Pub Date : 2025-10-01Epub Date: 2025-04-11DOI: 10.1016/j.recesp.2025.03.012
Covadonga Fernández-Golfín , Ana García-Martín
{"title":"Del estetoscopio a la inteligencia artificial: decodificando la enfermedad tricuspídea","authors":"Covadonga Fernández-Golfín , Ana García-Martín","doi":"10.1016/j.recesp.2025.03.012","DOIUrl":"10.1016/j.recesp.2025.03.012","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 848-849"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-05-05DOI: 10.1016/j.recesp.2025.02.016
Andrea Zito , Francesco Burzotta , Cristina Aurigemma , Enrico Romagnoli , Francesco Bianchini , Emiliano Bianchini , Lazzaro Paraggio , Mattia Lunardi , Carolina Ierardi , Filippo Crea , Antonio Maria Leone , Carlo Trani
Introduction and objectives
The management of patients with coronary artery disease can benefit from devices that improve functional or anatomical evaluation. This study aimed to compare the efficacy of optical coherence tomography (OCT) and fractional flow reserve (FFR) guidance for managing vessels with angiographically intermediate coronary lesions according to angiographic lesion complexity.
Methods
The FORZA trial (NCT01824030) was a randomized trial comparing the use of OCT or FFR for revascularization decisions and percutaneous coronary intervention optimization in patients with angiographically intermediate coronary lesions. Complex lesions were defined as long (length > 38 mm), severely calcified, or bifurcation lesions. The primary outcome was major adverse cardiac events (MACE), defined as a composite of all-cause death, myocardial infarction, or target vessel revascularization.
Results
A total of 420 vessels (200 OCT-guided and 220 FFR-guided) were enrolled, including 212 vessels with complex lesions. At the 5-year follow-up, the MACE rate was 20.8% in vessels with complex lesions and 13.9% in vessels with noncomplex lesions (HR, 1.52; 95%CI, 0.95-2.44; P = .078). Compared with FFR, OCT was associated with a lower risk of MACE in vessels with complex lesions (HR, 0.53; 95%CI, 0.28-0.98; P = .044), but with a higher risk of MACE in vessels with noncomplex lesions (HR, 2.23; 95%CI, 1.04-4.81; P = .040; Pinteraction = .004).
Conclusions
In vessels with angiographically intermediate coronary lesions, angiographic lesion complexity may modulate the long-term efficacy of the guidance modality, with a potential benefit of OCT in complex lesions and FFR in noncomplex lesions.
介绍和目的冠状动脉疾病患者的治疗可以从改善功能或解剖评价的器械中获益。本研究旨在比较光学相干断层扫描（OCT）和分数血流储备（FFR）指导根据血管造影病变复杂性对冠脉造影中期病变血管的治疗效果。方法FORZA试验（NCT01824030）是一项随机试验，比较使用OCT或FFR进行血管重建决策和经皮冠状动脉介入治疗对血管造影中期冠状动脉病变患者的影响。复杂病变被定义为长（长度>； 38mm），严重钙化或分叉病变。主要终点是主要心脏不良事件（MACE），定义为全因死亡、心肌梗死或靶血管重建术的综合结果。结果共纳入420条血管（oct引导200条，ffr引导220条），其中病变复杂的血管212条。在5年随访中，复杂病变血管的MACE率为20.8%，非复杂病变血管的MACE率为13.9% （HR, 1.52; 95%CI, 0.95-2.44; P = 0.078）。与FFR相比，OCT与复杂病变血管发生MACE的风险较低（HR, 0.53; 95%CI, 0.28-0.98; P = 0.044），但与非复杂病变血管发生MACE的风险较高（HR, 2.23; 95%CI, 1.04-4.81; P = 0.040； P相互作用= 0.004）。结论在冠状动脉造影中度病变的血管中，血管造影病变复杂性可能调节引导方式的长期疗效，在复杂病变中OCT和非复杂病变中FFR具有潜在的优势。
{"title":"Reserva fraccional de flujo u OCT para guiar el tratamiento de estenosis coronarias complejas y no complejas angiográficamente intermedias","authors":"Andrea Zito , Francesco Burzotta , Cristina Aurigemma , Enrico Romagnoli , Francesco Bianchini , Emiliano Bianchini , Lazzaro Paraggio , Mattia Lunardi , Carolina Ierardi , Filippo Crea , Antonio Maria Leone , Carlo Trani","doi":"10.1016/j.recesp.2025.02.016","DOIUrl":"10.1016/j.recesp.2025.02.016","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The management of patients with coronary artery disease can benefit from devices that improve functional or anatomical evaluation. This study aimed to compare the efficacy of optical coherence tomography (OCT) and fractional flow reserve (FFR) guidance for managing vessels with angiographically intermediate coronary lesions according to angiographic lesion complexity.</div></div><div><h3>Methods</h3><div>The FORZA trial (<span><span>NCT01824030</span><svg><path></path></svg></span>) was a randomized trial comparing the use of OCT or FFR for revascularization decisions and percutaneous coronary intervention optimization in patients with angiographically intermediate coronary lesions. Complex lesions were defined as long (length ><!--> <!-->38<!--> <!-->mm), severely calcified, or bifurcation lesions. The primary outcome was major adverse cardiac events (MACE), defined as a composite of all-cause death, myocardial infarction, or target vessel revascularization.</div></div><div><h3>Results</h3><div>A total of 420 vessels (200 OCT-guided and 220 FFR-guided) were enrolled, including 212 vessels with complex lesions. At the 5-year follow-up, the MACE rate was 20.8% in vessels with complex lesions and 13.9% in vessels with noncomplex lesions (HR, 1.52; 95%<span>C</span>I, 0.95-2.44; <em>P</em> <!-->=<!--> <!-->.078). Compared with FFR, OCT was associated with a lower risk of MACE in vessels with complex lesions (HR, 0.53; 95%CI, 0.28-0.98; <em>P</em> <!-->=<!--> <!-->.044), but with a higher risk of MACE in vessels with noncomplex lesions (HR, 2.23; 95%CI, 1.04-4.81; <em>P</em> <!-->=<!--> <!-->.040; <em>P</em><sub>interaction</sub> <!-->=<!--> <!-->.004).</div></div><div><h3>Conclusions</h3><div>In vessels with angiographically intermediate coronary lesions, angiographic lesion complexity may modulate the long-term efficacy of the guidance modality, with a potential benefit of OCT in complex lesions and FFR in noncomplex lesions.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 876-885"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-06-04DOI: 10.1016/j.recesp.2025.05.017
Lorenzo Fácila , Jezabel Pendás , Vicente Montagud , Miguel Benedito
{"title":"Impacto de la exclusión de accesos transapicales en los resultados por sexos del implante percutáneo de válvula aórtica: ¿una limitación metodológica?","authors":"Lorenzo Fácila , Jezabel Pendás , Vicente Montagud , Miguel Benedito","doi":"10.1016/j.recesp.2025.05.017","DOIUrl":"10.1016/j.recesp.2025.05.017","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 930-931"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-03-21DOI: 10.1016/j.recesp.2025.03.004
Alfonso Jurado-Román , José M. Montero-Cabezas
{"title":"Beneficio pronóstico de la revascularización percutánea de las oclusiones coronarias crónicas. Paradojas y contradicciones de un debate sin final","authors":"Alfonso Jurado-Román , José M. Montero-Cabezas","doi":"10.1016/j.recesp.2025.03.004","DOIUrl":"10.1016/j.recesp.2025.03.004","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 860-862"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-04-05DOI: 10.1016/j.recesp.2025.01.022
Woochan Kwon , Taek Kyu Park , Ki Hong Choi , Joo Myung Lee , Jeong Hoon Yang , Young Bin Song , Joo-Yong Hahn , Hyeon-Cheol Gwon , Seung-Hyuk Choi
Introduction and objectives
The clinical benefits of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remain controversial. This study aimed to investigate whether PCI for CTO located in the left anterior descending artery (LAD) could have beneficial effects on clinical outcomes.
Methods
Patients were retrospectively selected from a single-center CTO registry and followed up for approximately 10 years. The patients were grouped based on the presence of LAD CTO and whether the CTO was revascularized. Inverse probability weighting adjustment was also performed. The primary outcome was the composite of cardiac death or myocardial infarction at 10 years.
Results
Among 1323 patients with CTO, 1034 were male, and 417 had LAD CTO. PCI was attempted in 72.2% of participants in the LAD CTO group and in 49.9% of those in the non-LAD CTO group. In the non-LAD CTO group, PCI did not significantly affect the primary outcome (medical therapy vs PCI, 20.7% vs 13.4%, adjusted HR: 0.72, 95%CI, 0.47–1.10; P = .13). However, a significant difference in the incidence of the primary outcome between the treatment methods was observed in the LAD CTO group (30.8% vs 15.4%; adjusted HR: 0.44; 95%CI, 0.25-0.81; P = .007). A significant interaction was observed between LAD CTO and treatment method (P for interaction = .011).
Conclusions
The benefits of PCI compared with medical therapy for CTO might be more apparent when the CTO is located in the LAD.
简介和目的经皮冠状动脉介入治疗慢性全闭塞（CTO）的临床益处仍存在争议。本研究旨在探讨PCI治疗位于左前降支（LAD）的CTO是否会对临床结果产生有益影响。方法回顾性地从单中心CTO登记中选择患者，随访约10年。根据LAD CTO的存在和CTO是否血运重建对患者进行分组。还进行了逆概率加权调整。主要结局是10年时心脏死亡或心肌梗死的综合结果。结果1323例CTO中，男性1034例，LAD CTO 417例。在LAD CTO组中有72.2%的参与者尝试PCI，而在非LAD CTO组中有49.9%的参与者尝试PCI。在非lad CTO组中，PCI对主要结局没有显著影响（药物治疗vs PCI， 20.7% vs 13.4%，调整后风险比：0.72,95%CI, 0.47-1.10; P = 0.13）。然而，在LAD CTO组中，两种治疗方法的主要结局发生率有显著差异（30.8% vs 15.4%；调整后危险度：0.44;95%CI, 0.25-0.81; P = 0.007）。LAD CTO与治疗方法之间存在显著的交互作用（交互作用P = 0.011）。结论当CTO位于LAD时，PCI治疗CTO的优势比药物治疗更明显。
{"title":"Localización de la oclusión total crónica y resultados tras la intervención coronaria percutánea o el tratamiento médico: seguimiento a 10 años de un registro unicéntrico","authors":"Woochan Kwon , Taek Kyu Park , Ki Hong Choi , Joo Myung Lee , Jeong Hoon Yang , Young Bin Song , Joo-Yong Hahn , Hyeon-Cheol Gwon , Seung-Hyuk Choi","doi":"10.1016/j.recesp.2025.01.022","DOIUrl":"10.1016/j.recesp.2025.01.022","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The clinical benefits of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remain controversial. This study aimed to investigate whether PCI for CTO located in the left anterior descending artery (LAD) could have beneficial effects on clinical outcomes.</div></div><div><h3>Methods</h3><div>Patients were retrospectively selected from a single-center CTO registry and followed up for approximately 10 years. The patients were grouped based on the presence of LAD CTO and whether the CTO was revascularized. Inverse probability weighting adjustment was also performed. The primary outcome was the composite of cardiac death or myocardial infarction at 10 years.</div></div><div><h3>Results</h3><div>Among 1323 patients with CTO, 1034 were male, and 417 had LAD CTO. PCI was attempted in 72.2% of participants in the LAD CTO group and in 49.9% of those in the non-LAD CTO group. In the non-LAD CTO group, PCI did not significantly affect the primary outcome (medical therapy vs PCI, 20.7% vs 13.4%, adjusted HR: 0.72, 95%CI, 0.47–1.10; <em>P</em> <!-->=<!--> <!-->.13). However, a significant difference in the incidence of the primary outcome between the treatment methods was observed in the LAD CTO group (30.8% vs 15.4%; adjusted HR: 0.44; 95%CI, 0.25-0.81; <em>P</em> <!-->=<!--> <!-->.007). A significant interaction was observed between LAD CTO and treatment method (<em>P</em> for interaction<!--> <!-->=<!--> <!-->.011).</div></div><div><h3>Conclusions</h3><div>The benefits of PCI compared with medical therapy for CTO might be more apparent when the CTO is located in the LAD.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 850-859"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-03-21DOI: 10.1016/j.recesp.2025.01.023
Chi-Hion Pedro Li , Lluís Asmarats , Albert Massó van Roessel , Helena Capellades , Xavier Millán , Dabit Arzamendi
{"title":"Predictibilidad y tilting de dispositivo en la reparación mitral de borde a borde","authors":"Chi-Hion Pedro Li , Lluís Asmarats , Albert Massó van Roessel , Helena Capellades , Xavier Millán , Dabit Arzamendi","doi":"10.1016/j.recesp.2025.01.023","DOIUrl":"10.1016/j.recesp.2025.01.023","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 924-926"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-04-02DOI: 10.1016/j.recesp.2025.01.020
Daiana Ibarretxe-Guerediaga , Cristina Marimón , Albert Feliu , Cèlia Rodríguez-Borjabad , Núria Plana , Lluís Masana
{"title":"Muerte súbita en un niño con hipercolesterolemia familiar homocigota y cardiomiopatía no compactada. ¿Es solo una coincidencia?","authors":"Daiana Ibarretxe-Guerediaga , Cristina Marimón , Albert Feliu , Cèlia Rodríguez-Borjabad , Núria Plana , Lluís Masana","doi":"10.1016/j.recesp.2025.01.020","DOIUrl":"10.1016/j.recesp.2025.01.020","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 922-924"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-03-17DOI: 10.1016/j.recesp.2025.01.018
Luigi Gerra , Tommaso Bucci , Ho Man Lam , Marta Mantovani , Antonios A. Argyris , Muath Alobaida , Kully Sandhu , Joseph Mills , Giuseppe Boriani , Gregory Y.H. Lip
Introduction and objectives
Data on the impact of amyloidosis on outcomes after transcatheter aortic valve implantation (TAVI) are limited. The objective of this study was to evaluate the 1-year risk of adverse events post-TAVI in patients with amyloidosis.
Methods
Patients undergoing TAVI (between 2005 and 2023) were categorized into 2 groups based on the presence of amyloidosis. The primary outcome was the 1-year risk of a composite endpoint: heart failure (HF), ischemic stroke, pacemaker implantation, acute kidney injury, and all-cause death. Secondary outcomes assessed the individual components of the composite. Propensity score matching was used to balance the groups, and Cox regression was used to assess the risk of adverse outcomes associated with amyloidosis. Composite outcomes were analyzed for early (30-days) and long-term (30-days to 1 year) follow-up.
Results
Data from 589 TAVI patients with amyloidosis (mean age 78.9 ± 8.2 years, 31.9% female) were compared with 52 296 individuals without amyloidosis (mean age 78.1 ± 8.8 years, 40.3% female). After propensity score matching, patients with amyloidosis had a significantly higher 1-year risk of adverse events (HR, 1.27; 95%CI, 1.08-1.49). Specifically, patients with amyloidosis showed an increased risk of HF (HR, 1.37; 95%CI, 1.10-1.70). Stroke risk (HR, 1.67; 95%CI, 1.16–2.40) and pacemaker implantation (HR, 2.25; 95%CI, 1.15-4.41) were higher during long-term follow-up, while no differences were found for acute kidney injury or all-cause mortality between the 2 groups.
Conclusions
Among patients undergoing TAVI, those with amyloidosis are at a higher risk of adverse events, particularly HF, and have an increased risk of pacemaker implantation and stroke in the long-term.
{"title":"Impacto de la amiloidosis en los resultados tras el implante percutáneo de prótesis valvular aórtica","authors":"Luigi Gerra , Tommaso Bucci , Ho Man Lam , Marta Mantovani , Antonios A. Argyris , Muath Alobaida , Kully Sandhu , Joseph Mills , Giuseppe Boriani , Gregory Y.H. Lip","doi":"10.1016/j.recesp.2025.01.018","DOIUrl":"10.1016/j.recesp.2025.01.018","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Data on the impact of amyloidosis on outcomes after transcatheter aortic valve implantation (TAVI) are limited. The objective of this study was to evaluate the 1-year risk of adverse events post-TAVI in patients with amyloidosis.</div></div><div><h3>Methods</h3><div>Patients undergoing TAVI (between 2005 and 2023) were categorized into 2 groups based on the presence of amyloidosis. The primary outcome was the 1-year risk of a composite endpoint: heart failure (HF), ischemic stroke, pacemaker implantation, acute kidney injury, and all-cause death. Secondary outcomes assessed the individual components of the composite. Propensity score matching was used to balance the groups, and Cox regression was used to assess the risk of adverse outcomes associated with amyloidosis. Composite outcomes were analyzed for early (30-days) and long-term (30-days to 1 year) follow-up.</div></div><div><h3>Results</h3><div>Data from 589 TAVI patients with amyloidosis (mean age 78.9<!--> <!-->±<!--> <!-->8.2 years, 31.9% female) were compared with 52 296 individuals without amyloidosis (mean age 78.1<!--> <!-->±<!--> <!-->8.8 years, 40.3% female). After propensity score matching, patients with amyloidosis had a significantly higher 1-year risk of adverse events (HR, 1.27; 95%CI, 1.08-1.49). Specifically, patients with amyloidosis showed an increased risk of HF (HR, 1.37; 95%CI, 1.10-1.70). Stroke risk (HR, 1.67; 95%CI, 1.16–2.40) and pacemaker implantation (HR, 2.25; 95%CI, 1.15-4.41) were higher during long-term follow-up, while no differences were found for acute kidney injury or all-cause mortality between the 2 groups.</div></div><div><h3>Conclusions</h3><div>Among patients undergoing TAVI, those with amyloidosis are at a higher risk of adverse events, particularly HF, and have an increased risk of pacemaker implantation and stroke in the long-term.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 886-895"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-04-15DOI: 10.1016/j.recesp.2025.01.016
Andrea Ruberti , Pedro Cepas-Guillén , Julio Echarte-Morales , Dabit Arzamendi , Vanessa Moñivas , Fernando Carrasco-Chinchilla , Manuel Pan , Luis Nombela-Franco , Isaac Pascual , Claudio E. Guerreiro , Tomás Benito-González , Ruth Pérez , Iván Gómez-Blázquez , Ignacio J. Amat-Santos , Eduardo Flores-Umanzor , Ignacio Cruz-González , Ángel Sánchez-Recalde , Ana Belén Cid Álvarez , Manuel Barreiro-Pérez , Laura Sanchis , Xavier Freixa
Introduction and objectives
This study aimed to assess the effectiveness and clinical outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) in patients with cardiac implantable electronic devices (CIEDs).
Methods
This subanalysis of the Transcatheter Tricuspid Valve Repair in Spain (TRI-SPA) registry included patients with at least severe tricuspid regurgitation (TR) who were treated with T-TEER between June 2020 and May 2023 in Spain. Patients with CIEDs and no or mild tricuspid lead-leaflet interaction were compared with those without CIEDs. The primary composite endpoint was all-cause mortality, heart failure-related hospitalization, and tricuspid valve reintervention at 12 months.
Results
Among 310 patients (mean age 75.5 ± 9.1 years, 70% female) with significant TR treated with T-TEER, 35 (11%) had CIEDs. Device implantation success was high in both groups (97.1% in the CIED group vs 96.4% in the non-CIED group, P = .81), with a similar rate of ≤ 2+ residual TR (84.9% in the CIED group vs 91.0% in the non-CIED group, P = .26). Patients with CIEDs experienced comparable rates of the primary composite endpoint to the non-CIED group (23.8% vs 19.1%, respectively, HR, 1.40; 95%CI, 0.60-3.31; P = .44), sustained successful TR reduction (≤ 2+ in 55.0% vs 73.8%, P = .07), and functional improvement (NYHA class I/II 81.8% vs 79.9%, P = .79).
Conclusions
In a real-world setting, T-TEER seems to be an effective therapeutic option for selected patients with more than moderate TR and CIEDs with no or mild lead-leaflet interaction, offering comparable cardiovascular outcomes and clinical improvement to those without leads. However, the presence of CIEDs may represent an independent risk factor for TR recurrence.
本研究旨在评估三尖瓣经导管边缘到边缘修复（T-TEER）在心脏植入式电子装置（cied）患者中的有效性和临床结果。方法：对西班牙经导管三尖瓣修复（TRI-SPA）登记的患者进行亚分析，包括2020年6月至2023年5月在西班牙接受T-TEER治疗的至少严重三尖瓣反流（TR）患者。没有或轻度三尖瓣铅-小叶相互作用的cied患者与没有cied的患者进行比较。主要综合终点为全因死亡率、心力衰竭相关住院和12个月时三尖瓣再干预。结果在接受T-TEER治疗的310例明显TR患者中（平均年龄75.5±9.1岁，70%为女性），35例（11%）发生cied。两组植入术成功率均较高（CIED组为97.1%，非CIED组为96.4%,P = 0.81），残余TR≤2+的比例相似（CIED组为84.9%，非CIED组为91.0%,P = 0.26）。cied患者的主要综合终点率与非cied组相当（分别为23.8% vs 19.1%， HR为1.40；95%CI为0.60-3.31;P = 0.44），持续成功的TR降低（55.0% vs 73.8%, P = 0.07）和功能改善（NYHA I/II类81.8% vs 79.9%, P = 0.79）。结论：在现实环境中，T-TEER似乎是中度以上TR和cied患者的有效治疗选择，没有或轻微的铅叶相互作用，与没有铅叶的患者相比，T-TEER提供了相当的心血管结局和临床改善。然而，cied的存在可能是TR复发的独立危险因素。
{"title":"Eficacia de la reparación percutánea de borde a borde para la insuficiencia tricuspídea en pacientes portadores de dispositivos cardiacos implantables: resultados del registro TRI-SPA","authors":"Andrea Ruberti , Pedro Cepas-Guillén , Julio Echarte-Morales , Dabit Arzamendi , Vanessa Moñivas , Fernando Carrasco-Chinchilla , Manuel Pan , Luis Nombela-Franco , Isaac Pascual , Claudio E. Guerreiro , Tomás Benito-González , Ruth Pérez , Iván Gómez-Blázquez , Ignacio J. Amat-Santos , Eduardo Flores-Umanzor , Ignacio Cruz-González , Ángel Sánchez-Recalde , Ana Belén Cid Álvarez , Manuel Barreiro-Pérez , Laura Sanchis , Xavier Freixa","doi":"10.1016/j.recesp.2025.01.016","DOIUrl":"10.1016/j.recesp.2025.01.016","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>This study aimed to assess the effectiveness and clinical outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) in patients with cardiac implantable electronic devices (CIEDs).</div></div><div><h3>Methods</h3><div>This subanalysis of the Transcatheter Tricuspid Valve Repair in Spain (TRI-SPA) registry included patients with at least severe tricuspid regurgitation (TR) who were treated with T-TEER between June 2020 and May 2023 in Spain. Patients with CIEDs and no or mild tricuspid lead-leaflet interaction were compared with those without CIEDs. The primary composite endpoint was all-cause mortality, heart failure-related hospitalization, and tricuspid valve reintervention at 12 months.</div></div><div><h3>Results</h3><div>Among 310 patients (mean age 75.5<!--> <!-->±<!--> <!-->9.1 years, 70% female) with significant TR treated with T-TEER, 35 (11%) had CIEDs. Device implantation success was high in both groups (97.1% in the CIED group vs 96.4% in the non-CIED group, <em>P</em> <!-->=<!--> <!-->.81), with a similar rate of ≤<!--> <!-->2+ residual TR (84.9% in the CIED group vs 91.0% in the non-CIED group, <em>P</em> <!-->=<!--> <!-->.26). Patients with CIEDs experienced comparable rates of the primary composite endpoint to the non-CIED group (23.8% vs 19.1%, respectively, HR, 1.40; 95%CI, 0.60-3.31; <em>P</em> <!-->=<!--> <!-->.44), sustained successful TR reduction (≤<!--> <!-->2+ in 55.0% vs 73.8%, <em>P</em> <!-->=<!--> <!-->.07), and functional improvement (NYHA class I/II 81.8% vs 79.9%, <em>P</em> <!-->=<!--> <!-->.79).</div></div><div><h3>Conclusions</h3><div>In a real-world setting, T-TEER seems to be an effective therapeutic option for selected patients with more than moderate TR and CIEDs with no or mild lead-leaflet interaction, offering comparable cardiovascular outcomes and clinical improvement to those without leads. However, the presence of CIEDs may represent an independent risk factor for TR recurrence.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 863-875"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-03-28DOI: 10.1016/j.recesp.2025.01.014
Giovanni Occhipinti , Andrea Alberto Ruberti , Jorge Alcocer , Marc Giménez-Mila , Bárbara Vidal , Ander Regueiro
{"title":"Diferencias de sexo en pacientes sometidos a recambio valvular aórtico: una historia de dos corazones","authors":"Giovanni Occhipinti , Andrea Alberto Ruberti , Jorge Alcocer , Marc Giménez-Mila , Bárbara Vidal , Ander Regueiro","doi":"10.1016/j.recesp.2025.01.014","DOIUrl":"10.1016/j.recesp.2025.01.014","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 10","pages":"Pages 916-918"},"PeriodicalIF":5.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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