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Alegret JM, Masana L, Martinez-Micaelo N, Heras M, Beltrán-Debón R. LDL cholesterol and apolipoprotein B are associated with ascending aorta dilatation in bicuspid aortic valve patients. QJM 2015; 108:795-801. [PMID: 25660598 DOI: 10.1093/qjmed/hcv032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 10/10/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The factors related to ascending aorta dilation (AAD) in patients with bicuspid aortic valve (BAV) are not completely understood. In addition, the role of cholesterol metabolism in AAD has not been studied. METHODS We analyzed the relationship between different lipid parameters and the ascending aorta diameter/presence of aortic dilatation in 91 consecutive patients with BAV. RESULTS We observed a positive linear correlation between the total cholesterol, low-density lipoprotein (LDL) cholesterol and apolipoprotein B (ApoB) levels and the ascending aorta diameter. The patients with AAD had higher LDL cholesterol and ApoB levels. Whereas LDL cholesterol and ApoB were identified as independent factors predictors of the aortic root diameter, only ApoB predicted the diameter of the ascending aorta. On the other hand, the levels of ApoB were an independent factor related to the dilatation of the aortic root. CONCLUSIONS We have observed that cholesterol is associated with ascending aorta diameter and dilation in BAV patients. Further experimental and clinical studies are needed to explain the pathobiology of this association.
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Affiliation(s)
- J M Alegret
- From the Grup de Recerca Cardiovascular, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili, Reus, Spain and
| | - L Masana
- Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, Hospital Universitari de Sant Joan, IISPV, CIBERDEM, Reus, Spain
| | - N Martinez-Micaelo
- From the Grup de Recerca Cardiovascular, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili, Reus, Spain and
| | - M Heras
- Unitat de Recerca en Lípids i Arteriosclerosi, Universitat Rovira i Virgili, Hospital Universitari de Sant Joan, IISPV, CIBERDEM, Reus, Spain
| | - R Beltrán-Debón
- From the Grup de Recerca Cardiovascular, Hospital Universitari de Sant Joan, IISPV, Universitat Rovira i Virgili, Reus, Spain and
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Ferrán A, Alegret JM, Subirana I, Aragonès G, Lluis-Ganella C, Romero-Menor C, Planas F, Joven J, Elosua R. Asociación de los polimorfismos rs2200733 y rs7193343 con la fibrilación auricular en población española y metanálisis de la evidencia existente. Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2013.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferrán A, Alegret JM, Subirana I, Aragonès G, Lluis-Ganella C, Romero-Menor C, Planas F, Joven J, Elosua R. Association between rs2200733 and rs7193343 genetic variants and atrial fibrillation in a Spanish population, and meta-analysis of previous studies. Rev Esp Cardiol (Engl Ed) 2014; 67:822-9. [PMID: 25262128 DOI: 10.1016/j.rec.2013.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 06/18/2013] [Accepted: 12/19/2013] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND OBJECTIVES The objectives of this study were to analyze the association between two genetic variants (rs2200733 and rs7193343) in a Spanish population and the risk of developing atrial fibrillation, and to carry out a systematic review and meta-analysis of these associations. METHODS We performed a case-control study involving 257 case patients with atrial fibrillation and 379 controls. The case patients were individuals who had donated samples to the Spanish National DNA Bank; the controls were participating in a population-based cross-sectional study. Genotyping was carried out using a TaqMan assay. We conducted a systematic literature search in which 2 independent reviewers extracted the necessary information. The study involved a meta-analysis, a heterogeneity analysis, and a meta-regression analysis to identify the variables that explain the heterogeneity across studies. RESULTS In our population, the presence of atrial fibrillation was found to be associated with rs2200733 (odds ratio = 1.87; 95% confidence interval, 1.30-2.70), but not with rs7193343 (odds ratio = 1.18; 95% confidence interval, 0.80-1.73). In the meta-analysis, we observed an association between atrial fibrillation and both variants: odds ratio = 1.71 (95% confidence interval, 1.54-1.90) for rs2200733 and odds ratio = 1.18 (95% confidence interval, 1.11-1.25) for rs7193343. We observed heterogeneity among the studies dealing with the association between rs2200733 and atrial fibrillation, partially related to the study design, and the strength of association was greater in case-control studies (odds ratio = 1.83) than in cohort studies (odds ratio = 1.41). CONCLUSIONS Variants rs2200733 and rs7193343 are associated with a higher risk of atrial fibrillation. Case-control studies tend to overestimate the strength of association between these genetic variants and atrial fibrillation.
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Affiliation(s)
- Albert Ferrán
- Grupo de Investigación en Epidemiología y Genética Cardiovascular, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - José María Alegret
- Sección de Cardiología, Hospital Universitari de Sant Joan, Grup de Recerca Cardiovascular, IISPV, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Isaac Subirana
- Grupo de Investigación en Epidemiología y Genética Cardiovascular, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Barcelona, Spain
| | - Gerard Aragonès
- Sección de Cardiología, Hospital Universitari de Sant Joan, Grup de Recerca Cardiovascular, IISPV, Universitat Rovira i Virgili, Reus, Tarragona, Spain; Centre for Omic Sciences, Servei de Recursos Científics i Tècnics, Universitat Rovira i Virgili, Tarragona, Spain
| | - Carla Lluis-Ganella
- Grupo de Investigación en Epidemiología y Genética Cardiovascular, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
| | - César Romero-Menor
- Servicio de Cardiología, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Francesc Planas
- Servicio de Cardiología, Hospital Municipal de Badalona, Badalona, Barcelona, Spain
| | - Jorge Joven
- Unidad de Investigación Biomédica (URB-CRB), IISPV, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, Reus, Tarragona, Spain
| | - Roberto Elosua
- Grupo de Investigación en Epidemiología y Genética Cardiovascular, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.
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Permanyer E, Alegret JM, Muñoz-Guijosa C, Padró JM. Inferior vena cava obstruction by a cardiac mass: unusual presentation of primary antiphospholipid syndrome. Thorac Cardiovasc Surg 2011; 59:182-3. [PMID: 21480144 DOI: 10.1055/s-0030-1250501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We present a previously healthy 43-year-old woman with a cardiac mass that caused almost total occlusion of the inferior vena cava at its junction with the right atrium. The resected mass proved to be a thrombus. Preoperative imaging tests could not distinguish it from other intracardiac tumors such as myxoma. A postoperative immunological study revealed a primary antiphospholipid syndrome. This case presents an unusual diagnosis of antiphospholipid syndrome and a rare location of a cardiac thrombus.
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Affiliation(s)
- E Permanyer
- Department of Cardiac Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Pálinkás A, Antonielli E, Picano E, Pizzuti A, Varga A, Nyúzó B, Alegret JM, Bonzano A, Tanga M, Coppolino A, Forster T, Baralis G, Delnevo F, Csanády M. Clinical value of left atrial appendage flow velocity for predicting of cardioversion success in patients with non-valvular atrial fibrillation. Eur Heart J 2001; 22:2201-8. [PMID: 11913482 DOI: 10.1053/euhj.2001.2891] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [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] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Echocardiographic parameters for predicting cardioversion outcome in patients with non-valvular atrial fibrillation are not accurately defined. OBJECTIVE To evaluate the role of left atrial appendage flow velocity detected by transoesophageal echocardiography for prediction of cardioversion outcome in patients with non-valvular atrial fibrillation enrolled in a prospective. multicentre, international study. METHODS Four hundred and eight patients (257 males, mean age: 66 +/- 10 years) with non-valvular atrial fibrillation lasting more than 48 h but less than 1 year underwent transthoracic echocardiography and transoesophageal echocardiography before either electrical (n=324) or pharmacological (n=84) cardioversion. RESULTS Cardioversion was successful in restoring sinus rhythm in 328 (80%) and unsuccessful in 80 patients (20%). Mean left atrial appendage peak emptying flow velocity was significantly higher in patients with successful than in those with unsuccessful cardioversion (32.4 +/- 17.7 vs 23.5 +/- 13.6 cm x s(-1); P<0.0001). At multivariate logistic regression analysis, three parameters proved to be independent predictors of cardioversion success: the atrial fibrillation duration <2 weeks (P=0.011, OR=4.9, CI 95%=1.9-12.7), the mean left atrial appendage flow velocity >31 cm x s(-1) (P=0.0013, OR=2.8, CI 95%=1.5-5.4) and the left atrial diameter <47 mm (P=0.093, OR=2.0, CI 95%=1.2-3.4). These independent predictors of cardioversion success outperformed other univariate predictors such as left ventricular end-diastolic diameter <58 mm, ejection fraction >56% and the absence of left atrial spontaneous echo contrast. CONCLUSION In patients with non-valvular atrial fibrillation, measurement of the left atrial appendage flow velocity profile by transoesophageal echocardiography before cardioversion provides valuable information for prediction of cardioversion outcome.
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Affiliation(s)
- A Pálinkás
- 2nd Department of Medicine and Cardiology Center, Albert Szent-Györgyi Medical Faculty, University of Sciences, Szeged, Hungary
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Alegret JM, Martí V, Rodriguez-Font E, Alonso C, Guindo J, Domínguez De Rozas JM. Effects of thrombolysis in the evolution of right bundle-branch block complicating an acute anterior myocardial infarction. Acta Cardiol 2001; 56:297-301. [PMID: 11712825 DOI: 10.2143/ac.56.5.2005690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 11/18/2022]
Abstract
INTRODUCTION There is scant information about the effects of thrombolysis in the evolution of right bundle-branch block (RBBB) in the setting of acute anterior myocardial infarction. The aim of this study has been to analyse these effects and its impact on prognosis. METHODS We studied 54 patients who presented a RBBB related to an acute anterior myocardial infarction. We defined two groups: those who received thrombolytic treatment and those who did not. We analysed the evolution of RBBB (transience, moment of onset, moment of disappearance) and its relationship with in-hospital mortality.Twenty-one patients (39%) received thrombolytic treatment (groupT) and 33 patients (61%) (group NT) did not. RESULTS The incidence of late appearance (> 6 h) of RBBB was less frequent in group T compared with group NT (10% vs. 33%, p = 0.04). The incidence of transient block was similar in the two groups (57% vs. 45%, p ns). However, early disappearance of RBBB (in < 6 hours) was more common in group T than in group NT (33% vs. 9%, p = 0.04). Mortality was higher in patients with RBBB present at 24 h after admission) than in those with RBBB resolved in less than 24 hours (in group NT, 55% vs. 8%, p = 0.02 and in group T 50% vs. 0%, p = 0.02, respectively). CONCLUSIONS Thrombolysis seems to influence the moment of onset and disappearance of RBBB by promoting its early disappearance and avoiding its late appearance. Disappearance of RBBB is associated with a better prognosis.
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Affiliation(s)
- J M Alegret
- Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Alegret JM, Viñolas X, Palazón O, Vernis JM, Ferrer A, Oter R. [Intermittent pre-excitation after adenosine administration]. Rev Esp Cardiol 2000; 53:1132-5. [PMID: 10956609] [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: 02/17/2023]
Abstract
We describe a case of 2:1 intermittent preexcitation after adenosine administration in a patient with an accessory pathway that did not show preexcitation on the basal ECG. We review the mechanisms involved that explain this event and the possible utility of adenosine to show accessory pathways that do not show preexcitation on the ECG.
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Affiliation(s)
- J M Alegret
- Sección de Cardiología. Hospital Universitari de Sant Joan. Reus. Departamento de Cardiología.aHospital de la Santa Creu i Sant Pau. Barcelona
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Alegret JM, Borràs X, Alonso C, Carreras F, Gurguí M, Cámara ML, Coll B, Pons-Lladó G. [Emergency valvular replacement in infective endocarditis: hospital and long term clinical course. Analysis of 45 patients]. Med Clin (Barc) 2000; 114:299-301. [PMID: 10774519 DOI: 10.1016/s0025-7753(00)71275-9] [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: 11/21/2022]
Abstract
BACKGROUND To define the evolution of patients with infective endocarditis who require urgent valve replacement in our environment. PATIENTS AND METHODS We followed 45 consecutive cases of infective endocarditis that require valve replacement during their hospitalization. 32 patients had native valve infective endocarditis, 7 early prosthesis valve endocarditis and 6 late prosthesis valve endocarditis. Patients were followed for a long-term period, clinical and echocardiographycally. RESULTS In 39 cases valve replacement was performed before ending antibiotic therapy. The main indications for surgery were refractory heart failure (24 patients) and shock (11 patients). The mortality rate was 24%: 19% in native valve infective endocarditis, 43% in early prosthetic valve endocarditis and 33% in late prosthesis valve endocarditis. The first cause of death was septic shock (46%). We followed 31 over 34 survivors for a mean time 65 (DS 49) months. We found two relapses and six deaths (1 sudden death, 2 endocarditis) and 72% of patients presented class I NYHA. We detected 17% prosthetic leaks (34% in the prosthetic valve endocarditis group). CONCLUSIONS The need of urgent valve replacement in the context of infective endocarditis is associated with a high mortality rate, and should be considered a serious condition. Long term prognosis is, however, acceptable, although 17% of patients had prosthesis leak, specially those with prosthetic valve endocarditis.
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Affiliation(s)
- J M Alegret
- Departament de Cardiologia i Cirurgia Cardiaca, Hospital de la Santa Creu i Sant Pau, Barcelona
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Martí V, Ramírez J, Lamich R, García J, Guiteras P, Aymat RM, Alegret JM, Augé JM. [Coronary stent placement for recurrent angina secondary to myocardial bridging]. Rev Med Chil 1998; 126:1362-6. [PMID: 10349180] [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: 02/12/2023]
Abstract
Myocardial bridging of the epicardic coronary arteries is not an uncommon finding in angiographic or necropsic studies. Patients who have symptoms usually improve with medical treatment. However, in refractory patients a surgical myotomy of overlying myocardium and/or a coronary bypass may be needed. We report two patients with long myocardial bridges in the mid-left anterior descending coronary artery, who had recurrent angina refractory to conventional treatment. In both patients two consecutive coronary stents were successfully implanted. At five and six months follow-up they are asymptomatic and with good exercise tolerance.
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Affiliation(s)
- V Martí
- Unidad de Hemodinámica y Cardiología Intervencionista, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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Rodríguez Font E, Viñolas Prat X, Alegret JM, Varela MC, Torner P, Oter R. [Image of pseudocapture caused by micro-dislodgment of the electrode in a VDD pacemaker]. Rev Esp Cardiol 1997; 50:909-12. [PMID: 9470458 DOI: 10.1016/s0300-8932(97)74699-2] [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: 02/06/2023]
Abstract
The new AV sequential pacemakers have improved the suitability for the election of the best pacing mode for each patient. The complexity of the systems may mask some dysfunctions. In the presented case, a failure to capture due to micro-dislodgment, may have been missed in a simple pacemaker control, because of the combination of several factors: the presence of normal AV conduction at that moment, the concordance between the pacemaker stimulus and the conducted QRS complex and the similar morphology of the conducted and paced QRS complex.
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Affiliation(s)
- E Rodríguez Font
- Departamento de Cardiología y Cirugía Cardíaca, Hospital de la Santa Creu i Sant Pau, Barcelona
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Abstract
The presence of liver methastasis and serotonin in plasma in the carcinoid tumor are responsible for the carcinoid syndrome. We present a case of tricuspid and pulmonary valvular disease secondary to this syndrome. The finding of liver hyperechogenic nodules added to the described valvular disease by subcostal echocardiogram oriented the diagnosis.
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Affiliation(s)
- J M Alegret
- Departamento de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona
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