Revista espanola de cardiologia最新文献

英文中文

Corrección en el artículo de Molina-Lerma et al. «Registro español de marcapasos. XXI informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2023)», Rev Esp Cardiol. 2024;77:947–956 更正Molina-Lerma等人的文章“西班牙起搏器登记”。《西班牙心脏学会心脏节律协会第二十一次正式报告》（2023年），Rev Espp Cardiol， 2024年；77:947—956

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-12-03 DOI: 10.1016/j.recesp.2025.11.001

引用次数: 0

Menos stents para el IAMCEST: ¿está listo el balón farmacoactivo para su gran momento? IAMCEST的支架更少了：药丸准备好迎接它的大时刻了吗？

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-10-21 DOI: 10.1016/j.recesp.2025.08.007

Bruno Scheller

引用次数: 0

Actividad física en pacientes con fibrilación auricular y eventos adversos: resultados de un estudio de cohortes prospectivo multicéntrico europeo 耳部颤动和不良事件患者的身体活动：欧洲多中心前瞻性队列研究的结果

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-10-04 DOI: 10.1016/j.recesp.2025.07.010

Marco Vitolo , Marco Proietti , Marta Mantovani , Jacopo Francesco Imberti , Davide Antonio Mei , Niccolò Bonini , Giulio Francesco Romiti , Bernadette Corica , Igor Diemberger , Laurent Fauchier , Francisco Marín , Gheorghe-Andrei Dan , Tatjana S. Potpara , Gregory Y.H. Lip , Giuseppe Boriani

Introduction and objectives

Increased physical activity may improve outcomes in patients with atrial fibrillation (AF), but available data are limited. This study aimed to analyze the association between physical activity and major adverse outcomes in a large European AF cohort.

Methods

We used data from a prospective, observational, large-scale multicenter study of AF in European patients, involving 27 countries and 250 centers. Patients self-reported their physical activity levels during the preceding 2 years, categorized as none (physically inactive), occasional, regular, or intense. The primary outcome was a composite of major adverse cardiovascular (CV) events and all-cause mortality.

Results

A total of 9525 patients with AF were included (median age 71 years; 41% female). Overall, 43% reported being physically inactive. Among those who reported physical activity, 56.9% described it as occasional, 36.5% as regular, and 6.6% as intense. Inactive patients had a higher burden of both CV and non-CV comorbidities. Over a median follow-up of 728 days, 16.2% of the patients experienced the primary composite endpoint. Physical activity was independently associated with a lower risk of the primary endpoint (adjusted HR, 0.68; 95% CI, 0.59-0.76), with a progressively lower incidence as activity levels increased. Interaction analyses showed that the beneficial effect of physical activity was consistent among several subgroups, with no significant interactions.

Conclusions

Physical activity, even at low levels, was associated with a reduced incidence of CV events and all-cause mortality. These benefits appear to be independent of CV risk factors and comorbidities, highlighting the importance of incorporating physical activity into holistic AF management strategies.

简介和目的增加体力活动可能改善心房颤动（AF）患者的预后，但现有数据有限。本研究旨在分析欧洲大型房颤队列中体力活动与主要不良后果之间的关系。方法：我们使用的数据来自一项前瞻性、观察性、大规模的多中心研究，涉及27个国家和250个中心的欧洲AF患者。患者自我报告前2年的身体活动水平，分为无运动（不运动）、偶尔运动、定期运动或剧烈运动。主要结局是主要心血管不良事件和全因死亡率的综合结果。结果共纳入9525例房颤患者（中位年龄71岁，女性41%）。总体而言，43%的人表示自己缺乏体育锻炼。在报告有体育锻炼的人中，56.9%的人说自己偶尔运动，36.5%的人说自己经常运动，6.6%的人说自己剧烈运动。不运动的患者有更高的CV和非CV合并症负担。在中位728天的随访中，16.2%的患者达到了主要的复合终点。体力活动与主要终点较低的风险独立相关（调整后的HR， 0.68; 95% CI, 0.59-0.76），随着体力活动水平的增加，发病率逐渐降低。相互作用分析表明，体育活动的有益效果在几个亚组中是一致的，没有显著的相互作用。结论：体力活动，即使是低水平的体力活动，也与降低心血管事件发生率和全因死亡率相关。这些益处似乎与心血管危险因素和合并症无关，强调了将体育活动纳入房颤整体管理策略的重要性。

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引用次数: 0

Clasificación, prevalencia y riesgo cardiovascular de los diferentes tipos de hipercolesterolemia 不同类型高胆固醇血症的分类、患病率和心血管风险

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-10-03 DOI: 10.1016/j.recesp.2025.07.007

Fernando Civeira , Estíbaliz Jarauta , Victoria Marco-Benedí , Ana M. Bea , Rocío Mateo-Gallego , Itziar Lamiquiz-Moneo , Irene Gracia-Rubio , Daniel Bello-Álvarez , Martín Laclaustra , María Teresa Tejedor , Salvador Olmos , Ana Cenarro

Introduction and objectives

The frequency, clinical characteristics and risk of atherosclerotic cardiovascular disease (ASCVD) of the different types of hypercholesterolemia are not well established. The primary and secondary objectives of this study were to determine the cause of hypercholesterolemia and whether the cause confers a different ASCVD prognosis.

Methods

The analysis included 3474 probands with primary hypercholesterolemia, of whom 3283 (94.8%) were followed up for 9.33 ± 5.8 years for ASCVD. Genetic analysis of familial hypercholesterolemia (FH) genes, polygenic risk score for hypercholesterolemia, and lipid concentrations, including lipoprotein(a), were used to classify hypercholesterolemia.

Results

The diagnoses were heterozygous FH, n = 400 (11.5%); hyperlipoproteinemia(a), n = 181 (5.2%); polygenic hypercholesterolemia, n = 434 (12.5%); hyperlipoproteinemia(a) plus polygenic hypercholesterolemia, n = 128 (3.7%); multifactorial, n = 1562 (45.0%); and idiopathic, n = 769 (22.1%). At baseline, low-density lipoprotein cholesterol levels were higher in heterozygous FH, and the prevalence of ASCVD was higher in hyperlipoproteinemia(a). Other clinical and biochemical characteristics did not differ among hypercholesterolemia subgroups. The survival rate was lower in participants with hyperlipoproteinemia(a) than in the other hypercholesterolemia groups (P = .001). Variables independently associated with ASCVD events during follow-up were age, male sex, the presence of ASCVD, diabetes or hypertension at baseline, current smoking, lipoprotein(a) concentration, and high-density lipoprotein cholesterol concentration, the latter being inversely associated with ASCVD events. Total mortality was independent of the type of hypercholesterolemia.

Conclusions

Genetic hypercholesterolemia has a worse prognosis for ASCVD than nongenetic hypercholesterolemia. Among individuals with genetic hypercholesterolemia, those with elevated lipoprotein(a) have the worst prognosis. Conventional lipid-lowering treatment for low-density lipoprotein cholesterol appears to be less effective in hypercholesterolemia due to hyperlipoproteinemia(a) than in other forms of hypercholesterolemia.

不同类型高胆固醇血症患者发生动脉粥样硬化性心血管疾病（ASCVD）的频率、临床特征和风险尚不明确。本研究的主要和次要目的是确定高胆固醇血症的原因，以及该原因是否会导致不同的ASCVD预后。方法分析3474例原发性高胆固醇血症先证患者，其中3283例（94.8%）因ASCVD随访9.33±5.8年。家族性高胆固醇血症（FH）基因的遗传分析、高胆固醇血症的多基因风险评分和脂质浓度，包括脂蛋白(a)，被用来对高胆固醇血症进行分类。结果诊断为杂合子型FH， n = 400例（11.5%）；高脂蛋白血症(a), n = 181 (5.2%)；多基因高胆固醇血症，n = 434 (12.5%)；高脂蛋白血症(a)加多基因高胆固醇血症，n = 128 (3.7%)；多因素，n = 1562 (45.0%)；特发性，n = 769（22.1%）。基线时，杂合子FH患者低密度脂蛋白胆固醇水平较高，高脂蛋白血症患者ASCVD患病率较高(a)。其他临床和生化特征在高胆固醇血症亚组之间没有差异。高脂蛋白血症(a)患者的生存率低于其他高胆固醇血症组（P = .001）。随访期间与ASCVD事件独立相关的变量有年龄、男性、是否存在ASCVD、基线时是否患有糖尿病或高血压、当前吸烟、脂蛋白(a)浓度和高密度脂蛋白胆固醇浓度，后者与ASCVD事件呈负相关。总死亡率与高胆固醇血症的类型无关。结论遗传性高胆固醇血症对ASCVD的预后较非遗传性高胆固醇血症差。在遗传性高胆固醇血症患者中，脂蛋白(a)升高的患者预后最差。传统的低密度脂蛋白胆固醇降脂治疗在高脂蛋白血症引起的高胆固醇血症(a)中似乎不如其他形式的高胆固醇血症有效。

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引用次数: 0

Miocardiopatía hipertrófica con obstrucción intracavitaria secuencial resuelta con mavacamten 用mavacamten治疗伴有连续腔内阻塞的肥厚性心肌病

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-09-29 DOI: 10.1016/j.recesp.2025.08.002

Margarida G. Figueiredo, José Miguel Viegas, Sílvia Aguiar Rosa

引用次数: 0

Implante de stent para la estenosis recurrente tras la reparación del arco aórtico en niños pequeños: resultados a corto y medio plazo sin reintervenciones 为幼儿主动脉弓修复后复发性狭窄植入支架：无需再干预的中短期效果

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-09-16 DOI: 10.1016/j.recesp.2025.07.002

Katarzyna Gendera , Stanimir Georgiev , Andreas Eicken , Andrea Amici , Alfred Hager , Maria von Stumm , Daniel Dilber , Peter Ewert , Pinar Bambul Heck

Introduction and objectives

Stent implantation has become the gold standard for the treatment of native coarctation of the aorta (CoA) and recurrent CoA in adolescents and adults. In smaller children, however, stent implantation remains technically challenging due to anatomical constraints and growth considerations. Furthermore, data on the optimal treatment strategy in this age group are still limited. This study retrospectively analyzed clinical outcomes in young children treated with stent implantation for recurrent aortic arch stenosis.

Methods

A total of 101 patients (63 male; 62%) with a body weight of less than 15 kg were treated with endovascular stent implantation for restenosis of the reconstructed aortic arch (n = 94; 93%) or native CoA (n = 7; 7%). The median age at the time of stent implantation was 4.8 months (IQR, 3.2-9.6 months) with a median body weight of 5.9 kg (IQR, 4.7-8.4 kg). The median follow-up period was 46.4 months (IQR, 11.0-76.6 months).

Results

All procedures were successful, and no serious complications occurred. The peak-to-peak gradient decreased significantly from a median of 32.5 mmHg (IQR, 17.3-46.0 mmHg) to 0.0 mmHg (IQR, 0.0-2.5 mmHg; P < .005). The diameter of the narrow segment increased from a median of 3.0 mm (IQR, 2.0-4.0 mm) to 6.9 mm (IQR, 6.0-8.0 mm; P < .005). During follow-up, none of the patients required reoperation

Conclusions

Stent implantation is a safe and feasible treatment option in patients with restenosis after complex aortic arch reconstruction or native CoA in whom surgical treatment would pose an elevated risk of complications. However, repeated dilatations and, ultimately, intentional stent fracture are required during follow-up.

简介与目的支架植入术已成为治疗青少年和成人先天性主动脉缩窄（CoA）和复发性CoA的金标准。然而，在较小的儿童中，由于解剖限制和生长考虑，支架植入在技术上仍然具有挑战性。此外，关于该年龄组最佳治疗策略的数据仍然有限。本研究回顾性分析了接受支架置入术治疗复发性主动脉弓狭窄的幼儿的临床结果。方法101例体重小于15 kg的主动脉弓再狭窄患者（男性63例，62%）分别采用血管内支架植入术（94例，93%）或天然辅酶a（7例，7%）治疗。支架植入时的中位年龄为4.8个月（IQR, 3.2-9.6个月），中位体重为5.9 kg （IQR, 4.7-8.4 kg）。中位随访时间为46.4个月（IQR, 11.0-76.6个月）。结果所有手术均成功，无严重并发症发生。峰间梯度从中位数32.5 mmHg （IQR, 17.3-46.0 mmHg）显著下降到0.0 mmHg （IQR, 0.0-2.5 mmHg; P < 0.005）。窄段直径中位数从3.0 mm （IQR, 2.0-4.0 mm）增加到6.9 mm （IQR, 6.0-8.0 mm; P < 0.005）。结论对于复杂主动脉弓重建后再狭窄或原发CoA术后手术治疗并发症风险较高的患者，支架植入术是一种安全可行的治疗方案。然而，在随访期间，需要反复扩张和最终故意支架断裂。

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引用次数: 0

Inteligencia artificial (IA): …y otra de cal 人工智能（AI）：

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-09-16 DOI: 10.1016/j.recesp.2025.08.016

Fernando A. Navarro

引用次数: 0

Registro español de desfibrilador automático implantable. XXI informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2024) 自动植入去纤颤器的西班牙注册。西班牙心脏学会心率协会第二十一次正式报告（2024年）

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-09-16 DOI: 10.1016/j.recesp.2025.08.005

Joaquín Osca Asensi , Ignacio Fernández-Lozano , David Calvo , en representación de los colaboradores del Registro español de desfibrilador automático implantable

Introduction

This report presents data on implantable cardioverter-defibrillator (ICD) implants performed in Spain in 2024.

Methods

The registry is based on information submitted by centers after device implantation to the Heart Rhythm Association of the Spanish Society of Cardiology through the online national registry platform (CardioDispositivos). Additional data sources included: a) submissions from manufacturing and marketing companies; b) local databases provided by ICD-implanting centers; and c) the ICD Technical Report. Implantation rates were calculated using population data from the National Institute of Statistics.

Results

In 2024, 203 hospitals participated in the registry. A total of 8793 devices were reported, compared with 8975 reported by Eucomed (European Confederation of Medical Suppliers Associations). The overall rate was 186 implants/million population, representing an increase compared with previous years. Marked differences among the autonomous communities persisted, and Spain continued to have the lowest implantation rate of all European countries participating in Eucomed.

Conclusions

The 2024 registry reflects virtually all ICD implants performed in Spain. Despite the improvement observed in implantation rates, Spain's position in Europe remains unchanged, as do the large differences among its autonomous communities.

Full English text available from:www.revespcardiol.org/en

本报告介绍了2024年在西班牙实施的植入式心律转复除颤器（ICD）植入的数据。方法器械植入后中心通过在线国家注册平台（CardioDispositivos）向西班牙心脏病学会心律协会提交注册信息。其他数据来源包括：a)生产和销售公司提交的资料；b) icd植入中心提供的本地数据库；c) ICD技术报告。着床率是根据国家统计局的人口数据计算的。结果2024年共有203家医院参与登记。报告的器械总数为8793台，而欧洲医疗供应商协会联合会（Eucomed）报告的器械总数为8975台。总体比率为186个植入物/百万人口，与前几年相比有所增加。各自治区之间的明显差异仍然存在，西班牙继续是所有参加Eucomed的欧洲国家中普及率最低的。2024年的登记反映了几乎所有在西班牙进行的ICD植入。尽管植入率有所提高，但西班牙在欧洲的地位没有改变，其自治区之间的巨大差异也没有改变。完整的英文文本可从：www.revespcardiol.org/en

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Corazón de hierro: miocardiopatía secundaria a hepatopatía 铁心：继发性心肌病至肝病

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Revista espanola de cardiologia

Pub Date : 2025-09-06 DOI: 10.1016/j.recesp.2025.08.015

María Fernández García , Andrés Castaño-García , Luis Gutiérrez de la Varga

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Arco aórtico en sacacorchos. Síndrome de PHACES 弓弓的软木塞。阶段综合症

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia

Pub Date : 2025-09-06 DOI: 10.1016/j.recesp.2025.09.002

María Catalina Sánchez Cornelio , Francisco Castillo-Castellón , Leanny Alcántara Alcántara

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