Silvia López-Fernández
- Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | - Sonia Mirabet-Pérez
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
| | - Inés Gómez-Otero
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Complexo Hospitalario Universitario de Santiago de Compostela, 15706 A Coruña, Spain
| | | | - Beatriz Díaz-Molina
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
| | - Josebe Goirigolzarri-Artaza
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Hospital Universitario Clínico de San Carlos, 28040 Madrid, Spain
| | - Luis Miguel Rincón-Díaz
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Hospital Ramón y Cajal, 28034 Madrid, Spain
| | - Domingo Andrés Pascual-Figal
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
| | | | - Javier Muñiz
- Instituto de Investigación Biomédica de A Coruña, Universidade da Coruña (UDC), 15006 A Coruña, Spain;
| | - María G. Crespo-Leiro
- Centro de Investigación Biomédica En Red Cardiovascular (CIBERCV), 28029 Madrid, Spain; (J.S.-C.); (L.A.-B.); (J.M.G.-P.); (S.M.-P.); (I.G.-O.); (B.D.-M.); (J.G.-A.); (L.M.R.-D.); (D.A.P.-F.); (M.G.C.-L.)
- Servicio de Cardiología, Complexo Hospitalario Universitario, 15006 A Coruña, Spain
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Álvarez Rubio J, Manovel Sánchez AJ, González-Costello J, García-Pavía P, Limeres Freire J, García-Pinilla JM, Zorio Grima E, García-Álvarez A, Valverde Gómez M, Espinosa Castro MÁ, Barge-Caballero G, Gimeno Blanes JR, Bosch Rovira MT, Rincón Díaz LM, Aibar Arregui MÁ, Gallego-Delgado M, Jiménez-Jáimez J, Martínez Moreno M, Basurte M, Arana Achaga X, Hernández Baldomero IF, Ripoll-Vera T. Characterization of hereditary transthyretin cardiac amyloidosis in Spain. ACTA ACUST UNITED AC 2021; 75:488-495. [PMID: 34711514 DOI: 10.1016/j.rec.2021.07.020] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Hereditary transthyretin amyloidosis (hATTR) is a disease caused by mutations in the transthyretin gene that frequently shows cardiac involvement due to amyloid deposition in the myocardium. Our objective was to identify cardiac involvement in a Spanish cohort. METHODS Retrospective multicenter study of patients diagnosed with hATTR with cardiac involvement from Spanish centers. We collected demographic, clinical, and genetic data. RESULTS A total of 181 patients from 26 centers were included (65.2% men, with a median age at diagnosis of 62 years). The most frequent mutations were Val50Met (67.7%) and Val142Ile (12.4%). The main reason for consultation was extracardiac symptoms (69%), mainly neurological. The mean N-terminal pro-B-type natriuretic peptide level was 2145±3586 pg/mL. The most characteristic electrocardiogram findings were a pseudoinfarct pattern (25.9%) and atrioventricular block (25.3%). Mean ventricular thickness was 15.4±4.1mm. Longitudinal strain was reduced in basal segments by 29.4%. Late diffuse subendocardial enhancement was observed in 58.8%. Perugini grade 2 or 3 uptake was observed in 75% of scintigraphy scans. During follow-up, 24.9% of the patients were admitted for heart failure, 34.3% required a pacemaker, and 31.6% required a liver transplant. One third (32.5%) died during follow-up, mainly due to heart failure (28.8%). The presence of non-Val50Met mutations was associated with a worse prognosis. CONCLUSIONS HATTR cardiac amyloidosis in Spain shows heterogeneous genetic and clinical involvement. The prognosis is poor, mainly due to cardiac complications. Consequently early diagnosis and treatment are vital.
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Affiliation(s)
- Jorge Álvarez Rubio
- Unidad de Cardiopatías Familiares y Unidad Multidisciplinar de Amiloidosis TTR, Servicio de Cardiología, Hospital Universitario Son Llàtzer, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Balearic Islands, Spain
| | | | - José González-Costello
- Unidad Multidisciplinar de Amiloidosis Familiar, Servicio de Cardiología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Pablo García-Pavía
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain
| | - Javier Limeres Freire
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, 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, IBIMA, Málaga, Spain
| | - Esther Zorio Grima
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe de Valencia, Instituto de Investigación Sanitaria La Fe de Valencia, Valencia, Spain
| | - Ana García-Álvarez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - María Valverde Gómez
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain; Laboratorio de Genética, Health in Code, A Coruña, Spain
| | - M Ángeles Espinosa Castro
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Gregorio Marañón, Madrid, Spain
| | - Gonzalo Barge-Caballero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Juan Ramón Gimeno Blanes
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - María Teresa Bosch Rovira
- Servicio de Medicina Interna, Hospital Universitario Son Espases, Palma de Mallorca, Balearic Islands, Spain
| | - Luis Miguel Rincón Díaz
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Miguel Ángel Aibar Arregui
- Servicio de Medicina Interna, Hospital Clínico Universitario de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS-A), Zaragoza, Spain
| | - María Gallego-Delgado
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Instituto de Investigación Biomédica de Salamanca (IBSAL), Complejo Asistencial Universitario de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Salamanca, Spain
| | - Juan Jiménez-Jáimez
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Marina Martínez Moreno
- Servicio de Cardiología, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - Mayte Basurte
- Servicio de Cardiología, Complejo Universitario de Navarra, Navarra, Pamplona, Spain
| | - Xabier Arana Achaga
- Servicio de Cardiología, Hospital Universitario Donostia, Donostia, Guipúzcoa, Spain
| | - Idaira Famara Hernández Baldomero
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Tomás Ripoll-Vera
- Unidad de Cardiopatías Familiares y Unidad Multidisciplinar de Amiloidosis TTR, Servicio de Cardiología, Hospital Universitario Son Llàtzer, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Balearic Islands, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain.
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9
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Robles-Mezcua A, Morcillo-Hidalgo L, Martín-Velázquez M, León-Fradejas M, García-Pinilla JM. A novel genetic variant in the NM_000169.2 region of the GLA gene (p.Gly163*) responsible for Fabry disease. Rev Esp Cardiol (Engl Ed) 2021; 74:712-714. [PMID: 33589392 DOI: 10.1016/j.rec.2021.01.004] [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: 11/20/2020] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Ainhoa Robles-Mezcua
- 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; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
| | - Luis Morcillo-Hidalgo
- 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; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | | | | | - José Manuel García-Pinilla
- 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; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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10
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Robles-Mezcua A, Rodríguez-Miranda L, Morcillo-Hidalgo L, Jiménez-Navarro M, García-Pinilla JM. Phenotype and progression among patients with dilated cardiomyopathy and RBM20 mutations. Eur J Med Genet 2021; 64:104278. [PMID: 34174465 DOI: 10.1016/j.ejmg.2021.104278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Over 70 genes that encode different cell components have been involved in the aetiology of dilated cardiomyopathy. Genotype-phenotype interactions are an unsolved problem, and to a large extent the effects of mutations in the expression mechanisms involved in the disease remain unknown, although associations are increasingly being established which have clinical and prognostic implications. METHODS AND RESULTS The objective of our work was to describe our population that has cardiomyopathy associated with mutations in the gene RBM20, and study the genotype-phenotype relationship. We studied 8 cases undergoing follow-up at our Unit, and collected data for demographic, clinical and diagnostic testing variables. The mean age on diagnosis was 55 years [52-59], with a median follow-up of 31.5 months [26.0-67.3]. It is worth noting that 62.5% of the patients in our group had a history of cardiomyopathy in first degree relatives, and 37.5% of them had a family history of sudden death. One of the genetic variations of the sample was shared by three subjects who had no apparent family relationship with each other, and this variation had not been described in controls. It is also interesting that arrhythmic events were found in 37.5% of the sample, and 50% of patients had an indication for implantable cardiac defibrillator. CONCLUSION This is the first analysis of patients with RBM20 mutations conducted in our country, and it indicates a profile with prominent arrhythmogenesis, a high penetrance of familial cardiomyopathy, and sudden death.
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Affiliation(s)
- Ainhoa Robles-Mezcua
- Heart Failure and Familial Heart Diseases Unit, Cardiology Service, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | - Laura Rodríguez-Miranda
- Heart Failure and Familial Heart Diseases Unit, Cardiology Service, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Luis Morcillo-Hidalgo
- Heart Failure and Familial Heart Diseases Unit, Cardiology Service, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Manuel Jiménez-Navarro
- Heart Failure and Familial Heart Diseases Unit, Cardiology Service, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - José Manuel García-Pinilla
- Heart Failure and Familial Heart Diseases Unit, Cardiology Service, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
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11
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Rodríguez-Capitán J, Fernández-Meseguer A, Márquez-Camas P, García-Pinilla JM, Calvo-Bonacho E, García-Margallo T, Cabrera-Bueno F, Gómez-Doblas JJ, Jiménez-Navarro MF, de Teresa-Galván E. Prevalence of hypertrophic cardiomyopathy in a large sample of the Spanish working population. Rev Clin Esp 2021; 221:315-322. [PMID: 32709302 DOI: 10.1016/j.rce.2020.01.014] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/27/2019] [Accepted: 01/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES To date, in Spain, there are no studies that have evaluated the prevalence of hypertrophic cardiomyopathy in the general population. The aim of this study was to assess the prevalence of hypertrophic cardiomyopathy in a large sample of the working population of Spain. MATERIALS AND METHODS The study included 13,179 workers (73% men; mean age, 40 years) from 5 regions of Spain who, between May 2008 and November 2010, had a medical examination with an electrocardiogram. The workers with suggestive abnormalities in the electrocardiogram or a predisposing medical history (exertional syncope or sudden death of a family member younger than 50 years) were referred for an echocardiographic evaluation. We defined hypertrophic cardiomyopathy as a parietal thickness ≥13mm in any segment of the left ventricle. We estimated the prevalence of hypertrophic cardiomyopathy in the entire sample and in the workers without hypertension. RESULTS A total of 1008 workers were selected for the echocardiogram, although only 496 (49.2% of those selected) of these attended the appointment. After the echocardiogram, we detected 16 cases of hypertrophic cardiomyopathy, estimating a prevalence of 0.24% for the entire sample. In the subgroup of workers with no hypertension, we observed 10 cases of hypertrophic cardiomyopathy, which corresponds to an estimated prevalence of 0.19%. CONCLUSIONS In our sample of the working population in Spain, the estimated prevalence of hypertrophic cardiomyopathy was 0.24%. In the subgroup of patients with no hypertension, the estimated prevalence was 0.19%.
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Affiliation(s)
- J Rodríguez-Capitán
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, España
| | | | - P Márquez-Camas
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, España
| | - J M García-Pinilla
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, España
| | | | | | - F Cabrera-Bueno
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, España
| | - J J Gómez-Doblas
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto Biosanitario de Málaga (IBIMA), Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud (FIMABIS), Universidad de Málaga, Málaga, España
| | - M F Jiménez-Navarro
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto Biosanitario de Málaga (IBIMA), Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud (FIMABIS), Universidad de Málaga, Málaga, España.
| | - E de Teresa-Galván
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España; Instituto Biosanitario de Málaga (IBIMA), Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud (FIMABIS), Universidad de Málaga, Málaga, España
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12
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Rodríguez-Capitán J, Fernández-Meseguer A, Márquez-Camas P, García-Pinilla JM, Calvo-Bonacho E, García-Margallo T, Cabrera-Bueno F, Gómez-Doblas JJ, Jiménez-Navarro MF, de Teresa-Galván E. Prevalence of hypertrophic cardiomyopathy in a large sample of the Spanish working population. Rev Clin Esp 2021; 221:315-322. [PMID: 34059228 DOI: 10.1016/j.rceng.2020.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 01/07/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES To date, in Spain, there are no studies that have evaluated the prevalence of hypertrophic cardiomyopathy in the general population. The aim of this study was to assess the prevalence of hypertrophic cardiomyopathy in a large sample of the working population of Spain. MATERIALS AND METHODS The study included 13,179 workers (73% men; mean age: 40 years) from 5 regions of Spain who, between May 2008 and November 2010, had a medical examination with an electrocardiogram. The workers with suggestive abnormalities in the electrocardiogram or a predisposing medical history (exertional syncope or sudden death of a family member younger than 50 years) were referred for an echocardiographic evaluation. We defined hypertrophic cardiomyopathy as a parietal thickness ≥13mm in any segment of the left ventricle. We estimated the prevalence of hypertrophic cardiomyopathy in the entire sample and in the workers without hypertension. RESULTS A total of 1008 workers were selected for the echocardiogram, although only 496 (49.2% of those selected) of these attended the appointment. After the echocardiogram, we detected 16 cases of hypertrophic cardiomyopathy, estimating a prevalence of 0.24% for the entire sample. In the subgroup of workers with no hypertension, we observed 10 cases of hypertrophic cardiomyopathy, which corresponds to an estimated prevalence of 0.19%. CONCLUSIONS In our sample of the working population in Spain, the estimated prevalence of hypertrophic cardiomyopathy was 0.24%. In the subgroup of patients with no hypertension, the estimated prevalence was 0.19%.
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Affiliation(s)
- J Rodríguez-Capitán
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | | | - P Márquez-Camas
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - J M García-Pinilla
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - F Cabrera-Bueno
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto Biosanitario de Málaga (IBIMA), CIBERCV Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - J J Gómez-Doblas
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto Biosanitario de Málaga (IBIMA), Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud (FIMABIS), Universidad de Málaga, Málaga, Spain
| | - M F Jiménez-Navarro
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto Biosanitario de Málaga (IBIMA), Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud (FIMABIS), Universidad de Málaga, Málaga, Spain.
| | - E de Teresa-Galván
- UGC Área del Corazón, Servicio de Cirugía Cardiovascular y Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain; Instituto Biosanitario de Málaga (IBIMA), Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud (FIMABIS), Universidad de Málaga, Málaga, Spain
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Robles-Mezcua A, Morcillo-Hidalgo L, Martín-Velázquez M, León-Fradejas M, García-Pinilla JM. Una nueva variante genética en la región NM_000169.2 del gen GLA (p.Gly163*) causante de la enfermedad de Fabry. Rev Esp Cardiol (Engl Ed) 2021. [DOI: 10.1016/j.recesp.2021.01.008] [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: 10/21/2022]
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Robles-Mezcua A, Villaescusa-Catalán JM, Melero-Tejedor JM, García-Pinilla JM. A new approach to the treatment of advanced heart failure: a case report. Eur Heart J Case Rep 2021; 5:ytaa541. [PMID: 33738406 PMCID: PMC7954250 DOI: 10.1093/ehjcr/ytaa541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/21/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023]
Abstract
Background Autonomic imbalance characterized by sympathetic predominance and decreased parasympathetic transmission is a classic feature of heart failure (HF) with reduced left ventricular ejection fraction, leading to disease progression, exercise intolerance, ventricular remodelling, arrhythmias, and premature death. The underlying mechanisms to these processes are not yet fully understood, but the current treatments influence this dysregulation, towards an inhibition of sympathetic hyperactivation. New therapies, such as the stimulation of carotid baroreceptors, enhance this inhibition to restore autonomic balance and to be able to cope with these mechanisms. Case summary We report the case of a 76-year-old male with advanced HF at an advanced stage, refractory to optimal treatment, and included in a programme of ambulatory infusions of Levosimendan as compassionate treatment. The patient presented with multiple episodes of decompensated HF secondary to ventricular arrhythmias. A multidisciplinary team decided to implant a baroreceptor stimulator device (Barostim Neo) in order to improve HF symptoms and quality of life, as well as trying to decrease the burden of arrhythmias. The procedure was performed with no complications and good therapeutic response, resulting in a significant reduction of arrhythmias. Discussion Treatment with a baroreceptor stimulating device is presented as a safe and effective option in our patients with advanced HF refractory to conventional treatment, to improve their quality of life and reduce symptoms; in addition to appearing as a promising option in those with arrhythmic events, which are difficult to control with usual treatments and procedures.
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Affiliation(s)
- Ainhoa Robles-Mezcua
- Unidad de Gestión Clínica de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Biomedicina de Málaga (IBIMA), CIBER CV, Málaga, Spain
| | - José Manuel Villaescusa-Catalán
- Unidad de Gestión Clínica de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Biomedicina de Málaga (IBIMA), CIBER CV, Málaga, Spain
| | - José María Melero-Tejedor
- Unidad de Gestión Clínica de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Instituto de Biomedicina de Málaga (IBIMA), CIBER CV, Málaga, Spain
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15
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Yun S, Enjuanes C, Calero E, Hidalgo E, Cobo M, Llàcer P, García-Pinilla JM, González-Franco Á, Núñez J, Morales-Rull JL, Beltrán P, Delso C, Freixa-Pamias R, Moliner P, Corbella X, Comín-Colet J. Study design of Heart failure Events reduction with Remote Monitoring and eHealth Support (HERMeS). ESC Heart Fail 2020; 7:4448-4457. [PMID: 32940428 PMCID: PMC7754948 DOI: 10.1002/ehf2.12962] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 01/10/2023] Open
Abstract
AIMS The role of non-invasive telemedicine (TM) combining telemonitoring and teleintervention by videoconference (VC) in patients recently admitted due to heart failure (HF) ('vulnerable phase' HF patients) is not well established. The aim of the Heart failure Events reduction with Remote Monitoring and eHealth Support (HERMeS) trial is to assess the impact on clinical outcomes of implementing a TM service based on mobile health (mHealth), which includes remote daily monitoring of biometric data and symptom reporting (telemonitoring) combined with VC structured, nurse-based follow-up (teleintervention). The results will be compared with those of the comprehensive HF usual care (UC) strategy based on face-to-face on-site visits at the vulnerable post-discharge phase. METHODS AND RESULTS We designed a 24 week nationwide, multicentre, randomized, controlled, open-label, blinded endpoint adjudication trial to assess the effect on cardiovascular (CV) mortality and non-fatal HF events of a TM-based comprehensive management programme, based on mHealth, for patients with chronic HF. Approximately 508 patients with a recent hospital admission due to HF decompensation will be randomized (1:1) to either structured follow-up based on face-to-face appointments (UC group) or the delivery of health care using TM. The primary outcome will be a composite of death from CV causes or non-fatal HF events (first and recurrent) at the end of a 6 month follow-up period. Key secondary endpoints will include components of the primary event analysis, recurrent event analysis, and patient-reported outcomes. CONCLUSIONS The HERMeS trial will assess the efficacy of a TM-based follow-up strategy for real-world 'vulnerable phase' HF patients combining telemonitoring and teleintervention.
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Affiliation(s)
- Sergi Yun
- Community Heart Failure Program, Departments of Cardiology and Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Enjuanes
- Community Heart Failure Program, Departments of Cardiology and Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Esther Calero
- Community Heart Failure Program, Departments of Cardiology and Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Encarnación Hidalgo
- Community Heart Failure Program, Departments of Cardiology and Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marta Cobo
- Department of Cardiology, Puerta de Hierro Majadahonda University Hospital, Puerta de Hierro-Segovia de Arana Health Research Institute (IDIPHSA), Madrid, Spain.,Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Pau Llàcer
- Department of Internal Medicine, Manises Hospital, Medical Research Institute of Hospital La Fe (IIS La Fe), València, Spain
| | - José Manuel García-Pinilla
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Carlos III Health Institute (ISCIII), Madrid, Spain.,Department of Cardiology, Heart Failure and Familial Cardiomyopathy Unit, Virgen de la Victoria University Hospital (HUVV), Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain
| | - Álvaro González-Franco
- Department of Internal Medicine, Central de Asturias University Hospital (HUCA), Foundation for Health and Biomedicine Research and Innovation of Asturias (FINBA), Oviedo, Spain
| | - Julio Núñez
- Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV), Carlos III Health Institute (ISCIII), Madrid, Spain.,Department of Cardiology, Clinic of València University Hospital, Biomedical Research Institute of València (INCLIVA), School of Medicine, University of València, València, Spain
| | - José Luis Morales-Rull
- Department of Internal Medicine, Heart Failure Unit, Arnau de Vilanova University Hospital, Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
| | - Paola Beltrán
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Viladecans Hospital, Institut Català de la Salut (ICS), Viladecans, Barcelona, Spain
| | - Cristina Delso
- Chronic Care Teams, Primary Care Service (SAP) Delta Llobregat, Foundation University Institute for Research in Primary Health Care Jordi Gol i Gurina (IDIAPJGol), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Román Freixa-Pamias
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Sant Joan Despí Moisès Broggi Hospital, Consorci Sanitari Integral (CSI), Department of Clinical Sciences, School of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Pedro Moliner
- Community Heart Failure Program, Departments of Cardiology and Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Corbella
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Hestia Chair in Integrated Health and Social Care, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Josep Comín-Colet
- Community Heart Failure Program, Departments of Cardiology and Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona (UB), Barcelona, Spain
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Barrios V, Cosín-Sales J, Bravo M, Escobar C, Gámez JM, Huelmos A, Ortiz Cortés C, Egocheaga I, García-Pinilla JM, Jiménez-Candil J, López-de-Sá E, Torres Llergo J, Obaya JC, Pallares-Carratalá V, Sanmartín M, Vidal-Pérez R, Cequier Á. [Telemedicine consultation for the clinical cardiologists in the era of COVID-19: present and future. Consensus document of the Spanish Society of Cardiology]. Rev Esp Cardiol 2020; 73:910-918. [PMID: 32836664 PMCID: PMC7345370 DOI: 10.1016/j.recesp.2020.06.027] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
La pandemia producida por la infección por el coronavirus SARS-CoV-2 (COVID-19) ha cambiado la forma de entender nuestras consultas. Para reducir el riesgo de contagio de los pacientes más vulnerables (aquellos con cardiopatías) y del personal sanitario, se han suspendido la mayoría de las consultas presenciales y se han puesto en marcha las consultas telemáticas. Este cambio se ha implementado en muy poco tiempo, pero parece que ha venido para quedarse. No obstante, hay grandes dudas sobre aspectos organizativos, legales, posibilidades de mejora, etc. En este documento de consenso de la Sociedad Española de Cardiología, tratamos de dar las claves para mejorar la calidad asistencial en nuestras nuevas consultas telemáticas, revisando las afecciones que el cardiólogo clínico atiende con más frecuencia en su consulta ambulatoria y proponiendo unos mínimos en ese proceso asistencial. Estas enfermedades son la cardiopatía isquémica, la insuficiencia cardiaca y las arritmias. En los 3 escenarios tratamos de clarificar los aspectos fundamentales que hay que revisar en la entrevista telefónica, a qué pacientes habrá que atender en una consulta presencial y cuáles serán los criterios para su seguimiento en atención primaria. El documento también recoge distintas mejoras que pueden introducirse en la consulta telemática para mejorar la asistencia de nuestros pacientes.
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Affiliation(s)
- Vivencio Barrios
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, España
| | - Juan Cosín-Sales
- Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, España
| | - Marisol Bravo
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España
| | - Carlos Escobar
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España
| | - José M Gámez
- Servicio de Cardiología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - Ana Huelmos
- Servicio de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - Carolina Ortiz Cortés
- Servicio de Cardiología, Hospital Universitario San Pedro de Alcántara, Cáceres, España
| | | | - José Manuel García-Pinilla
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, España.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
| | | | | | | | | | | | - Marcelo Sanmartín
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, España
| | - Rafael Vidal-Pérez
- Servicio de Cardiología, Complejo Hospitalario Universitario A Coruña, A Coruña, España
| | - Ángel Cequier
- Servicio de Cardiología, Hospital Universitario de Bellvitge, IDIBELL, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
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García-Pinilla JM, Díez-Villanueva P, Crespo Leiro MG, Bonanad-Lozano C. Oxygen therapy and palliative care in patients with heart failure. Response. Rev Esp Cardiol (Engl Ed) 2020; 73:599. [PMID: 32376230 DOI: 10.1016/j.rec.2020.01.024] [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: 01/09/2020] [Accepted: 01/15/2020] [Indexed: 06/11/2023]
Affiliation(s)
- José Manuel García-Pinilla
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | | | - María G Crespo Leiro
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Clara Bonanad-Lozano
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
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18
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Crespo-Leiro MG, Barge-Caballero E, Segovia-Cubero J, González-Costello J, López-Fernández S, García-Pinilla JM, Almenar-Bonet L, de Juan-Bagudá J, Roig-Minguell E, Bayés-Genís A, Sanz-Julve M, Lambert-Rodríguez JL, Lara-Padrón A, Pérez-Ruiz JM, Fernández-Vivancos Marquina C, de la Fuente-Galán L, Varela-Román A, Torres-Calvo F, Andrés-Novales J, Escudero-González A, Pascual-Figal DA, Ridocci-Soriano F, Sahuquillo-Martínez A, Bierge-Valero D, Epelde-Gonzalo F, Gallego-Page JC, Dalmau González-Gallarza R, Bover-Freire R, Quiles-Granado J, Maggioni AP, Lund LH, Muñiz J, Delgado-Jiménez J. Hiperpotasemia en pacientes con insuficiencia cardiaca en España y su impacto en las recomendaciones. Registro ESC-EORP-HFA Heart Failure Long-Term. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Mitroi C, Martín-García A, Mazón Ramos P, Virizuela Echaburu JA, Arenas-Prat M, García-Sanz R, Arrarte Esteban V, García-Pinilla JM, Cosín-Sales J, López-Fernández T. Current functioning of cardio-oncology units in Spain. Clin Transl Oncol 2019; 22:1418-1422. [PMID: 31863353 DOI: 10.1007/s12094-019-02250-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/11/2019] [Accepted: 11/24/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of the current survey was to describe the functioning of cardio-oncology (C-O) units in Spain. METHODS All members of the Spanish Society of Cardiology pertaining to scientific communities related to C-O received questionnaires on the existence of specific programs at their institutions. A second, more extensive questionnaire was sent to the centers which reported C-O organization. RESULTS We identified 56 centers with C-O programs of which 32 (62.5%) replied to the extended questionnaire. 28% of all centers reported having a multidisciplinary unit involving specialists in several areas. More than 80% of the centers developed surveillance protocols locally adapted which included advanced echocardiographic techniques (68%) or troponin (82%). CONCLUSIONS The number of institutions with C-O programs is still limited but higher than reported in a survey in 2017. Development of multidisciplinary units of C-O should be promoted to improve the cardiovascular health of cancer patients.
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Affiliation(s)
- C Mitroi
- Cardiology Department, University Hospital Puerta de Hierro, Majadahonda, Manuel de Falla 1, 28222, Madrid, Spain.
| | - A Martín-García
- Cardiology Department, Institute for Biomedical Research of Salamanca (IBSAL), CIBER-CV, University Hospital of Salamanca (CAUSA), Salamanca, Spain
| | - P Mazón Ramos
- Cardiology Department, University Clinical Hospital Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | - M Arenas-Prat
- Radiation Oncology Department, University Hospital Sant Joan de Reus, Rovira i Virgili University, Reus, Tarragona, Spain
| | - R García-Sanz
- Hematology Department, Institute for Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca (CAUSA), Salamanca, Spain
| | - V Arrarte Esteban
- Cardiology Department, University General Hospital Alicante, Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - J M García-Pinilla
- Cardiology Department, IBIMA, CIBER-CV, University Hospital Virgen de la Victoria, Málaga, Spain
| | - J Cosín-Sales
- Cardiology Department, Arnau de Vilanova Hospital, Valencia, Spain
| | - T López-Fernández
- Cardiology Department, Institute for Health Research La Paz, CIBER-CV, University Hospital La Paz, Madrid, Spain
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López-Sainz Á, Salazar-Mendiguchía J, García-Álvarez A, Campuzano Larrea O, López-Garrido MÁ, García-Guereta L, Fuentes Cañamero ME, Climent Payá V, Peña-Peña ML, Zorio-Grima E, Jordá-Burgos P, Díez-López C, Brugada R, García-Pinilla JM, García-Pavía P. Características clínicas y pronóstico de la enfermedad de Danon. Análisis del registro multicéntrico español. Rev Esp Cardiol 2019. [PMID: 30108015 DOI: 10.1016/j.recesp.2018.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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López-Sainz Á, Salazar-Mendiguchía J, García-Álvarez A, Campuzano Larrea O, López-Garrido MÁ, García-Guereta L, Fuentes Cañamero ME, Climent Payá V, Peña-Peña ML, Zorio-Grima E, Jordá-Burgos P, Díez-López C, Brugada R, García-Pinilla JM, García-Pavía P. Clinical Findings and Prognosis of Danon Disease. An Analysis of the Spanish Multicenter Danon Registry. ACTA ACUST UNITED AC 2018; 72:479-486. [PMID: 30108015 DOI: 10.1016/j.rec.2018.04.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/10/2018] [Accepted: 04/23/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Danon disease (DD) is caused by mutations in the LAMP2 gene. It is considered a multisystemic disease characterized by hypertrophic cardiomyopathy with pre-excitation and extreme hypertrophy, intellectual disability, myopathy, childhood presentation, and worse prognosis in men. There are scarce data on the clinical characteristics and prognosis of DD. METHODS We analyzed the clinical records of patients with DD from 10 Spanish hospitals. RESULTS Twenty-seven patients were included (mean age, 31 ± 19 years; 78% women). Male patients showed a high prevalence of extracardiac manifestations: myopathy (80%), learning disorders (83%), and visual alterations (60%), which were uncommon findings in women (5%, 0%, and 27%, respectively). Although hypertrophic cardiomyopathy was the most common form of heart disease (61%), the mean maximum wall thickness was 15 ± 7 mm and dilated cardiomyopathy was present in 12 patients (10 women). Pre-excitation was found in only 11 patients (49%). Age at presentation was older than 20 years in 16 patients (65%). After a median follow-up of 4 years (interquartile range, 2-9), 4 men (67%) and 9 women (43%) died or required a transplant. Cardiac disease and adverse events occurred later in women (37 ± 9 vs 23 ± 16 and 36 ± 20 vs 20 ± 11 years, respectively). CONCLUSIONS The clinical characteristics of DD differ substantially from traditional descriptions: age at presentation of DD is older, the disease is not multisystemic in women, and pre-excitation is infrequent.
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Affiliation(s)
- Ángela López-Sainz
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Joel Salazar-Mendiguchía
- Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Departamento de Genética, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Ana García-Álvarez
- Servicio de Cardiología, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Oscar Campuzano Larrea
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Centro Genética Cardiovascular, Institut d'Investigacions Biomèdiques de Girona, Girona, Spain; Departamento Ciencias Médicas, Facultad de Medicina, Universidad de Girona, Girona, Spain
| | - Miguel Ángel López-Garrido
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Luis García-Guereta
- Servicio de Cardiología Pediátrica, Hospital Universitario La Paz, Madrid, Spain
| | | | - Vicente Climent Payá
- Servicio de Cardiología, Hospital General Universitario de Alicante, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - María Luisa Peña-Peña
- Unidad de Imagen y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Esther Zorio-Grima
- Unidad de Cardiopatías Familiares, Muerte Súbita y Mecanismos de Enfermedad (CaFaMuSMe), Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Paloma Jordá-Burgos
- Servicio de Cardiología, Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Carles Díez-López
- Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ramón Brugada
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Centro Genética Cardiovascular, Institut d'Investigacions Biomèdiques de Girona, Girona, Spain; Departamento Ciencias Médicas, Facultad de Medicina, Universidad de Girona, Girona, Spain; Unidad Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
| | - José Manuel García-Pinilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Pablo García-Pavía
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain.
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García-Pinilla JM, Farrero Torres M, González-Vílchez F, Barge Caballero E, Masip J, Segovia Cubero J. Selección de lo mejor del año 2017 en insuficiencia cardiaca aguda y crónica. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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23
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García-Pinilla JM, Farrero Torres M, González-Vílchez F, Barge Caballero E, Masip J, Segovia Cubero J. Selection of the Best of 2017 in Acute and Chronic Heart Failure. Rev Esp Cardiol (Engl Ed) 2018; 71:298-299. [PMID: 29373252 DOI: 10.1016/j.rec.2017.11.026] [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: 09/17/2017] [Accepted: 11/02/2017] [Indexed: 06/07/2023]
Affiliation(s)
- José Manuel García-Pinilla
- Servicio de Cardiología, Unidad de Gestión de Cardiología y Cirugía Cardiaca, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain.
| | | | | | - Eduardo Barge Caballero
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidad de A Coruña (UDC), A Coruña, Spain
| | - Josep Masip
- Servicio de Cardiología, Hospital Sanitas CIMA Barcelona, Servei de Medicina Intensiva, Consorci Sanitari Integral, Universitat de Barcelona, Barcelona, Spain
| | - Javier Segovia Cubero
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
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24
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Charron P, Elliott PM, Gimeno JR, Caforio ALP, Kaski JP, Tavazzi L, Tendera M, Maupain C, Laroche C, Rubis P, Jurcut R, Calò L, Heliö TM, Sinagra G, Zdravkovic M, Kavoliūnienė A, Felix SB, Grzybowski J, Losi MA, Asselbergs FW, García-Pinilla JM, Salazar-Mendiguchia J, Mizia-Stec K, Maggioni AP, Anastasakis A, Biagini E, Bilinska Z, Castro FJ, Celutkiene J, Chakova N, Chmielewski P, Drago F, Frigy A, Frustaci A, Garcia-Pavia P, Hinic S, Kindermann I, Limongelli G, Medrano C, Monserrat L, Olusegun-Joseph A, Ripoll-Vera T, Rocha Lopes L, Saad A, Sala S, Seferovic PM, Sepp R, Urbano-Moral JA, Villacorta E, Wybraniec M, Yotti R, Zachara E, Zorio E. The Cardiomyopathy Registry of the EURObservational Research Programme of the European Society of Cardiology: baseline data and contemporary management of adult patients with cardiomyopathies. Eur Heart J 2018; 39:1784-1793. [DOI: 10.1093/eurheartj/ehx819] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/09/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Philippe Charron
- Centre de Référence des Maladies Cardiaques Héréditaires, Assistance Publique-Hôpitaux de Paris, ICAN, Hôpital Pitié-Salpêtrière, 47 Bvd de l’hôpital, 75013 Paris, France
- Université Versailles Saint Quentin & AP-HP, CESP, INSERM U1018, Hôpital Ambroise Paré, 9, Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
| | - Perry M Elliott
- University College London and Inherited Cardiac Diseases Unit, Barts Heart Centre, St Bartholomew’s Hospital, West Smithfield, EC1A 7BE London, UK
| | - Juan R Gimeno
- Cardiac Department, Hospital Universitario Virgen de la Arrixaca, Ctra. Murcia-Cartagena s/n, 30120 El Palmar Murcia, Spain
- CIBER in Cardiovascular Diseases, Instituto Carlos III, Av. de Monforte de Lemos 5, 28029 Madrid, Spain
| | - Alida L P Caforio
- Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences, University of Padova, via N Giustiniani 2, 35100 Padova, Italy
| | - Juan Pablo Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, WC1N 3JH London, UK
| | - Luigi Tavazzi
- GVM Care and Research, E.S. Health Science Foundation, Maria Cecilia Hospital, Via Corriera, 1, 48010 Cotignola, Italy
| | - Michal Tendera
- Department of Cardiology and Structural Heart Diseases, School of Medicine in Katowice, Medical University of Silesia, Ziolowa Street 45/47, 40-635 Katowice, Poland
| | - Carole Maupain
- Centre de Référence des Maladies Cardiaques Héréditaires, Assistance Publique-Hôpitaux de Paris, ICAN, Hôpital Pitié-Salpêtrière, 47 Bvd de l’hôpital, 75013 Paris, France
| | - Cécile Laroche
- EURObservational Research Programme, European Society of Cardiology, 2035 Route des colles, CS 80179 Biot, 06903 Sophia-Antipolis Cedex, France
| | - Pawel Rubis
- Department of Cardiac and Vascular Diseases, John Paul II Hospital, Institute of Cardiology, Jagiellonian University Medical College, Pradnicka street 80, 31-202 Krakow, Poland
| | - Ruxandra Jurcut
- Institute of Emergency for Cardiovascular Diseases “Prof.dr.C.C.Iliescu”, UMF “Carol Davila”, Sos. Fundeni 258, 22328 Bucharest, Romania
| | - Leonardo Calò
- Policlinico Casilino, U.O. Cardiologia, Via Casilina, 1049, 00169 Roma, Italy
| | - Tiina M Heliö
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland
| | - Gianfranco Sinagra
- Cardiovascular Department, Center for Cardiomyopathies, Azienda Sanitaria Universitaria Integrata, University of Trieste, Via P. Valdoni 7, 34100 Trieste, Italy
| | - Marija Zdravkovic
- University Hospital Medical Center Bezanijska kosa, Faculty of Medicine, University of Belgrade, Dragise Brasovana 13/8, 11077 Belgrade, Serbia
| | - Aušra Kavoliūnienė
- Lithuanian University of Health Sciences, Eiveniu Str. 2, 50009 Kaunas, Lithuania
| | - Stephan B Felix
- Department for Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch Strasse, 17475 Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Jacek Grzybowski
- Department of Cardiomyopathies, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Maria-Angela Losi
- Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S. Pansini 5, 80131 Naples, Italy
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, 3508 GA Utrecht, The Netherlands
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, Gower Street, WC1E 6BT London, UK
| | - José Manuel García-Pinilla
- CIBER in Cardiovascular Diseases, Instituto Carlos III, Av. de Monforte de Lemos 5, 28029 Madrid, Spain
- Heart failure and familial cardiomyopathies division, Cardiology department, Hospital Universitario Virgen de la Victoria, IBIMA, Campus Universitario Teatinos, 29010 Málaga, Spain
| | - Joel Salazar-Mendiguchia
- Cardiomyopathy, Heart Failure and Transplant Program, Hospital Universistari de Bellvitge, Heart Diseases Institute, Av. Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Katarzyna Mizia-Stec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Ochojec, Ziolowa Street 45/47, 40-635 Katowice, Poland
| | - Aldo P Maggioni
- EURObservational Research Programme, European Society of Cardiology, 2035 Route des colles, CS 80179 Biot, 06903 Sophia-Antipolis Cedex, France
- ANMCO Research Center, Via La Marmora, 34 50121 Firenze, Italy
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Rodríguez-Capitán J, Fernández-Meseguer A, García-Pinilla JM, Calvo-Bonacho E, Jiménez-Navarro M, García-Margallo T, Cabrera-Bueno F, Echeverria-Lucotti I, Gómez-Doblas JJ, De Teresa-Galván E. Frequency of different electrocardiographic abnormalities in a large cohort of Spanish workers. Europace 2017; 19:1855-1863. [PMID: 28339570 DOI: 10.1093/europace/euw283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/07/2016] [Accepted: 08/13/2016] [Indexed: 11/13/2022] Open
Abstract
Aims Our aim was to describe the electrocardiographic findings of a large sample of Spanish workers from several different employment sectors. Methods and results Between May 2008 and November 2010, 13 495 consecutive 12-lead resting electrocardiograms (ECGs) were obtained during health examinations of working adults aged 16-74 years in 5 cities in different regions of Spain. Of those, 13 179 ECGs suitable for interpretation were included in this study. All tracings were classified by the same cardiologist, according to the Minnesota Code criteria. The mean age of the sample was 40 years, and 73.4% were male. Frequencies of complete right bundle branch block, complete left bundle branch block, and left ventricular hypertrophy were 1.1, 0.2, and 3.6%, respectively. Major Q wave abnormalities were observed in 1.7% of the subjects, T wave abnormalities in 0.7%, early repolarization in 2.4%, and other ST segment abnormalities in 0.2%. Atrial fibrillation was present in 0.08% of the workers and atrial flutter in 0.02%. Frequencies of the Wolff-Parkinson-White pattern, Brugada pattern, long QT pattern, and short QT pattern were 0.2, 0.068, 0.038, and 0.015%, respectively. Conclusion This study shows the electrocardiographic findings of a large sample of Spanish workers from several different employment sectors. The frequencies of many ECG patterns related to an adverse prognosis (left ventricular hypertrophy, complete left bundle branch block, T wave abnormalities, ST segment abnormalities, and atrial fibrillation) were low.
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Affiliation(s)
| | | | - José Manuel García-Pinilla
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | | | - Manuel Jiménez-Navarro
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | | | - Fernando Cabrera-Bueno
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | | | - Juan José Gómez-Doblas
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Eduardo De Teresa-Galván
- Unidad de Gestión Clínica del Corazón, Hospital Clínico Universitario Virgen de la Victoria de Málaga Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
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26
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Becerra-Muñoz VM, Sobrino-Márquez JM, Rangel-Sousa D, Fernández-Cisnal A, Lage-Gallé E, García-Pinilla JM, Martínez-Martínez Á, de Teresa-Galván E. Long-term prognostic role of CA-125 in noncongestive patients undergoing a cardiac transplantation. Biomark Med 2017; 11:239-243. [PMID: 28156128 DOI: 10.2217/bmm-2016-0247] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIM To evaluate the possible relationship between high levels of CA-125 and long-term prognosis in chronic heart failure patients after they undergo a cardiac transplantation (CT). MATERIALS & METHODS We retrospectively studied all patients who underwent a CT and had a previous determination of CA-125. Congestive patients and those whose survival was <1 year after CT were excluded. RESULTS Of 55 patients, 23 had elevated CA-125 levels (>35 U/ml). After CT, survival was significantly inferior in this group (96.3 vs 81%, 84.9 vs 64%, 70.7 vs 32.9% at 2, 5 and 8 years, p = 0.014). CA-125 >35 U/ml was the only factor independently associated to long-term mortality (OR: 3.94; 95% CI: 1.2-12.82; p = 0.023). CONCLUSION Noncongestive patients with high levels of CA-125 had inferior long-term survival after CT.
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Affiliation(s)
- Víctor Manuel Becerra-Muñoz
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), CIBERCV Enfermedades Cardiovasculares, Málaga, Spain
| | - José Manuel Sobrino-Márquez
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Diego Rangel-Sousa
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Ernesto Lage-Gallé
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - José Manuel García-Pinilla
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), CIBERCV Enfermedades Cardiovasculares, Málaga, Spain
| | | | - Eduardo de Teresa-Galván
- Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), CIBERCV Enfermedades Cardiovasculares, Málaga, Spain
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Crespo-Leiro MG, Segovia-Cubero J, González-Costello J, Bayes-Genis A, López-Fernández S, Roig E, Sanz-Julve M, Fernández-Vivancos C, de Mora-Martín M, García-Pinilla JM, Varela-Román A, Almenar-Bonet L, Lara-Padrón A, de la Fuente-Galán L, Delgado-Jiménez J. Adecuación en España a las recomendaciones terapéuticas de la guía de la ESC sobre insuficiencia cardiaca: ESC Heart Failure Long-term Registry. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2015.03.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Crespo-Leiro MG, Segovia-Cubero J, González-Costello J, Bayes-Genis A, López-Fernández S, Roig E, Sanz-Julve M, Fernández-Vivancos C, de Mora-Martín M, García-Pinilla JM, Varela-Román A, Almenar-Bonet L, Lara-Padrón A, de la Fuente-Galán L, Delgado-Jiménez J. Adherence to the ESC Heart Failure Treatment Guidelines in Spain: ESC Heart Failure Long-term Registry. ACTA ACUST UNITED AC 2015; 68:785-93. [PMID: 26003504 DOI: 10.1016/j.rec.2015.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 12/03/2014] [Accepted: 03/11/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION AND OBJECTIVES To estimate the percentage of heart failure patients in Spain that received the European Society of Cardiology recommended treatments, and in those that did not, to determine the reasons why. METHODS The study included 2834 consecutive ambulatory patients with heart failure from 27 Spanish hospitals. We recorded general information, the treatment indicated, and the reasons why it was not prescribed in some cases. In patients who met the criteria to receive a certain drug, true undertreatment was defined as the percentage of patients who, without justification, did not receive the drug. RESULTS In total, 92.6% of ambulatory patients with low ejection fraction received angiotensin converting enzyme inhibitors or angiotensin receptor blockers, 93.3% beta-blockers, and 74.5% mineralocorticoid receptor antagonists. The true undertreatment rates were 3.4%, 1.8%, and 19.0%, respectively. Target doses were reached in 16.2% of patients receiving angiotensin converting enzyme inhibitors, 23.3% of those with angiotensin receptor blockers, 13.2% of those prescribed beta-blockers, and 23.5% of those with mineralocorticoid receptor antagonists. Among patients who could benefit from ivabradine, 29.1% received this drug. In total, 36% of patients met the criteria for defibrillator implantation and 90% of them had received the device or were scheduled for implantation, whereas 19.6% fulfilled the criteria for resynchronization therapy and 88.0% already had or would soon have the device. In patients who met the criteria, but did not undergo device implantation, the reasons were not cost-related. CONCLUSIONS When justified reasons for not administering heart failure drugs were taken into account, adherence to the guideline recommendations was excellent. Exclusive use of the percentage of treated patients is a poor indicator of the quality of healthcare in heart failure. Measures should be taken to improve the attainment of optimal dosing in each patient.
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Affiliation(s)
- María G Crespo-Leiro
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), A Coruña, Spain.
| | - Javier Segovia-Cubero
- Unidad de Insuficiencia Cardiaca Avanzada, Trasplante e Hipertensión Pulmonar, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - José González-Costello
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante, Servicio de Cardiología, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Bayes-Genis
- Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Silvia López-Fernández
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Eulàlia Roig
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marisa Sanz-Julve
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante, Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Manuel de Mora-Martín
- Unidad de Gestión del Corazón y Enfermedades Cardiovasculares, Servicio de Cardiología, Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - José Manuel García-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Área de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Alfonso Varela-Román
- Servicio de Cardiología, Hospital Clínico Universitario Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Luis Almenar-Bonet
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Antonio Lara-Padrón
- Servicio de Cardiología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Luis de la Fuente-Galán
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Juan Delgado-Jiménez
- Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Rodríguez-Capitán J, García-Pinilla JM, Ruiz-Zamora I, Rueda-Calle E, Morcillo-Hidalgo L, Jurado-Canca C, Robledo-Carmona J, Gómez-Doblas JJ, de Teresa-Galván E. Reply to the letter "Prognostic value of late gadolinium enhancement in cardiomyopathy: Causative risk factor or surrogate marker?". Int J Cardiol 2014; 181:102-3. [PMID: 25497528 DOI: 10.1016/j.ijcard.2014.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 12/01/2014] [Indexed: 12/17/2022]
Affiliation(s)
- Jorge Rodríguez-Capitán
- Sección de Cardiología, Unidad de Medicina Interna, Hospital de Poniente, Carretera de Almerimar s/n, 04700 El Ejido, Almería, Spain.
| | - José Manuel García-Pinilla
- Área del Corazón, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010 Málaga, Spain
| | - Isabel Ruiz-Zamora
- Sección de Cardiología, Unidad de Medicina Interna, Fundación Hospital Calahorra, Carretera de Logroño s/n, 26500 Calahorra, La Rioja, Spain
| | - Eloy Rueda-Calle
- Área del Corazón, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010 Málaga, Spain
| | - Luis Morcillo-Hidalgo
- Área del Corazón, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010 Málaga, Spain
| | - Carmen Jurado-Canca
- Unidad de Cardiología, Hospital Parque San Antonio, Avenida Pintor Joaquín Sorolla n°2, 29016, Málaga, Spain
| | - Juan Robledo-Carmona
- Área del Corazón, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010 Málaga, Spain
| | - Juan José Gómez-Doblas
- Área del Corazón, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010 Málaga, Spain
| | - Eduardo de Teresa-Galván
- Área del Corazón, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010 Málaga, Spain
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Rodríguez-Capitán J, García-Pinilla JM, Ruiz-Zamora I, Rueda-Calle E, Morcillo-Hidalgo L, Jurado-Canca C, Robledo-Carmona J, Gómez-Doblas JJ, de Teresa-Galván E. Long-term prognostic value of late gadolinium enhancement in a cohort of patients with nonischemic dilated cardiomyopathy. Int J Cardiol 2014; 177:17-9. [DOI: 10.1016/j.ijcard.2014.09.110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 09/20/2014] [Indexed: 10/24/2022]
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Ruiz-Salas A, Cabrera-Bueno F, García-Pinilla JM, Barrera-Cordero A, Peña-Hernández J, Fernández-Pastor J, Medina-Palomo C, Alzueta-Rodríguez J. Long-term prognosis of patients with arrhythmogenic right ventricular cardiomyopathy and implantable defibrillator. Int J Cardiol 2014; 174:794-6. [PMID: 24794057 DOI: 10.1016/j.ijcard.2014.04.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 04/09/2014] [Indexed: 01/23/2023]
Affiliation(s)
- Amalio Ruiz-Salas
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain.
| | - Fernando Cabrera-Bueno
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - José Manuel García-Pinilla
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Alberto Barrera-Cordero
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - José Peña-Hernández
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Julia Fernández-Pastor
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Carmen Medina-Palomo
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Javier Alzueta-Rodríguez
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
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Subirana MT, Barón-Esquivias G, Manito N, Oliver JM, Ripoll T, Lambert JL, Zunzunegui JL, Bover R, García-Pinilla JM. 2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant. ACTA ACUST UNITED AC 2014; 67:211-7. [PMID: 24774396 DOI: 10.1016/j.rec.2013.10.012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 10/02/2013] [Indexed: 11/25/2022]
Abstract
This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices.
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Affiliation(s)
- M Teresa Subirana
- Unidad de Cardiopatías Congénitas del Adolescente y Adulto Vall d'Hebron-Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | | | - Nicolás Manito
- Unidad de Insuficiencia Cardiaca y Trasplante Cardiaco, Hospital Universitario de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain
| | - José M Oliver
- Unidad de Cardiopatías Congénitas del Adulto, Hospital La Paz, Madrid, Spain
| | - Tomás Ripoll
- Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - Jose Luis Lambert
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco del Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - José L Zunzunegui
- Unidad de Cardiología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ramon Bover
- Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital Clínico Universitario San Carlos Madrid, Spain
| | - José Manuel García-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Hospital Universitario Virgen de la Victoria, Málaga, Spain
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Isasti G, García-Pinilla JM, Jiménez-Navarro MF, Gómez-Doblas JJ, Cabrera-Bueno F, Rodríguez-Losada N, Robledo-Carmona J, de Teresa-Galván E. Elevation of circulating progenitor cells in patients with acute myocarditis. Int J Cardiol 2014; 172:608-9. [PMID: 24485612 DOI: 10.1016/j.ijcard.2014.01.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/18/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Guillermo Isasti
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - José Manuel García-Pinilla
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Manuel F Jiménez-Navarro
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain.
| | - Juan José Gómez-Doblas
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Fernando Cabrera-Bueno
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Noela Rodríguez-Losada
- Laboratorio de Medicina Regenerativa, Instituto de Biomedicina de Málaga (IBIMA), Hospital Regional Carlos Haya, Avda. Carlos Haya s/n, Málaga, Spain
| | - Juan Robledo-Carmona
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
| | - Eduardo de Teresa-Galván
- UGC del Corazón, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, Málaga, Spain
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Subirana MT, Barón-Esquivias G, Manito N, Oliver JM, Ripoll T, Lambert JL, Zunzunegui JL, Bover R, García-Pinilla JM. Actualización 2013 en cardiopatías congénitas, cardiología clínica e insuficiencia cardiaca y trasplante. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jiménez-Navarro MF, González FJ, Caballero-Borrego J, Marchal JA, Rodríguez-Losada N, Carrillo E, García-Pinilla JM, Hernández-García JM, Pérez-González R, Ramírez G, Aránega A, de Teresa Galván E. La extensión de la enfermedad coronaria determina la movilización de las células progenitoras endoteliales y las citocinas tras un primer infarto de miocardio con elevación del ST. Rev Esp Cardiol 2011; 64:1123-9. [DOI: 10.1016/j.recesp.2011.07.003] [Citation(s) in RCA: 7] [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] [Received: 05/12/2011] [Accepted: 07/03/2011] [Indexed: 01/14/2023]
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Garrido-Sánchez L, García-Pinilla JM, Jiménez-Navarro M, Fernández-Pastora J, Alonso-Briales JH, Hernández-Garcia JM, De-Teresa-Galván E, Tinahones FJ. Reduced levels of anti-MDA LDL antibodies in patients with carbohydrate metabolism disorders. Clin Lab 2011; 57:901-907. [PMID: 22239020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Diabetic patients undergoing percutaneous coronary intervention (PCI) have a worse prognosis than non-diabetic patients. The anti-oxidized LDL antibodies (anti-LDLox ab) have recently been suggested to be protective against the development of diabetes. The aim of this study was to compare the levels of IgG and IgM anti-oxidized LDL antibodies with reference to the new diagnostic criteria for carbohydrate metabolism disorders after an oral glucose tolerance test (OGTT) in hospitalized patients scheduled to undergo percutaneous coronary intervention. METHODS We undertook a cross-sectional study of 110 patients undergoing PCI. The patients were classified as being normal (oral glucose test tolerance normal, OGTT-N), or having impaired glucose tolerance (IGT) or type 2 diabetes mellitus (T2DM) according to their glucose levels at baseline and after an OGTT. RESULTS An inverse slope was found in the levels of IgG anti-oxidized LDL antibodies between the OGTT-N patients (optical density (OD) = 0.109) and the patients with IGT (OD = 0.099) or T2DM (OD = 0.084) (p = 0.019). An inverse correlation was also detected between the levels of IgG anti-oxidized LDL antibodies and baseline glycemia (r = -0.23, p = 0.018). CONCLUSIONS Patients with coronary disease and carbohydrate metabolism disorders have much lower levels of IgG anti-oxidized LDL antibodies than normoglycemic patients.
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Molina-Mora MJ, Cabrera-Bueno F, Jiménez-Navarro M, Linde-Estrella A, García-Pinilla JM, Teresa-Galván ED. [Prognostic value of B-type natriuretic peptide in unstable angina and non-ST-elevation myocardial infarction]. Med Clin (Barc) 2009; 133:569-73. [PMID: 19783260 DOI: 10.1016/j.medcli.2009.04.057] [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: 02/09/2009] [Accepted: 04/16/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The B-type natriuretic peptide (BNP) has recently emerged as a prognostic marker in acute coronary syndromes (ACS). This role is based on results from randomized trials and other high selected population studies. The aim of this study was to determine the prognostic value of BNP in unselected patients with non-ST-elevated-ACS. PATIENTS AND METHOD BNP plasma concentrations were measured in 100 consecutive patients admitted in 2007 with non-ST-elevated-ACS, taking as cut-off value 80pg/ml (high BNP levels on 48% of patients). RESULTS After one year-of follow-up, 21 major adverse cardiovascular events occurred: 12 ACS, 7 hospitalizations for heart failure and 2 sudden cardiac deaths. No relationship was found between BNP levels and events on follow-up. BNP >80pg/ml was the only independent predictor of heart failure and death. No relationship was found between high levels of BNP and coronary events during the follow-up. CONCLUSIONS BNP was an independent predictor of heart failure and mortality in unselected patients with non-ST-elevated-ACS.
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Caballero-Borrego J, Gómez-Doblas JJ, Cabrera-Bueno F, García-Pinilla JM, Melero JM, Porras C, Olalla E, De Teresa Galván E. Incidence, associated factors and evolution of non-severe functional mitral regurgitation in patients with severe aortic stenosis undergoing aortic valve replacement. Eur J Cardiothorac Surg 2008; 34:62-6. [DOI: 10.1016/j.ejcts.2008.03.055] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 03/25/2008] [Accepted: 03/31/2008] [Indexed: 10/22/2022] Open
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García-Pinilla JM, Gálvez J, Cabrera-Bueno F, Jiménez-Navarro M, Gómez-Doblas JJ, Galisteo M, Camuesco D, de Teresa Galván C, Espinosa-Caliani S, Zarzuelo A, de Teresa-Galván E. Baseline glutathione peroxidase activity affects prognosis after acute coronary syndromes. Tex Heart Inst J 2008; 35:262-267. [PMID: 18941641 PMCID: PMC2565519] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Oxidative stress is associated with atherosclerosis and plaque lesions in experimental in vitro models. Few in vivo studies have examined the association between redox status and the prognosis of acute coronary syndromes.We undertook a prospective, observational study of 137 patients who had been admitted because of an acute coronary syndrome. We determined glutathione peroxidase activity (a marker of systemic antioxidant status) and recorded clinical and angiographic features and cardiovascular events (cardiovascular death, reinfarction, readmission with a new ischemic event, or need for coronary revascularization).The mean age of the patients (78% of whom were men) was 61.7 +/- 10.9 years; 76% were admitted with non-ST-segment-elevation acute coronary syndrome. Left ventricular ejection fraction was normal in 61%. In the 23.4% who experienced cardiovascular events, glutathione peroxidase activity was higher (mean, 2.38 vs 1.76 mU/mg of protein; P < 0.01). Two-year event-free survival was lower in patients whose glutathione peroxidase activity was higher than the 50th percentile (63% vs 82%; P = 0.01). Multivariate analysis showed a direct independent relationship between glutathione peroxidase activity and cardiovascular events (hazard ratio, 3.72; 95% confidence interval, 1.53-9.02; P < 0.01).We conclude that patients who experienced acute coronary syndromes and events during follow-up had higher plasma glutathione peroxidase activity, and that glutathione peroxidase activity was an independent predictor of events during follow-up.
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Cabrera-Bueno F, García-Pinilla JM, Peña-Hernández J, Jiménez-Navarro M, Gómez-Doblas JJ, Barrera-Cordero A, Alzueta-Rodríguez J, de Teresa-Galván E. Repercussion of functional mitral regurgitation on reverse remodelling in cardiac resynchronization therapy. Europace 2007; 9:757-61. [PMID: 17573358 DOI: 10.1093/europace/eum122] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Cardiac resynchronization therapy (CRT) reduces the degree of functional mitral regurgitation (FMR). However, FMR has also been associated with a lack of clinical response to CRT. We undertook this study to determine whether the presence of FMR influences the reverse remodelling induced by CRT. METHODS AND RESULTS We used Doppler echocardiography to assess 20 patients with dilated cardiomyopathy before and 6 months after undergoing CRT. We evaluated the effect of reverse remodelling (reduction > or = 10% in end-systolic volume) according to the presence or absence of important FMR, defined as a regurgitant orifice area (ROA) of > or = 0.20 cm(2). Of the 20 patients (mean age, 64.7 +/- 8.2 years, eight women), 9 had marked FMR (ROA 0.40 +/- 0.12 cm(2)), 6 mild FMR (ROA 0.15 +/- 0.02 cm(2)), and 5 had trivial or no FMR. CRT reduced the presence of mitral regurgitation by 33.3% and induced reverse remodelling in 60% of the patients. A ROA > or = 0.20 cm(2) was associated with a lack of reverse remodelling, despite presenting similar baseline characteristics and a reduction in asynchrony to the other patients. Reverse remodelling was produced in all the other patients, with a significant reduction in end-systolic volume (41.7 +/- 21%; P = 0.003), accompanied by improvement in the ejection fraction (P = 0.003) and myocardial performance index (P = 0.027). CONCLUSION CRT improved FMR, although the baseline presence of important mitral regurgitation, with a ROA > or = 0.20 cm(2), in patients undergoing CRT was associated with a lack of response in reverse remodelling.
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Affiliation(s)
- Fernando Cabrera-Bueno
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria de Málaga, Campus de Teatinos s/n, Colonia Santa Ines, Malaga, Spain.
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García-Pinilla JM, Espinosa-Caliani S, Gómez-Doblas JJ, Jiménez-Navarro M, Gaitán MJ, Muñoz-Morán E, Cabrera-Bueno F, Hernández-García JM, Ortega-Jiménez MV, Ruiz-Galdón M, Reyes-Engel A, de Teresa-Galván E. Influence of high homocysteine and low folate plasmatic levels in medium-term prognosis after acute coronary syndromes. Int J Cardiol 2007; 118:220-6. [PMID: 17023072 DOI: 10.1016/j.ijcard.2006.06.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Revised: 06/05/2006] [Accepted: 06/11/2006] [Indexed: 11/22/2022]
Abstract
BACKGROUND To test prospectively whether moderate hyperhomocysteinemia and low folate levels could have an influence in the prognosis of 155 patients who presented with an acute coronary syndrome. METHODS AND RESULTS After a mean follow-up of 13.4+/-7.4 months, patients with low folate levels had higher percentages of cardiovascular death and major cardiovascular events (33% vs. 5%, p<0.001; 44% vs. 22%, p<0.05) and patients with high homocysteine levels had a higher percentage of major cardiovascular events (31% vs. 14.5%, p<0.03). Kaplan-Meier survival estimates analysis showed that patients with low folate levels had a significantly higher probability of cardiovascular death and lower free-of-events survival (log rank statistic: 21.17, p<0.001 and 6.59, p=0.01). Patients with high homocysteine levels had a lower free-of-events survival (log rank statistic: 4.95, p=0.02). Different survival multivariate analysis model showed that the presence of low folate levels was an independent predictor of cardiovascular death (hazard ratio 8.85, 95% confidence interval 2.6-29.3, p<0.000) and high homocysteine levels was identified as independent predictor of major cardiovascular events (hazard ratio 2.34, 95% confidence interval 1.07-5.12, p<0.03). CONCLUSIONS Low folate levels and moderate hyperhomocysteinemia were identified as independent predictors of cardiovascular events in the follow-up.
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Affiliation(s)
- José Manuel García-Pinilla
- Cardiology Department, Hospital Universitario Virgen de la Victoria, School of Medicine, University of Malaga, Spain
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Cabrera-Bueno F, García-Pinilla JM, Gómez-Doblas JJ, Montiel-Trujillo A, Rodríguez-Bailón I, de Teresa-Galván E. Beta-blocker therapy for dynamic left ventricular outflow tract obstruction induced by exercise. Int J Cardiol 2007; 117:222-6. [PMID: 16844244 DOI: 10.1016/j.ijcard.2006.04.080] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2005] [Revised: 04/05/2006] [Accepted: 04/28/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND In patients who present with angina, dynamic left ventricular outflow tract obstruction may be responsible of symptoms. The aim of our study was to evaluate the effect of negative inotropic therapy on ventricular physiology and symptoms of patients with dynamic left ventricular outflow tract obstruction induced by exercise in the absence of hypertrophic cardiomyopathy. METHODS Seventy eight patients with symptoms of angina, normal exercise SPECT test and normal resting left ventricular systolic function were prospectively analysed with exercise echocardiography. Fifteen of them developed high outflow tract velocities (greater than 2.57 m/s) on effort. After treatment with bisoprolol (mean dose 6.9+/-3.5 mg) in these patients, symptoms and dynamic left ventricular outflow tract obstruction during exercise were re-evaluated. RESULTS After negative inotropic therapy, there was a significant reduction of 86.6% in the development of intracavitary gradient (15 to 2 patients). In all patients the left ventricular outflow tract velocities decreased (2.91+/-0.4 m/s to 1.92+/-0.46 m/s, p=0.001). However, the oxygen consumption during exercise was higher (7.3+/-1.7 METs to 8.5+/-1.8 METs, p=0.005), and symptoms improved significantly following therapy, with a reduction in mean NYHA class from 1.9+/-0.5 to 1.0+/-0.0 (p=0.001). CONCLUSIONS Negative inotropic therapy may represent a beneficial therapeutic approach in selected patients with dynamic left ventricular outflow tract obstruction induced by exercise and identified during exercise echocardiography.
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Affiliation(s)
- Fernando Cabrera-Bueno
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Teatinos S/n, Colonia Santa Inés, 29010 Málaga, Spain.
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Jiménez-Navarro MF, Muñoz García AJ, García-Pinilla JM, Gómez Hernández G, Gómez-Doblas JJ, de Teresa Galván E. Evolución de las hospitalizaciones por insuficiencia cardíaca en Andalucía en la última década. Rev Clin Esp 2006; 206:474-6. [PMID: 17129514 DOI: 10.1157/13094894] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES The cost of hospitalization represents the greatest proportion of total expenditure due to heart failure. Our objective was to analyze the trends of morbidity of chronic heart failure in Andalusia between 1990-2000. MATERIAL AND METHODS The data on hospitalizations in Andalusia (title 428 of the ninth revision of the International Disease Classification) were obtained from the National Survey of Hospital Morbidity of the National Institute of Statistics. The rates, standardized by age and gender, of admission due to heart failure were calculated by the direct standardization method. RESULTS The absolute number of hospitalizations due to hear failure in people over 45 years was 4,345 in 1990 and 10,153 in 2000 (a relative increase of 230%) and it represents 14.2% hospitalizations in Spain. The increase was focused on those over 65 years and the standardized rates were slightly greater in women than in men. CONCLUSIONS Hospitalization discharge rates increased mostly in the population older than 65 and women showed hospitalization rates slightly greater than men.
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Affiliation(s)
- M F Jiménez-Navarro
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España.
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Jiménez-Navarro MF, Alonso-Briales J, Hernández-García JM, Curiel E, Kühlmorgen B, Gómez-Doblas JJ, García-Pinilla JM, Robledo J, De Teresa E. Usefulness of fractional flow reserve in multivessel coronary artery disease with intermediate lesions. J Interv Cardiol 2006; 19:148-52. [PMID: 16650243 DOI: 10.1111/j.1540-8183.2006.00122.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Calculation of myocardial fractional flow reserve (FFR) enables coronary stenoses to be evaluated. OBJECTIVES We determined the usefulness of measuring the FFR in multivessel coronary artery disease, reflected in changes in the therapeutic options for patients with moderate coronary stenosis. METHODS We studied 38 patients (30 men, 8 women; mean age: 59.8+/-10 years) with multivessel coronary artery disease with 41 moderate lesions. Indications for coronary angiography were unstable angina in 24 patients (60%), acute myocardial infarction in 10 (27%), and stable angina in 4 (13%). We studied the FFR (in nonactive lesions) in the left anterior descending artery in 23 patients (56%), the left coronary trunk in 8 (19.5%), the circumflex artery in 5 (12.2%), the right coronary artery in 3 (7.3%), and the left internal mammary artery and diagonal branch in 1 patient each. RESULTS Twelve patients had a positive FFR, which resulted in no change in the mode of revascularization; 26 patients had a negative FFR, in 20 (77%) of whom the revascularization approach was changed, especially those with moderate lesions of the left coronary trunk or anterior descending artery. No differences were detected in the angiographic characteristics of the lesions examined. Cardiac events during follow-up were few. CONCLUSIONS The results of FFR may influence the decision-making process after diagnostic coronary angiography in multivessel coronary artery disease with moderate lesions, especially in patients with a negative FFR in nonculprit lesions of the left trunk or left anterior descending artery.
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García-Pinilla JM, Jiménez-Navarro MF, Gómez Doblas JJ, Alonso JH, Hernández García JM, de Teresa Galván E. [Therapeutic attitude after coronariography in elderly patients with ischemic heart disease]. Rev Clin Esp 2006; 205:595-600. [PMID: 16527181 DOI: 10.1016/s0014-2565(05)72652-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The incidence of ischemic heart disease in the elderly is high. These patients are increasing referred for coronariography. OBJECTIVES Identify factors associated with coronary revascularization in elderly patients. MATERIAL AND METHODS Retrospective study of 473 patients > or = 75 years who underwent coronariography in relationship with ischemic heart disease. Their clinical-epidemiological characteristics and treatment adopted were analyzed. A multivariate analysis model was used to identify factors associated with revascularization. RESULTS Mean age was 77.6 +/- 2.8 years; 70.4% were men. A total of 36% smoked, 53% were hypertensive, 33% diabetics and 30% dislipidemic. Thirty one % had multivessel disease and 11% involvement of left coronary trunk. There was evidence of anterior descending artery in 68%. Medical treatment was done in 48.4%, percutaneous revascularization in 41.5% and surgical in 10.1%. Patients with lesions of the anterior descending artery were revascularized in greater proportion: 67.7% vs 32.3%; p. 0.001. A logistic regression model was used to identify revascularization predictors, obtaining a direct relationship with the involvement of the anterior descending artery (OR: 4.87; 95% CI: 2.98-7.94; (p < 0.001) and inverse on with the previous revascularization (OR: 0.47; 95% CI: 0.26-0.85; p < 0.02), left ventricular dysfunction (OR: 0.58; 95% CI: 0.39-0.88; p = 0.01) and presence of multivessel disease (OR: 0.51; 95% CI: 0.31-0.84; p < 0.01). CONCLUSIONS The elderly subjects with ischemic heart disease who underwent coronariography received revascularizing treatment in somewhat more than 50% of the cases. A direct relationship was found between involvement of the anterior descending artery and performance of revascularizing treatment and an inverse on between previous revascularization, left ventricular dysfunction and presence of multivessel disease.
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Affiliation(s)
- J M García-Pinilla
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga.
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Jiménez-Navarro M, Hernández-García JM, Alonso-Briales JH, Kühlmorgen B, Gómez-Doblas JJ, García-Pinilla JM, López-Salguero R, Galván EDT. Should we treat patients with moderately severe stenosis of the left main coronary artery and negative FFR results? J Invasive Cardiol 2004; 16:398-400. [PMID: 15282411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND The prognostic importance of significant left main coronary artery disease is unequivocal. However, moderate lesions of the left main coronary artery (LMCA) are sometimes found in patients presenting significant stenosis in other coronary arteries or equivocal symptoms. The ability of myocardial fractional flow reserve (FFR) to predict coronary events could be useful in the decision-making process in these patients. The present study was designed to investigate the occurrence of cardiac events in patients with coronary syndromes and LMCA stenosis of moderate severity in whom FFR failed to show an haemodynamic significant repercussion of the LMCA. METHODS AND RESULTS We studied 27 consecutive patients (mean age 62.7 +/- 10.5 years) with moderate stenoses (30-50%) of the LMCA. In seven patients who presented significantly reduced FFR (< 0.75) at the LMCA level (Group A), coronary revascularization of this vessel was performed. In 20 patients with negative FFR (greater than or equal to 0.75) at the LMCA level (Group B), the LMCA stenosis was not revascularized, being the revascularization procedures (if any) limited to other arteries with significant obstructions. During a mean follow-up period of 26.2 +/- 12.1 months, clinical events occurred in 3 patients in the whole group. One patient with positive FFR died during coronary bypass surgery. Two group B patients were surgically revascularized 4 months and 4 years after the initial coronariography. CONCLUSIONS Patients with coronary lesions of moderate severity on the LMCA and negative FFR may constitute a subgroup of good prognosis in the follow-up. Our findings suggest that negative FFR is a potentially useful indicator of the likelihood of cardiac events, and thus represents a useful aid in clinical decision-making in the hemodynamics laboratory.
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Affiliation(s)
- Manuel Jiménez-Navarro
- Servicio de Cardiologia, Unidad de Hemodinamica, Hospital Clinico Universitario Virgen de la Victoria, Campus de Teatinos s/n, E-29010 Malaga, Spain.
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García-Pinilla JM, Gómez-Doblas JJ, Rodríguez-Bailón I, Alcantara R, Jiménez-Navarro MF, De Teresa E. Reversible tricuspid stenosis secondary to massive ascites in hepatic cirrhosis. Ann Intern Med 2004; 140:233-4. [PMID: 14757628 DOI: 10.7326/0003-4819-140-3-200402030-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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